The aim of the study was to analyze modern approaches to the use of uterotonic drugs for the prevention and treatment of postpartum hemorrhage. Materials and methods: The information databases of the PubMed, MEDLINE, e-library systems were evaluated. Key words (search words): «uterotonic drugs», «uterotonics», «uterotonic therapy». The search depth was 3 years (2020-2023). Results. As a result of the search, 138 publications were found, 38 publications corresponded to the search criteria. One of the main methods of management of hypotonic postpartum hemorrhage is uterotonic therapy, either as monotherapy or in combination with other methods, such as compression suture and/or controlled balloon tamponade. Oxytocin and carbetocin are generally recognized as first-line uterotonics, and ergot alkaloids and prostaglandins are generally recognized as second-line uterotonics. The high efficacy and safety of terlipressin in high-risk patients with delivery by caesarean section has been proven. Conclusions. Further multicenter studies are needed to determine the minimum effective dose of uterotonics in low-risk patients and the possibility of combining different uterotonics in high-risk patients.

The aim of the research. To conduct an analytical review of modern sources of scientific literature covering the issues of premenstrual syndrome. Materials and methods. The analysis of 42 foreign and domestic literature sources on this topic was carried out. Results. About 70-80 % of women have PMS symptoms. The current understanding of the pathogenesis of PMS can be used in the treatment of both medicinal and herbal preparations. In the first-line treatment of PMS and PMDD, drospirenone-containing COCP are used. For maintenance therapy-preparations with herbal components. Conclusion. Treatment should be carried out according to the form and severity of premenstrual disorder.

The aim of the research. To conduct an analytical review of modern sources of scientific literature covering the issues of premenstrual syndrome. Materials and methods. The analysis of 42 foreign and domestic literature sources on this topic was carried out. Results. About 70-80 % of women have PMS symptoms. The current understanding of the pathogenesis of PMS can be used in the treatment of both medicinal and herbal preparations. In the first-line treatment of PMS and PMDD, drospirenone-containing COCP are used. For maintenance therapy-preparations with herbal components. Conclusion. Treatment should be carried out according to the form and severity of premenstrual disorder.

The aim of this study was to conduct an analytical review of modern scientific publications about features of contraception in women of advanced maternity age. Materials and methods. The analysis of 43 foreign and domestic literature sources on this topic has been carried out. Results. Despite the decline in fertility, women in the period of menopausal transition need contraception. The methods of choice are intrauterine and hormonal contraception, as well as surgical sterilization. After 50 years, hormonal contraception can include only progestogen-containing drugs; to prevent bone loss, DMPA should be stopped. Contraceptive methods can have therapeutic non-contraceptive effects, but their prescription should be based on health and likely risk factors. Since the risk of pregnancy becomes extremely low when a woman reaches the age of 55, contraception can be stop at this age even in menstruating women. Conclusion. Contraception in advanced maternity age has significant characteristics and should be recommended in accordance with the existing risk factors.

Objective – to evaluate the dynamics of anthropometric indices, hormonal and metabolic indices in infertile women of reproductive age with obesity during the treatment with orlistat. Materials and methods. The study included 30 infertile women of reproductive age with obesity. All patients were prescribed a low-calorie diet (1200 kcal) and orlistat at a dose of 360 mg/day. Anthropometric study, the determination of the hormonal and metabolic levels were carried out before the start of treatment and 12 months later. Results. A decrease in body weight was registered in 18 (60 %) patients from 5 to 21 kg, on average, by 10.42 ± 3.89 kg, respectively, there was a decrease in BMI from 36.77 ± 3.01 to 32.73 ± 3, 02 (p < 0.001). As a result of the treatment in patients, the level of fasting glucose, insulin resistance, the level of cholesterol, TG, cholesterol-LDL, Ka, and statistically significant increase in cholesterol-HDL cholesterol significantly decreased. After obesity treatment, a statistically significant decrease in the level of LH, LH / FSH, IRI, E1 and, conversely, an increase in the level of FSH was detected. In addition, almost 2-fold increase in the level of progesterone was registered (p = 0.020). The frequency of menstrual irregularities decreased from 66.7 % women to 16.6 % (p = 0.007). Desired pregnancy within a year occurred in one patient. Conclusion. In infertile patients of reproductive age with obesity, the use of orlistat in combination with a low-calorie diet for 12 months is an effective option in restoring metabolic processes, reducing body weight and restoring menstrual and reproductive function.

Aim: To study the level of thyroid-stimulating and thyroid hormones in pregnant women with obesity and their newborns. Materials and Methods. We consecutively recruited 40 pregnant women and their newborns. Blood sampling in pregnant women was carried out at the end of the third trimester 12 hours after the last meal while in newborns it was conducted immediately after birth. Measurement of serum thyroid-stimulating hormone, thyroxine, triiodothyronine, and free thyroxine was performed using chemiluminescent immunoassay. Results. Thyroid disease was significantly more common in pregnant women with obesity. Clinical and latent hypothyroidism in obese pregnant women was observed 1.5-fold more frequently as compared with those having normal body weight. In keeping with these findings, goiter and elevated thyroxine were also more common in obese pregnant women. Newborns from obese women were more often characterized by a transient hypothyroidism in combination with an augmented thyroid-stimulating hormone. Conclusion. Levels of thyroid-stimulating and thyroid hormones in obese pregnant women and their newborns significantly differ from the patients with normal body weight.

Цель. Провести сравнительную оценку влияния препарата, содержащего 0,03 мг этинилэстрадиола (ЭЭ) и 3 мг дроспиренона (ДРСП), на состояние кожи и антропометрические показатели по сравнению с препаратом, содержащим 0,02 мг ЭЭ и 3 мг ДРСП. Материалы и методы. В проспективное сравнительное рандомизированное исследование были включены 40 женщин репродуктивного возраста без противопоказаний к применению комбинированного орального контрацептива (КОК). Первую группу составили 20 женщин, которым назначена комбинация 0,03 мг ЭЭ и 3 мг ДРСП согласно инструкции по схеме 21/7; во 2-ю группу включены 20 пациенток, которым назначена комбинация 0,02 мг ЭЭ и 3 мг ДРСП согласно инструкции по схеме 24/4. Протокол исследования включал 8 визитов: на 0-м проводилась оценка критериев включения и исключения, 1-м - рандомизация пациентки (метод конвертов) и назначение препарата, 2-7-м (один раз в месяц) - выполнялись измерение артериального давления, определение антропометрических показателей: массы тела, роста, окружности талии, окружности бедер; определение индекса массы тела, оценка степени гирсутизма (шкала Ферримана-Галвея), оценка жирности кожи и волос, акне (по 10-балльной визуальной шкале). Результаты. Комбинация 0,03 мг ЭЭ и 3 мг ДРСП в течение 6 мес приема не оказывает значительного влияния на массу и индекс массы тела, окружность талии и бедер. К 6-му месяцу приема комбинация 0,03 мг ЭЭ и 3 мг ДРСП приводит к статистически значимому уменьшению жирности кожи и выраженности акне, а также уменьшению проявлений гирсутизма, что сопоставимо с клинической эффективностью комбинации 0,02 мг ЭЭ и 3 мг ДРСП. Выводы. Комбинация 0,03 мг ЭЭ и 3 мг ДРСП обладает сходным с комбинацией 0,02 мг ЭЭ и 3 мг ДРСП влиянием на жирность кожи, выраженность акне и гирсутизм, также не оказывая значимого воздействия на основные антропометрические показатели. Вероятно, влияние на уровень андрогенов и жировую ткань ДРСП-содержащих КОК обусловлено именно влиянием ДРСП, а не дозой ЭЭ.