Purpose. Comparative analysis of the effectiveness of pharmacological correction of fetal growth retardation using monotherapy with diosmin and dipyridamole.

Materials and methods. A retrospective and prospective examination of 160 pregnant women with a singleton pregnancy at a gestational age of 28 to 36 weeks with a confirmed diagnosis of fetal growth restriction was conducted. An extensive collection and analysis of anamnesis, general clinical and obstetric-gynecological examination, laboratory and ultrasound methods were carried out. Newborns were assessed using Apgar scores at birth and 5 min later. In the early neonatal period, congenital and incident pathological syndromes were assessed.

Results. In patients receiving diosmin, a decrease in the resistance index of the right and left uterine arteries was achieved to 0.42±0.002 and 0.45±0.002, respectively, and for the umbilical cord artery to 0.52±0.02, which is significantly lower than in the group of patients taking dipyridamole. A positive effect of diosmin on the intrauterine state of the fetus was revealed, which is realized in the form of an increase in its compensatory abilities to adapt to chronic hypoxia in a significantly higher percentage of cases compared to dipyridamole.

Conclusion. The data obtained demonstrate the difference in the pharmacokinetics of these drugs: diosmin equally improves both maternal and fetal blood flow, which is most valuable in the treatment of fetal growth restriction, while dipyridamole affects only uterine blood flow.

Background. According to foreign authors, this condition affects at least 60% of women worldwide. To identify symptoms, patients are typically advised to fill out a specific questionnaire (for example, the Daily Record of Severity of Problems, DRSP), but there is no standardized template in Russia. The principles for monitoring patients with PMS during treatment and rehabilitation have not been established, particularly regarding the use of educational programs aimed at preventing the development of PMS. However, with the advancement of digital technologies, new horizons are opening up for more accurate and effective diagnosis of this condition. The article describes the experience of using a specifically developed chatbot in Telegram PMS BOT, for diagnosis and dynamic monitoring of patients.

Objective. Determining the prevalence and severity of pain syndromes throughout the menstrual cycle in women suffering from PMS, as well as the possibility of assessing the effectiveness of taking herbal preparation (Cyclodynon) based on Vitex agnus-castus, using a specially developed Telegram chatbot PMS BOT.

Materials and methods. One hundred fifty-eight women of reproductive age participated in the study. Over six consecutive cycles, the patients completed a short daily survey, recording data on symptoms, their intensity, and duration in the Telegram chatbot PMS BOT, similar to maintaining a menstrual diary. The women chose the time for the survey notification themselves, initiating the chat with the bot. The main group consisted of 70 patients with a regular menstrual cycle but with varying degrees of PMS symptoms that hindered their professional activities, education, and usual social functioning, without taking hormonal medications in the last six months. The control group included 88 women without clinical signs of PMS. All participants were of reproductive age. The average age of patients with PMS was 29.1±0.8 years, while the control group had an average age of 29.3±0.3 years. The study was conducted during the I and II phases of the menstrual cycle to obtain a dynamic view of symptom development, intensity, and duration. For the first three months, the patients did not take any medications, while in the following three months, both groups took a preparation based on Vitex agnus-castus.

Results. In the study of pain syndromes during the first half of the menstrual cycle, the diagnosis of primary fibromyalgia, according to the criteria of the American College of Rheumatology (1990), fully corresponded to 15 (21.4 %) women in the main group. No cases of primary fibromyalgia were identified in the control group. Complaints of headaches were reported by 33 (47.14 %) patients with PMS and 9 (10.22 %) clinically healthy women. When examining the prevalence of various manifestations of premenstrual syndrome according to the chatbot data in the second half of the menstrual cycle, a predominance of complaints related to pain manifestations (46 %) was observed among women in the main group. In the main group, at least one symptom of fibromyalgia was present in 72 (93.5 %) women, which was significantly more frequent (p<0.05) compared to healthy women. Complaints of headaches in the second half of the menstrual cycle were reported by 48 (68.57%) patients with PMS. At the same time, the number of women suffering from headaches in the control group remained unchanged at 9 (10.22%). After the examination, women in the main group were prescribed a preparation based on Vitex agnus-castus. After three months of taking the medication, according to the survey conducted via the Telegram chatbot PMS BOT, complete recovery was reported by 58 (82.6%) women, significant improvement was noted in 10 (14.3%), and no effect was observed in 2 (2.6%) patients.

Conclusion. The advantages of integrating digital technologies in PMS diagnosis include a more personalized approach to treatment, convenience in data collection, and the potential for closer interaction between doctors and patients. A medicinal product based on VAC extract (Cyclodynon) has proven its effectiveness in patients with premenstrual syndrome. Due to its hormone-regulating and anti-inflammatory effects this herbal medicine allows a differentiated selection of treatment for women who do not require contraception or are unable to take hormonal medications for various reasons. Despite the positive results of studies, further clinical trials are necessary to gain a more comprehensive understanding of its mechanisms of action and to adjust dosages accordingly. It is important to note that the treatment approach to PMS should be personalized, and medicinal product based on Vitex agnus-castus can be used as part of a comprehensive treatment plan.

Symptoms of the genitourorinar menopausal syndrome appear simultaneously with vasomotor symptoms when menopause and even in perimenopause: soreness, itching and dryness in the vagina, dyspareunia, etc. This is due to the developmental atrophic changes in the urogenital tract, which sharply reduces the quality of life and is a risk factor for the development of recurrent infections of the genitourinary system. More than 65% of women in postmenopause without systemic menopausal hormonal therapy (MGT) suffer from manifestations of urogenital atrophy. This article discusses all modern methods of treating HUMS, describes various methods of treatment, their effectiveness, duration of application. As the first line of therapy, non -hormonal lubricants are recommended. With an average and severe degree of vulvovaginal atrophy and in the absence of contraindications, local intravaginal administration of estriol is used. The new promising methods of treatment with the State Unitary Enterprise are also described: Ospemicifen-oral, active selective selective modhertator of estrogen receptors (SERM), laser therapy, dehydroepiapianrosterone.

Conclusions. Genitouine menopausal syndrome – an underestimated common disease, but the frequency of use of local estrogens is low. Treatment should be continued for a long time to prevent relapse of the symptoms of Hums. Vaginal moisturizers can be used both in monotherapy and in combination with estriol.

The purpose of the study is to improve diagnostic methods for platelet hemostasis disorders in patients with thrombophilia (protein C deficiency and protein S deficiency) and complicated pregnancy.

Material and methods. The study involved 80 women aged 18 to 43 years (Me 37.7 [18; 43]), including 20 non-pregnant women (group 1 [control]) and 60 pregnant women at 12–14 weeks of gestation: 30 pregnant women with thrombophilia (protein S deficiency and protein C deficiency) (group 2) and 30 with physiological pregnancy (group 3). Standard hematological parameters and indices and the impedance aggregatometry method were used to assess the state of the platelet link of hemostasis. Morphodensitometric study of platelets was performed in real time on living unfixed and unstained cells using reagent-free quantitative phase imaging technology (QPI) based on the domestic optical hardware and software complex MIM 340 (OOO Shvabe, Moscow).

Results. The heterogeneity of the circulating platelet population was assessed in women outside pregnancy, pregnant women with thrombophilia, and in physiological pregnancy. The ratio of functional cell types (resting forms, platelets with low and high activity, degeneratively altered) was 63.2, 21.5, 13.2 and 2.1 %; 57.4, 25.2, 14.3 and 3.1 %; 61.1, 23.2, 13.4 and 2.3 %, respectively. The size parameters of circulating platelets in patients with thrombophilia differed in greater values of diameter and perimeter by 16.0 % and 21.9 % (p<0.05) in relation to the parameters outside pregnancy and by 7.4 % and 9.9 %, respectively, in relation to the group with physiological pregnancy. Correlation analysis of the correspondence of morphodensitometric parameters of platelets with the results of the study of their cell aggregation activity showed the presence of a connection between them.

Conclusion. The obtained data expand theoretical understanding of the functioning of the platelet link during physiological pregnancy and thrombophilia, demonstrate the effectiveness and feasibility of using reagent-free quantitative phase imaging technology for personalized assessment of platelet hemostasis in pregnant women. ionic activity of cells showed the presence of a connection between them.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age for which a lifestyle approach is an integral part of treatment. Despite modern therapies for this syndrome, a significant number of women with this condition do not achieve treatment goals, suggesting that there are other features of this syndrome that are not taken into account in the assessment and therefore choice of therapeutic approach. Chronotype is known to play a role in determining dietary preferences and the risk of developing endocrine-metabolic diseases, including those of PCOS.

Aim: to study differences in circadian rhythms in women with PCOS and to evaluate their role in determining metabolic aspects of the disease.

Materials and methods: 109 women aged 18–36 years (mean age 26.3±4.3 years) with a confirmed diagnosis of PCOS were included in the study and divided into 3 groups according to chronotype: Group 1 (evening chronotype) – 19 (17.4 %) subjects, Group 2 (intermediate chronotype) – 38 (34.9%) subjects and Group 3 (morning chronotype) – 52 (47.7%) subjects. All patients underwent standard clinical, laboratory and instrumental examinations to determine the status of PCOS, as well as a medical history and physical examination with assessment of anthropometric parameters.

Results: patients with the evening chronotype exercised less regularly and were significantly less physically active, and had higher rates of smoking and arterial hypertension than patients with other types of circadian rhythm. The evening chronotype was associated with higher body mass index (BMI; p=0.001), waist and hip circumference (WC and HC; p=0.004 and p=0.003, respectively), WC/HC ratio (p=0.017), neck circumference (NC; p=0.013), and Deurenberg fat mass percentage (p=0.001), as well as lower prolactin and 25(OH)D levels (p=0.046 and p=0.037, respectively) compared to the mid-phase phenotype. And compared to the morning phenotype, women with the PCOS and evening phenotypes had significantly higher BMI (p<0.001), WC (p<0.001), HC (p<0.001), OB (p<0.001), WC/HC (p=0.009), NC (p<0.001), Deurenberg fat mass percentage (p<0.001) and levels of very low density lipoproteins (p=0.042), ApoA1 (p=0.042), insulin (p=0.020), HOMA-IR index (p=0.035) and lower 25(OH)D (p=0.004). Low-density lipoproteinemia was more common in the morning circadian variant compared to the evening PCOS group (p=0.042), and isolated lipid abnormalities were less common compared to the intermediate chronotype (p=0.028).

Conclusions: women with PCOS and evening chronotype have worse anthropometric indices, more severe degree of IR and in general are less likely to lead a healthy lifestyle, suffer more often from arterial hypertension compared to women with PCOS and other types of chronotypes. Further study of circadian rhythm abnormalities in PCOS has significant potential and may help to develop effective treatment strategies for this disease.

A review of clinical studies indicates a high prevalence of hypertension in pregnant women. Arterial hypertension of pregnant women has a negative impact on the course of pregnancy and childbirth, as well as the health of the newborn. An analysis of 150 SMADS and information from the EMIAS was carried out, according to which 30 pregnant women with arterial hypertension were identified. SMAD profiles, office pressure measurements, body mass index (BMI), and glucose levels were analyzed. the relationship of arterial hypertension in pregnant women with age, the presence of concomitant diseases, the duration of pregnancy, the outcome of pregnancy and childbirth. The results show that about half (41.4 %) of pregnant women with hypertension have this disease before pregnancy and receive antihypertensive therapy during pregnancy. SMAD analysis shows that daily blood pressure values do not exceed the upper limit of the norm. According to the daily SAD index, non-dippers predominate, while dippers predominate according to the daily DAD index. Pregnant women with hypertension have several times higher risks of developing gestational diabetes than pregnant women with normal blood pressure. In pregnant women with arterial hypertension, the number of Cesarean section deliveries is higher than the national average, and the number of deliveries without complications is only a small percentage. The results of the study showed the importance of monitoring blood pressure in pregnant women not only in the doctor’s office, but also independently at home. In our opinion, daily blood pressure monitoring should be considered as one of the main methods for verifying the diagnosis of hypertension in pregnant women.

Rationale. Contraception is an important aspect in preventing the reduction of female infertility by preventing abortions leading to the development of gynecological diseases and psychological stresses.

Purpose. Study the contraceptive behavior of women in the age aspect in a large center of Western Siberia.

Materials and methods. A study was conducted to study the methods of contraception used in women of different ages using a questionnaire, which included 313 women. All women were divided into 4 research groups: in group A, the age of girls (43 people) ranged from 16 to 18 years; group B included women aged 19–35 years (147 respondents), group C – 36–45 years (79 women) and group G – from 46 to 52 years (44 people). The criteria for inclusion in the study were: women living sex and using any methods of pregnancy prevention. Exclusion criteria: age of women under 16 years, age of 53 years and older.

Study results. Girls under the age of 18 who live sexually use traditional (less effective) methods of contraception (88.4%) are 1.5 times more likely than women of the heyday (57.8%), and 2.8 times more likely than women of the transitional menopause (31.8%). Modern hormonal methods of contraception were more often used at the age of 19–35 years (in 35.4% of observations), at the age of 36–45 years (in 53.2%), while in the group of women 46–52 years more often than in other groups hormonal intrauterine contraceptives were used (11.4%). Contraindications to the use of hormonal contraceptives were most often in transition (20.5%), with smoking being the most common contraindication.

Conclusion. Adherence to modern hormonal methods of contraception, which are more reliable and effective, comes to women with age, while combined oral contraceptives are most often used. Hormonal contraceptive drugs were used in 22.7 % of respondents of the transition period for therapeutic purposes (more often the intrauterine hormonal system), while in reproductive age hormonal contraceptives were used for the same purpose in 12.7–16.6 % of women. The longest duration of hormonal contraception was in groups of women over the age of 46: 13.6 % of respondents used it for more than 15 years.

The roles of folates (vitamin B9) in the formation of healthy oocytes (which is important for preventing malformations) are well known. Other B vitamins are also necessary for the physiological effects of folates to be realized: vitamins B1, B6, B12, and B8 (inositols). Myoinositol (MI) and D-chiroinositol (DCI) are the two most studied inositols necessary for supporting oocytes, restoring ovulatory cycles, and preventing folate-resistant malformations. DCI and MI metabolism is impaired against the background of insulin resistance, including in patients with obesity and polycystic ovary syndrome (PCOS). Conversely, supplementing patients with MI and DCI in a physiological ratio of 40:1 helps eliminate insulin resistance, hyperandrogenism, and anovulation, which prevent the formation of healthy oocytes and, consequently, conception.