Due to refinements of assisted reproductive technology, the number of multiple pregnancies has increased substantially. Time-lapse microscopy (TLM) is a tool for selecting quality embryos for transfer. This study aimed to assess the outcomes of single-embryo transfer of autologous oocytes performed on day 5 of embryo incubation in a TLM-equipped system in patients with good ovarian reserve. The study was carried out in 208 infertile women with good ovarian reserve (over 8 oocytes retrieved). Single-embryo transfer following incubation in a TLM-equipped incubator was performed in 95 patients, who formed the main group; the control group consisted of 113 patients undergoing single-embryo transfer following a traditional culture and embryo selection procedure. We assessed the quality of transferred embryos, the rates of clinical pregnancy and pregnancy loss. Two subgroups were identified in each group of the participants: the 5SET subgroup (nonelective single-embryo transfer), which included 45 patients from the main group and 67 controls, and the 5eSET subgroup (elective single-embryo transfer), which consisted of 50 main group patients and 46 controls. The groups did not differ in terms of age, infertility factors and infertility duration. The quality of transferred embryos was excellent or good in all main group patients (100%); in the control group, the quality of transferred embryos was excellent or good in 93.8% of cases (p = 0.037). Clinical pregnancies were achieved in 64.2% of women in the main group and in 60.2% of controls (p = 0.65). Delivery rates were 54% and 51.1% in the 5eSET and 5SET subgroups of the main group, respectively (p = 0.940). For the control group, delivery rates were 54.4% and 34.3% in the 5eSET and 5SET subgroups, respectively (p = 0.052, Fisher exact test). Elective single-embryo transfer (5eSET) and the use of TLM increased the chance of pregnancy 2.17-fold (p = 0.01).

According to modern literature, the frequency of preoperative diagnostic errors for tumour-like formations is 30.9–45.6%, for malignant ovarian tumors is 25.0–51.0%. The complexity of this situation is asymptomatic tumor in the ovaries and failure to identify a neoplastic process, which is especially important for young women, as well as ease the transition of tumors from one category to another (evolution of the tumor) and the source of the aggressive behavior of the tumor. The purpose of our study was to evaluate the history of concomitant gynecological pathology in a group of patients of reproductive age with ovarian tumors and tumoroid formations, as a predisposing factor for the development of neoplastic process in the ovaries. In our work, we collected and processed complaints and data of obstetric and gynecological anamnesis of 168 patients of reproductive age (18–40 years), operated on the basis of the Department of oncogynecology for tumors and ovarian tumours in the Samara Regional Clinical Oncology Dispensary from 2012 to 2015. We can conclude that since the prognosis of neoplastic process in the ovaries is generally good with timely detection and this disease occurs mainly in women of reproductive age, doctors need to know that when assessing the parity and the presence of gynecological pathology at the moment or in anamnesis, it is not possible to identify alarming risk factors for the development of cancer in the ovaries.

Aim to study the microbiome of the placenta in full-term pregnancy with premature rupture of the membranes (PROM) in comparison with the intact membranes. Material and methods. The study was conducted on the basis of Samara City Clinical Hospital N 1 named after N.I. Pirogov and involved 43 pregnant women at 37-41 weeks of gestation subject to elective cesarean section. The patients were divided in two groups: the main group included 24 women with PROM, the control group was formed with 19 women with intact fetal membranes. The placental tissues were taken for the real-time PCR-test for the following microorganisms: Lactobacillus spp., Enterobacteriaceae, Streptococcus spp., Staphylococcus spp., Gardnerella vaginalis / Prevotella bivia / Porphyromonas spp., Eubacterium spp., Sneathia spp. / Leptotrihia spp. / Fusobacterium spp., Megasphaera spp. / Veillonella spp. / Dialister spp., Lachnobacterium spp. / Clostridium spp., Mobiluncus spp. / Corynebacterium spp., Peptostreptococcus spp., Atopobium vaginae, Mycoplasma hominis, Ureaplasma (urealyticum + parvum), Candida spp., Mycoplasma genitalium. Results. At the end of physiological full-term pregnancy, the bacterial population was detected in 66.7% of placentas in the main group, total bacterial count Ме 103,2 Q1:Q3 0,0 103,4 GE/sample; and in 78.9% of the placentas in the control group, total bacterial count Ме 103,3 Q1:Q3 103,1 103,5 GE/sample. The main representatives of the identified microorganisms were Enterobacteriaceae spp. (Me 103,2 GE/sample for PROM and Me 103,2 GE/sample for intact amniotic sac (p0.05)). Lactobacillus spp. were determined in the placenta only in the PROM group in 8.3% of patients. The presence of Lactobacillus spp. in the tissues of the placenta is typical only for patients with PROM. Microorganisms not identified by the Femoflor-16 test were found in 50% of patients with PROM, Me 102,1 GE/sample, and in 63.2% of patients with an intact fetal bladder, Me 103,2 GE/sample, (p = 0.09). No correlation was found between PROM incidents and the characteristics of the placental microbiota. Conclusion. In case of physiologically proceeding full-term pregnancy, it is possible to detect using the real-time PCM test a bacterial population represented by the Enterobacteriaceae spp., while in cases of PROM, Lactobacillus spp. and anaerobic vaginal flora were also detected in placental samples.

Premature rupture of membranes (PROM) is diagnosed in 6–26.5% of full-term pregnancies. An analysis of the characteristics of labor and the frequency of complications in tPROM could allow us to identify «weak» points and optimize the managing this category of patients.The aim of the study was to assess the characteristics of labor during full-term pregnancy (at 37.0–41.0 weeks), complicated by premature rupture of the membranes.Materials and methods. A prospective analysis of the course of labor and the postpartum period was carried out in 425 patients with singleton pregnancy in cephalic presentation, 37,0–41,0 weeks of gestation, women of low and moderate risk groups, without contraindications to vaginal delivery.. As a complication of the pregnancy, 310 of them had PPROM (main group) and 115 women in labor went into labor with intact fetal membrane (comparison group). The features of the delivery and postpartum complications were analyzed.Results: The features of delivery patients with PROM was the longer duration of rupture – 4.7 times higher than in the comparison group (p<0.001), the second stage of labor – in the main group more an average of 7 minutes (p=0.008). The frequency of abnomally labor activity in the main group, such as abnormally slow or protracted labor (primary and secondary), was 2 times higher than it was in the comparison group. The diagnosis of «cervical dystocia» was observed in 27 cases (8.7%) only in the group with PROM. In the main group, oxytocin was used in 165 patients (53.2%), which is more than 2 times higher than in the comparison group – 25 (21.7%, p<0.001), respectively, the total dose of oxytocin used was higher at vaginal delivery: 8 .06 (0.44) U and 1.06 (0.46) U (p<0.001). The differences in this parameter at patents of both group with C-section were not signifcant. Medical analgesia in the main group was required 2 times more often than in the comparison group (83.5 and 43.5%; <0.001).The problem of tPROM is a higher percentage of operative delivery and obstetric trauma. Thus, in our study, the incidence of C-section was 54 cases (17.4%) compared with the another group – 2 cases (1.7%), vaginal operative delivery – 20 cases (6.5%) and 3 (2.6%)%) respectively (Xi=21.88; Df=2; p<0.001), cervical ruptures: 11.3% (p=0.002), episiotomies: 8.3% (p=0.099). The frequency of postpartum septic complications was comparable in groups, but high level of leukocyts and antibiotic therapy were more often in patients with PROM.Conclusion: the management of labor in patients with PROM is associated with a high percentage of the use of oxytocin, antibacterial therapy, various methods of medical analgesia, and operative delivery.