The conducted scientific research is devoted to the problem of finding predictors of preterm birth, because the available tests either have low information content or are an expensive technique. The purpose of the study. To develop a computer program for predicting premature births among women in the Kemerovo region – Kuzbass. Materials and methods. To determine the most significant independent predictors of preterm birth, we conducted a study (n = 350), which analyzed more than 100 factors related to the development of preterm birth. As a result of binary logistic regression, four independent laboratory, clinical and paraclinical predictors of the risk of preterm birth were identified. Results. Based on the study, the most significant indicators affecting the risk of premature birth were identified. They include levels of prostaglandin class A antibodies, benzo[a]pyrene class G antibodies, cervical length at 18+0-20+6 weeks of pregnancy and smoking. Conclusion. You can use the program by clicking on the QR-code.

Despite low incidence of pregnancy-induced sacroiliitis, it is associated with significant morbidity and mortality. Sacroiliitis can be particularly difficult to diagnose because its symptoms are non-specific. A clinical case of postpartum sacroiliitis in a 24-year old patient is reported. The patient complained of severe right buttock pain radiating to the right thigh. In addition, the symptoms of systemic inflammatory response syndrome were present. Right-sided sacroiliitis was recognized by magnetic resonance imaging (MRI). Non-brucellar and non-tuberculous infectious sacroiliitis is a rare disease with misleading clinical signs that delay diagnosis. Most observations are based on individual case reports or small case series. Infectious sacroiliitis should be considered as a differential diagnosis even in low-risk women who present with debilitating pelvic pain during pregnancy and delivery. Thus, it may facilitate timely diagnosis and treatment.

Aim – the aim of the study is to carry out a comparative assessment of clinical and anamnestic indicators and features of caesarean section surgery in patients with a high risk of developing intraoperative bleeding, delivered with and without the use of the vasopressor drug Terlipressin. Materials and methods. A retrospective case-control study of 92 women, with a high risk of developing intraoperative bleeding, delivered at the Belyaev Kuzbass Regional Clinical Hospital for 2020-2021 was conducted. The main group was 12 women who were injected intraoperatively into the thickness of myometry with the drug Terlipressin immediately after crossing the umbilical cord. The control group included 80 women operated without terlipressin. Statistical data processing was carried out using the computer program Microsoft Excel 2007. To compare the frequencies of qualitative features, the criterion χ2 was used. The level of statistical significance when testing the null hypothesis was taken as corresponding p < 0.05. Results. Patients who were administered terlipressin at caesarean section had a higher incidence of placental presentation and placenta accreta, i.e., initially belonged to the group of extremely high risk of obstetric bleeding. During caesarean section surgery, these patients were naturally statistically significantly more likely to undergo dressing of the descending branch of the uterine artery, application of compression sutures, additional administration of uterotonic preparations, tranexamic acid, colloidal solutions. The average blood loss in patients who received terlipressin was slightly higher than in the control group, however, no differences were found in the severity of blood loss, the frequency of massive blood loss was recorded in only one woman (8.3 %) who needed Cell Saver and hemotrasfusion. Conclusions. The analogue of vasopressin «Terlipressin» during caesarean section surgery is significantly more often used in patients of extremely high obstetric risk. Use of this preparation in combination with compression sutures and ligation of the descending branch of the uterine artery allows preventing massive blood loss. Further in-depth research is needed in this direction.

Describes the clinical observation of a complete rupture of the uterus along the previous scar during pregnancy of 39-40 gestation weeks in a patient with a burdened obstetric and gynecological history outside the hospital. The patient was undergo surgical operation for emergency indications after 10 minutes from the moment of admission to the hospital. Timely assistance provided predetermined a favorable outcome for the mother and fetus.

Describes the clinical observation of a complete rupture of the uterus along the previous scar during pregnancy of 39-40 gestation weeks in a patient with a burdened obstetric and gynecological history outside the hospital. The patient was undergo surgical operation for emergency indications after 10 minutes from the moment of admission to the hospital. Timely assistance provided predetermined a favorable outcome for the mother and fetus.

Aim: To study specific characteristics of the course of pregnancy and labor, newborn status in labor induction. Materials and Methods. 216 maternal/newborn medical records in the maternity hospital N 1, State Autonomous Healthcare Institution «Podgorbunsky M.A. Regional Clinical Hospital of Emergency Health Service» in 2016, were retrospectively reviewed. The study group (Group 1, n = 108) included women and their newborns after induction of labor, and the control group (Group 2, n = 108) – women and their newborns after spontaneous labor. Inclusion criteria were as follows: 37-41 weeks of gestation, induction of labor, singleton pregnancy. Exclusion criteria were as follows: premature birth, the presence of maternal/fetal diseases or conditions, requiring C-section. Results. Indications for labor induction included an exacerbation of somatic pathology in 42 patients (32,1 %), preeclampsia, resistant to conservative management – in 33 (27,2 %); premature rupture of membranes (PROM) without any signs of spontaneous labor in full term pregnancy – in 16 (11,3 %), postterm pregnancy – in 27 patients (22,9 %). The Bishop score of less than 6 points indicates an unripe cervix, 6-8 points – a poor cervical ripening, over 8 points – a ripe cervix. Thus, 10 patients (9,6 %) had unripe cervices, 27 (26,0 %) – a poor cervical ripening and 69 (65,4 %) – ripe cervices. Аt 10 (9,2 %) during pregnancy by results of ultrasonography the low placentation, at 12 (11,1 %) the broken amount of amniotic waters was revealed; at 29 fruits (26,8 %) violations of KTG as borderline cases of action of the heart are revealed. The most common labor complications were trauma in labor: 66 patients (66,7 %) in the study group vs. 18 patients (60 %) in the control group, p < 0,05), abnormal labor (37 patients (34,2 % ) vs. 4 patients (13,8 %), p < 0,05, respectively) including uterine inertia (21 patients (18,7 %) vs. 2 patients (3,1 %), p < 0,05, respectively) and incoordinate uterine activity (17 patients (15,5 %) vs. 1 patient (2,6 %), p < 0,05, respectively. Conclusions. Labor induction is associated with increased blood loss, higher rates of abnormal labor, birth canal traumaand prolonged postnatal hospital stay in newborns.

Objective – to optimize therapy and prevention of arterial hypotension caused by spinal anesthesia during Cesarean section. Methods. Pregnant women undergoing Caesarean section under spinal anesthesia were divided into two groups depending on the predominance of sympathetic or parasympathetic tone. A comparison of central haemodynamic parameters on the basis of non-invasive monitoring were perfomed. Results. Low cardiac output, arterial hypotension, bradycardia, consumption of vasopressors and cholinolitics were significantly more often observed in the group of patients with a predominance of parasympathetic tone. Conclusion. Considering the preoperative measurement of autonomic nervous system tone, pathogenetic approach to the treatment and prevention of arterial hypotension during Caesarean section with administration of atropine could be assumed instead of recommended routine application of adrenoagonists.

The growing number of people infected with human immunodeficiency virus (HIV) in Russia nearly by 400 thousand during 2016 with women mostly infected makes the study of this issue relevant. Objective – to study the risk factors and features of a course of pregnancy, birth and the fetus condition in HIV-infected women. Materials and Methods. We conducted a retrospective case-control study that includes 180 women. The main group consisted of 90 HIV-positive pregnant women and their newborns, the control group – 90 pregnant women without symptoms of HIV infection and their newborn. Results. Sexually transmitted HIV occurred in 71 patients (79 %). The viral load of more than 1000 copies / ml was diagnosed in 30 % patients. Failure to receive antiretroviral therapy (ART) during pregnancy has been observed in 40 % patients. In the main group nicotine and drug dependence, chronic diseases are significantly more often observed. Among the complications of pregnancy vaginal dysbiosis, yeast vulvovaginitis, gestational edema, threatening abortion in the second trimester, abnormal fetal presentation are observed. The deliveries usually performed by the caesarean section were indicated by high viral load and the anomalies of labor activity. The frequency of episiotomy and perineal ruptures increased in spontaneous deliveries. Newborns of HIV-positive women more often have intrauterine growth retardation and higher overall morbidity. In addition, the lack of contact of the infected women with qualified specialists, late search for medical care, poor adherence to the treatment lead to the absence or inadequacy of ART that increases the risk of the vertical HIV transmission.