It is known that during pregnancy, the hemostatic system, like the rest of the body's systems, undergoes certain changes: there is a gradual increase in the activity of coagulation unit of the hemostasis reaching a maximum before childbirth. However, if pregnancy is complicated by various hypertensive conditions, such as preeclampsia, an imbalance is observed in the hemostasis: against the background of an increase in the activity of coagulation link, depletion of anticoagulation factors and dysfunction of fibrinolytic system are observed. All these changes create a pathogenetic basis for the occurrence of severe thrombohemorrhagic complications that are fatal for both mother and fetus. Thus, the timely detection of these violations is an important task for modern obstetrics. Unfortunately, the applied screening methods for assessing the hemostasis system in practice provide extremely limited information: the tests have low sensitivity to hypercoagulation, as well as moderate to hypocoagulation, they do not allow to fully evaluate the dynamics of coagulation process in real time. In addition, when performing the same tests with reagents of different companies in the same patient, there may be a significant difference in the results. Disadvantages of screening tests became the reason for the search for a test to assess the functioning of the hemostatic system, which can reflect the complete picture of the state of blood coagulation system, and not of its individual links. Such tests are the so-called global tests for assessing the hemostatic system: thrombin generation test, thromboelastography, low-frequency piezothromboelastography and thrombodynamics. Each of the listed global tests has been successfully tested in obstetric and gynecological practice.

Development of reproductive medicine, namely, extracorporal fertilization, set the task of preservation and preserving of biological suitability of female and men's gametes for scientific community. Opening of a method of a vitrification showed its benefit before other methods of a cryopreservation and became the encouraging event in development of cryobank of gametes. In this work the history of emergence of a method of a cryopreservation is described; modern aspects of a cryopreservation of gametes; shortcomings and benefits of various techniques of selection of full-fledged gametes are reflected; some protocols of carrying out a cryo-preservation are provided; short characteristic of separately used cryoprotectors and their various combinations capable more effectively to protect the freezing objects from damage, than, each of cryoprotectors separately is given. It is noted that in modern literature special attention is paid to consideration of mechanisms of cryodamages and cryoprotection during the freezing and a vitrification. Characteristics of the changes happening in gametes after the procedure of freezing and thawing are discussed. Modern techniques of assessment of viability of gametes before and after a cryopreservation are given. It is shown that violation of compaction of chromatin and fragmentation of DNA in morphologically not changed spermiya has negative impact and on quality of embryos. The benefit of a structurally functional condition of oocytes of mammals at a cryopreservation of oocytes in structure is emphasized an oocyte-kumulyusnykh of complexes in comparison with the oocytes which ripened in the kultivatsionny environment.

Introduction. Preeclampsia (PE) is a specific complication of pregnancy holding a lead place in maternal and perinatal morbidity and mortality worldwide. The development of PE in the maternal body is accompanied by severe hypercoagulation, disturbed anticoagulation and fibrinolytic systems. As a result, vascular microthrombosis in diverse organs with developing endothelial dysfunction, impaired utero-placental blood circulation emerge that leads to adverse perinatal outcomes.Aim: to study status of coagulation arm in pregnant women with moderate and severe PE, after delivery by cesarean section, to optimize management of the postoperative period.Materials and Methods. There were enrolled 50 pregnant women with PE: 16 with moderate and 34 with severe PE after surgical delivery. A status of coagulation arm was examined by evaluating major parameters in coagulogram (fibrinogen, activated partial thromboplastin time, prothrombin, international normalized ratio) as well as assay for early diagnostics of blood clotting disorders to reveal bleeding and thrombosis risks.Results. It was found that prior to surgery patients with severe PE had significantly increased clot growth rate (V) by 1.09-fold (p = 0.001), relative clot density (D) by 1.15-fold (p = 0.001), and time of spontaneous clot appearance (Tsp) was accelerated by 2-fold (p = 0.001) compared to moderate PE. After surgical delivery, patients from both groups had changes evidencing about activated coagulation system: increased V, D, as well as the Tsp. Upon that, all such parameters in patients with severe PE were significantly elevated: the V – by 1.25-fold (p = 0.005); the D – by 1.1-fold (p = 0.02); the Tsp was accelerated by 2-fold (p = 0.03) compared to patients with moderate PE. All parameters in both groups tended to normalize on day 5 after surgical delivery, but patients with severe PE were shown to have significantly increased the V – by 1.5-fold (p = 0.001); the D – by 1.14-fold (p = 0.001); the clot size – by 1.14-fold (p = 0.001); the Tsp – accelerated by 41 % (p = 0.001) compared to patients with moderate PE.Conclusion. Thus, patients with moderate and severe PE after surgical delivery by cesarean section were featured with markedly activated coagulation hemostasis, which may justify a prolonged use of low-molecular-weight heparins in the postoperative period, especially in patients with PE.

The article is devoted to modern views on the diagnosis and treatment of hyperprolactinemia syndrome in women. Prolactinomas are the leading cause of hyperprolactinemia syndrome. The main clinical manifestations of a pathological increase in the level of prolactin are hypogonadism and galactorrhea, in some cases there are neurological symptoms, as well as psycho-emotional and asthenovegetative disorders. The publication reviews management tactics of patients with prolactinomas and pathological conditions secondary to elevated prolactin levels. Both conservative approaches to the correction of hyperprolactinemia and surgical treatment methods are described. It is noted that at present, drug therapy has priority over surgery. In the medical treatment of hyperprolactinemia, dopamine receptor agonists are used. The duration of therapy with this group of drugs is at least 2 years. The targets should be long-term normalisation of prolactin levels and a significant reduction in the size of the tumour or its absence according to the results of magnetic resonance imaging of the brain. Women with drug-resistant prolactinomas are advised to increase the dose of dopamine receptor agonists to the maximum tolerated dose before considering surgical intervention. Special attention is paid to the management of patients whose pregnancy occurred amid a pathological increase in the level of prolactin. In addition, methods for correcting drug-induced hyperprolactinemia are considered. The long list of drugs that can cause increased prolactin levels shows that the problem of hyperprolactinemia may be encountered by doctors of various specialties. The data presented in the publication are based on clinical guidelines approved by the Russian Ministry of Health and comply with the principles of evidence-based medicine.

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