Objective. To compare the protective effects of erythropoietin (EPO) and the antioxidant lazaroid U-74389G on ovarian pathology (OP). Materials and methods. This analysis was based on two preliminary experimental studies, each investigating one of the agents in an animal model of ovarian ischemia–reperfusion (IR). Female albino Wistar rats were randomly allocated into six groups (n = 10 per group). All animals were subjected to 45 min of induced ischemia, followed by reperfusion lasting either 60 or 120 min depending on the group. Groups A and B received placebo, groups C and D received EPO, and groups E and F received U-74389G. Ovaries were collected at 60 or 120 min of reperfusion. Outcomes were evaluated using histological criteria and biochemical markers of inflammation and oxidative stress, specifically tumor necrosis factor alpha (TNF-α) and malondialdehyde (MDA). Results. In the first preliminary study, EPO demonstrated a non-significant effect on total OP within the “lesion-free” grade (+0.0181818 ([-0.1288954 to +0.1652591]; p = 0.8037). In the second study, U-74389G significantly reduced total OP within the same grade (-0.1772727 ([-0.3208232 to +0.0337223]; p = 0.0169). Given that both studies were conducted under identical experimental conditions, a combined analysis was performed. This co-analysis revealed that EPO was less effective than U-74389G in improving OP, with a statistically significant difference in the “lesion-free” grade (-0.2833333 ([-0.0265021 to +0.5931687]; p = 0.0328). Measurements of TNF-α and MDA levels supported these findings. Conclusion. The lazaroid U-74389G exhibited a more pronounced protective effect than EPO in the ovarian IR model. This superiority was reflected in both histological findings and biochemical markers, although the degree of statistical significance varied. Key words: ischemia, erythropoietin, U-74389G, ovaries, reperfusion
Severe apical prolapse is often complicated by the development of decubitus ulcers on the cervix and/or vagina, which is associated with the risk of infection. This necessitates improving the methods of treatment in such patients, including both conservative and surgical approaches. This article presents a clinical case of organ preservation surgery performed in a 49-year-old patient with complete uterine prolapse, pelvic floor muscle dysfunction, and a long-standing non-healing decubitus ulcer on the ectocervix. The patient insisted on uterine preservation. A four-stage surgical program was developed and implemented to correct the identified pathology. It included partial removal of the cervix, hysterosuspension using a narrow tape-like titanium mesh implant, and reinforcement of the pelvic floor via transvaginal access. Key words: apical prolapse, decubitus ulcer, tape-like titanium mesh implant
Advanced telemedicine technologies enable remote cardiotocography (CTG) monitoring of the fetus, allowing patients to record data independently and send it to their physician for evaluation and clinical decision-making. This article presents two clinical cases of patients at high risk for perinatal complications who were diagnosed with intrauterine hypoxia using remote CTG. Conclusion. Remote CTG provides opportunities for personalized and optimized fetal monitoring, facilitates the timely detection of critical conditions, reduces the burden on inpatient facilities, and contributes to lower healthcare expenditures. Key words: intrauterine hypoxia, remote monitoring, fetal distress, cardiotocography, electronic fetal monitoring
Objective. To evaluate the efficacy of using the hyaluronic acid-carboxymethylcellulose anti-adhesion gel “Antiadhesin” during cesarean section (CS) in patients with uterine scars after previous abdominal delivery and/or myomectomy. Patients and methods. This prospective cross-sectional pilot study included 80 pregnant women with uterine scars following previous CS and/or myomectomy with entry into the uterine cavity. In 50 patients, the anti-adhesion gel “Antiadhesin” was administered during repeat CS. The comparison group consisted of 30 women who did not receive an adhesion barrier during стеabdominal delivery. All patients underwent an ultrasound examination at 2 and 6 months after CS to assess the presence of pelvic adhesions and the condition of the postoperative scar. Pain syndrome regression, time to patient mobilization, and the cosmetic appearance of the scar on the anterior abdominal wall were also evaluated. Results. Pelvic ultrasound in the postoperative period revealed a significant reduction in the incidence of adhesive pelvioperitonitis in patients who received the hyaluronic acid-carboxymethylcellulose gel during CS relative to the comparison group. In addition, these patients reported a more favorable postoperative recovery period and greater satisfaction with the cosmetic appearance of the post-CS scar. Conclusion. Adhesive pelvioperitonitis is one of the leading causes of chronic pain syndrome, reproductive function disorders, and complications in subsequent surgical interventions. Therefore, the use of effective anti-adhesion agents, capable of creating a temporary barrier and preventing tissue adhesion, represents an important strategy to improve surgical outcomes and preserve patients’ reproductive potential. In this pilot study, the hyaluronic acid-based anti-adhesion gel was used to prevent adhesive pelvioperitonitis in patients undergoing repeat CS. The study demonstrated clinically significant efficacy of intraoperative gel application in preventing postoperative adhesions in patients at high risk for this complication. Key words: cesarean section, uterine scar, ultrasound diagnosis, adhesive disease, anti-adhesion gel
Müllerian duct anomalies (MDAs) are congenital malformations caused by failure of embryonic development of the paramesonephric ducts. Uterus didelphys is one of the rarest forms, which results from complete non-fusion of both Müllerian ducts. The prevalence of this condition ranges from 0.1% to 3.5% in the general population, accounting for approximately 8% of all MDAs. This article presents a clinical case of uterus didelphys in a pregnant patient with completely symmetrical and functional reproductive organs. Key words: developmental anomaly, uterus didelphys, Müllerian ducts, pregnancy, cesarean section
