The aim: To determine the feasibility of using Tivortin in metabolic disorders during pregnancy and its effect on the course of pregnancy, childbirth, fetal and neonatal status. Materials and methods: We examined 210 pregnant women with metabolic disorders using clinical and laboratory data, uterine artery Doppler, determi¬nation of lipid peroxidation and antioxidant system, leptin and placental growth factor content. The fetal condition was assessed by ultrasound examination with Doppler, determination of biophysical profile, and cardiotocography. Results: Metabolic disorders in pregnant women increase the risk of obstetric and perinatal complications by activating lipid peroxidation and inhibiting the antioxidant system, reducing the content of placental growth factor and increasing the level of leptin in the blood plasma. After treatment, there was a significant decrease in leptin levels and an increase in placental growth factor levels, normalization of lipid peroxidation and antioxidant system, uterine artery pulsatility index and umbilical cord peak systolic velocity index, systolic-diastolic ratio, fetal biophysical profile and cardiotocography. The incidence of complications in childbirth decreased by 3 times, surgical interventions – by 2 times, postpartum infectious complications – by 1.7 times, and the birth of infants in a state of asphyxia – by 1.8 times. Conclusions: Metabolic disorders in pregnant women are a significant factor in the development of obstetric and perinatal complications due to the intensity of lipid peroxidation and depression of the antioxidant system, and a decrease in the content of placental growth factor. The use of Tivortin in the treatment of pregnant women with metabolic disorders has proven its safety and efficacy.

Fallopian tube cancer (FTC) is an extremely rare case in oncogynecological practice with an incidence of 0,14-1,8 % among all malignant diseases of the female genital organs. The lack of specific symptoms, imitation of other malignant gynecological diseases, significant similarity with endometrial and ovarian cancer make FTC a disease that is difficult to diagnose. At the preoperative stage, FTC can be detected in 0 to 21% of cases. We present a clinical case of FTC at an early stage in a 64-year-old woman. The patient was referred to the gynecological department of the hospital because of abnormal uterine bleeding (AUB) and pain in the lower abdomen, which had been bothering her for the last 2 months. During the gynecological examination, a tumor-like mass up to 5 cm in diameter was palpated on the left side, with a dense consistency, sensitive to palpation, and limited mobility. Transvaginal ultrasound, CT, oncological markers were made. 7 days later, after performing hysteroresectoscopy with polypectomy, the patient underwent Pfannenstil laparotomy, total hysterectomy with bilateral salpingo-oophorectomy and omentectomy, drainage of the abdominal cavity. Morphological result: in the wall of the left fallopian tube, the growth of adenocarcinoma, pT1a, G2 with foci of necrosis and invasion into the muscular layer of the wall of the fallopian tube is determined. Perineural and lymphovascular invasion in the studied material is not determined. This case of FTC in a postmenopausal woman confirms that it is difficult to detect malignant tumors of tubal localization at the preoperative stage.