The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-0604
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2025
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Lyashko E.S.

Federal State Budgetary Educational Institution of the Higher Education «A.I. Yevdokimov Moscow State University of Medicine and Dentistry» of the Ministry of Healthcare of the Russian Federation

Arustamyan R.R.

Federal State Budgetary Educational Institution of the Higher Education «A.I. Yevdokimov Moscow State University of Medicine and Dentistry» of the Ministry of Healthcare of the Russian Federation

Saribekian A.S.

Municipal Clinical Hospital No.15 named after O.M. Filatov Department of Health of Moscow

Cavernous malformations of the brain and pregnancy

Authors:

Lyashko E.S., Arustamyan R.R., Saribekian A.S.

More about the authors

Journal: Russian Journal of Human Reproduction. 2023;29(6): 73‑80

DOI: 10.17116/repro20232906173

Read: 1737 times

Download PDF (RU)
Contact the author
Table of contents

CAVERNOUS MALFORMATIONS OF THE BRAIN AND PREGNANCY
CAVERNOUS MALFORMATIONS OF THE BRAIN AND PREGNANCY

To cite this article:

Lyashko ES, Arustamyan RR, Saribekian AS. Cavernous malformations of the brain and pregnancy. Russian Journal of Human Reproduction. 2023;29(6):73‑80. (In Russ.)
https://doi.org/10.17116/repro20232906173

Подписка 2026 Проблемы репродукции (Russian Journal of Human Reproduction)
 
МСФ на ЯМ
Использование инфографики авторами научных работ
Close metadata
Abstract:

Cavernous malformations of cerebral vessels are not often diagnosed during pregnancy. Currently, there are no unambiguous data on an increase in the incidence of clinical manifestations of CM in pregnant women. Treatment of cerebral CMs can be conservative with consistent imaging and follow-up. Also, microsurgical resection can be offered for CM, depending on the clinical situation. Radiosurgery is not used during pregnancy.

Keywords:

cavernous malformation
hemorrhage
pregnancy

Authors:

Lyashko E.S.

Federal State Budgetary Educational Institution of the Higher Education «A.I. Yevdokimov Moscow State University of Medicine and Dentistry» of the Ministry of Healthcare of the Russian Federation

Arustamyan R.R.

Federal State Budgetary Educational Institution of the Higher Education «A.I. Yevdokimov Moscow State University of Medicine and Dentistry» of the Ministry of Healthcare of the Russian Federation

Saribekian A.S.

Municipal Clinical Hospital No.15 named after O.M. Filatov Department of Health of Moscow

Received:

07.06.2023

Accepted:

20.06.2023

Close metadata

References:

  1. Tu T, Peng Z, Ren J, Zhang H. Cerebral Cavernous Malformation: Immune and Inflammatory Perspectives. Frontiers in Immunology. 2022;13:922281. https://doi.org/10.3389/fimmu.2022.922281
  2. Khattar NK, Adams SW, Schaber AS, et al. Endoscopic Endonasal Surgery for the Resection of a Cavernous Hemangioma with a Sellar Extension. Cureus. 2018;10(11):e3663. https://doi.org/10.7759/cureus.3663
  3. Li H, Zhang B, Wang W, et al. Clinical Features, Intradural Transcavernous Surgical Management, and Outcomes of Giant Cavernous Sinus Hemangiomas: A Single-Institution Experience. World Neurosurgery. 2019;125:e754-e763. https://doi.org/10.1016/j.wneu.2019.01.165
  4. Pandey SK, Mani SE, Sudhakar SV, et al. Reliability of Imaging-Based Diagnosis of Lateral Ventricular Masses in Children. World Neurosurgery. 2019;124:e693-e701. https://doi.org/10.1016/j.wneu.2018.12.196
  5. Li W, Sun Q, Duan X, et al. Etiologies and risk factors for young people with intracerebral hemorrhage. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2018;43(11):1246-1250.
  6. Negoto T, Terachi S, Baba Y, et al. Symptomatic brainstem cavernoma of elderly patients: timing and strategy of surgical treatment. Two case reports and review of the literature. World Neurosurgery. 2018;1(11):227-234.  https://doi.org/10.1016/j.wneu.2017.12.111
  7. Sazonov IA, Belousova OB. Cavernous malformation that caused the development of extensive acute subdural hematoma. Case study and literature review. Zhurnal Voprosy nejrohirurgii im. N.N. Burdenko. 2019;83(3):73-76. (In Russ.). https://doi.org/10.17116/neiro20198303173
  8. Sabayan B, Lineback C, Viswanathan A, et al. Central nervous system vascular malformations: A clinical review. Annals of Clinical and Translational Neurology. 2021;8(2):504-522.  https://doi.org/10.1002/acn3.51277
  9. Flemming KD, Lanzino G. Cerebral Cavernous Malformation: What a Practicing Clinician Should Know. Mayo Clinic Proceedings. 2020;95(9):2005-2020. https://doi.org/10.1016/j.mayocp.2019.11.005
  10. Dalyai RT, Ghobrial G, Awad I, et al. Management of incidental cavernous malformations: a review. Neurosurgical Focus. 201;31(6):E5.  https://doi.org/10.3171/2011.9.FOCUS11211
  11. Meador KJ, Pennell PB, May RC, et al; MONEAD Investigator Group. Changes in antiepileptic drug-prescribing patterns in pregnant women with epilepsy. Epilepsy and Behavior. 2018;84:10-14.  https://doi.org/10.1016/j.yebeh.2018.04.009
  12. Xie MG, Li D, Guo FZ, et al. Brainstem Cavernous Malformations: Surgical Indications Based on Natural History and Surgical Outcomes. World Neurosurgery. 2018;110:55-63.  https://doi.org/10.1016/j.wneu.2017.10.121
  13. Caton MT, Shenoy VS. Cerebral Cavernous Malformations. [Updated 2022 Oct 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Accessed October 24, 2023. https://www.ncbi.nlm.nih.gov/books/NBK538144/
  14. Clatterbuck RE, Moriarity JL, Elmaci I, et al. Dynamic nature of cavernous malformations: a prospective magnetic resonance imaging study with volumetric analysis. Journal of Neurosurgery. 2000;93(6):981-986.  https://doi.org/10.3171/jns.2000.93.6.0981
  15. Родич А., Смеянович А., Сидорович Р. и др. Современные подходы к хирургическому лечению кавернозных ангиом головного мозга. Наука и инновации. 2018;10(188):70-73. 
  16. Rodich A, Smeyanovich A, Sidorovich R, et al. Modern approaches to surgical treatment of cavernous angiomas of the brain. Nauka i innovacii. 2018;10(188):70-73. (In Russ.).
  17. Ene C, Kaul A, Kim L. Natural history of cerebral cavernous malformations. Handbook of Clinical Neurology. 2017;143:227-232.  https://doi.org/10.1016/B978-0-444-63640-9.00021-7
  18. Stapleton CJ, BarkerI FG. Cranial Cavernous Malformations. Natural History and Treatment. Stroke. 2018;49:1029-1035. https://doi.org/10.1016/B978-0-444-63640-9.00021-7
  19. Orlov KYu. Kavernoznye mal’formacii golovnogo mozga: Dis. ... kand. med. nauk. SPb. 2003. (In Russ.).
  20. Kurihara N, Suzuki H, Kato Y, et al. Hemorrhage owing to cerebral cavernous malformation: imaging, clinical, and histopathological considerations. Japanese Journal of Radiology. 2020;38(7):613-621.  https://doi.org/10.1007/s11604-020-00949-x
  21. Akers A, Al-Shahi Salman R, Awad I, et al. Synopsis of guidelines for the clinical management of cerebral cavernous malformations: consensus recommendations based on systematic literature review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel. Neurosurgery. 2017;80(5):665-680.  https://doi.org/10.1093/neuros/nyx091
  22. Tu J, Stoodley MA, Morgan MK, Storer KP. Ultrastructural characteristics of hemorrhagic, nonhemorrhagic, and recurrent cavernous malformations. Journal of Neurosurgery. 2005;103(5):903-909.  https://doi.org/10.3171/jns.2005.103.5.0903
  23. Karri SB, Uppin MS, Rajesh A, et al. Vascular malformations of central nervous system: A series from tertiary care hospital in South India. Journal of Neurosciences in Rural Practice. 2016;7(2):262-268.  https://doi.org/10.4103/0976-3147.176196
  24. Joseph NK, Kumar S, Brown RD Jr, et al. Influence of Pregnancy on Hemorrhage Risk in Women with Cerebral and Spinal Cavernous Malformations. Stroke. 2021;52(2):434-441.  https://doi.org/10.1161/STROKEAHA.120.031761
  25. Mouchtouris N, Chalouhi N, Chitale A, et al. Management of cerebral cavernous malformations: from diagnosis to treatment. Scientific World Journal. 2015;2015:808314. https://doi.org/10.1155/2015/808314
  26. Horne MA, Flemming KD, Su IC, et al; Cerebral Cavernous Malformations Individual Patient Data Meta-analysis Collaborators. Clinical Course of Untreated Cerebral Cavernous Malformations: A Meta-Analysis of Individual Patient Data. Lancet. Neurology. 2016;15:166-173.  https://doi.org/10.1016/S1474-4422(15)00303-8
  27. Garrett M, Spetzler RF. Surgical treatment of brainstem cavernous malformations. Surgical Neurology. 2009;72 (suppl 2):3-9.  https://doi.org/10.1016/j.surneu.2009.05.031
  28. Flemming KD, Link MJ, Christianson TJ, Brown RD Jr. Prospective hemorrhage risk of intracerebral cavernous malformations. Neurology. 2012;78(9):632-636.  https://doi.org/10.1212/WNL.0b013e318248de9b
  29. Flemming KD. Clinical Management of Cavernous Malformations. Curr Cardiol Rep. 2017;19(12):122.  https://doi.org/10.1007/s11886-017-0931-1
  30. Tian KB, Zheng JJ, Ma JP, et al. Clinical course of untreated thalamic cavernous malformations: hemorrhage risk and neurological outcomes. Journal of Neurosurgery. 2017;127(3):480-491.  https://doi.org/10.3171/2016.8.JNS16934
  31. Snellings DA, Hong CC, Ren AA, et al. Cerebral Cavernous Malformation: From Mechanism to Therapy. Circulation Research. 2021;129(1):195-215.  https://doi.org/10.1161/CIRCRESAHA.121.318174
  32. Hong T, Xiao X, Ren J, et al. Somatic MAP3K3 and PIK3CA Mutations in Sporadic Cerebral and Spinal Cord Cavernous Malformations. Brain. 2021;144(9):2648-2658. https://doi.org/10.1093/brain/awab117
  33. Retta SF, Perrelli A, Trabalzini L, Finetti F. From Genes and Mechanisms to Molecular-Targeted Therapies: The Long Climb to the Cure of Cerebral Cavernous Malformation (CCM) Disease. Methods in Molecular Biology. 2020;215(2):3-25.  https://doi.org/10.1007/978-1-0716-0640-7_1
  34. Zafar A, Quadri SA, Farooqui M, et al. Familial Cerebral Cavernous Malformations. Stroke. 2019;50(5):1294-1301. https://doi.org/10.1161/STROKEAHA.118.022314
  35. McDonald DA, Shi C, Shenkar R, et al. Lesions from patients with sporadic cavernous malformations harbor somatic mutationsin the CCM genes: evidence for a common biochemical pathway for CCM pathogenesis. Human Molecular Genetics. 2014;23(16):4357-4370. https://doi.org/10.1093/hmg/ddu153
  36. Jenny Zhou H, Qin L, Zhang H, et al. Endothelial Exocytosis of Angiopoietin-2 Resulting From CCM3 Deficiency Contributes to Cerebral Cavernous Malformation. Nature Medicine. 2016;22(9):1033-1042. https://doi.org/10.1038/nm.4169
  37. Haghighi A, Fathi D, Shahbazi M, et al. Mystery Case: Cutaneous Lesions in KRIT1-Associated Cerebral Cavernous Malformations. Journal of Neurological Sciences. 2013;334(1-2):97-101.  https://doi.org/10.1016/j.jns.2013.07.2518
  38. Li ZH, Wu Z, Zhang JT, Zhang LW. Surgical Management and Outcomes of Cavernous Sinus Hemangiomas: A Single-Institution Series of 47 Patients. World Neurosurgery. 2019;122:e1181-e1194. https://doi.org/10.1016/j.wneu.2018.11.015
  39. Jain R, Robertson PL, Gandhi D, et al. Radiation-induced cavernomas of the brain. AJNR: American Journal of Neuroradiology. 2005;26(5):1158-1162.
  40. Choquet H, Kim H. Genome-Wide Genotyping of Cerebral Cavernous Malformation Type 1 Individuals to Identify Genetic Modifiers of Disease Severity. Methods in Molecular Biology. 2020; 2152:77-84.  https://doi.org/10.1007/978-1-0716-0640-7_6
  41. Rustenhoven J, Tanumihardja C, Kipnis J. Cerebrovascular Anomalies: Perspectives from Immunology and Cerebrospinal Fluid Flow. Circulation Research. 2021;129(1):174-194.  https://doi.org/10.1161/CIRCRESAHA.121.318173
  42. Perrelli A, Retta SF. Polymorphisms in Genes Related to Oxidative Stress and Inflammation: Emerging Links with the Pathogenesis and Severity of Cerebral Cavernous Malformation Disease. Free Radical Biology and Medicine. 2021;172:403-417. 
  43. Konovalov AN, Belousova OB, Okishev DN, et al. Klinicheskie rekomendacii. Lechenie bol’nyh s kavernoznymi mal’formaciyami central’noj nervnoj sistemy. M. 2014. (In Russ.).
  44. Krylov VV, Dashyan VG, Mukha AM. Surgical treatment of ruptured cavernous malformations of the brain. Nevrologicheskij zhurnal. 2016;21(1):24-29. (In Russ.).
  45. Al Shammary M, Mahmmoud S, Sehar S, Abdulwahab Al Jabari. Pregnancy Outcomes Complicated with Cavernous Angioma: a Systematic Review. Open Access Journal of Neurology and Neurosurgery. 2019;11(3):555814.
  46. Merlino L, Del Pretea F, Titi L, Piccionia MG. Cerebral cavernous malformation: Management and outcome during pregnancy and puerperium. A systematic review of literature. Journal of Gynecology Obstetrics and Human Reproduction. 2021;50(1):101927. https://doi.org/10.1016/j.jogoh.2020.101927
  47. Zauberman H, Feinsod M. Orbital hemangioma growth during pregnancy. Acta Opthalmologica. 1970;48(5):929-933.  https://doi.org/10.1111/j.1755-3768.1970.tb08213.x
  48. Awada A, Watson T, Obeid T. Cavernous angioma presenting as pregnancy-related seizures. Epilepsia. 1997;38(7):844-846.  https://doi.org/10.1111/j.1528-1157.1997.tb01473.x
  49. Moriarity JL, Wetzel M, Clatterbuck RE, et al. The natural history of cavernous malformations: a prospective study of 68 patients. Neurosurgery. 1999;44(6):1166-1171.
  50. Robinson JR, Awad IA, Little JR. Natural history of the cavernous angioma. Journal of Neurosurgery. 1991;75(5):709-714. 
  51. Porter PJ, Willinsky RA, Harper W, Wallace MC. Cerebral cavernous malformations: natural history and prognosis after clinical deterioration with or without hemorrhage. Journal of Neurosurgery. 1997;87(2):190-197.  https://doi.org/10.3171/jns.1997.87.2.0190
  52. Pozzati E, Acciarri N, Tognetti F, et al. Growth, subsequent bleeding, and de novo appearance of cerebral cavernous angiomas. Neurosurgery. 1996;38(4):662-669. 
  53. Sabers A. Influences on seizure activity in pregnant women with epilepsy. Epilepsy and Behavior. 2009;15(2):230-234.  https://doi.org/10.1016/j.yebeh.2009.03.031
  54. Safavi-Abbasi S, Feiz-Erfan I, Spetzler RF, et al. Hemorrhage of cavernous malformations during pregnancy and in the peripartum period: causal or coincidence? Case report and review of the literature. Neurosurgical Focus. 2006;21(1):E12.  https://doi.org/10.3171/foc.2006.21.1.13
  55. Yamada S, Nakase H, Nakagawa I, et al. Cavernous malformations in pregnancy. Neurologia Medico-Chirurgica. 2013;53(8):555-560.  https://doi.org/10.2176/nmc.53.555
  56. Gross BA, Lin N, Du R, Day AL. The natural history of intracranial cavernous malformations. Neurosurgical Focus. 2011;30(6):E24.  https://doi.org/10.3171/2011.3.FOCUS1165
  57. Gazzaz M, Sichez J, Capelle L, Fohanno D. Saignements itératifs d’un angiome caverneux sous traitement hormonal [Recurrent bleeding of thalamic cavernous angioma under hormonal treatment. A case report]. Neurochirurgie. 1999;45(5):413-416. 
  58. Kaya AH, Ulus A, Bayri Y, et al. There are no estrogen and progesterone receptors in cerebral cavernomas: a preliminary immunohistochemical study. Surgical Neurology. 2009;72(3):263-265.  https://doi.org/10.1016/j.surneu.2008.09.014
  59. Kalani MY, Zabramski JM. Risk for symptomatic hemorrhage of cerebral cavernous malformations during pregnancy. Journal of Neurosurgery. 2013;118(1):50-55.  https://doi.org/10.3171/2012.8.JNS12241
  60. Simonazzi G, Curti A, Rapacchia G, et al. Symptomatic cerebral cavernomas in pregnancy: a series of 6 cases and review of the literature. Journal of Maternal-Fetal and Neonatal Medicine. 2014;27(3):261-264.  https://doi.org/10.3109/14767058.2013.809417
  61. Maor GS, Faden MS, Brown R. Prevalence, risk factors and pregnancy outcomes of women with vascular brain lesions in pregnancy. Archives of Gynecology and Obstetrics. 2020;301(3):665-670.  https://doi.org/10.1007/s00404-020-05451-3
  62. Maier S, Motataianu A, Bajko Z, et al. Pontine cavernoma haemorrhage at 24 weeks of pregnancy that resulted in eight-and-a-half syndrome. Acta Neurologica Belgica. 2019;119(3): 471-474.  https://doi.org/10.1007/s13760-019-01147-x
  63. Witiw CD, Abou-Hamden A, Kulkarni AV, et al. Cerebral cavernous malformations and pregnancy: hemorrhage risk and influence on obstetrical management. Neurosurgery. 2012;71(3):626-630.  https://doi.org/10.1227/NEU.0b013e31825fd0dc
  64. Burkhardt JK, Bozinov O, Nürnberg J, et al. Neurosurgical considerations on highly eloquent brainstem cavernomas during pregnancy. Clinical Neurology and Neurosurgery. 2012;114(8):1172-1176. https://doi.org/10.1016/j.clineuro.2012.02.040
  65. Zambrano MD, Miller EC. Maternal Stroke: an Update. Current Atherosclerosis Reports. 2019;21(9):33.  https://doi.org/10.1007/s11883-019-0798-2
  66. Miller EC, Leffert L. Stroke in Pregnancy: A Focused Update. Anesthesia and Analgesia. 2020;130(4):1085-1096. https://doi.org/10.1213/ANE.0000000000004203
  67. Porras JL, Yang W, Philadelphia E, et al. Hemorrhage Risk of Brain Arteriovenous Malformations During Pregnancy and Puerperium in a North American Cohort Stroke. Stroke. 2017;48(6):1507-1513. https://doi.org/10.1161/STROKEAHA.117.016828
  68. Tanaka H, Katsuragi S, Tanaka K, et al. Impact of pregnancy on the size of small cerebral aneurysm. Journal of Maternal-Fetal and Neonatal Medicine. 2017;30(22):2759-2762. https://doi.org/10.1080/14767058.2016.1262345
  69. van Beijnum J, Wilkinson T, Whitaker HJ, et al; Scottish Audit of Intracranial Vascular Malformations collaborators; Klijn CJ. Relative risk of hemorrhage during pregnancy in patients with brain arteriovenous malformations. International Journal of Stroke. 2017;12(7):741-747.  https://doi.org/10.1177/1747493017694387
  70. Bourjeily G, Paidas M, Khalil H, et al. Pulmonary embolism in pregnancy. Lancet. 2010;375(9713):500-512.  https://doi.org/10.1016/S0140-6736(09)60996-X
  71. Melchiorre K, Sharma R, Khalil A, Thilaganathan B. Maternal Cardiovascular Function in Normal Pregnancy: Evidence of Maladaptation to Chronic Volume Overload Hypertension. Hypertension. 2016;67(4):754-762.  https://doi.org/10.1161/HYPERTENSIONAHA.115.06667
  72. Xu Y, Song Y, Zhou X, et al. Case Report Pregnancy combined with epilepsy and cerebral cavernous hemangioma: a case report and literature review. International Journal of Clinical and Experimental Medicine. 2017;10(3):5705-5710.
  73. Mesbahi T, Tahrir Y, Guettabi K, et al. Management of a Cerebral Cavernoma During Pregnancy: Case Report. European Journal of Medical and Health Sciences. 2021;3(5):54-56. 
  74. Feske SK, Singhal AB. Cerebrovascular disorders complicating pregnancy. Continuum. 2014;20 (1 Neurology of Pregnancy):80-99.  https://doi.org/10.1212/01.CON.0000443838.95260.4b
  75. Li Ma, Shuo Zhang, Zongze Li, et al. Morbidity after Symptomatic Hemorrhage of Cerebral Cavernous Malformation. A Nomogram Approach to Risk Assessment. Stroke. 2020;51:2997-3006.
  76. James H, Bushnell CD, Jamison MG, Myers ER. Incidence and risk factors for stroke in pregnancy and the puerperium. Obstetrics and Gynecology. 2005;106(3):509-516.  https://doi.org/10.1097/01.AOG.0000172428.78411.b0
  77. Davie CA, O’Brien P. Stroke and pregnancy. Journal of Neurology, Neurosurgery, and Psychiatry. 2008;79(3):240-245.  https://doi.org/10.1136/jnnp.2007.116939
  78. Deutsch H, Jallo GI, Faktorovichand GI, Epstein F. Spinal intramedullary cavernoma: clinical presentation and surgical outcome. Journal of Neurosurgery. 2000;93(suppl):65-70.  https://doi.org/10.3171/spi.2000.93.1.0065
  79. Katayama Y, Tsubokawa T, Maedaand T, Yamamoto T. Surgical management of cavernous malformations of the third ventricle. Journal of Neurosurgery. 1994;80(1):64-72.  https://doi.org/10.3171/jns.1994.80.1.0064
  80. De Jong A, Benayoun L, Bekrar Y, et al. Anesthésie obstétricale chez des patientes porteuses de cavernomes cérébraux : à propos de deux cas [Obstetric anaesthesia in two patients with cerebral cavernomas: about two cases]. Annales Francaises d’Anesthesie et de Reanimation. 2012;31(7-8):635-637. 
  81. Samii M, Eghbal R, Carvalhoand GA, Matthies C. Surgical management of brainstem cavernomas. Journal of Neurosurgery. 2011; 95(5):825-832.  https://doi.org/10.3171/jns.2001.95.5.0825
  82. Dammann P, Jabbarli R, Wittek P, et al. Solitary sporadic cerebral cavernous malformations: risk factors of first or recurrent symptomatic hemorrhage and associated functional impairment. World Neurosurgery. 2016;91:73-80.  https://doi.org/10.1016/j.wneu.2016.03.080
  83. Elwatidy S, Jamjoom Z, Elgamal E, Abdelwahab A. Management strategies for acute brain lesions presenting during pregnancy: a case series. British Journal of Neurosurgery. 2011;25(4):478-487.  https://doi.org/10.3109/02688697.2010.550345
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.