Background. Exposure to physical and chemical work-related hazards can lead to an impairment of reproductive function, gynecological diseases and a pregnancy course worsening. Aim to determine methods of prevention and treatment of occupational disorders of the reproductive system in women and men who deals with harmful labour conditions. Outcomes and methods. To write this review a search for domestic and foreign publications in Russian and international search systems (PubMed, eLibrary, etc.) for the last 2-15 years was conducted. The review includes articles from peer-reviewed literature. Results. Evaluation of a relationship and its degree between a reproductive system diseases and workplace conditions showed that women working in harmful conditions (class 3.1-3.3) had complications of pregnancy and childbirth disorders which were to a high or medium degree related to their labour conditions. Newborns’ health disorders were assessed as a category of very high degree relationships with the mother’s work. Thus the fact that maternal occupational risks induce a child’s health disorders can be considered as fundamentally proven. This study data showed that occupations of high risk of a reproductive health disorders include female workers who work in conditions of class 3 of the 2nd degree of harm. Conclusions. Obstetrician-gynecologists, occupational physicians who work as part of medical commissions for preliminary and periodic medical examinations as well as obstetrician-gynecologists who deals with women of reproductive age in women’s consultation clinic and reproductive health centers (including those planning childbearing) need to make decisions strictly according to legal and regulatory acts on health protection of employees who work under arduous and harmful labour conditions, and above all to consider on maintenance of their reproductive function.

Introduction. Based on the knowledge of early gestational disorders related to metabolic syndrome (MS), pathogenetically relevant preventive treatment meeting the requirements of perinatal pharmacology can be developed. Aim. To reveal clinical and laboratory characteristics of early pregnancy and develop pathogenetically relevant preventive monotherapy for unfavorable gestational and perinatal outcomes in women with metabolic syndrome. Material and methods. A total of 230 women were investigated and divided into four groups: Group I consisted of 68 pregnant women with MS who refused any preventive measures; Group II comprised 97 women with MS who received periconceptional preventive monotherapy with dydrogesterone, a progestagen; Group III consisted of 35 healthy primigravidas women with physiological course of gestation; Group IV comprised 30 healthy non-pregnant women. Laboratory testing during IIII trimesters allowed to assess the dynamics demonstrated by markers of lipid spectrum, endothelial dysfunction, apoptosis, decidualization, energy metabolism, and immunomodulation. Results. A balance between factors of physiological damage and gestational adaptation in the course of physiological pregnancy has been shown to be of primary significance. In women with MS, embryo-placental dysfunction develops during early pregnancy, and this stage is preceding for major obstetric syndromes. Preventive administration of dydrogesterone in women with MS appeared highly effective: NNT (number needed to treat) was 1.33 (95% CI 0.91.8); OR 5.2 (95% CI 4.65.7). Conclusion. Pregestational changes and atherogenic profile of gestational process determine the course of early pregnancy in women with MS with the development of embryo-placental dysfunction and major obstetric syndromes. High efficacy in the prevention of unfavorable gestational and perinatal outcomes was shown by preventive dydrogesterone monotherapy.

Objectives - efficiency assessment of the dienogest (Visan^) in treatment of perimeopausal patients with adenomyosis and postmenopausal women, in whom the adenomyosis was newly diagnosed. Material and methods. Included in the study, there were 64 patients (aged 45-52 years) who had undergone the surgical treatment of adenomyosis followed by the dienogest treatment at a dose of 2 mg, and 47 women in the age of 54-57 years with newly diagnosed adenomyosis in the course of menopausal hormone therapy (MHT). All patients received 2 mg of dienogest (Visannе, Bayer) during the period of 3-6 months. Medical checkup was performed in 3 and 6 months after initiation of treatment. Results and Discussion. The remarkable reduction in clinical manifestations and improvement of uterine walls structure was registered in both groups of patients in 3 months of treatment. However, in 25% of patients the echographic changes remained significant. In 6 months all the patients had a sustained remission and amenorrhea. Conclusion. In the course of investigation the dienogest (Visan^) at a dose of 2 mg revealed high efficacy in treatment of endometriosis in late perimeopausal and postmeopausal patients with a diagnosed abnormal uterine bleeding associated with adenomyosis.