Breast dishormonal diseases and premenstrual syndrome (PMS) have a common pathogenetic mechanism: hyperprolactinemia, decreased progesterone levels, thyroid dysfunction, increased cortisol including as a result of stress, dysphoric disorders.Purpose of the study was to optimize monotherapy of breast dishormonal diseases in combination with PMS with phytoselective complex Tazalok™ and to compare the clinical efficacy with traditional therapy with Vitex agnus-castus derivative.Materials and methods. 120 women aged 22–39 years were observed into 2 groups: group I – 60 patients who received monotherapy Tazalok™ for 3 months; group II – 60 patients who received monotherapy with derivative of Vitex agnus-castus. Data analysis was performed after 1 and 3 months of treatment. Sex hormones, thyroid, gonadotropic hormones levels were determined. Ultrasound examination with color Doppler flow mapping of mammary glands, pelvic organs, and thyroid was performed. Dysphoric disorders were assessed on the Beck depression scale, pain was assessed on the visual-analog scale (VAS).Results. Group I showed an improvement in hormonal profile, reduction of subjective complaints after 1 month, in group II there was mainly a decrease in prolactin and relative normalization of follicle-stimulating hormone, luteinizing hormone; PMS complaints persisted. By 3 months patients in group I had normalization of all hormonal parameters, including cortisol, thyroid hormones, decreased pathological vascularization of mammary glands, thyroid, and pelvic organs, and a significant reduction in the Beck depressive score and VAS. In group II there was no normalization of cortisol, thyroid hormones, significantly reduced levels of progesterone and luteinizing hormone compared to group I, there was pathological vascularization in the thyroid gland, uterus. Dysphoric disorders decreased slightly, pain syndrome on the VAS decreased moderately, but the score was higher than among women taking Tazalok™.Conclusions. Tazalok™ directly affects reproductive system and balance of stress hormones, has a therapeutic effect on the thyroid gland. Under its action sonographic picture of hormone-dependent organs was normalized in contrast to the Vitex agnus-castus derivative. Tazalok™ has a pronounced effect on dysphoric disorders of PMS, helps to normalize the neuropsychological and cognitive state, to prevent of psychosomatic disorders.

Annotation. In 2001, M. S. Robson proposed a classification based on criteria to identify pregnant women whose birth is not possible naturally. The purpose of the study is to analyze the frequency and structure of indications for caesarean section to determine promising ways to optimize the management of labor. Materials and methods. Based on the final diagnoses, an analysis of the structure of the absolute and percentage number of women groups M.S. Robson, the caesarean section frequency in each group, and the caesarean section structure for individual groups in 2071 women giving birth in the Kharkov city perinatal center, including 726 (35,1 %), by caesarean section. Results. The most promising in terms of reducing the frequency of cesarean section are women of the 1st, 2d and 3rd groups. In most cases, caesarean section in these groups was performed due to complications of childbirth or in connection with obtaining new data on the risk of complications during childbirth. Among these women, a rather frequent indication for emergency surgery is primary weakness of labor (in the 1st and 3rd groups) or weakness of labor after unsuccessful induction of labor (2a and much less often – 4a group). It is this contingent of pregnant women and women in childbirth that requires special attention. On the one hand, it is a reserve to reduce the frequency of cesarean section, on the other hand, in some cases, the operation is performed late, which leads to severe depletion of the woman in labor during childbirth, complete suppression of the contractile function of the uterus with a lack of sensitivity to oxytocin and to severe hypoxic-ischemic complications in the fetus. Conclusions. To substantiate a decrease in the frequency of cesarean section, the most promising is the group of women with first or repeated births with full-term single-term pregnancy and head presentation of the fetus (groups 1 and 3 according to M.S. Robson), and with planned induction of labor (groups 2a and 4a), that make up more than 20 % of women after cesarean section. Planning the optimal tactics of labor management for these women on the basis of identifying risk factors and determining the contingent of women for whom a set of preventive and therapeutic measures is appropriate is to reduce the frequency of cesarean section.

Electronic poster abstractswith a birthweight

Study objective: to optimize diagnostic measures in patients with adenomyosis and/or hyperplastic endometrial processes (HEP).Material and methods. The study included 128 patients aged from 27 to 53 years. The first group included 38 (29.6%) patients with a grade I–II adenomyosis, the second group included 41 (32.1%) patients with a combination of grade I–II adenomyosis and HEP and/or uterine leiomyoma, the third group included 39 (30.5%) women with only HEP, the fourth (control) group included 10 (7,8%) women without endometrial pathology. Patients underwent hysteroscopy with targeted biopsy, elucidated the pathomorphological features of connective tissue component of the endometrium and uterus transitional zone, studied specific markers of adenomyosis progression, namely vascular endothelial growth factor and Ki-67 proliferation index, and also determined the parameters of shear wave ultrasound elastography.Results. Routine histological examination of adenomyosis was confirmed only in 11 (30.6%) cases out of 36 suspected, while HEP (polyps, glandular hyperplasia) and hyperplastic pathology of endocervix (polyps) – in 34 (97.1%) cases out of 35 suspected. Ki-67 antigen expression was positive in the nuclei of epithelial cells in the adenomyosis glands and in the cytogenic stroma cells. A greater value of expression was in the epithelium of glands in superficially located heterotopies – with grade I–II adenomyosis compared with other studied groups. Shear wave elastography showed significant differences in the myometrium color between the first, third and control groups. The unchanged myometrium in all patients of the control group was characterized by staining in shades of blue, while in 9 (90%) patients the color was uniform.Conclusion. It is recommended to use a shear wave ultrasound elastography in laboratory and instrumental examination with determination of Ki-67 proliferation protein expression and intensification of the neovascularization process in endometrial biopsy specimens to improve the diagnosis of adenomyosis.

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