The review article presents data on the features of psychosomatic disorders that contribute to the development of infertility among married couples. Socio-psychological features of reproductive setting of infertile men and women, peculiarities of self-perception and female self esteem in infertile marriages, general identity of women who suffer from infertility, reasons of psychological unreadiness to maternity.The causes of psychological infertility are revealed, which should be search not only from women, but also among men. The importance of psychotherapy in the treatment of this pathology is highlighted. In the general structure of the reproductive sphere, the physiological and psychological components are interrelated. This means that women with a history of infertility have certain psychological problems that complicate the formation of readiness for pregnancy and motherhood. These can be fears, anxieties related to family history, personal experience of a woman, her individual personal qualities or features of the current life situation (relationship with a partner and other loved ones, alternative life values, financial problems), which manifests itself in unconscious resistance , is realized in somatic form. Infertility leads to the negative changes in the structure of woman’s psycho emotional state, self esteem and social well-being of couple and can cause breach in family relationship. That is why it is recommended to pass complex examination, which includes first of all psycho diagnostic of psycho emotional sphere of individual.

Vitamin D deficiency is recognized as a public health problem in many countries around the world, with special attention being paid to pregnant women. In the last decade, studies have been conducted to link vitamin D deficiency during pregnancy with a wide range of obstetric and perinatal complications, namely preeclampsia, gestational diabetes, bacterial vaginosis, fetal growth retardation syndrome, low birth weight, impaired fetal formation and bone loss. Aim. To study the characteristics of pregnancy and childbirth in women with vitamin D deficiency. Materials and methods. The article presents the study results of the pregnancy and childbirth characteristics in women with vitamin D deficiency. In total, 100 pregnant women of reproductive age were examined and two groups were formed: the main group-50 pregnant women with vitamin D deficiency and the control group-50 somatically healthy pregnant women with a normal level of 25(OH)D. Three peripheral blood sampling were performed to determine the serum level of 25(OH)D: at 10-12, 20-22 and 30-32 weeks of gestation. Results. As a result of our study, the most common complications of vitamin D deficiency were: risk of pregnancy termination, which was observed in 28 (56.0 %) women of the main group and in 6 (12.0 %) women of the control group, P < 0, 05. The threat of preterm birth was observed in 19 (38.0 %) women of the main group and 7 (14.0 %) women of the control group, P < 0.05. Mild preeclampsia was diagnosed in 18 (36.0%) women of the main group and in 4 (8.0 %) women of the control group, P < 0.05; moderate preeclampsia was diagnosed in 9 (18.0 %) women of the main group and in none of the control women; severe preeclampsia-in 2 (4.0 %) women of the main group, which was not characteristic of the control group. Based on the glucose tolerance

Endometriosis is a disease associated with the presence of tissue morphologically similar to the endometrium outside the uterine cavity and it is an important medical and social problem. Statistical analysis of the endometriosis prevalence is complicated by polymorphism of manifestations a gradual increase of symptoms and a long period of time from the first symptoms to diagnosis. Manifestations of endometriosis are chronic pain, algodismenorea, dyspareunia, decreased fertility. All these manifestations worsen the quality of life and do not allow a woman to realize her reproductive potential. The most common forms of endometriosis are superficial peritoneal endometriosis, endometrioid ovarian cysts and deep infiltrative endometriosis. Treatment tactics depends on the form and stage of disease, woman's age, presence or absence of reproductive plans, previous treatment. It is possible to use both medical and surgical methods of treatment. Surgical methods can be organ-preserving and radical. The optimal surgical approach should weigh the risks of the surgery itself and the likelihood of recurrence in the radicalism absence. Modern techniques of surgical intervention are considered as one of the main methods of endometriosis treatment. Severe forms of endometriosis are a serious challenge for the surgical team, as chronic inflammation and adhesions alter the normal pelvis anatomy. Such operations often require the involvement of surgeons, urologists and other specialists, and the decision about final operation scope is made during the operation. Endometriosis surgery aims at the maximum possible in each case, the removal of pathological foci, which leads to relief of pain and increase the likelihood of reproductive plans. This article describes the rational scope of surgical interventions and optimal strategies for the management of patients with various forms of endometriosis. The data of international researches of efficiency of various methods of surgical interventions, influence of degree of radicalism on a disease course, probability of recurrence and quality of patient’s life are resulted.

Fallopian tube cancer (FTC) is an extremely rare case in oncogynecological practice with an incidence of 0,14-1,8 % among all malignant diseases of the female genital organs. The lack of specific symptoms, imitation of other malignant gynecological diseases, significant similarity with endometrial and ovarian cancer make FTC a disease that is difficult to diagnose. At the preoperative stage, FTC can be detected in 0 to 21% of cases. We present a clinical case of FTC at an early stage in a 64-year-old woman. The patient was referred to the gynecological department of the hospital because of abnormal uterine bleeding (AUB) and pain in the lower abdomen, which had been bothering her for the last 2 months. During the gynecological examination, a tumor-like mass up to 5 cm in diameter was palpated on the left side, with a dense consistency, sensitive to palpation, and limited mobility. Transvaginal ultrasound, CT, oncological markers were made. 7 days later, after performing hysteroresectoscopy with polypectomy, the patient underwent Pfannenstil laparotomy, total hysterectomy with bilateral salpingo-oophorectomy and omentectomy, drainage of the abdominal cavity. Morphological result: in the wall of the left fallopian tube, the growth of adenocarcinoma, pT1a, G2 with foci of necrosis and invasion into the muscular layer of the wall of the fallopian tube is determined. Perineural and lymphovascular invasion in the studied material is not determined. This case of FTC in a postmenopausal woman confirms that it is difficult to detect malignant tumors of tubal localization at the preoperative stage.

TORCH-infection is one of the most important and relevant challenges in obstetrics today. This group of infections refers to diseases for which a woman and a man should be examined before conception for the prevention of intrauterine infection of the fetus. The non-specific clinical manifestations of these diseases are the difficulty to their timely and rapid diagnosis.The objective: an analysis and comparison of the basic criteria for the management of pregnant women with suspected intrauterine infection in Ukraine, countries in Western Europe and the United States.Materials and methods. An analysis of literary publications, protocols, Internet resources devoted to the management of pregnancy in the women with suspected intrauterine infection of the fetus. Results. The protocols and clinical guidelines devoted to the management of pregnancy in the women with suspected intrauterine infection of the fetus in various countries, such as Ukraine, Spain, Great Britain and the United States, were analyzed. According to the literature data, this pathology accounts for a significant percentage and the incidence rates for perinatal infections differ in different countries. So, in Sweden, the prevalence is 117 people per 1000 population, Spain – 100, the Czech Republic – 163, the USA – 50, Russia – 1. The article presents recommendations on screening, management of pregnancy and childbirth in the presence of such infections as toxoplasmosis, rubella, chlamydia, syphilis, hepatitis B, genital herpes, human immunodeficiency virus and bacterial vaginosis in the mother. Some differences have been established in the management of pregnant women with infection pathogens in different countries.Conclusions. The results of the analysis of the literature data demonstrate the necessity for further research on the tactics of pregnancy management in case of intrauterine infection, as well as the features of newborn’ conditions in the presence of intrauterine infection.