Abstract:

Department of Obstetrics and Gynaecology of the Therapeutic and Moscow Faculties of Scientific Research Practical Laboratory of intracardiac and contrast methods of roentgenological studies under the Federal Facility Russian State Medical University of the Russian Ministry of Public Health, Moscow.

This article opens a new series of publications dedicated to a currently important issue of endovascular treatment of uterine myoma - uterine artery embolization (UAE). The authors presently possessing the most abundant hands-on experience in UAE in Russia, based on own experience and literature data discuss herein the most urgent problems related to UAE in treatment for uterine myoma and other obstetrical and gynaecological pathology. Amongst them are the problems of determining the indications for and contraindications to an intervention, outcomes of UAE (including that combined with other therapeutic methods), problems of optimization of the technique and development of technical procedures allowing for UAE to be performed virtually in any situation, as well as the problems related to selection of embolizing substances. The authors also give a detailed consideration to the so-called "myths" about UAE - currently existing negative views on certain aspects of intervention, which are based on outdated and inexact evidence. The authors draw a conclusion that endovascular methods are highly promising in obstetrical and gynaecological pathology.

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 Abstract:

Material and methods. Study population includes 47 women with arterial hypertension (AH) in the third term of pregnancy.

Results and сonclusion. High grade AG was shown to be associated with high resistive index and thus higher value of total peripheral vascular resistance (TPVR). Bisoprolol and Nifedipin GITS normalize blood pressure and alleviates endothelial dysfunction. Antihypertensive therapy tends to lower TPVR in fetal, placental and uterine circulation providing better flow. 

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Abstract:

Aim: was to estimate ultrasound signs of placental insufficiency in women whose pregnancy was the result of extracorporeal fertilization (ECF) and embryo replanting.

Materials and methods: the study involved 84 women who became pregnant as a result of ECF and replanting embryos. Terms of pregnancy were 18-40 weeks. Age of women was from 24 to 46 years. Ultrasound examination was performed by standard methods recommended for pregnant women, with an estimation of basic fetal metric parameters and their compliance with the term of pregnancy, the heart rate of the fetus, the degree of maturity of the placenta, thickness, location and sonographic features of the placenta (calcifications, cysts, heart attacks, expand the intervillous space varying degrees of severity) the quantity and quality of amniotic fluid.

Results: during ultrasound of women whose pregnancy was the result of ECF and embryos replanting, in 38 (35.6%) patients pathological changes in the placenta were diagnosed. It is evident in discrepancy of placenta maturity for a full-term pregnancy The combination of 3 or more of features identified during the ultrasound examination may indicate the development of placental insufficiency in women after ECF. Ultrasound features include: the degree of maturity mismatch placenta given gestational age; the thickness of the placenta; violation of utero-placental or fetus-placental blood flow; fetal growth retardation; amount of water.

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