Aim: to study a role of undifferentiated connective tissue dysplasia (uCTD) in etiology of cervical incompetence and its effect on pregnancy and childbirth course.Material and Methods. There were enrolled 60 patients with cervical incompetence. Patients were divided into 3 groups according to the modified CTD scale: group 1 - patients without uCTD (n = 21); group 2 - patients with mild uCTD (n = 25); group 3 - patients with moderate-to-severe uCTD (n = 14). Intensity of CTD clinical signs was assessed based on health status, gynecological and obstetric history, the course of pregnancy, labor and the postpartum period.Results. It was found that patients with more prominent CTD developed earlier (r-Spearman = -0.26) and more marked (r-Spearman = -0.29) cervical shortening and opening of the internal orifice of the uterus (r-Spearman = 0.28). It was also noted that likelihood of occurring preterm labor was significantly higher in patients with CTD (p = 0.02).Conclusion. The data obtained evidence that uCTD affects intensity of manifested cervical insufficiency and rate of preterm delivery.

Relevance. Despite the assisted reproductive techniques being widely used in modern gynaecology, the challenge of restoring fallopian tube patency in patients with hydrosalpinx, distal tubal occlusion, peritubal and periovarial adhesions remains relevant.Objective. The aim of this study was to evaluate the effectiveness of laparoscopic surgery in restoring fertility in patients with tubal factor infertility.Materials and methods. We included 99 patients, who underwent laparoscopic surgery for tubal factor infertility. During the follow-up we assessed the rate of spontaneous pregnancy and pregnancy after IVF.Results. Pregnancy occurred in 41 (41.4%) patients with a history of tubal factor infertility. Moreover, after reconstructive plastic surgery on the fallopian tubes out of 66 patients, in 17 cases (25.8%) pregnancy occurred spontaneously. In 33 patients tubectomy was performed due to impossibility of adequate fallopian tube reconstruction. In 24 (24.2%) patients, pregnancy occurred after IVF (after salpingo-ovariolysis or after tubectomy). The frequency of pregnancy after IVF in these patients was 1,5 times higher than in patients that underwent IVF in the same medical institution during the same period (42.5% and 27.8%, respectively).Conclusion. In patients with tubal factor infertility younger than 35 with preserved ovulation and the absence of pathospermia in a partner, laparoscopy is an effective method for restoring patency of the fallopian tubes. If a severe falopian tube lesions are present in patients with infertility, bilateral tubectomy should be considered, since bilateral tubectomy in such patients increases the effectiveness of IVF.

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