CHANGES OF GASTRiC AND ESOPHAGEAL MOTOR ACTiViTY AT SOME PATHOLOGiCAL CONDiTiONS OF STOMACH

The article reviews problem, of changes of gastric and esophageal motor activity at the pathologies of gastrointestinal tract. Obtained data allow to estimate value of gastric motor activity in the pathogenesis of such diseases as chronic gastritis, ulcerous disease and. others, to give more definite recommendations for the diagnostics and. treatment of patients with diseases of gastrointestinal tract

The effects of alcohol on the fetus, and pregnancy outcome. Fetal alcohol syndrome and fetal alcohol spectrum disorders

In a review of the scientific literature describes the current understanding of the problem of the teratogenic effects of alcohol on the fetus, and pregnancy outcome. Attention is paid to the occurrence, clinical manifestations of fetal alcohol syndrome and fetal alcohol spectrum disorders. It is shown that in Russia accurate epidemiological data on the incidence of fetal alcohol syndrome and fetal alcohol spectrum disorders are not available. It is noted that the use of alcohol by women is associated with adverse pregnancy outcome. May manifest clinically delayed fetal development, risk of miscarriage and low birth weight. In reviewing the domestic and foreign literature revealed that in Russia the problem is insufficiently known, relevant. Therefore, the study of this problem will be of great theoretical and practical significance

Ectopic pregnancy and acute appendicitis during intrauterine pregnancy after in vitro fertilization

The paper presents a clinical case of the Patient T., 34years old, who underwent the treatment in the Department of ART of the Regional Perinatal Center for tubal peritoneal infertility for seven years. In the anamnesis: one spontaneous uterine pregnancy, culminating in medical abortion for up to 12 weeks, treatment for chronic salpingo-oophoritis, tubectomy on the right side for a progressing ectopic pregnancy. The patient denied the presence of Chlamydia infection in the anamnesis. Studies on sexually transmitted infections before the 1VF program were negative. During laparoscopic tubectomy, no endometriotic foci were found. There were four programs of ART in anamnesis: in 2009, 2012, 2014,2016. During the fourth ART program in 2016, two embryos were transferred to the uterine cavity, resulting in a uterine pregnancy in combination with an ectopic pregnancy diagnosed in the ultrasound study at 4 to 5 weeks of gestation, in the absence of clinical symptoms. The patient underwent emergency laparoscopic tubectomy on the left, the course of the postoperative period proceeded without complications. Later, in the period of uterine pregnancy of 7-8 weeks, with a clinical picture of acute appendicitis, the woman was hospitalized in the surgical department where she underwent laparoscopic appendectomy. Later the pregnancy proceeded without complications, at 39 weeks the planned cesarean section was performed, a girl weighing 3480 grams, 51 cm long with an Apgar score of 9-10 points was extracted on the operation. The course of the early postoperative period without complications, the patient was discharged with the child on the 4th day

Assisted hatching in cryopreservation protocols in patients with tuboperitoneal infertility

At present, the problem of increasing the effectiveness of programs of assisted reproductive technologies and successful infertility treatment is still relevant. Assisted hatching used in the devitrificated embryo transfer facilitates the exit of the embryo from the pellucide zone. Yet the clinical efficacy of assisted hatching is relevant and debatable. There are no clear indications for the use of this technology, and no groups of patients have been identified.The aim of the study. To assess the effectiveness of laser hatching in the frozenthawed embryo transfer programs in patients with tuboperitoneal infertility.Materials and methods. We examined 300 women with tuboperitoneal infertility who had their embryos frozen for transfer. Inclusion criteria: age from 18 to 35 years; tuboperitoneal infertility; embryos cryopreserved for transfer. Exclusion criteria: age more than 36 years; other infertility factors. Women were divided into 2 groups: group 1 – women who had a frozen-thawed embryo transfer with preliminary laser hatching (n = 137); group 2 – control group (n = 163).Results. There were no differences between the groups in the mean age, body mass index and the age at menarche. According to the results of the embryological stage, there were also no differences in the number and quality of frozen embryos. The pregnancy rate in the group with preliminary laser hatching was 44.5 %, which is significantly higher than in the control group (42.3 %; р ≤ 0.001). We also found statistically significant differences in pregnancy outcomes: in the frequency of spontaneous miscarriages – 13.1 % and 20.2 % respectively (p ≤ 0.001), in the frequency of term deliveries – 30.7 % and 22.1 % respectively (p ≤ 0.001).Conclusion. In our study, the using laser hatching in women with tuboperitoneal infertility positively affected the embryos implantation in the cryopreservation protocols. Pregnancy and live birth rates are higher after using hatching technology, and the frequency of miscarriages up to 12 weeks is lower. This provide an opportunity to further study the effect of hatching on long-term outcomes, such as gestation course and childbirth

ETHNIC PATTERNS OF PREECLAMPSIA

Pre-eclampsia is one of the most dangerous complications of pregnancy and increases the risk of adverse outcomes for both mother and fetus. Objective: to study the course of pregnancy, circadian blood pressure profile, autonomic regulation of the heart and metabolic systems in pregnant Buryat women with pre-eclampsia. To achieve the objectives of the research we have studied pregnancy courses and birth outcomes in 581 women. For the analysis wereformed thefollowing groups; the Igroup 240 pregnant Buryat women with pre-eclampsia; II group 341 pregnant Russian women with pre-eclampsia. In all patients we evaluated hematological, biochemical and hemostatic data as soon as perform daily monitoring of blood pressure. Our studies have shown that Buryat women developed early severe pre-eclampsia early, demonstrated no response for treatment with requiring early surgical delivery. Hemostasis changes in preeclampsia in pregnant Buryat women indicate the prevalence of vascular-platelet disorders (F = 27,18). Their circadian blood pressure profile is characterized by a lack of pressure reduction at night, in a paradoxical increase of mean dynamic blood pressure at night (F = 27,18) as soon as Russian pregnant had higher rates of maximum systolic and diastolic blood pressure during the day (F=30,29). The autonomic regulation of the heart function in pregnant Buryat women with pre-eclampsia is characterized by imbalance in parasympathetic and sympathetic innervation with vagotonia domination as in the daytime and at night, which increasing with severity progression of the pre-eclampsia. High daytime level of VLF-in Buriat women with severe pre-eclampsia evidences of stress adaptation processes

REALIZATION OF FEDERAL AND REGIONAL PROGRAMS OF INFERTILITY TREATMENT

High frequency of infertility in the Irkutsk region (18—20 %) sharply limits population reproduction. Tubo-peritoneal factor (97,3 %), man's infertility (20 %) are leading factors of infertility in Irkutsk region. It predisposes wide using of IVF as the main way of reproductive problems solution in population. Efficiency of IVF programs depends on such factors as age of patients; duration and causes of infertility

RISK FACTORS AND CRITERIA FOR PREDICTION OF OVARIAN HYPERSTIMULATION SYNDROME

Ovarian hyperstimulation syndrome (OHSS) is the most frequent and dangerous complication of IVF programmers. Evaluation of OHSS risk factors allows to perform differentiated, approaches to controlled ovarian stimulation. This article presents the results of OHSS risk factors analysis in 775 IVF cycles. It was found that young age (< 35 years), PCOS, tubal factor of infertility and low BMI (< 25 kg/m2) are the significant risk factors for OHSS

DISCRIMINANT ANALYSIS AS A METHOD OF DETERMINATION OF GESTATIONAL PERIOD IN DRINKING WOMEN AND HEALTH CONDITION OF THEIR NEWBORNS

The article presents the methods of mathematical analysis of the impactof alcohol on pregnancy, childbirth, postpartum and the state of health of newborn state. With the help of this analysis we revealed informative diagnostic features that let determine the effect of alcohol on pregnancy, childbirth, postpartum and newborn state: the use of alcohol before pregnancy once per month; alcohol consumption before pregnancy 2-4 times per month; smoking during pregnancy; abortion history; anemia during pregnancy; congenital heart disease on the third ultrasound screening; abnormal birth activity; subinvolution of uterus in the postpartum period; newborn gender; gestational age; prematurity and generally heavy state of a newborn. Linear classification function can be calculated by the formula 1.2. Canonical linear discriminant function can be calculated from equation [formula 3]. Diagnostic accuracy of decision rules in the middle is quite high - 76,69 %, in the first group - 75,7 %, in the second group - 77,6 %

ETHNIC PATTERNS OF ARTERIAL PRESSURE DAILY PROFILE, AUTONOMIC REGULATION OF CARDIAC FUNCTION AND METABOLIC SYSTEM IN PREGNANT WOMEN WITH ARTERIAL HYPERTENSION

Arterial hypertension (AH) is observed in 4-8 % of pregnant women. Even light previous AH increases the risk of pregnancy and delivery complications up to twice, thereby significantly degrading the prognosis of pregnancy and childbirth. The aim of the study is to evaluate the main cardiovascular and metabolic patterns in pregnant women with AH in depends on their ethnicity. We studied the pregnancy courses in 295 pregnant women with AH. The 1st group was 138 Buryat women and the 2nd group were Russian. In all patients we evaluated hematological, biochemical and hemostatic data as soon as perform daily monitoring of blood pressure. We observed some ethnic patterns of arterial hypertension. Buryat women had dyslipidemia and elevated fibrinogen. Also these patients demonstrated elevation of the value of morning rise in diastolic blood pressure during (DBP) their pregnancies with the most significant value of variability of night DBP. We found the direct link of serum fibrinogen with night DBP в In the 2nd trimester of pregnancy

ESTIMATION OF EFFICIENCY OF FROZEN-THAWED EMBRYOS TRANSFERS IN IVF CYCLES

Cryo-embryos transfer is less expensive and less aggressive method in compare with repeated ovarian stimulation and transfer of «fresh» embryos. The article presents the analysis of influence of various factors on the efficiency of cryo-embryo transfers in 118 IVF cycles. The main success criteria is the quality of thawed embryos