Статья посвящена важнейшему разделу перинатологии — развитию головного мозга плода, правильное формирование которого является залогом нервно-психического здоровья в дальнейшей жизни ребенка и взрослого человека, во многом определяя его когнитивные и интеллектуальные способности. Представлен обзор новейших мировых исследований основных процессов нейрогенеза и кортикогенеза (пролиферация и миграция нейронов, их спецификация и дифференцировка, цитоархитектоническое объединение нейронов, образование нейронных сетей и связей, синаптогенез, устранение избыточных элементов клеток и апоптоз, пролиферация и дифференцировка глиальных клеток, миелинизация). Подчеркнуто, что интенсивность гистогенетических событий варьирует в разные сроки беременности, во время которых развивающийся мозг плода характеризуется повышенной уязвимостью к воздействию неблагоприятных эндогенных и внешних факторов. Приведены клинические примеры, демонстрирующие, что нарушение пренатальной программы развития мозга плода, в том числе ятрогенного генеза, могут быть основой неврологических и психоневрологических заболеваний в последующей жизни человека. Представленная в статье информация должна учитываться при планировании терапевтических и хирургических вмешательств во время беременности.

This publication is devoted to the most common problem in women of reproductive age - dysmenorrhea. Unfortunately, the underestimation of the importance of dysmenorrhea often occurs on the part of both patients and doctors. Meanwhile, dysmenorrhea causes not only a decrease in the quality of life, but also a number of serious disorders, including the risk of developing endometriosis, adenomyosis and even tumorous diseases. With such articles as prevention and prevention of diseases.

This publication examines the existing risks of obstetric complications and other reproductive disorders in women with gynecological diseases. The paper also discusses the issues of the pre-school training of women with gynecological diseases, with special emphasis on the use of dipyridamole, due to its pleiotropic action.

Morphofunctional state of the endometrium is one of the key factors determining both the successful implantation and full development of the embryo, including in cycles of «in vitro fertilization» (IVF). The most common cause of the impairment of the structure and function of the endometrium being chronic endometritis (CE), the frequency of its detection in infertile patients varies between 13 and 68%, reaching its maximum in women with tubal peritoneal factor and unsuccessful attempts of IVF in the anamnesis. The increasing prevalence and steady growth of the currently occurrence rate of CE cases in infertility is promoted by an increase in the role of intrauterine contraception and intrauterine interventions, including artificial abortions. On the other hand, happened in the last decades the evolution of the etiologic factor of CE towards the predominance of associations of facultative and obligate anaerobic microorganisms and viruses in the endometrium often leads to the development of erased, sluggish and atypical forms of the disease, which significantly hamper the diagnosis of CE and significantly reduce the effectiveness of traditional schemes of its treatment. CE is a clinically significant nosological form requiring the timely detection and treatment. The complex phased and pathogenetically substantiated therapy of CE in most cases leads to the restoration of the morphofunctional potential of the endometrium and, as a consequence, promotes the successful realization of the reproductive function.

The article focuses on the identification of causal relationships between dysmenorrhea, endometrioid and tumor processes. Studies have shown that dysmenorrhea, apart from a decline in the quality of life, can be the cause of development of a number of serious health disturbances, including endometriosis, adenomyosis and even tumoral diseases. Non-steroidal anti-inflammatory drugs are not only the effective means of therapy for dysmenorrhea patients, but also a pathogenetically reasonable approach to prevent the outbreak of the disease.

The aim of the study is to identify the most significant clinical and anamnestic risk factors for the onset and progression of endometrial hyperplastic processes and the development of malignant transformation of endometrium in women of perimenopausal age, with taking into account their importance on the basis of statistical analysis. Methods. Based on Spearman’s correlation analysis and determination the degree of dependence of the development of endometrial cancer (from 0 to 1) on clinical-anamnestic and diagnostic risk factors (risk ratio (RR) in groups), there were obtained coefficients for a mathematical model allowing with the use of the binary logistic regression method predict the risk of the appearance of endometrial cancer. Results. The most clinically and statistically significant risk factors for the progression of the pathological process of the endometrium, having a high RR (greater than 1) and a confidence interval of 95% (p < 0.05), are (in the order of significance): recurrence of the endometrial hyperplastic process, obesity, the pronounced blood flow in Ultrasound with color Doppler mapping, polycystic ovary syndrome, abnormal ovarian formations, infertility (primary and secondary), type 2 diabetes mellitus, combined uterine pathology (myoma and/or adenomyosis), hereditary predisposition to cancer development, hypertension, age of 50 years and older. Conclusion. The tactics of the management and treatment of patients with hyperplastic endometrial processes should be based on the detection of the degree of the risk of the progression of pathological processes and the development of the malignant transformation of the endometrium. The study of the individual prognosis of endometrial cancer in patients with hyperplastic endometrial processes currently is becoming increasingly important due to the need to construct a rational treatment plan of the management and performing the follow-up dispensary observation on the basis of a scientifically justified forecast. Results obtained during our work allowed us identify statistically significant risk factors for the development of endometrial cancer. There were obtained coefficients for the creation a reliable mathematical model. With the use of the method of binary logistic regression, it is possible to calculate the risk of developing cancer and choose an effective management tactic for patients with hyperplastic endometrial processes at the perimenopausal age.

The article is devoted to the subject of topical interest to women of reproductive age. Affecting not only the health of women, but also various aspects of their life, dysmenorrhea is a medical and social problem. The use of nonsteroidal anti-inflammatory agents in this condition is an effective means of pathogenetic therapy that significantly improves the quality of life of women.

This publication is devoted to one of the most relevant areas of gynecological practice - menopausal hormone therapy. The information is presented in the form of an analytical review of international studies on the benefits and risks of menopausal hormone therapy. Given the rapid growth in the number of women in middle and middle age, it is extremely important to identify the benefits and risks of menopausal therapy in order to optimize the quality of life and long-term well-being.

The article is devoted to the subject of topical interest to women of reproductive age. Affecting not only the health of women, but also various aspects of their life, dysmenorrhea is a medical and social problem. The use of nonsteroidal anti-inflammatory agents in this condition is an effective means of pathogenetic therapy that significantly improves the quality of life of women.

The objective of current research was to study clinical-anamnestic characteristics in women with benign and precancerous processes in uterine cervix with combined uterine pathology (myoma, adenomyosis, endometrial hyperplasia and benign processes in uterine cervix). The results demonstrate that changes in uterine cervixes are more frequent in patients with combined uterine diseases compared with patients with monopathology.

We have identified risk factors and determined their significance and relative risk in endometrial oncotransformation based on mathematical analysis of clinical and anamnestic data and molecular-biological indicators. The structural, functional and molecular mechanisms of hyperplastic processes of endometrium in premenopausal women were investigated based on a complex immunohistochemical studies. Our study revealed the features of the expression of tumor suppressor gene PTEN and the marker of tight junctions Claudin 3 and the proliferation marker Ki-67 in epithelial and stromal components based on morphological variant of the pathological process of the endometrium.We have performed a comparative analysis of clinical, morphological and molecular biological studies and as a result suggested a new approach to the study of endometrial hyperplastic processes in premenopausal women, that helps to detect women with increased risk of endometrial oncopathology and gives opportunity to perform pathogenetically based approach to therapy.

One of the commonest forms of genital endometriosis is the ovarian endometriotic lesion. The main treatment step, surgical intervention, may promote endometriosis progression if performed non-radically. Analysis of clinical particulars of disease in two comparison groups. The clinical particulars of disease were studied on 139 patients divided into 2 groups: the first group (41 females) comprised patients with repeated hospitalization due to recurrent endometriotic cysts at the backdrop of conducted anti-relapsing therapy. The second group included 98 patients hospitalized with newly diagnosed endometriotic cyst, and in whom after surgical treatment, there was no recurrence during 2-3 years after surgery. For evaluation of recurrence risk, 10 criteria have been assessed: the immunohistochemical parameters, such as CD-95; Ki-67; CD-34; ММР-7; TIMP-1; EGF; the level of circulation using color Doppler mapping; diagnosed peritoneal endometriosis; presence of microfocal ovarian endometriosis and intensity of clinical manifestations. Should 3 or less signs be present, this was defined as the low rate of risk of recurrence, and in case of 4, 5 or 6 signs present, this was defined as the moderate rate of risk of recurrence. In case of high recurrence rate, the post-operation therapy was conducted using hormonal drugs (GnRh-A for 6 months). In case of moderate rate of risk the administration of a variant of hormonal therapy was decided upon individually. In case of low recurrence rate, the combination oral contraceptives were administered aimed at prophylaxis of recurrence. The results of investigation confirm that studying of individual prognosis of recurrence in patients with ovarian endometriotic cysts is gaining an increasingly greater significance owing to the necessity to draw up a rational plan of differential approach to treatment based on scientifically substantiated prognosis

Clinical morphological changes causing development of hyperplastic processes of endometrium are reviewed, According authors assumptions genetic modifications may have place in development of malignant processes in women reproductive system (e.g. endometrium cancer, cervical dysplasia etc.). Specific moleculas markers or their combination can evaluate the prognosis of disease development, facilitate optimal treatment tactics and new therapeutical agents development.

In this work, we studied molecular-biological factors leading to cervical cancer. The clinicopathologic characteristics and immunohistochemical features of 185 patients with cervical pathologies associated with human papillomavirus infection were examined. Immunohistochemical features analyzed included histone deacetylases (HDAC1, HDAC2) and DNA methyltransferases (DNMT1, DNMT2). Strong correlations of these factors with cervical pathologies including malignancies were identified.

This paper presents the clinical and morphological variants of adenomyosis, reflecting the clinical features of disease caused by regular features of molecular-biological processes involved in the development of endometriosis disease, which implies a differentiated approach to the treatment of adenomyosis, depending on the variant of the disease.