В исследовании определено влияние локального применения эстриола на параметры обмена коллагена в ткани слизистой оболочки влагалища после пластической операции у пациенток послеродового периода с дисфункцией тазового дна. В исследование включены 18 пациенток с жалобами на начальные проявления дисфункции тазового дна. После операции — сайт-специфической пластики стенок влагалища по авторской методике (по поводу опущения стенок влагалища и несостоятельности мышц тазового дна) — пациенткам назначено применение вагинальных суппозиториев «Овестин» в дозе 0,5 мг эстриола 2 раза в неделю в течение 2 мес, начиная с 3 недели после операции. Сразу после завершения курса суппозиториев эстриола пациентки проходили повторную биопсию в амбулаторных условиях. Оценку параметров коллагеногенеза проводили на основании уровня матричных РНК (мРНК) специфических белков соединительной ткани влагалища методом полимеразной цепной реакции в реальном времени. В ходе исследования обнаружено статистически значимое увеличение уровней экспрессии генов металлопротеиназ 2 и 9, декорина, коллагенов 1А1 и 3А1. Параллельно выявлено компенсаторное увеличение экспрессии генов тканевых ингибиторов металлопротеиназ — TIMP1,2. Полученные результаты свидетельствуют о положительном влиянии курсового локального применения эстриола на коллагеногенез в слизистой оболочке влагалища у пациенток после операции по поводу дисфункции тазового дна в послеродовом периоде.

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Background. Vitamin D is an essential component that regulates calcium homeostasis and many other cellular functions. Hypovitaminosis D is associated with a risk of osteopenia, obesity, type 1 and type 2 diabetes, malignant neoplasms and immune disorders. Inadequate vitamin D intake during pregnancy increases a risk of pre-eclampsia, preterm birth, low birth weight as well as it has a negative impact on both children’s and adolescents’ health. It is important for the clinician to be known administrating of vitamin D prophylactic and therapeutic regimens according to serum 25(OH)D levels. Aim. To determine causes and effects of vitamin D deficiency and to elaborate ways of their correction. Materials 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. The article shows that vitamin D has a significant impact on both the cardiovascular, endocrine, digestive, respiratory and other systems functioning and perinatal outcomes that necessitates vitamin D deficiency correction. It provides schemes for effective therapeutic and prophylactic drug doses calculating depending on vitamin D3 blood serum concentration. Conclusion. Preference should be given to cholecalciferol (vitamin D3) due to its better absorption properties and more efficient conversion to active vitamin metabolites (class IIC).

Chronic endometritis is a clinical morphological syndrome that develops as a result of a self-sustaining pathological process, which is based on a violation of the production of pro-inflammatory cytokines initiated by an infectious factor. The article presents the clinical and etiological classification of endometritis, the pathogenesis of development in terms of involvement of immunocompetent cells, standards for diagnosis and therapy.

Hydatidiform mole (HM) is a disease of trophoblast tissue with saved proliferative potential and it develops after aberrant fertilization. Complete HM is characterized by a rapid increase in a size of the uterus, a significant increase in human b-chorionic gonadotropin (hCG), bleeding, symptoms of hyperthyroidism, severe vomiting of pregnant, and early preeclampsia. Thecalutein cysts are formed in the ovaries as a result of exposure to high titers of hCG and prolactin. Multiple pregnancy may be complicated by the development of complete and partial HM in one of the fetuses in one case for 20 000-100 000 pregnancies. The article presents a clinical case of pregnancy care of a 32-year-old woman with dichorial biamniotic twins and a complete HM of one fetus. Pregnancy occurred spontaneously, proceeded with threatening miscarriage up to 12 weeks, threatened preterm labor, pre-eclampsia from 24 weeks. The patient underwent induction of labor at 28 weeks due to severe pre-eclampsia, a live premature girl with a weight of 1030 g weight, height of 33 cm tall and Apgar score of 6/7 points was born. On the 40th day after birth, b-hCG level was negative.