The aim of the study was to elucidate the effects of the different methods of intra and postoperative analgesia on functional status of hemostatic system in patients undergoing surgical treatment of uterine fibromyoma. 75 patients aged 35-55 years were examined by the instrumental method of hemocoagulography. The study included four stages: before surgery, one hour after surgery, the first and the third postoperative days. The method of analgesia was selected depending on the type of initial hemostatic dysfunction (hypocoagulation or hypercoagulation). Patients with hypocoagulation underwent general anesthesia while patients with hypercoagulation had epidural anesthesia. Analysis of data revealed that parameters of the hemostatic system after surgery in women with initial hypocoagulation were similar to those in control group. Improvement in parameters of hemostatic system was found in patients with initial hypercoagulation. Both groups of patients underwent multimodal and continuous epidural analgesia in postoperative period. All examined parameters of the hemostasis system remained normal in patients who underwent multimodal analgesia while application of the continuous epidural analgesia resulted in decrease of coagulative potential. Our data suggest that differential approach for selection of the method of intra and postoperative analgesia in patients undergoing surgical treatment of uterine fibromyoma can be considered a nonspecific preventive measure of thrombotic and hemorrhagic complications.

The aim of research: to study the dependence of the level of hyperandrogenism and a number of characteristics of the porphyrinic fractions metabolism during physiological pregnancy and pregnancy complicated by fetoplacental insufficiency in women with hyperandrogenism. Research materials: 62 pregnant women 18-35 years old in the II-III trimesters of pregnancy. Methods of research: DHEAS and testosterone level determination, external cardiotocography, ultrasound, Doppler sonography, endogenous protoporphyrin and coproporphyrin of blood concentrations determination by spectral luminescent method; microviscosity of red blood cells membranes determination by pyren excimerization degree with fluorescent spectra measuring. Results of research: endogenous porphyrins of blood concentrations ratio in healthy expectant mothers and women with hyperandrogenism are quiet different. Inverse correlation dependence between dihydroepiandrosterone sulphate level and protoporphyrins to coproporphyrins concentrations ratio is obtained. Increase of red blood cells membranes microviscosity in pregnant women with hyperandrogenism is found. Presence of developed placental dysfunction in all women with hyperandrogenism by the end of II, beginning of III trimester of pregnancy is defined. Conclusion: relative decrease of protoporphyrin concentration to coproporphyrin one in pregnant women with hyperandrogenism is accompanied by the increase of microviscosity characteristics of red blood cells membranes, that deteriorates characteristics of fetoplacental blood flow and is confirmed by clinic laboratorial markers of placental insufficiency.

An examination of 92 pregnant women in the age of 18-35 years old was held on the 28-30 weeks of pregnancy. 1 group consisted of 52 woman with hyperandrogenism (HA), 2 group 40 women with physiological pregnancy. During the study of aggregative thrombocyte ability using aggregation inductor (adrenaline, collagen, ADP) on aggregometer "Biola LA 230 2", we revealed plausible increase of thrombocyte functional activity in 1 group patients with HA in compare with control group. This increase was confirmed by thromboelastogram indicators and combined with the decrease of antithrombotic potential of vessels endothelium, which in its turn was confirmed by increase of Willebrand factor level in blood plasma. The study of hemostasis system revealed increase in coagulative blood potential during pregnancy with HA, and modifications of rheological and coagulative blood properties of mothers are among key factors of placental insufficiency development.

The research object: to reveal early ultrasound and Doppler mapping evidences of forming placental insufficiency with the subsequent morphological studying of structural changes of placenta in women with hyperandrogenism in the II trimester of pregnancy. Materials of research: longitudinal studies in parallel groups of 52 women, directed for artificial termination of pregnancy on medical indications on 20-22 week of gestation. Methods: ultrasound, Doppler mapping, morphological researches of placenta. Results of research: occurrence of echoscopic and morphological signs of initial placental insufficiency and suffering of a fetus of pregnant women with hyperandrogenism in the II trimester.

Molecular genetic factors of inherited thrombophilia of gestosis of different severity of 140 Russian women were studied. Control group was formed out of 150 recently delivered Russian mothers with physiological pregnancy. It was established that women who have inherited thrombophilia markers such as allelic variants C677T and A1298C of methylenetetrahydrofolate reductase gene (MTHFR), G20210A of prothrombin gene (F11), polymorphism of G1691A gene of the fifth factor of blood coagulability (FV), mutation of -675 4G/5G gene inhibitor plasminogen activator (PA11) increase the risk of gestosis development of different severity to a great extant. So the molecular-genetic analysis of inherited thrombophilia should be taken into consideration in choosing the effective prophylaxis of gestosis.

At research of the general contamination by human papilloma virus of high oncogenic risk of healthy and patients with pathology of cervix uteri inflammatory and proliferative genesis at women living in Tomsk region and r. Tyva, influence of regional features on frequency of distribution and spectrum VPH have been shown. At women of Republic Tyva higher is observed, in comparison with inhabitants of Tomsk region, a level of the general contamination VPH, alongside with the increased frequency of occurrence VPH of 16 and 18 types.

Study results of «Vessel due F (sulodexid)» using to prevent hemorheologic disturbances in placentar insufficiency which is due to hyperandrogenia are given in the article. Large efficacy of complex therapy of placentar insufficiency in the setting of hyperandrogenia which includes using sulodexid is shown compared with analogical method which uses desaggregants (trental).

The association of a ratio of blood porphyrin fraction concentrations in pregnant women with hyperandrogenism (HA) with the osmoresistance of red blood cells and the microviscosity of their membranes was studied. A cohort examination was made in parallel groups of 64 pregnant women aged 20 to 30 years at 28-36 weeks gestation. The levels of dehydroepiandrosterone sulfate (DHEAS) and testosterone were measured. External cardiotocography, ultrasonography, and Doppler study were conducted. The blood concentrations of endogenous protoporphyrin (PP) and coproporphyrin (CP) were estimated by the spectral fluorescence technique. Erythrocytic membrane microviscosity was determined from the degree of pyrene eximeration, by measuring the fluorescence spectra; erythrocytic osmoresistance was ascertained by the procedure developed by N. L. Vasilevskaya. The pregnant women with placental insufficiency in the presence of HA were found to have an altered ratio of the concentrations of erythrocytic porphyrin fractions, which enhanced the microviscosity and resistance of red blood cell membranes, causing worse microcirculation. There was an inverse correlation between the level of DHEAS and the ratio of the concentrations of endogenous PP to CP. It is concluded that the development of placental insufficiency in pregnant women with HA is attended by the decreased ratio of PP to CP along with the higher microviscous characteristics of erythrocytic membranes and the lower amplitude of their osmoresistance, by increasing the lower osmoresistance range.

The study results of peculiarities of energy cellular change in the system mother-fetus-newborn in pregnancy complicated by gestosis are presented in the article. We examined 80 pregnant women and their newborn children. Reliable depression of oxidativereduction activity of syccinatdehydrogenase and ?-glycerophosphatdehydrogenase enzymes peripheral blood lymphocytes in women and their newborn children. Presence of direct correlation between decreased activity of enzymes gestosis severity degree. The study performed is of practical value for predicting pregnancy course and protecting severe hypoxia in newborns.