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Introduction. Loss of pregnancy remains an extremely acute public health problem today. Live birth accounts for only 30% of gestational outcomes, all other pregnancies that occur end in reproductive losses: 30% – implantation, 30% – postimplantation, 10% – spontaneous miscarriages. In conditions of declining birth rates, reducing reproductive losses is the most important element of the state’s demographic policy.Аim. Тo assess the reproductive health of women of fertile age in the Tyumen region, registered in antenatal clinics and other medical institutions in connection with pregnancy, as well as the risks associated with an increase in the frequency of diseases endemic for the West Siberian region.Materials and methods. The study used data from federal statistical observation. Statistical analysis of the data was carried out using the statistical program Statistica (version 13.0). Quantitative features are described by absolute and relative (percent) indicators. The difference is considered significant at p < 0.05. Results. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. The incidence of HIV and hepatitis C among pregnant women for five years and for each of the given nosologies exceeds 1% of the number of patients admitted under the supervision of health care facilities. At the same time, since 2018, the incidence of ectopic pregnancy associated with HIV has significantly increased (p >< 000.1). These data also indicate an increased risk of spontaneous abortion in HIV-infected pregnant women (p >< 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control. Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. >< 0.05.Results. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. The incidence of HIV and hepatitis C among pregnant women for five years and for each of the given nosologies exceeds 1% of the number of patients admitted under the supervision of health care facilities. At the same time, since 2018, the incidence of ectopic pregnancy associated with HIV has significantly increased (p < 000.1). These data also indicate an increased risk of spontaneous abortion in HIV-infected pregnant women (p >< 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control. Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. >< 000.1). These data also indicate an increased risk of spontaneous abortion in HIV-infected pregnant women (p < 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control. Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. >< 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control.Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate.
Introduction. Loss of pregnancy remains an extremely acute public health problem today. Live birth accounts for only 30% of gestational outcomes, all other pregnancies that occur end in reproductive losses: 30% – implantation, 30% – postimplantation, 10% – spontaneous miscarriages. In conditions of declining birth rates, reducing reproductive losses is the most important element of the state’s demographic policy.Аim. Тo assess the reproductive health of women of fertile age in the Tyumen region, registered in antenatal clinics and other medical institutions in connection with pregnancy, as well as the risks associated with an increase in the frequency of diseases endemic for the West Siberian region.Materials and methods. The study used data from federal statistical observation. Statistical analysis of the data was carried out using the statistical program Statistica (version 13.0). Quantitative features are described by absolute and relative (percent) indicators. The difference is considered significant at p < 0.05. Results. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. The incidence of HIV and hepatitis C among pregnant women for five years and for each of the given nosologies exceeds 1% of the number of patients admitted under the supervision of health care facilities. At the same time, since 2018, the incidence of ectopic pregnancy associated with HIV has significantly increased (p >< 000.1). These data also indicate an increased risk of spontaneous abortion in HIV-infected pregnant women (p >< 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control. Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. >< 0.05.Results. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. The incidence of HIV and hepatitis C among pregnant women for five years and for each of the given nosologies exceeds 1% of the number of patients admitted under the supervision of health care facilities. At the same time, since 2018, the incidence of ectopic pregnancy associated with HIV has significantly increased (p < 000.1). These data also indicate an increased risk of spontaneous abortion in HIV-infected pregnant women (p >< 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control. Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. >< 000.1). These data also indicate an increased risk of spontaneous abortion in HIV-infected pregnant women (p < 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control. Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. >< 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control.Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate.
Uterine fibroids are considered one of the most common benign tumors of the reproductive system. This disease ranks second (20–50 %) among the causes of hospitalization in gynecological hospitals. The aim of the study is to evaluate the effect of homocysteine levels on the state of uterine fibroids. Materials and Methods. The study involved 112 women: 60 with uterine fibroids and 52 without uterine fibroids. General clinical, biochemical, ultrasound, and statistical research methods were used. Mathematical data processing was carried out according to Lang T. and Altman D. (2014). Quantitative data analysis on the normality of distribution was carried out using the Shapiro-Wilk test. Results. The normal homocysteine (Hc) level was found in 80.7 (5.5) % of patients without uterine fibroids, which is statistically more significant than in the group of women with uterine myoma (38.3 (6.3) %, p<0.001). HC level was at the upper normal level in 33.3 (6.1) % of women in the main group and 15.3 (5.0) % of women in the comparison group. An excess of normal values was found in 25.0 (5.6) % of women in the main group and only in one in the comparison group (p<0.001). Due to additional therapy of uterine fibroids, the state of myomatous nodes stabilized in 61.6 (6.3) % of patients. There was no progression of uterine fibroids during a year. Before complex therapy, surgical indications were in 25.0 (5.6) % of patients with uterine fibroids. After a year of complex therapy, surgical indications remained only in 6.6 (3.3) % of women with uterine fibroids, which is statistically less significant than before the prescribed treatment (p=0.005). Conclusion. In women with uterine fibroids, there are multiple genital and somatic pathologies that contribute to the increase of Hc level and the development of uterine fibroids. The use of folic acid and B-group vitamins in addition to the clinical protocol for the treatment of uterine fibroids made it possible to stabilize the myomatous nodes and reduce surgical treatment by 4 times.
Despite the fact that homocysteine was first described in 1932, at present, the study of changes in the synthesis and content of this amino acid reveals new mechanisms for the disease development. It should be mentioned that studies confirming the correlation between elevated homocysteine levels and human pathologies (cardiovascular diseases, pregnancy complications, neuropsychiatric disorders) have appeared only recently. This indicates that hyperhomocysteinemia has not been resolved and deserves clinicians’ and researchers’ attention. Most publications present studies on hyperhomocysteinemia as part of the pathogenesis of cardiovascular diseases. However, more recently, elevated homocysteine level has been considered as a marker in preeclampsia and postoperative thromboembolism, including that after reproductive surgery. It was noted that in early pregnancy the activation of endothelial cells is changed in women with hyperhomocysteinemia and uterine fibroids. It increases thrombosis risks, and later, during the chorion formation, an endothelial defect can cause fetoplacental insufficiency, and in case of endotheliosis progression lead to preeclampsia and eclampsia. In recent years, some authors associate hyperhomocysteinemia with disorders of the female reproductive system and ovulatory abilities, possible pathogenesis of benign tumors, pregnancy pathologies and delivery issues. A detailed study of elevated homocysteine in women can help in solving a number of issues, such as the role of hyperhopmocysteinemia in the pathogenesis of gynecological diseases and development of reproductive disorders. There is much information on the role of homocysteine in the development of endothelial dysfunction and significant metabolic disorders. At the same time, there is not enough studies on the changes in folate metabolism, which cause hyperhomocysteinemia and directly affect the development of endocrine gynecological and obstetric pathologies. These problems require further analysis. The correlation between the hyperhomocysteinemia and development of gynecological pathologies is currently one of the promising scientific areas. Special attention is paid to the pathogenesis of uterine fibroids in terms of vascular theory. Despite ongoing research, there is only insufficient information on the role of excess homocysteine in the pathogenesis of uterine fibroids.
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