V.A. Burlev^1,3, N.A. Il'yasova^1,3, E.D. Dubinskaya², A.S. Gasparov²

¹Federal State Institution «Research Center for Obstetrics, Gynecology and Perinatology» of Ministry of Healthcare and Social Development of Russian Federation, Moscow, Russian Federation; ²People's Friendship University of Russia, Department of Obstetrics, Gynecology and Reproductive Medicine, Moscow, Russian Federation; ³Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden

Background. The role of anti-inflammatory factors in adhesion formation has not yet been fully established.

Objectives. To evaluate the role of serum and peritoneal pro- and anti-inflammatory markers in patients with varying degrees of inflammatory pelvic adhesions.

Method. 60 patients were included in 1st group with stage 1-2 adhesions and infertility, 2nd group consisted of 110 patients with pelvic peritoneal adhesions of 3-4 stage and infertility. Diagnosis of adhesions was established by laparoscopy. The control group consisted of 20 healthy women who underwent laparoscopic tubal sterilization.

Results. The levels of IL-1α, IL-6, sgp130 in serum were significantly lower in controls vs both groups with adhesions. In the serum and in the peritoneal fluid IL-1α, IL-6, sgp130 were increased in atients with stage 3-4 compare to the 1-2 stage. Expression of IL-proinflamatornoy factors in peritoneum 1Rα, IL-6Rα, gp130 in patients with peritoneal adhesions 3-4 stage were significantly increased in relation to the stage of 1-2. At the same time, the expression of SOCS1 was (2.8 fold) significantly higher in patients with stage 1-2 compare to patients with stage 3-4 endometriosis.

Conclusion. We found imbalance in serum and peritoneal pro- and anti-inflammatory markers in patients with adhesion. Based on our data we have identified tree types of adhesions: with low prevalence proinflamatory reaction over antiinflamatoroy (type 1), with a high prevalence proinflamatonoy reaction over antiinflamatornoy (type 2) and the mixed type (type 3).

Key words: peritoneal adhesions, peritoneum, cytokines (page 12-19).

O.A. Gornykh², Yu.Yu. Tabakman¹, A.K. Bishtavi², K.T. Gogoladze¹,  A.M. Chabrov³,  A.Yu. Kostin³

¹Department of Obstetrics and Gynecology 1 MGMU, Moscow, Russian Federation; ²Department of Obstetrics and Gynecology MGMSU, Moscow, Russian Federation; ³Cancer Clinic №1 Department of Health, Moscow, Russian Federation

Background. When the diagnosis of atypical endometrial hyperplasia is based on the results of diagnostic curettage or aspiration biopsy of the endometrium, there is a chance that endometrial cancer will not be detected and it can influence approach to the patient.

Objectives. To analyze the results of pathology findings after hysterectomy in patients referred with diagnosis of atypical endometrial hyperplasia.

Method. Retrospective chart review. The pathology results of surgical treatment in 132 patients referred with diagnosis ofatypical endometrial hyperplasia for a period of 2005-2008 yr had been analyzed.

Results. Post-operative findings were: endometrial cancer - in 19%, atypical hyperplasia - in 35%, simple and complex hyperplasia - in 33%, atrophic endometrial changes - in 13% of patients. The tumor was within the endometrium in 5 patients, the superficial invasion of the myometrium (1-2 mm) were in 8 patients, invasion to half of the myometrium layer - in 9 patients, invasion for more than half of the myometrium -  in 3 patients.

Conclusion. Discrepancy between diagnostic and postoperative histological findings from patients with atypical hyperplasia is relatively high.  The approach to treatment of atypicalendometrial hyperplasia is under discussion.

Key words: atypical endometrial hyperplasia, endometrial cancer (page 20-23).

O.R. Grigoryan, E.N. Andreeva

FSBE «Endocrinological Research Center», Moscow, Russian Federation

Background. Combined hormonal contraceptives as a risk factor of venous thrombosis is well known in general population, but not in patients with diabetes mellitus type I.

Objectives. To study the effect of modern hormonal contraceptives on coagulation system in women with type 1 diabetes mellitus.

Method. Single-center, open label prospective parallel-group randomized controlled trial, conducted in 200 women with type 1 diabetes, divided into eight groups using different types and regiments of contraceptives and two control groups without intervention (22 women with type 1 diabetes and 28 healthy women).

Results. All hormonal contraception use was associated with statistically significant increase of antithrombin III activity. Combined oral contraception with ethinyl estradiol/drospirenone usage was associated with increased prothrombin time after 3 months (p=0.023) and 36 months of use, increased fibrinogen levels after 24 and 36 months (p<0.05 for both), increase in the proportion of platelets involved in aggregates (p=0.48) increase in intravascular platelet activation (p=0.023). The use of contraceptive with ethinyl estradiol/gestodene was associated with an increase of the amount of reactive platelets after 36 months (p<0.05). The 3-year follow-up of patients with type 1 diabetes without hormonal contraception showed increased activity of prothrombin III by 34.7% compared to healthy controls. There was shown that in women with diabetes blood lipids (total cholesterol, LDL-C) and intravascular platelet activation were largely correlated with the level of HbA1c % in the blood, rather than with the hormonal contraceptives use. The increasing of number of thrombocytes were related to HbA1c level.

Conclusion. Our data shows that the use of hormonal contraceptive regimens in women with type 1 diabetes play a role as a risk factor for venous thromboembolism in women with associated hyperlipidemia and/or hemostatic disorders.

Key words: diabetes mellitus, levonorgestrel-releasing intrauterine system, contraception, coagulation, fibrinolysis, venous thrombosis (page 24-32 ).

O.A. Fat'kina, E.V. Sibirskaya, I.V. Poddubnyy, T.M. Glybina

Moscow State University of Medicine and Dentistry, Department of Pediatric surgery and  Department of Reproductive Medicine and Surgery, Post-Graduate Education Faculty, Moscow, Russian Federation

Background. The prevalence of pelvic inflammatory disease in combination with appendicitis  (appendicular-genital syndrome) in a pediatric patient is not known and approach is not well established.

Objectives. To evaluate the prevalence and clinical features of appendicular-genital syndrome in girls and develop an algorithm for diagnosis and treatment.

Method. Retrospective chart review of 1833 cases of girls operated for acute abdominal surgical emergency over the 15-year period (from 1997 to 2013) in Izmailovo Children's Clinical Hospital, Moscow.

Results. The incidence of combined appendicular-genital syndrome was 6% (84 patients) from the total number of cases. There were following main clinical findings related to patients withappendicular-genital syndrome: in 30 (35.7%) patients - history of menstrual irregularities, in 9 (10.7%) - history of functional ovarian cysts, in 4 (7.6%) - history of PID, body temperature was - 37.4±0.08, white blood cells - 14.8±0.53, nausea - 44 (52.4%), vomiting - 34 (40.5%) cases, pain was localized in the right iliac region - in 50 (59.5%), in suprapubical area -35 (41.7%), in periumbilical area - 27 (32.1%), and in the left iliac region - 11 (13.1%), peritoneal signs were found in 37 (44.1%) patients, symptoms related to inflammatory disease of internal reproductive organs found in 26 (36.1%). Intraoperative findings were: primary changes of the appendix were found in 42 (50%) cases, the primary changes of adnexa in 13 (15.5%) cases. Secondary changes in adnexa and appendix related to idiopathic pelvioperitonitis were discovered in 29 (34.5%) patients. Catarrhal inflammation of the appendix was detected in 9 (10.7%) cases, appendicular abscess in 16 (19.1%) cases, empyema of the appendix in 1 (1.2%) case, gangrenous form in 8 (9.5%) cases, gangrenous form associated with perforation, in 8 (9.5%) cases. Typical location appendix was found in 35 (41.7%) cases, the location of the appendix in the pelvic cavity - 33 (39.3%) cases, right adnexal involvement was detected in 36% of cases, the left - in 4% of cases, bilateral involvement was found in 60% of cases. For  appendicular form Escherichia coli (42.9%) was commonly prevalent, in genital form - hemolytic Staphylococcus aureus (38.5%), in idiopathic form - Staphylococcus epidermidis (20.7%) and Klebsiella pneumonia (17.2 %).

Conclusion. The prevalence appendicular-genitalsyndrome is relatively common. Clinical features related to this pathology allowed us to distinguish few forms of this pathology, depending on the primary inflammatory location  and propose diagnostic and treatment algorithm.

Key words: appendicitis, pelvic inflammatory disease, pediatric patient (page 33-40).

 E.D. Dubinskaya¹, A.S. Gasparov¹, T.A. Fedorova², N.V. Lapteva¹

People's Friendship University of Russia, Moscow, Russian Federation; ²Federal State Institution «Research Center for Obstetrics, Gynecology and Perinatology» of Ministry of Healthcare and Social Development of Russian Federation, Moscow, Russian Federation

Background. Family studies of endometriosis indicate that close relatives of patients with endometriosis have an increased risk for the disease, suggesting that genetic components perhaps contribute to endometriosis. The role of allelic variants of the human NAT2 gene needs to be evaluated.

Objectives. To determine whether a gene allelic variant of NAT2 is associated with peritoneal endometriosis.

Method. Nighty female patients with peritoneal endometriosis diagnosed by laparoscopy were recruited into this study. 

Results. We have identified a mutation in an allelic variants of NAT2 gene in 75.6% of patients with infertility and peritoneal endometriosis, which exceeds the average rate in the population. In the group of patients who did not achieve pregnancy the presence of heterozygous variants of c.341T>C, c.481C>T, c.590G>A and c.803A>G were 73.2, 73.2, 5.4 and 62.5% respectively. Comparison of allelic polymorphism at different stages of endometriosis showed no significant differences, however, the presence of tree or more "mutant" homozygous allelic variations were significantly higher for stage 3-4 endometriosis patients.

Conclusion. NAT2 gene polymorphism could be used as an additional criteria for predicting the effectiveness of infertility treatment in women with peritoneal endometriosis.

Key words: infertility, endometriosis, polymorphism gene NAT2 (page 41-46).

E.M. Ayzyatulova

Scientific Research Institute of Medical and Social Family Problems DNMU, Donetsk, Ukraine

Background. Vasopressin analog Terlipressin use is the most effective approach for the management of hepatorenal syndrome. Hepatorenal syndrome and ovarian hyperstimulation syndrome shares a common clinical sign, which is ascites, although the underlying mechanism is different; we suggest that terlipressin could be used for OHSS prevention.

Objectives. This study was designed to evaluate the effects of terlipressin use on OHSS prevention in a rodent model of OHSS.

Method. Mice were divided into tree groups - one was a control group (n=5) with no intervention and two experimental (1^st group n=12, 2^nd group=15). The animals in a control group were at the stage of estrus, which corresponds to the spontaneous ovulation. Animals in both experimental groups received a hormonal stimulation with gonadotropins - 20 IU of pregnant mare serum gonadotropin (PMSG) and after 48 hours - 20 IU of human chorionic gonadotropin (hCG). Additionally animals from second experimental group received terlipressin 4.8 mg immediately after hCG administration and 3 hours after.

Results. Ovarian stimulation with our protocol led to the development of several OHSS symptoms features: swelling of the ovaries, increase in their size, hyperemia and presence of hemorrhagic follicles as compared to control. On the sixth day of observation in the group of animals treated with terlipressin there was reduction in ovarian size comparable to control group and morphological improvement in ovarian parenchyma, which was not observed in animals who did not received terlipressin.

Conclusion. It was shown that terlipressin administration in mice model of OHSS provides marked therapeutic action and accelerates ovary recovery rate and folliculogenesis restoration. The possible mechanism of terlipressin action is to be considered.

Key words: ovarian hyperstimulation syndrome, terlipressin, glipresin, mouse (page 47-52).

N.B. Dmitrieva, S.A. Yakovenko, V.P. Apryshko, S.Yu. Nshanyan

In vitro Fertilization Clinic Altra Vita, Moscow, Russian Federation

Background. In general there is no evidence of a significant difference between depot and daily GnRH use for pituitary down regulation in IVF cycles using the long protocol, but the data on depot gonadotropin-releasing hormone agonist use in an oocyte donor programs is insufficient.

Objectives. To evaluate the results of depot gonadotropin-releasing hormone agonist use (Buserelin depot) in an oocyte donor programs performed for late reproductive age patients and women with diminished ovarian reserve.

Method. Retrospective chart review of forty-eight IVF cycles with donor oocytes. Ovulation stimulation protocol with recombinant FSH (rFSH) and GnRH agonist (Buserelin depot), the dose of 225 IU of rFSH has been used.

Results. The number of oocytes retrieved were 14.9±6.2, the number of mature oocytes - 12.6 (83.9%), immature oocytes - 2.1 (11.0%), degenerative oocytes per retrieval - 0.7 (3.2%), fertilization rate - 76.6%, blastocyst rate - 45.2%, embryos transferred - 1.6±0.7, pregnancy rate per embryo transfer - 51.4% with 14.3% of multiple gestation, number of embryos appropriate for cryopreservation - 63.2%.

Conclusion. Depot gonadotropin-releasing hormone agonist use for an oocyte donor programs showed sufficient pregnancy rate in a group of late reproductive age patients and women with depleted ovarian reserve.

Key words: in vitro fertilization (IVF), oocyte donation, gonadotropin releasing hormone agonist, Buserelin depot (page 53-54).

T.V. Blashkiv, A.A. Shepel, T.Y. Voznesenskaya

Bogomoletz Institute of Physiology NASU, Kiev, Ukraine

The development of an accurate method for selection of high-quality embryos is essential to achieve high pregnancy rates. The cumulus cells have several functions in the ovary, mediating transmission of endocrine signals and supporting oocyte growth and maturation. Cumulus cells reflect the characteristics of the oocyte, providing a noninvasive ways to assess oocyte quality. Our review shows that current data on gene expression by cumulus cells is a promising field in identification of oocyte and embryo quality.

Key words: cumulus cells, gene expression, oocyte, embryo (page 55-58).

M.V. Ekimova¹,  E.A. Teplyashina¹, A.B. Salmina¹, S.A. Arutyunyan², E.A. Pozhilenkova¹, A.V. Petropavlovskiy², A.V. Avdeenko²

¹Krasnoyarsk State Medical University named after Professor V.F.Voino-Yasenetsky, Krasnoyarsk, Russian Federation; ²Siberian State Technological University, Krasnoyarsk, Russian Federation

Background. Follicular fluid composition determines the oocyte quality and influences the outcome of ART programs. It was suggested that several follicular hormones, growth factor could be related to IVF effectiveness.

Objectives. To identify the relationships of follicular hormones and growth factors with IVF outcome in patients with endocrine infertility.

Method. Follicular fluid  (FF) collected from 169 follicles at different developmental stages from hyperandrogenic patients (n=65), patients with hyperprolactinemia (n=59) and woman with regular cycle (n=45) undergoing IVF.

Results. We found few statistically significant correlation of FF hormones and growth factors with IVF outcomes. For control group: E2 level was correlated to normal fertilization rate (r=–0.39), EGF was correlated to embryo number (r=0.33). For patients with hyperprolactinemia: IGF-1 and testosterone were correlated to normal fertilization rate (r=0.35, r=–0.28 respectively), EGF to embryo number (r=–0.35), TGF-β and endothelin-1 to implantation rate (r=–0.15, r=–0.31 respectively),TGF-β to implantation rate (r=–0.15). For hyperandrogenic women: bFGF and TGF-β were correlated to cumulative embryo score (Gardner) (r=0.56; r=0.82 respectively), endotelin-1 was correlated to implantation rate (r=–0.56).

Conclusion. We have identified several regulatory molecules that were related to normal and pathological stages of folliculogenesis (Е2 and EGF for normal folliculogenesis; IGF-1, EGF, testosterone, TGF-β, endothelin-1, for hyperprolactinemia; bFGF, TGF-β, endothelin-1 – for women with hyperandrogegism).

Key words: endocrine infertility, folliculogenesis, oocytes quality, growth factors (page 59-64).

E.F. Galimova

Bashkir State Medical University, Ufa, Russian Federation

Background. There is some data that serum adipokines could be transferred into or expressed in the male reproductive tract and could have a direct or indirect influence on the maturation and functionality of spermatozoa, but the exact role of leptin and adiponectin in the regulation of spermatogenesis is not clear.

Objectives. To evaluate the levels and relationships of leptin and adiponectin in semen and serum on semen quality in men suffering from idiopathic infertility, compare to controls.

Method. Prospective controlled study. There were three groups: 30 infertile men without significant changes in sperm, 46 infertile men with pathospermia and 26 fertile controls.

Results. Both groups of infertile man demonstrated statistically significant lower levels of adiponectin in sperm and serum (p<0.05 for both) and its negative correlation with the number of pathological forms and sperm concentration (r=–0.43; p<0.01 and r=–0.52; p<0.005 , respectively); there were also increased leptin concentrations in the semen of infertile men (2.6 times higher in the group with normal spermogram and 2.8 times higher in the group with pathospermia) compared to control group. In the group with pathospermia there was negative correlation of leptin with the level of adiponectin (r=–0.48; p<0.01) and sperm concentration (r=–0.54; p<0.01). In the group of infertile men the adiponectin / leptin ratio was decreased in sperm and serum compare to controls.

Conclusion. Adipokine imbalance found in sperm and serum of men suffering from idiopathic infertility is related to semen quality.

Key words: leptin, adiponectin, infertility, ejaculate, serum (page 65-67).

I.N. Gorenko, E.V. Tipisova

Arkhangelsk Scientific Center, RAS Ural Branch; Institute of Environmental Adaptation Physiology, Arkhangelsk, Russian Federation

Background. Serotonin, which exhibits rhythmic secretion profile, is sensitive to increases and decreases in the day length and can influence other endocrine functions related to reproduction. Males living in polar regions could have several specific characteristics of hormonal secretion, which have to be evaluated.

Objectives. To identify specific features of the endocrine system functioning related to reproduction in males living in the polar and sub - polar latitudes.

Method. There were 149 men from two Northern regions were studied: 97 men in Arkhangelsk (sub-polar regions) and 52 men from Nesh (polar region), they were divided into three age groups: group 1 - 22-35 years (n=54 and 17, respectively), group 2 - 36-45 years (n=22 and 13, respectively), group 3 - 46-60 years (n=21 and 22 respectively).

Results. It has been shown the absence of age-related dopamine dynamics with lowering the fluctuation limits at the age of 46-60 years in men from Arkhangelsk. Men aged 46-60 years from Nesh demonstrated increase in sex hormone binding β-globulinand FSH levels and offset of dehydroepiandrosterone sulfate fluctuation limits to lower-normal range. There were positive correlation of the dopamine level with the levels of estradiol and sperm antibodies in men from Arkhangelsk (r=0.26; p=0.024; r=0.33; p=0.002 respectively) and the negative correlation of the dopamine level with the levels of free testosterone and sex hormone binding β-globulin in men from Nesh (r=–0.34; p=0.047;r=–0.31; p=0.07 respectively).

Conclusion. There were several specific endocrine features related to secretion/relationships of dopamine, estradiol, FSH, androgens, sex hormone binding β-globulin identified in males living in the polar and sub-polar regions.

Key words: dopamine, northern regions, testosterone (page 68-73).

N.V. Ivanov, N.V. Vorokhobina

North-Western State Medical University named after I. I. Mechnikov, Scientific Institute of Endocrinology, Department of Endocrinology and Reproduction, St. Petersburg, Russian Federation

Background. It has been suggested that acetyl-carnitine may serve several potential functions in sperm, such as transporting medium- and long-chain fatty acids into the mitochondria for metabolism, maintaining a proper acetyl-CoA:free CoA ratio by buffering excess acetyl-CoA, serving as a storage medium for acetyl groups which may then be used as an energy source, and serving as an antioxidant.

Objectives. To determine the effect of oral carnitine supplementation on the semen parameters: concentration, morphology and motility.

Method. Observational study of 43 men with infertility and asthenozoospermia varying severity who receive acetyl-L-carnitine (1,000 mg per day) for a period of 3 months. The basic parameters of the ejaculate criteria were evaluated in accordance with WHO criteria.

Results. There was no significant influence on sperm density and morphology, but Acetyl-L-carnitine supplementation demonstrated improvement in sperm motility. The amount of sperm category A was increased from 11±5% before treatment to 16±6% after treatment, p=0.004, for category B increase was from 13±7 to 19±12% before and after therapy, p=0.005, for category C increase was from 6±4% before treatment to 13±6 % after 3 months of treatment, p=0.004. Six spontaneous pregnancies occurred during follow up period (6 month), 4 pregnancies after in utero insemination and ten patients were referred to IVF clinics.

Conclusion. Acetyl-L-carnitine supplementation (1,000 mg per day) demonstrated improvement in sperm motility, in men with idiopathic asthenozoospermia.

Key words: male infertility, asthenozoospermia, carnitine, acetyl-L-carnitine (page 74-76).

A.S. Galkina, A.B. Van, K.R. Nekrasova, E.M. Dzhobava, U.E. Dobrokhotova 

The Russian National Research Medical University named after N.I. Pirogov, Department of Obstetrics and Gynecology №2, Moscow, Russian Federation

Preterm delivery is the main cause of perinatal and neonatal mortality and morbidity. Over the past 40 years, numerous treatments and diagnostic tests have been proposed to prevent preterm labor. This article reviews the literature on diagnostic approach and tocolytic therapy in patients with threatening premature labor.

Key words: preterm labor, tocolytic therapy, diagnosis of preterm labor (page 77-81).

A.M. Torchinov, M.M. Umakhanova, G.L. Doronin, G.N. Dzhonboboeva, M.G. Ron

Moscow State University of Medicine and Dentistry, Department of Obstetrics and Gynecology, Faculty of Dentistry, Moscow, Russian Federation

Background. The results of inpatient treatment withcombined therapy for the first trimester retrochorial hematoma in patients with pregnancy loss is not well studied.

Objectives. To evaluate the effect of combination therapy in conjunction with inpatient treatment for the first trimester retrochorial hematoma for patients with recurrent pregnancy loss and to study pro-inflammatory serum cytokines activity compare to controls.

Method. Intervention group consisted of 100 pregnant women with retrochorial hematoma and control group of 60 women with normal pregnancy at the same gestational age. Gestational age ranged from 4 to 13th week of pregnancy. Combined therapy included the use of Valeriana extract or motherwort, magnesium sulfate, Drotaverine or papaverine, dydrogesterone or micronized progesterone for 4 weeks.

Results. The combined inpatient therapy was associated with 7% spontaneous miscarriage rate, 11% moderate abdominal pain, 2% genital bleeding, 4% combination of two symptoms, 14% - hematoma with symptoms of regression, 5% - persistent hematoma. Comparative analysis showed that persistent hematoma was more common in patients with its initially large diameter. Before treatment the levels of IFN-α, IFN-γ, IL-2 were increased in patients with retrochorial hematoma compare to controls (p<0.001) and the levels of IL-4 and IL-10 were decreased to 2.5 and 2.7 times respectively (p<0.001 for both).  After the treatment levels of Il-2 and IFN-α, IFN-γ were significantly reduced (p<0,001) compare to before treatment levels, and levels of IL-4 IL-10, increased to 2.6 and 2.8 times respectively (p<0.001).

Conclusion. The combined inpatient therapy for the first trimester retrochorial hematoma in patients with pregnancy loss is associated with an improvement in clinical symptoms and pro-inflammatory activity in most of patients. 

Key words: retrochorial hematoma, pregnancy miscarriage, first trimester of pregnancy, Doppler, ultrasonography (page 82-86).

N.A. Shakhbazova

Scientific-research Institute of Obstetrics and Gynecology of the Azerbaijani Republic, Baku, Azerbaijan

Background. Hypertensive disorders of pregnancy are complex and unresolved problems of modern obstetrics. The role of PGF in placental function has been extensively studied in recent years.

Objectives. To evaluate the significance of PlGF in the genesis of placental insufficiency in hypertensive disorders of pregnancy. 

Method. This case control study was performed in 231 pregnant woman, 1st group consisted of 106 pregnant women with hypertensive disorders (basic group I), 2nd group consisted of 105 pregnant women with risk factors for preeclampsia at 20-24 weeks gestation (basic group II), there were 20 healthy pregnant women at the same gestational period in a control group.

Results. We found that hypertensive disorders in pregnancy were associated with 4 fold PIGF decrease as compared to control group. Severity of hypertensive disorders was inversely associated with the level of PlGF in the blood in pregnant women. Patients with hypertensive disorders and placental insufficiency associated with intrauterine growth retardation had minimal PIGF concentrations. Blood levels of PlGF were prognostic for pre-eclampsia in a range within 50-100 pg/ml and for combination of fetal IUGR with pre-eclampsia were PlGF levels up to 50 pg/ml, for the risk factors - the most significant were obesity, multiple pregnancy and associated non-gynecological maternal disorders. Prognostic significance of PlGF levels in the blood for pre-eclampsia, placental insufficiency and IUGR fetus was 87.1 % and - 67.7% for gestational hypertension.

Conclusion. PlGF could be used as a prognostic factor for placental insufficiency in hypertensive disorders during gestation.

Key words: pregnancy, hypertensive disorders, PIGF, placental insufficiency (page 87-91).

E.E. Grodnitskaya, A.A. Grabovskaya, O.A. Latyshkevich

Family Planning and Reproductive Health Center, Governmental Budget Institution of Moscow City Healthcare Department, Moscow, Russian Federation

Background. Monoamine neurotransmitters seems to be involved in the pathophysiology of hot flushes in postmenopausal women, and folic acid (FA) was found to interact with its receptors.

Objectives. To evaluate the effect of FA supplementation on hot flushes in postmenopausal women.

Method. Prospective controlled study. Forty menopausal women were divided into 2 groups (n=20 each): treatment and control. Treatment group received FA 5mg daily for 30 days and control group received no treatment.

Results. FA supplementation was associated with 49,6% reduction in the number of hot flushes by day 30. There were reported 13.9±5.1 hot flushes before treatment and 7.1±3.9 after treatment completion (p<0.05). No reduction was observed in a control group.

Conclusion. FA supplementation may cause subjective improvement of hot flushes.

Key words: folic acid, hot flushes, postmenopausal women (page 92-94).