Objective. Objective of this review is the systematic analysis and summarization the scientifc data available in the current literature on the predictive approach to the management of women with endometrial hyperplasia without atypia.

Material and methods. Scientifc literature was searched in PubMed, CochraneLibrary, Science Direct, and ELibrary databases using the keywords,endometrial hyperplasia and cancer, pathogenesis, risk factors, and recurrence for 2012–2022.

Framework. Endometrial hyperplasia (EH) is a common disease that affects women of reproductive age and is caused by a disturbance of the local hormonal homeostasis of the endometrium. Several factors, such as age over 35, lack of pregnancy history, obesity, genetic predisposition, diabetes mellitus, anovulatory cycles, hormone replacement therapy, including menopausal therapy (without the progestin component) and immunosuppression can lead to the development of this condition. Modern predictive medicine can be used to identify women at high risk for developing this condition and target screening and surveillance, as well as individualized treatment plans. Overall, the use of predictive in the management of endometrial hyperplasia without atypia may improve the treatment outcomes of the patients in the cohort studied.

Conclusion. Combined oral contraceptives (COCs) have been proven to have not only high contraceptive effcacy, but also to be considered as a pathogenetically justifed prevention of EH without atypia and its recurrence. Gestoden-containing COCs are recognized as an effective means not only for the prevention of endometrial hyperplasia, but also for the prevention of endometrial carcinoma, while having absolutely similar effcacy to other progestins, such as levonorgestrel. Thus, OCs containing gestoden should be considered as an attractive option not only to prevent unwanted pregnancy with high contraceptive effcacy, but also to regulate the menstrual cycle, to minimize breakthrough bleeding and to prevent EH without atypia.

Endometriosis is a benign inflammatory hormone-dependent disease characterized by pain and infertility. It seriously affect women’s health., endometriosis is a chronic disease it requires long-term treatment. Currently, hormonal drugs are most widely used for the treatment of endometriosis, which is based on the endocrine mechanisms of its pathogenesis. Key points are estrogen dependence and progesterone resistance, which provide implantation of ectopic endometrial cells, reduce apoptosis and increase oxidative stress, inflammation and neuroangiogenesis. the pain and infertility is explained by hormonal and inflammatory changes, as well as the systemic diseases and psychiatric disorders often associated with endometriosis. Hormonal treatment of endometriosis is aimed at suppressing ovulation through inhibition of the hypothalamic-pituitary-ovarian axis, as well as directly on endometrioid implants. Gonadotropin-releasing hormone (GnRH) agonists and antagonists, progestins, combined oral contraceptives (COCs) are now offcially approved for use to relieve the symptoms of endometriosis. The review provides information on the current possibilities of hormonal therapy for endometriosis, based on an understanding of the pathogenesis of the disease.

A study was made of the prevalence and severity of pain syndromes in women with premenstrual syndrome in the dynamics of the menstrual cycle. 96 patients suffering from premenstrual syndrome and 78 healthy women were examined. Both a high association of pain syndromes with premenstrual syndrome and a signifcant decrease in pain thresholds were revealed, which indicates insuffcient activity of the antinociceptive system in this category of patients.

The article presents a modern, comprehensive approach to the treatment of anemia in abnormal uterine bleeding in patients with endometrial hyperplastic processes. The effectiveness of therapy with the iron-containing drug Sorbifer Durules was evaluated.

Over the past 30 years, assisted reproductive technologies (ART) have developed signifcantly, despite this, not every woman gets a long-awaited pregnancy on her frst attempt at in vitro fertilization (IVF). Not only the quality of gametes is important for successful embryo implantation, but also the readiness of the endometrium for nidation. Dysbiosis of the uterine microbiome can interfere with the necessary physiological changes of the endometrium in the dynamics of the menstrual cycle, reducing the success rate of ART programs. Endometrial structure mismatch with embryonic development leads to an implantation window shift, which together with uterine microbiome changes is one of the causes of recurrent implantation failures (RIF). In recent years, to improve the effectiveness of ART programs, increasing attention has been paid to the study and preparation of the endometrium for embryo transfer. High-throughput sequencing and analysis of the variable regions of the 16S ribosomal RNA gene is a rapid and affordable diagnostic tool that allows identifcation of culturable and non-culturable microorganisms. The debate about the need for treatment of chronic endometritis (CE), becomes more relevant when considering the prevalence of CE (21% among RIFs). The use of matrix RNA sequencing from endometrial tissue sample cells (RNA-seq) as an additional diagnostic method for RIF causes can help in personalized embryo transfer. This can increase the chances of successful implantation. RIF of endometrial origin is a complex problem of modern reproductive medicine. Currently, there is no consensus on the role of the listed endometrial factors of RIF. Receptive endometrium is one of the determinants of successful implantation. However published studies are insuffcient to reasonably recommend the wide application of methods for diagnosis and treatment of such endometrial factors as uterine microbiome changes and implantation window displacement.

Anti-Müllerian Hormone (AMH) is produced by small antral follicles and has evolved over the past three decades as an assumed potential marker of the number of follicles in the human ovaries, also known as ovarian reserve. This quantitative measure, given the gradual decline over time and its non-replenishable feature, could be the dreamed marker for predicting the fnal exhaustion of ovarian storage: the post-menopause. This introductory chapter summarizes current knowledge with regard to the contribution of serum AMH measurements to predict age of normal menopause and critically discuss its potential in this regard. Furthermore, its predictive role in the context of menopause in association with several frequently occurring fertility disorders such as premature menopause, polycystic ovarian syndrome and endometriosis are discussed. Overall, while ovarian reserve markers including AMH are unmistakably related to age at menopause, they are insuffciently precise to inform on an individual’s journey of ovarian aging.

Relevance. He has a signifcant number of studies describing the morphological features of the placenta according to SDRP [4]. Various pathomorphological changes in the placenta tend to correlate with pregnancy outcomes. The study of the placental morphostructure in patients with NWRP allows us to fnd a pathophysiological explanation for the occurrence of this pathology, for choosing a rational strategy of antenatal observation during subsequent pregnancies because this complication may occur during the next pregnancy [1, 2]. At the same time, NWRP is a risk factor for the development of cardiovascular diseases, type 2 diabetes mellitus, and obesity in adulthood. Multiple studies conducted in populations living in different territories, in different ethnic groups, have proved that the birth of children with SDRP increases the risk of pathological conditions in adulthood [3, 4]. In this regard, scientifc research on the NWRP is relevant.

Purpose. To study the features of the somatic anamnesis of pregnant women, the course of the gestation process, childbirth, the condition of newborns, the morphological structure of the placenta of full-term infants with SDRP (main group – 200 pregnant women), in comparison with patients randomly selected who gave birth to children with normal body weight (comparison group – 200 pregnant women), observed and delivered in the Republic of Mordovia during from 2020–2021.

Materials and methods. As the main research methods, the comparative method and the method of analysis are used in the article, which make it possible to establish causal relationships of phenomena and processes with the greatest accuracy. The research materials are data from sources [1–30].

Results and conclusions. When analyzing the data obtained, it was reliably revealed that pregnant women whose gestational process was complicated by SDRP had a younger age, bad habits, socially signifcant diseases (HIV, tuberculosis, and syphilis).

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.