A systematic analysis of fundamental and clinical studies has shown that it is impossible for iron to perform its biological functions in the human body without heme and synergistic cofactors (copper, zinc, calcium, manganese, cobalt and magnesium ions, vitamins В_2, PP, A, C, B₆, B₁₂, folates and tetrahydrobiopterin). The effects of various micronutrients on the pathophysiology of iron-deficiency anemia (IDA) and the evidence base for the preventive intake of multicomponent vitamin-mineral complexes (VMC) are considered. The intake of multicomponent iron-containing VMCs throughout pregnancy is an important factor in preventing IDA. VMCs for pregnant should contain an adequate form and dosage of the organic forms of iron (in particular, iron fumarate).

Dysfunction of endothelium underlies development of many vascular disturbances during pregnancy, and leads to development of many obstetric complications: loss of a fetus, placental vascular complications, intrauterine fetal growth restriction, preeclampsia. Application with the purpose of correction of dysfunction of an endothelium does a heparin-sulfates their perspective for wider use in an obstetric practice, including at thrombophilias and the syndrome of loss of a fetus bound to them.

To date, the mechanisms of the onset of gestational complications in intrahepatic cholestasis of pregnant women (VCB) are not fully understood, and clear predictors of their development are not known. Oxidative stress and antioxidant defense disorders, which are a pathogenetic link in various pathologies of pregnancy, can play a role in the development of complications of pregnancy in VCB and serve as a prognostic marker for their occurrence. Purpose of the study. Determination of the role of antioxidant status disorders in the development of complications of pregnancy in patients with VCB. Materials of the study. A prospective study included 97 pregnant women who had VCB. Of these, a group of 57 patients was randomly selected. Patients of the isolated group underwent clinical and laboratory examination with determination of biochemical markers of damage to liver function, ultrasound. Antioxidant status was assessed on the basis of the determination of the content of antioxidant defense enzymes (superoxide dismutase [SOD], glutathione peroxidase [GTP]) and their coenzymes (zinc, selenium). Severe pruritus was established in the range from 0 to 3 initially (with the detection of VCB), and after 1 and 2 weeks of treatment. The treatment was carried out with ursodeoxycholic acid preparations at a dose of 500 mg to 2 g per day. Results. in patients with VCB who had complications of pregnancy (preterm delivery, intrauterine fetal hypoxia, preeclampsia, the need for caesarean section), lower levels of SOD, GTP, selenium and zinc were observed compared to patients who did not have these complications. Factors contributing to the disturbance of antioxidant protection in patients with VCB were its early onset and prolonged course, multiple pregnancies, the use of assisted reproductive technologies and sex hormone drugs, the presence of biliary sludge and the low efficacy of treatment of pruritus. The conclusion. The depletion of protective mechanisms that inhibit the development of oxidative stress is one of the links in the pathogenesis of complications of pregnancy in patients with VCB. Disorders of antioxidant protection in VCB can be considered as a predictor of the development of pregnancy complications and an indication for active management of patients.

Acne vulgaris is one of the most common skin diseases. The well-known association of acne and hyperandrogenia justifies the use of combined oral contraceptives in the therapy of this disease. Topical therapy is also used to treat acne. The purpose of this study was to optimize the treatment of patients with acne on the basis of comparing the effectiveness of this two approaches in the treatment. The study involved 67 patients 18-25 years old with acne of mild to moderate severity, who received treatment depending on the initial status and reproductive plans. As a result of the study, an algorithm for differentiating the treatment for patients with mild or moderate acne was developed.

Oral hormone therapy (HT) is associated with an increased risk of venous thromboembolism (VTE), with the highest risk during the first year of treatment. Differences in the formulation, dose and duration of HT may affect the risk of VTE. A clinical trial was conducted to compare the effects of different oral HT regimens on thrombin generation and efficiency of fibrinolysis in postmenopausal women. 150 postmenopausal women were assigned in a randomized controlled study in which the effect of standard dose (1 mg of 17ß-estradiol / 5 mg of dydrogesterone), ultra-low-dose HT (0.5 mg of 17ß-estradi-ol / 2.5 mg of dydrogesterone) on fibrinolysis and coagulation was compared to controls. Factors measured included plasma clot lysis time (CLT), fibrinolysis activators and inhibitors, thrombin generation (prothrombin fragments 1+2 [F 1+2], endogenous thrombin potential [ETP]), normalized activated protein C sensitivity ratio (nAPCsr), and factor (F)Viii activity and were determined before and after 24 weeks of HT. The results demonstrated that in contrast to the standard HT, ultra-low-dose HT may enhance fibrinolysis through reduced PAi-1 levels. The current study is the first to show significant differences between combined oral ultra-low-dose HT and standard HT in the effects on fibrinolysis and thrombin generation in postmenopausal women.

Menopausal hormone therapy is the «gold standard» for treating women suffering from vasomotor and psychosomatic symptoms of the menopausal transition. However, there are a number of limitations and contraindications to the appointment of hormones, and some women, for various reasons, do not want to take hormonal drugs. For these categories of patients, alternative therapy is intended, which includes a large number of different drugs, dietary supplements and non-medicinal methods of influence. inadequate or short-term effects of alternative therapy, as well as possible adverse reactions to the administration of certain drugs, lead to a constant search for new solutions to the problem of alleviating climacteric symptoms. in a series of relatively new alternatives, the cytoplasm of plant pollen extract, known in Russia under the commercial name Serelis®, is of interest. The review presents the results of studies that have studied the effectiveness of the application of Serelis® in women in menopausal and postmenopausal periods, on the basis of which the expediency of using this alternative therapy for climacteric disorders is justified.

Introduction. Hyperplastic processes - a combined, multifaceted pathology, including hormonal, inflammatory, etc. links. The task of the clinician is to choose an adequate one with minimal side effects and maximally positive effects of conservative therapy. Purpose of the study. Establish the level of endogenous intoxication based on medium-mass molecules (peptide-nucleic, aromatic and amino acid coefficients) in patients of reproductive age with a hyperplastic process burdened by metabolic syndrome and hyperinsulinemia, assessing the possibility of adjuvant phytotherapy. Materials and methods of research. The study included 103 women of reproductive age. Group I (n = 57) - patients with simple, without atypia hyperplasia of the endometrium in combination with DDM, metabolic syndrome and hyperinsulinemia. Group II (n = 25) - patients with DSM, burdened by metabolic syndrome and hyperinulinemia. Comparison group III (n = 21) is a conditionally healthy woman. Results and discussion. The level of peptide-nucleotide, aromatic and amino acid coefficients was increased (from 1.3 to 7.0 times depending on the type of fractions) in all patients with GP on the background of metabolic disorders and hyperinsulinemia in comparison with a group of healthy women. Further analysis of the results was based on a strategy for assessing the efficacy of the phytopreparation Mastopol^®. The effectiveness of the combined Mastopol® preparation, taken by patients for six months, was confirmed by the results of biochemical analysis. In particular, after three months of use, the level of endogenous intoxication in the groups as a whole decreased by half. The most pronounced decrease was found in group II in patients with mammary gland pathology against hyperinsulinaemia, whereas in group I the decrease in MSM was observed, but only at the level of the trend. After six months of taking Mastopol^®, the level of peptide-nucleotide, aromatic and amino acid coefficients in groups I and II significantly decreased (p < 0.0001), clearly approaching that of healthy women.

Pelvic pain is one of the most common causes of treatment for a gynecologist. The occurrence of pelvic pain is associated with a variety of gynecological and non-gynecological diseases. Since pain is associated with inflammation, and pain and inflammation, in turn, are supported by estrogens, women are more likely to develop chronic pelvic pain with the development of peripheral and central sensitization of the nervous system. The pain symptom may be the first sign of endometriosis, but, on the other hand, a prolonged persistence of pain, arising for any reason, can cause the development of chronic estrogen-dependent inflammation, which is endometriosis. This determines the urgency of the pelvic pain problem, as a harbinger and the first symptom of endometriosis, and the task of timely alleviation of pain symptoms.

The problem of premature birth (PR) is one of the most urgent in modern obstetrics and requires a multifaceted study and an integrated approach to its solution. Currently, there is an active study of mechanisms for the realization of spontaneous preterm birth. In the literature there is more and more data on the role of innate immunity, neopterin in the implementation of PR. Many authors support the theory of the predominant fruit factor in the initiation of PR. The purpose of our study was to study the characteristics of the local immune status, neopterin and cortisol levels in various variants of preterm labor. Materials and methods. 77 patients were divided into two groups. The main group included 52 pregnant women with PR. The main group was divided into two subgroups. The first subgroup (1A) consisted of 28 pregnant women with premature rupture of membranes (PDO) in the absence of regular labor. The second subgroup (1B) was presented by 24 women with childbirth with the development of regular labor for the whole fetal bladder (true PR). In the control group were 25 women with timely delivery. The level of expression of mRNA genes of congenital immunity (IL1B, IL10, IL18, TNFa, TLR4, GATA3, CD 68, B2M) in the cervical canal was determined for all patients in the cervical canal by the ImmunoQvantex test system, as well as serum levels of neopterin and cortisol. The results obtained are analyzed by standard statistical methods. Results. There were no significant differences in the expression levels of most genes of innate immunity between study groups (p > 0.05). The study of expression of TLR4, GATA3 genes in different variants of PR revealed a significant decrease (p < 0.05) in patients with PDO (1A subgroup). In addition, it was in this subgroup that there was a higher inflammation index (Me = 99.5%, p < 0.01). There were no fundamental differences in the state of the local immune status between groups of true premature and timely births. Analysis of the neopterin content among the subjects showed a significant increase in the main group (PR) compared with the control (p = 0.0064). Comparison of the level of neopterin between different variants of PR showed that women with true PR had a higher index (p < 0.025). The concentration of cortisol in the study groups did not differ in principle from the basal (PR group) and control groups (p > 0.05). The maximum value of cortisol was found in subgroup 1B (true PR), which is significantly higher than in the subgroup 1A (with PDO), and in the control group (p < 0.01). Conclusion. The differences revealed by us in the state of local immune status in different variants of premature births indicate different mechanisms of initiation of preterm labor. It is likely that the ratio of genes of innate immunity and the index of inflammation determines the onset of PR. The level of neopterin can be used as a marker of PR development. The increase in cortisol determines the role of the fetus factor in the development of labor.

One of the issues important in operative gynecology is the problem of postinvasive antibiotic therapy. The etiological structure of PiD in modern conditions has a mixed character. A modern aggressive gynecology’ can play a significant role in climbing the infection. in gynecological practice, preventive antimicrobial therapy is widely used. The effectiveness of the antimicrobial preparation in the prevention of infectious postoperative complications in gynecological patients was noted, which also determines the additional economic benefits, including by reducing the costs of staying in the hospital.