The aim: The purpose of this study was to assess the long-term outcomes of restoration of reproductive function after surgical and medical treatment of ectopic pregnancy, taking into consideration the patency of the fallopian tubes and the incidence of uterine pregnancy. Materials and methods: A two-stage experimental approach was used to address research objectives. In the first stage, a retrospective analysis of 615 histories of patients with ectopic pregnancy has been performed. In a second stage – we examined 140 patients, which were divided into three groups, depending on the type of treatment. The first group consisted of patients with a disturbed ectopic pregnancy, who were treated with laparotomy and tubectomy. The second group included patients with exacerbated ectopic pregnancy, who were operated by laparoscopic access. Lastly, the third group comprised of women with ectopic pregnancy who were treated with methotrexate. The main source of information used for clinical and anamnestic analysis was “medical card-patient” (f. 003 / o). Results: The number of patients diagnosed with ectopic pregnancy increased from 2005 to 2015. In 2005 and 2006, the laparotomy operations were 86.88% and 83.33%, but conservative management only 13,16% and 16,67%, respectively. In 2015, the number of patients treated with methotrexate was more than half (51.35%) compared with 2010 and 2005 increased to 16.97% and 38.19% respectively, and laparotomy operations decreased from 86.88% in year 2005 to 18.92% in year 2015. Conclusions: The data showed that in women who underwent medical treatment with cytostatic, the patency of the fallopian tubes was significantly better than after surgical treatment. In cases of interrupted ectopic pregnancy for which laparotomy with the removal of the motor tube was applied, infertility of tubal peritoneal genesis developed in 60% of cases, which is consistent with the existing literature. Statistical analysis of the structure of ectopic pregnancy showed that in 2005 dominated interrupted ectopic pregnancy, due to late diagnostic and hospitalisation, that led to urgent laparotomy operations rather than conservative treatment.

Ключові слова: позаматкова вагітність, тубектомія, консервативне видалення плідного яйця, метотрексат.Ключевые слова: внематочная беременность, тубэктомия, консервативное удаление плодного яйца, метотрексат.

The aim: To conduct a comparative analysis of the results of ultrasound and hysteroscopic examinations with further histopathological findings and the clinical and anamnestic features of patients with hyperproliferative pathology in order to determine the etiopathogenetic mechanisms of the development of endometrial pathological processes. Materials and methods: We studied 119 medical records of patients of the Gynecological Department of Minipal Non-Commercial Enterprise “Ternopil Municipal City Hospital No. 2”, who applied for medical assistance because of benign endometrial hyperplasia in the reproductive age with a verified diagnosis of “uterine polyp” during 2017–2018. The control group consisted of 30 patients of the same age group, with menstrual disorders with no signs of hyperplastic processes of endometrium. With the consent of the patients, they were treated with diagnostic hysteroscopy in order to study evacuated material from the uterus. The results of the histological study confirmed the absence of signs of hyperplastic processes of endometrium. The results of diagnostic methods were evaluated by comparing the material’s histological data with the results of ultrasound and hysteroresectoscopy. Results: Taking into account the results of our research, women with hyperplastic processes of endometrium have the risk of the pathology of the nervous system is in 2.71 times higher (OR=2.71, CI–0.88: 8.33), cardiovascular pathology—in 2.04 (OR=2.04, CI–0.57:7.34), vascular diseases of the lower extremities—in 1.81 times (OR=1.81, CI–0.21:15.32) compared with the control group. While the risk of pathology of the urinary system and organs of vision is only—OR=0.48, CI–0.11:2.03 and OR=0.75, CI–0.08:7.48, respectively. Analyzing the results of the study using ultrasound examination, it was found that endometrial polyposis in combination with uterine leiomyoma was not detected in 3 women (15%), while all the results of hysteroscopy were confirmed by histopathological studies. When the endometrial hyperplastic processes were combined with adenomyosis— according to ultrasound examination a false positive result was obtained in 2 patients (13.3%), and in a hysteroscopic study we determined –1 false positive result. In patients the diagnosis of “endometrial polyp” according to the results of hysteroscopy was not confirmed in 2 women (2 false positive results 2.99%) and in 5 cases of ultrasound examination (5 false negative results 7.46%). The use of ultrasound examinations in patients with endometrial hyperplastic changes, according to our data, made it possible to identify pathology in 88.39% of cases, while the information content of the hysteroscopy was 98.21% (p<0.001). Conclusions: Thus, the results of the subjective examination of patients in the gynecological department: complaints, anamnestic data on gynecological and extragenital pathology should be used to identify etiopathogenetic factors and the formation of risk groups for the occurrence of hyperplastic processes of endometrium. Women with cervical erosion, uterine myoma and episodes of herpetic rash on the mucous membranes in past medical history have a higher likelihood of hyperplastic processes of endometrium. The vast majority of patients (63.87%) with polyps of the body of the uterus have a combined hyperproliferative pathology, which requires an individual approach to planning the scope of diagnostic examination and the choice of treatment method. Visualization of endometrium with hysteroscopy is more informative than ultrasound for diagnosing hyperproliferative processes, including uterine polyps. Hysteroscopic polypectomy has a high level of both clinical and economic benefits as well as diagnostic value in patients with hyperplastic processes of endometrium.

Introduction. The increase in the prevalence of hyperthyroidism justifies the feasibility of experimental studies to study the mechanisms of thyroid hormones on a number of metabolic processes and homeostasis in euthyroidism and hyperthyroidism in the experiment and increases against the background of preoperative stress.The aim of the study: to find out the peculiarities of the reaction of the immune system and free radical processes of experimental animals under conditions of simulated hyperthyroidism to the action of various drugs for anesthesia.Research methods. To simulate the state of hyperthyroidism, rats received L-thyroxine for 21 days. The effect of euthyroidism and hyperthyroidism on the level of homeostasis of the humoral part of the immune system and free radicals on the introduction of sodium thiopental and dexmedetomidine in the experiment compared.Results and discussion. In the blood plasma of animals with experimental hyperthyroidism, changes in the level of the humoral part of the immune system and free radicals were observed under the influence of sodium thiopental and dexmedetomidine hydrochloride under conditions of hyper-and euthyroidism.

Мета дослідження – оцінити ефективність застосування розвантажувальних акушерських песаріїв у жінок з багатоплідною вагітністю з високим ризиком невиношування.Матеріали та методи. Проаналізовано 40 випадків застосування розвантажувальних акушерських песаріїв у вагітних з двійнятами з ознаками невиношування у термінах 18–28 тижнів вагітності, котрі склали першу групу обстежуваних. Друга група – 12 вагітних з двійнятами, котрим був накладений шов на шийку матки з приводу істміко-цервікальної недостатності. Контрольна група – 18 вагітних з двійнею, яким призначалась консервативна терапія. Проведений аналіз перебігу вагітності, пологів, післяпологового періоду та стану неонатальної адаптації в обстежуваних групах.Результати дослідження та їх обговорення. Динаміка вкорочення шийки матки була значно повільнішою у пацієнток І групи, яким було встановлено розвантажувальний акушерський песарій, це є ефективним методом профілактики та лікування невиношування у жінок з багатоплідною вагітністю, зниження частоти пізнього аборту та передчасних пологів, перинатальних втрат. Пацієнтки І групи мали меншу кількість випадків передчасного розриву плодових оболонок у 7 (17,5 %) пацієнток І групи порівняно з 3 (25,0 %) жінками ІІ групи та у 5 (27,7 %) вагітних контрольної групи. В І групі обстежуваних термінові пологи відбулися у 34 (85 %) випадках, у ІІ групі – у 9 (75,0 %) випадках, у контрольній – 12 (66,6 %) випадках. В контрольній групі перинатальні втрати склали 2,7 %. В І групі перинатальних втрат не було. При оцінці стану неонатальної адаптації новонароджених обстежуваних груп прослідковується зниження росто-вагових показників у дітей ІІ та контрольної груп, також спостерігається зниження показників оцінки стану новонароджених за шкалою Апгар у ІІ та контрольній групах.Висновки. Методика застосування розвантажувального акушерського пессарія є патогенетично обґрунтованою у вагітних з багатопліддям і дозволяє пролонгувати вагітність до доношеного терміну у 85 % жінок досліджуваної групи, знизити медикаментозне навантаження на вагітну та плід.