No abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing, which is defined by the accumulation of multiple, small fluid-filled ovarian cysts without the selection of a single dominant follicle. Most PCOS phenotypes are characterized by the absence of spontaneous ovulation, resistance toward ovulation inductors, the production of a large immature oocytes number, and the high prevalence of ovarian hyperstimulation syndrome, resulting in reduced assisted reproductive technologies (ART) programs effectiveness. The review analyses current data about the relationship between polymorphism genotypes of KISS genes, follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH) and their receptors genes, gonadotropin-releasing hormone (GnRH), estrogen, and progesterone receptors genes, the PCOS risk and the features of ovarian response to stimulation during ART cycles. The use of single nucleotide polymorphisms (SNPs) as prognostic markers of ART programs outcomes would provide a personalized approach to the drugs and doses choice for ovarian stimulation and significantly increase the chance of pregnancy.

According to the World Health Organization, there are about 5.9 million annual perinatal deaths worldwide, the etiology of which, on average, remains unspecified in 15–50% of cases. This review presents an analysis of the existing classification systems for causes of perinatal mortality, estimates the current data on risk factors and possible pathophysiological mechanisms of sudden fetal and infant death, identifies several world health problems that prevent the reduction of stillbirth and neonatal mortality rates, and suggests the ways of their solution. Key words: perinatal mortality, stillbirth, sudden intrauterine death syndrome, brainstem, cardiac conduction system

Aim. Comparative assessment of the effect of high normotension and hypertension 12nd stage on the risk of gestational and perinatal complications. Materials and methods. A prospective cohort study (n=110) assessing the effect of high normotension on the risk of gestational complications and pregnancy outcomes was conducted. The main group (n=70) included 30 patients with high normotension subgroup A, and 40 patients with hypertension 12nd stage subgroup B. The comparison group included 40 patients with "white coat hypertension". Results. The most frequent complications in the 2nd and 3rd trimesters of pregnancy were toxaemia, threatened miscarriage, edema (detected in more than half of patients with high normotension and hypertension 12nd stage) and well as threatened preterm labor (p0.05). The frequency of pre-eclampsia development in subgroups A and B did not differ significantly, however, in patients with high normotension in the 3rd trimester during a test of endothelium-dependent vasodilation were detected signs of endothelial dysfunction, which may be one of the mechanisms for the subsequent formation of hypertension in these patients. Placental insufficiency of varying severity was detected only in subgroups A and B. Placental insufficiency, along with intrauterine fetal hypoxia of different etiologies, were the most frequent causes of emergency caesarean section, occurring only in the main group 3 (75.0%) in subgroup A and 6 (66.67%) in subgroup B and associated with blood pressure above 130/85 mm Hg. Conclusion. The importance of preventing blood pressure increase to high normal rate is explained by the development of endothelial dysfunction at late gestation, which can serve as the mechanisms of hypertension formation in this category of pregnant women.