УДК  618.ІІ-006.2-085

Background. Genital endometriosis is one of the most urgent problems of modern gynecology. Considering oxidative stress as a pathogenetic link of endometriosis, we believe it reasonable to use a combined drug containing superoxide dismutase, resveratrol, and zinc. The purpose of the work was to evaluate the effectiveness of the treatment for genital endometriosis supplemented with the use of superoxide dismutase, resveratrol, and zinc, taking into account the leading pathophysiological links of the pathology. 

Materials and methods. Thirty-seven women of reproductive age with genital endometriosis were under observation. Treatment in the first group was carried out in accordance with the Guideline Development Group recommendations. Thirty-nine women of the second group additionally received a drug containing superoxide dismutase, resveratrol, and zinc. The control group included 30 healthy women. The state of lipid peroxidation processes was assessed by the level of diene conjugates and malondialdehyde in the blood serum and the antioxidant defense system by the content of superoxide dismutase and glutathione peroxidase. To monitor the patients’ quality of life, pain syndrome was studied using the Visual Analogue Scale. Statistical processing of the obtained data was carried out by means of the standard StatSoft Statistica for Windows 13.0 program pac­kage.

Results. The assessment of the pain syndrome in the second group showed that it completely disappeared in women with the first stage of the disease. Among patients with the second stage, pain disappeared in 8 cases, 3 patients had a decrease from severe to mild pain. At the third stage, pain disappeared completely in 5 women, in 4 cases, it decreased from severe to mild, and in one woman, the pain decreased from unbearable to mild. All patients of the second group noted a decrease in pain during intercourse, and in the first stage — its absence, an increase in work capacity (r = 0.64, p < 0.01), a decrease in irritability and anxiety in the perimenstrual period (r = –0.59, p < 0.05) and overall satisfaction with the treatment result. Side effects were not noted in any of the patients. 

Conclusions. Improving treatment for genital endometriosis by supplementing therapy with superoxide dismutase, resveratrol, and zinc is pathogenetically justified, as it has a significant positive effect on the lipid peroxidation and antioxidant defense system, compared to the traditional treatment regimen.

Aim: The objective of this literature review was to determine the current aspects of the clinic, diagnosis and treatment of uterine leiomyoma in women of reproductive age. 

Materials and methods: Pubmed, Google Scholar, Web of Science, and Scopus databases were used to search for materials on current aspects of the clinic, diagnosis, and treatment of uterine leiomyoma in women of reproductive age. 

Conclusions: Women who have a pregnancy in the background of leiomyomas of the uterus, constitute a high-risk group for the occurrence of obstetric and perinatal complications, therefore, in the most dangerous periods of pregnancy, hospitalization in a specialized obstetrical hospital is recommended. It is advisable to exclude the tactics of passive surveillance of women of childbearing age with leiomyoma of the uterus. Women of childbearing age with leiomyoma of the uterus are recommended to carry out organ-preserving operations in the volume of leiomyomectomy in order to preserve the reproductive function of the woman.

Background. Ascariasis remains one of the most common helminth infections in the world, particularly in countries with temperate climates, including Ukraine. The problem remains understudied and clinically underestimated in the field of outpatient gynaecology and primary care. The aim was to determine the relationship between the presence of ascariasis, skin rashes on the face, gynaecological diseases, changes in hormonal status and blood clotting disorders in women of reproductive age. 

Materials and methods. A total of 234 women aged 18 to 47 years who consulted a gynaecologist for vaginal discharge and had characteristic rashes on the skin of the face were examined. The comprehensive examination included: gynaecological examination, microscopy of smears, ultrasound of the pelvic organs and abdominal cavity, laboratory analysis of faeces for helminth eggs, examination for demodicosis, hormonal profile (oestrogens, cortisol), coagulogram, and clinical blood and urine tests. The control group consisted of 20 women with no signs of parasitic infestation or gynaecological pathology. 

Results. Ascaris lumbricoides eggs were found in the stool of 196 women (83.8 %), and Giardia cysts were also detected in 13 patients. Thrombocytosis was recorded in 62 (26.5 %) of the examined women, thrombocytopenia in 27, and prolonged activated partial thromboplastin time in 20 %. In 86 % of cases, inflammatory gynaecological diseases (endocervicitis, salpingo-oophoritis, endometriosis, bacterial vaginosis) were diagnosed. In 78 % of patients with acne and ascariasis, elevated cortisol levels were detected, and in 63 % — hormonal imbalance (hypoestrogenism or relative hyperestrogenism). Specific rashes in the lower third of the face appeared before menstruation or after stress. 

Conclusions. Women with ascariasis have a characteristic clinical triad: skin rashes (acne), gynaecological inflammatory diseases and dysbiosis caused by parasitic invasion, changes in immune and hormonal status, as well as disorders of the coagulation system. It is advisable to include parasitological and coagulation tests in the diagnostic algorithm for patients with recurrent acne, bacterial vaginosis, and endometriosis.

Intrauterine infection occurs as a result of transplacental, amniotic, ascending or descending infection. The spectrum of pathogens is diverse: bacteria, viruses, fungi, protozoa, mycoplasmas, chlamydia, and combinations of pathogens. When an infection enters the body of a pregnant woman, pathological changes in the fetus and amniotic fluid structures can have varying degrees of severity, from local to generalized. Cytomegalovirus infection is a widespread infection in the human population and affects 50 to 100% of the adult population. The infection leads to miscarriage, severe complications during pregnancy, birth of severely premature babies, birth of children with congenital malformations and pathology of internal organs, autism, further lag in physical and mental development, and disability of children. Timely prevention of CMV infection before and during pregnancy, compliance with hygiene standards, knowledge of a healthy lifestyle, culture of sexual relations, contraceptive methods and methods of prevention of sexually transmitted infections, rules of care for children with disabilities and the elderly, identification and formation of risk groups among pregnant women for primary infection or relapse of a chronic process, timely laboratory diagnosis of the activity of the infectious process and specific treatment.

Intrauterine infection occurs as a result of transplacental, amniotic, ascending or descending infection. The spectrum of pathogens is diverse: bacteria, viruses, fungi, protozoa, mycoplasma, chlamydia, and combinations of pathogens. When an infection enters the body of a pregnant woman, pathological changes in the fetus and amniotic fluid structures can have varying degrees of severity, ranging from local to generalised.
Cytomegalovirus infection is a widespread infection in the human population, affecting 50 to 100% of the adult population. The infection leads to miscarriage, severe complications during pregnancy, birth of severely premature babies, birth of children with congenital malformations and internal organ pathologies, autism, further lagging in physical and mental development, and disability of children. Timely prevention of CMV infection before pregnancy and during pregnancy, compliance with hygiene standards,
knowledge of leading a healthy lifestyle, culture of sexual relations, methods of contraception and methods of preventing infection with sexually transmitted infections, rules for caring for disabled children and the elderly , identification and formation of risk groups among pregnant women regarding primary infection or recurrence of a chronic process, timely laboratory diagnosis of the activity of the infectious process and carrying out specific treatment - make it possible to bear a healthy child, give birth to a healthy generation, and, accordingly, for the country - to have a healthy nation.