The rate of Cesarean section (CS) continues to rise and researchers have no clear understanding of the underlying drivers and consequences. Robson’s 10-group classification is based on simple obstetric parameters (parity, prior CS, gestational age, onset of labor, fetal presentation, and a number of fetuses), which allowed the authors to make an effective evaluation of indicators that lead to an increase in the frequency of abdominal delivery. In the context of the global increase in the frequency of abdominal delivery, further modification of the scale will allow the specialists not only to assess the frequency of CS but also to assess the levels of perinatal morbidity and mortality in the groups that make the most significant contribution to the level of CS. Global trends in the commercialization of childbirth require global approaches to reduce the level of abdominal delivery in the population.

Objective. The study aimed to compare the level of INF a2 immunoexpression in tissues obtained during medical abortion with the corresponding level of IFNa2 expression in a retained fetal egg tissues after the first missed abortion. The authors compared the anamnestic data on previous inflammatory diseases of the genital tract with the results of an extended morphological study of the material obtained during the evacuation of the contents of the uterine cavity during the first non-developing pregnancy in the first trimester.Materials and methods. The study included 15 patients with first-time missed abortions caused by a viral infection (6-8 weeks of pregnancy). All patients demonstrated either recurrent herpes simplex labialis/genitalis or PCR confirmed HSV, HPV, CMV. Exclusion criteria were recurrent miscarriage, blighted ovum, endocrinopathies, male factor infertility, and other causes of miscarriage. The comparison group included 20 women of the same age that chose to undergo a medical abortion.Results. In patients from the comparison group, the main producer of IFN a2 was syncytiotrophoblast as well as maternal decidual cells in the parietal endometrium and uteroplacental area. In the main group, manifested hematogenous infection (microabscesses, vasculitis, lymphocytic and macrophage infiltration) with dystrophy and necrosis of decidual maternal cells and secondary pathological changes in the placental villi were diagnosed, which led to a significant decrease in the IFN a2 immunoexpression in all the studied cells.Conclusion. The lack of anamnestic data on previous urogenital infections does not exclude the etiological role of the inflammatory component in the genesis of non-developing pregnancy. First-time occurred pregnancy loss requires adequate postoperative interferon therapy and a thorough examination of a couple.

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Objective: to study the nature of uterine contractile activity, hormonal status, melatonin metabolism, blood flow in the uterine and fetal vessels, and the state of the fetus wellbeing before and after standard drug treatment and combination therapy involving the additional use of light deprivation. Materials and methods: a total of 547 women with threatening preterm birth were examined at 28 – 35 weeks of pregnancy. Among these, 198 pregnant women received standard therapy and 196 women received combined treatment, medical along with light deprivation. The control group consisted of 153 women with physiological pregnancy. We used cardiotocography to study the contractile activity of the uterus and the fetal cardiac rhythm, enzyme-linked immunosorbent assay methods to study the expression of hormones (ACTH, cortisol, progesterone, estriol, placental lactogen) in the blood and 6-sulfatoxymelatonin in the urine of pregnant women. Results: threatening preterm labor is accompanied by an increase in the level of generalized (bilateral) uterine activity, a decrease in the level of melatonin and an increase in the level of stress hormones. After using standard drug therapy, there is a suppression of any form of uterine activity, which leads to a deterioration of the fetus state in 30,2% of women, while combined therapy increases the level of melatonin, decreases the activity of stress-liberating subsystems of the mother’s body, and increases the level of right-sided uterine contractions that contribute to maintaining functional activity of the uteroplacental “pump”, contributing to the prevention of fetal distress. Conclusions: the studies indicate an improvement in the therapeutic effect with using light deprivation, as an additional method for tocolysis in women with the threat of premature birth.

Objective: to evaluate the eff ectiveness of the regional cervical cancer screening program by liquid-based cytology. Materials and Methods: the geography of screening includes 54 medical units of the Rostov region, where patients are taken swabs from the cervix. HPV positive patients with abnormal PAP smears are invited to the Regional cervical pathology center for diagnosis and treatment. Methods. liquid-based cytology, the HPV test RealTime PCR, colposcopy with video recording, biopsy of the cervix by the method of loop excision or electroradiographic conization. Results: From 2014 to 2017, 188 641 cytology tests were performed. Cervical cancer was revealed in 189 women – (0.1 %), H-SIL and ASCH in 566 (0.3 %), 377 ASCUS (0.2 %), L-SIL in 23014 (12.2 %), absence of intracellular lesions or malignancy in 164495 (87.2 %). 2162 HPV-positive women aged 18 to 69 years were invited to the Regional cervical pathology center gynecologist for examination. Treatment by conization (622) and excision (830) of the cervix was performed in 1452 patients, H-SIL and CIS were revealed in 1162 women (78 %). Conclusion: tests such as liquid-based cytology and HPV testing, their optimal multiplicity and sequence allow timely detection and treatment of precancerous cervical epithelium lesions.