Optimal nutrition requires complete provision of the human needs not only for energy, macro- and micronutrients, but also for minor biologically active substances. Some of the most promising chemoprotectors are glucosinolates and their active derivatives, such as 3,3’-diindolylmethane (DIM). DIM has the ability to inhibit the development and progression of neoplasia by regulating multiple intracellular signaling pathways. Currently, the clinical efficacy of DIM is being studied in breast and prostate cancer, and the possibility of using DIM’s antioxidant and anti-inflammatory properties in neurodegenerative, metabolic and immune diseases is being investigated.

The article presents a review of the literature and our own data on the problem of prevention, diagnosis and treatment of iron deficiency and iron deficiency anemia in patients of reproductive age with a burdened somatic status with the development of a chronic inflammatory process. In the concept of patient blood management (PBM), the diagnosis and treatment of anemia in patients with gynecological diseases requiring subsequent surgical treatment is given paramount importance, since anemia and iron deficiency are considered risk factors for worse treatment outcomes for patients. Women with gynecological pathology often have diseases that are accompanied by the development of a systemic inflammatory response, which leads to activation of hepcidin protein synthesis and the development of so-called anemia of inflammatory diseases. Data are presented indicating the effectiveness and safety of the sucrosomial iron drug (SiderAL® Forte) in obstetric and gynecological patients with increased levels of C-reactive protein in combination with iron deficiency and iron deficiency anemia. The increase in ferrokinetic parameters in patients receiving sucrosomial iron is due to the unique physicochemical and pharmacokinetic characteristics of sucrosome, which provides protection of sucrosomial iron from the effects of gastric juice, excluding contact with the mucous membrane of the gastrointestinal tract and its absorption through special M-cells of the small intestinal mucosa followed by the release of iron in liver cells. Sucrosomial iron is novel, convenient, effective, and well tolerated compared with traditional oral iron supplements.

Purpose. To familiarize gynecologists with the clinical presentation, diagnosis and basic principles of treatment of thoracic endometriosis (TE).

Materials and Methods. The article presents a review of publications based on the results of search in electronic resources PubMed, Elibrary, EMBASE. The own clinical observation of the patient with TE is also presented.

Results. The clinical picture of TE can be different, in many patients it is asymptomatic. The typical symptom of TE is menstrual cycle-related, usually right-sided pain in the thoracic, scapular or shoulder area. Chest X-rays, computed tomography (CT), magnetic resonance imaging (MRI) and bronchoscopy are used in diagnosis. The gold standard for definitive diagnosis and effective treatment is video-assisted thoracoscopic surgery (VATS). As with pelvic disease, the first-line therapy for TE is medication to suppress ovarian steroid hormone production. Surgical treatment should be considered in patients with refractory or recurrent TE and in acute life-threatening conditions.

Conclusion. Management of patients with thoracic endometriosis requires an interdisciplinary approach involving gynecologists and thoracic surgeons.

Target. Optimize the diagnosis of chronic endometritis. To evaluate the influence of various factors on the formation of chronic endometritis in patients with infertility, to study the effectiveness of office hysteroscopy and endometrial biopsy in its diagnosis.

Materials and methods of research. A retrospective analysis of the medical histories of patients with chronic endometrioma and a history of infertility was conducted for the period from 2020 to 2022 at the Stavropol Regional Clinical Multidisciplinary Center in Stavropol.

Results. Hysteroscopy with endometrial scratching, as well as routine endometrial curettage, were among the leading risk factors for the development of chronic endometritis. More gentle office hysteroscopy with endometrial biopsy showed high sensitivity but average specificity in the diagnosis of chronic endometritis.

Target. To analyze the effectiveness of surgical and conservative treatment of patients with an incompetent uterine scar and endometriosis in the scar after cesarean section.

Materials and methods of research. A retrospective analysis of 64 medical records of patients with a uterine scar and endometriosis in the scar for the period from 2021 to 2023 was carried out at the medical center, which is the clinical base of the Department of Obstetrics and Gynecology No. 2 of the Stavropol State Medical University.

Results. The analysis showed the high effectiveness of surgical treatment of patients interested in subsequent pregnancies with an incompetent uterine scar and endometriosis in the scar. Conservative treatment given to patients not interested in subsequent pregnancies with an incompetent uterine scar and endometriosis in the scar has also demonstrated its effectiveness.

Objective. To evaluate the features of changes in the morphofunctional status of peripheral blood erythrocytes during normal pregnancy and in preeclampsia based on rapid analysis of biophysical parameters of cells.

Materials and methods. A total of 136 pregnant women were examined at 22–24 and 34–35 weeks of gestation. The comparison groups included: 40 pregnant women with moderate preeclampsia (PE), 30 pregnant women with severe preeclampsia, 30 pregnant women with chronic arterial hypertension (CAH), 36 women with normal pregnancy who do not have signs of hypertensive disorders. Electrokinetic features of peripheral blood erythrocytes were studied using cellular microelectrophoresis, the average value of the amplitude of oscillations of mobile erythrocytes (μm) and the proportion of mobile cells (%) were analyzed.

Results. At 22–24 weeks, the percentage of immobile erythrocytes in pregnant women with moderate PE increased by 2.8 times (p<0.05), the amplitude of oscillations of mobile cells decreased by 21% (p<0.05). In pregnant women with severe PE, the proportion of immobile erythrocytes increased by 3.2 times (p<0.05), the amplitude decreased by 30% (p<0.05). In pregnant women with CAH, a slight increase in the percentage of immobile cells (8.2 vs 6.8%) and a tendency to a decrease in the average amplitude (21.5 vs 23.2 μm) were noted. At 34–35 weeks in the group with moderate PE, the% of immobile erythrocytes exceeded the corresponding indicator in women with physiological pregnancy by 3.3 times (p<0.05), the average amplitude decreased by 28% (p<0.05), in pregnant women with severe PE, the% of immobile erythrocytes increased by 3.7 times (p<0.05), the amplitude decreased by 36% (p<0.05). In pregnant women with CAH, there was a tendency for a slight increase in the proportion of immobile erythrocytes.

Conclusion. The functional and morphological usefulness of erythrocytes as active participants in the pathogenesis of preeclampsia can be objectively assessed using indicators of electrokinetic activity of cells, and erythrocytes can be considered as biomarkers of the disease and a promising tool for stratifying patients for early detection of high-risk pregnancies.

Infertility is the inability of a couple of childbearing age to conceive a child within 1 year with regular unprotected sexual activity. In the modern world, the problem of infertility is felt very acutely. According to statistics, from 17 to 25% of couples are infertile, the indicators depend on the region. ART (assisted reproductive technologies) in the modern world often become the only possible solution for an infertile couple. In recent years, they have been resorted to much more often and this trend will clearly continue to be observed. Over the past 10 years, the number of women who have undergone embryo transplantation in the Department of Assisted Reproductive Technologies of the MRCCB Perinatal Center has increased from 203 to 501. Infertility of endocrine genesis is one of the main diagnoses with which patients seek the help of assisted reproductive technologies.

Background. Uterine fibroids (UF) is the most common tumor of the female reproductive system. In UF progression environmental factors are of great importance, which, without changing the genome, affect the activity of processes of hereditary information realization, the so-called epigenetic factors.

Objective. To identify the most significant factors enhancing uterine myoma growth and the factors having protective effect.

Material and methods of research. The study is a cohort retrospective non-randomized study in which 48 women took part: group 1–28 women with large-sized UF, group 2–20 women with small-sized UF. Retrospective analysis of medical records, questionnaire with the help of a questionnaire including 50 questions about the nature of lifestyle was carried out.

Results of the study. The studied groups were comparable in age, marital status, education and living conditions. The average age of the patients in the first group was 48,21±5,24 years, in the second group 46,20±3,75 years. Based on the data obtained, the factors influencing the growth of uterine fibroids were identified and ranked. The main factors accelerating the progression of UF are high obesity (OR7.34 95% CL 1,035–178.2, p<0.05), a history of cesarean section (OR4.85 95% CL 1,006–36.51, p<0.05), the presence of UF in the mother (OR4.12 95% CL 1,022–21.21, p<0.05), eating pork more than 3 times a week (OR4.12 95% CL 1,134–17.51, p<0.05), short courses of using oral contraceptives (OR4.12 95% CL 1,02–21.21, p<0.05), rare consumption of fish and seafood (OR3.88 95% CL 1,06–16.57, p<0.05), low physical activity (OR4.12 95% CL 1,134–17.51, p<0.05), duration of dynamic observation for more than 5 years (OR3.506 95% CL 1,042–12.75, p<0.05). Protective factors that slow down the growth of uterine fibroids can be called taking nonsteroidal anti-inflammatory drugs to relieve dysmenorrhea (OR0.28 95% CL 0.075–0.989, p<0.05), limiting sugar intake (OR0.187 95% CL 0.035–0.814, p<0.05), no pork consumption (OR0 95% CL 0.0–0.5097 p<0.05), consumption of fish and seafood 3 or more times a week (OR0.149 95% CL 0.0189–0.7756, p<0.05), the presence of 3 or more births in the anamnesis through the natural birth canal (OR0 95% CL 0.0–0.563, p<0.05), regular sexual activity (OR0.280 95% CL 0.0745–0.989, p<0.05), alcohol exclusion (OR0.495 95% CL 0.01893–0.7756, p<0.05), underweight (OR0.95% CL 0.0–0.3809, p<0.05).

Conclusion. It is necessary to encourage women not to postpone motherhood, to popularize having many children, family values, to modify the lifestyle of women with already detected uterine fibroids by increasing motor activity, limiting the consumption of pork and sugar, increasing the consumption of fish and seafood.