Objective: to analyze the course of pregnancy, childbirth and indications for mediolateral episiotomy in 439 women.Materials and methods: the comparative analysis of outcomes of Rostov-on-Don in two clinical groups on materials of maternity Department of the state hospital of emergency medical care No. 1 of the city of Rostov-on-Don was carried out. The  first group consisted of 439 women who are in childbirth according to the testimony was made episiotomy. Th e second clinical group consisted of 128 women who had no episiotomy if indicated.Results: the main indications for episiotomy in the fi rst clinical group was: threatened rupture of the perineum in 376 (85,65 %) cases, 41 (9,34 %) v distress of the fetus, at 22 (5,01 %) cases — the weakness of the attempts. In 128 women of the second clinical group, in the absence of an episiotomy, although indications for this operation were, there was a rupture of the perineum of the first and second degree.Conclusions: at the signs of a threatening rupture of the perineum or at the clinic of fetal hypoxia in the second period of labor, the mediolateral episiotomy is justified in modern obstetrics.

A retrospective analysis of the course of pregnancy and childbirth during the birth of a child with a congenital pathology «ichthyosis» was carried out. This clinical case is interesting because fetal ichthyosis was not diagnosed during pregnancy, but all the signs of this disease were revealed in the newborn after the birth.

Objective: to identify the main causes that contribute to the occurrence of ischemic-cervical insufficiency.Materials and methods: a retrospective analysis of the course of pregnancy, childbirth, outcomes for the fetus in 158 women with ischemic-cervical insufficiency was performed. All pregnant women, except for general clinical examination, underwent transvaginal ultrasound examination of the cervix.Results: of 158 women with isthmic-cervical insufficiency, there were 71 first-born (44.94 %), and 87 second-born (55.06 %). In the history of these women, 64 (40.51 %) had inflammatory processes of the female genitals, 38 (24.05 %) had extragenital pathology (cardiovascular diseases), 36 (22.78 %) were obese, 13 (8.23 %) had cervical erosion, and only 7 (4.43 %) had a favorable history. The diagnosis of ICN was established by a combination of data from vaginal and transvaginal ultrasound examination of the cervix. Correction of this pathology was carried out by applying a pessary to the cervix. Conclusion: we did not find a statistically significant difference between the occurrence, causes, and manifestation of clinical data in both first-and second-generation women. Among the causes of PPI, both in the first and second clinical groups, inflammatory diseases of the female genitals, cardiovascular pathology and obesity predominate. Early diagnosis of PPI reduces the risk of premature birth, reduces the percentage of premature birth, and contributes to the birth of children during full-term pregnancy.

Objective: a retrospective analysis of the results obtained by typing HLA-A, -B antigens and HLA DRB1 allele groups in patients with rheumatoid arthritis (RA) in the Rostov population.Materials and methods: typing of patients with rheumatic inflammatory diseases who were on inpatient treatment in the rheumatology department of the SBI “OKB No. 2” was carried out in the LITT SBI RO "BTS" in 2019-2020. 41 patients (9 men, 32 women, median age — 42 years) were diagnosed with RA. All patients were typed by HLA-DRB1 alleles by real-time polymerase chain reaction with DNA-TECH reagents (Russia). To isolate DNA, a set of Sample-Rapid-Genetics was used by NPO DNA Technology LLC. 39 patients were typed аccording to HLA-A, -B. Typing was carried out by a standard lymphocytotoxic test with DILEN reagents (Czech Republic). Lymphocytes were isolated in a density gradient of “Lympholot”, DILEN company. The control group consisted of healthy residents of the Rostov population (donors of the hematopoietic stem cell registry).Results: a retrospective analysis showed that HLA DRB1*04 occurs in 46.3% of the Rostov population with RA, in 61.1% of the seropositive RA group (control — 20%). There was a decrease in the frequency of HLA DRB1*13 (9.7%) compared to the control (24.4%).Conclusions: the high level of reliability (p<0.001) of the increase in the frequency of HLA DRB1*04 alleles confirms their associative relationship with RA in the Rostov population. A decrease in the frequency of HLA DRB1*13 indicates the protective function of these alleles in RA. Typing results are important for early diagnosis of RA.