Women Of Fertile Age Research Articles

Psychological disorders in women of fertile age and postmenopausal women with advanced cervical cancer

Cervical cancer is a very preventable disease that poses a significant threat to women, especially in countries with low economic development. The aim of the study was to study some aspects of the psychological status of patients with cervical cancer. The psychological status of patients with cervical cancer (n = 83) was studied at the Osh Interregional Oncology Center (Republic of Kyrgyzstan) using the hospital scale of anxiety and depression (HADS) and the scale of self-assessment of the level of reactive and personal anxiety (the test of Spielberger-Khanin). Patients diagnosed with cervical cancer are a vulnerable group for the development of psychological disorders, and they need screening programs that can potentially identify candidates for psychotherapeutic treatment. The hospital scale of depression and anxiety showed that patients of both fertile and postmenopausal age have a high frequency of clinically expressed anxiety, more common among the latter. However, signs of depression were more pronounced among those of fertile age, compared with postmenopausal. Regarding reactive and personal anxiety, the frequency of their spread was the same among people of fertile and postmenopausal age.

Pensions and Fertility: Microeconomic Evidence

This study identifies the causal effect of pension generosity on women’s fertility behavior. It capitalizes on Brazil’s expansion of the pension system to rural workers, whose pension wealth subsequently more than tripled. Difference-in-difference, instrumental variable, and event study methods show that the pension reform reduces the propensity of childbearing of women of fertile age by 8 percent in the short run. Completed fertility declines by 1.3 children within 20 years after the reform, reducing the contribution base of the pay-as-you-go long run. The fertility response is strongest at higher birth parities, among older women, and among mothers with sons. (JEL H55, I38, J13, J16, O15)

Traumatic brain injury during pregnancy is associated with increased rate of cesarean section: a nationwide multi-register study in Finland

Objective The literature on the incidence of traumatic brain injury (TBI) during pregnancy is lacking. Furthermore, only studies with small sample size have analyzed the impact of TBI during pregnancy to maternal and fetal outcomes. Thus, we aim to report the incidence of TBIs during pregnancy and study the pregnancy outcomes using nationwide high-quality registers. Methods This nationwide retrospective register-based matched cohort study utilized two national registers. All fertile-aged (15–49 years) women with a TBI hospitalization period during pregnancy were retrieved the Care Register for Health Care. Data were then linked with the data from the National Medical Birth Register (MBR). Propensity score matching was conducted according to maternal age during pregnancy, previous cesarean section (CS), maternal smoking status, maternal body mass index, and maternal gestational diabetes. The matching was conducted using the nearest neighbor methods with a caliber width if 0.15, and with a ratio 1:3 (patients/references). Adverse maternal and fetal outcomes were compared between patient group and reference group using Chi-squared tests. Results A total of 392 women having a TBI during pregnancy were found. The control group consisted of 722,497 women without TBI during pregnancy. Of the TBIs occurring during pregnancy, the most common types of TBIs were concussion (S06.0) (n = 359, 91.6%), diffuse traumatic brain injury (S06.2) (n = 11, 2.8%), traumatic subdural hemorrhage (n = 7, 1.8%), and unspecified intracranial injury S06.9 (n = 6, 1.5%). The incidence rates of pregnancies with a TBI have remained similar during pregnancy in Finland, peaking at 0.8 per 1000 pregnancies in 2016. The Chi-squared test showed higher rate for CS among women with TBI than for their matched references (21.4% vs. 15.5%, p = .008). Especially, women with TBI during 3rd trimester had higher rate for CS (29.0 vs. 15.0%, p = .016). Conclusions The main findings of this study were that the incidence rates for TBI during pregnancy have remained similar during our study period (2004–2018). TBI during pregnancy, even a mild one, is associated with an increased rate for CS. Especially, TBI during the 3rd trimester was associated with high rate for CS, but the etiology behind this remains unknown. In addition, we found no evidence of difference in fetal outcomes, such as preterm birth, low birth weight, or need for intensive care unit. Future studies should focus on the indications for elective CS, and reasons for unplanned CS among women with TBI during pregnancy, as these could possibly provide important information on the effects of TBI on the course of childbirth.

Risk assessment of dietary exposure to trace elements that are reproductive toxicants: Lead, molybdenum and nickel. The case study of Armenia

The research aimed to assess dietary exposure to developmental toxicants (Mo, Ni, Pb) among the Armenian adult female population of reproductive age (18–49 years). Commonly consumed foods with a daily intake of more than 1 g in Armenia have been selected to assess the occurrence of Mo, Ni, and Pb. Food consumption data among the adult population in Armenia were collected in the frame of the national survey via 24-h recall method. Estimated daily intakes (EDI) and associated potential health risks for both mean and high (95 percentile) consumers were assessed based on the health-based guidance values (HBGVs). None of the EDI values for the developmental toxicants via individual food consumption exceeded the HBGVs, however, the EDI of Pb in the case of aggregate consumption of all food products exceeded HBGV of 0.5 μg/kg b.w./day, indicating possible concerns for the neurodevelopmental effects. Noticeably, the intake of Pb through some individual food items (cheese curd, beef and veal, pelmeni and khinkali, black coffee, tap water) and the aggregate consumption of all the studied foods led to a Margin of Exposure lower than 10 compared to HBGV.This study is the first one carried out on dietary exposure to developmental toxicants among women of fertile age in a Caucasus country. The outcomes prompt the need to investigate sources of Pb pollution in foods consumed in Armenia (natural or human-derived environmental pollution, as well as food contact materials, etc.) and may pave the way for similar studies in the Caucasus region.

Multifetal gestations after traumatic brain injury: a nationwide register-based cohort study in Finland

BackgroundThere is a paucity of information regarding the association between traumatic brain injuries (TBIs) and subsequent multifetal gestations. Since TBIs are known to negatively affect the neuroendocrine system, we hypothesized that the functions of the whole reproductive system might be disturbed as a result. The aim of this study is to determine the association between previous TBIs and the risk of multifetal gestations using nationwide registers.MethodsIn this retrospective register-based cohort study, data from the National Medical Birth Register (MBR) were combined with data from the Care Register for Health Care. All fertile-aged women (15–49 years) who had sustained a TBI before pregnancy were included in the patient group. Women with prior fractures of the upper extremity, pelvis, and lower extremity were included in the control group. A logistic regression model was used to assess the risk for multifetal gestation after TBI. Odds ratios (ORs) and adjusted odds ratios (aOR) with 95% confidence intervals (CIs) between the groups were compared. The model was adjusted by maternal age and maternal BMI during pregnancy and previous births. The risk for multifetal gestations were evaluated during different periods following the injury (0–3 years, 3–6 years, 6–9 years, and 9 + years).ResultsA total of 14 153 pregnancies occurred after the mother had sustained a TBI, and 23 216 pregnancies occurred after the mother had sustained fractures of the upper extremity, pelvis, or lower extremity. Of these, 201 (1.4%) women had multifetal gestations after TBI and 331 (1.4%) women had multifetal gestations after fractures of the upper extremity, pelvis, or lower extremity. Interestingly, the total odds of multifetal gestations were not higher after TBI when compared to fractures of the upper extremity, pelvis, and lower extremity (aOR 1.04, CI 0.86–1.24). The odds were highest at 6–9 years (aOR 1.54, 1.03–2.29) and lowest at 0–3 years (aOR 0.84, CI 0.59–1.18).ConclusionThe risk for multifetal gestations after TBIs was not higher than after the other traumas included in this study. Our results provide good baseline information on the effects of TBIs on the risk for multifetal gestations, but further research is required on this topic.

ПРОГНОЗИРОВАНИЕ ВЕРОЯТНОСТИ РАЗВИТИЯ ХОБЛ В ЗАВИСИМОСТИ ОТ СТАЖА КУРЕНИЯ ЖЕНЩИН ФЕРТИЛЬНОГО ВОЗРАСТА

Introduction. The article presents the results of assessing the likelihood of developing chronic obstructive pulmonary disease, depending on the history of smoking and the number of cigarettes smoked per day by women of fertile age. Aim. The aim is to establish the probability and degree of influence of nicotine addiction on the formation of chronic obstructive pulmonary disease in women of fertile age. Material and methods. А cohort of 107 smoking women of fertile age with varying degrees of nicotine dependence observed was studied: 53 patients are active smokers exposed to passive smoking at home (first group 1), 54 patients are active smokers without passive smoking (group 2). The control group - 42 non-smoking women who do not have chronic diseases. The reliability of the results was evaluated using nonparametric statistical methods (Statistica 10, Microsoft Excel 2010). Results and discussion. With smoking experience in the range from one year to ten years in the second group, the probability of chronic obstructive pulmonary disease formation develops more slowly compared to that in the first group. This difference in probabilities is gradually decreasing from year to year. With ten years of smoking experience, the probabilities of chronic obstructive pulmonary disease in both groups become equal, and then the situation changes to the opposite. In the first group, the probability of chronic obstructive pulmonary disease begins to develop more slowly compared to the second group. The difference in probabilities is gradually decreasing from year to year, practically comparing with the smoking experience of twenty-two years.Conclusion. Passive smoking, in addition to active smoking, increases the nicotine load with the formation of more pronounced prerequisites for the pathogenetic processes of chronic obstructive pulmonary disease development. The probability of chronic obstructive pulmonary disease development in the second group decreases and it is possible that it is the number of cigarettes (from 10 to 16 cigarettes per day) more than passive smoking that is the main factor in the development of the disease. When overcoming the 11-year interval, regardless of the absence of passive smoking, the predominant factor is the smoking experience of 20 or more years.

Клинический случай сочетания врожденного токсоплазмоза с ВИЧ- и цитомегаловирусной инфекциями

Toxoplasmosis is one of the problems of medicine, which has serious socio-economic significance. Congenital toxoplasmosis is manifested by severe fetal damage, its chronic course with lifelong preservation of the parasite in various organs and tissues, as well as the possibility of adverse perinatal outcomes. Purpose. To present a clinical case of congenital toxoplasmosis in a child: intrauterine chorioretinitis, meningoencephalitis in combination with HIV infection and current cytomegalovirus infection. Material and methods. A patient transferred from the Ust-Ilimsky maternity hospital to the city of Ivano-Matreninsky Children's Clinical Hospital in Irkutsk. Clinical data: in an HIV-infected mother, from 4 pregnancies, 4 births, a child was born at 39–40 weeks, 2930 gr. Results. Based on the conducted studies and examinations, the child was diagnosed with: Basic: Congenital toxoplasmosis: transferred intrauterine chorioretinitis, meningoencephalitis with the formation of calcifications of cerebral vessels, ventriculomegaly. Related: 1) HIV infection, stage 2 B, progression phase on ART, IC+2, moderate immunodeficiency; 2) Congenital cytomegalovirus infection; 3) UPU. Muscular DMZHP. Ltd. CH0; 4) Normochromic anemia of moderate severity. Conclusions. Congenital toxoplasmosis remains one of the serious problems and requires in-depth study. As a prevention of the development of congenital toxoplasmosis, it is necessary to diagnose infection with toxoplasmosis in women of fertile age during family planning. Keywords: congenital toxoplasmosis, chorioretinitis, meningoencephalitis, HIV infection, CMV infection

Significance of insulin and insulin-like growth factor-1 in the pathogenesis of acne

Background. The potential involvement of insulin and insulin-like growth factor-1 in the pathogenesis of acne may be due to direct stimulation of sebaceous gland cells, an increase in androgen synthesis in the endocrine glands, activation of 5-reductase, and an increase in the sensitivity of androgen receptors in tissues.
 Aim. To study the level of insulin and insulin-like growth factor-1 in women of fertile age suffering from acne; to identify the dependence of these indicators on the clinical and anamnestic features of the disease and the nature of the nutrition of patients.
 Material and methods. 60 patients suffering from acne (mean age 23.90.92 years) were examined. Clinical indices, reflecting the severity of the skin process and quality of life, were calculated, hormonal status indicators (insulin, insulin-like growth factor-1, total testosterone, estradiol, progesterone) and blood plasma glucose levels were studied. The blood of 30 healthy women (mean age 25.91.04 years) was examined as a control. Groups were compared using Student's t-test and odds ratio calculation, correlation analysis was performed using Spearman's rank correlation coefficient.
 Results. Patients with acne showed a significant increase in the level of insulin-like growth factor-1 (p=0.0002) and total testosterone (p=0.005). The correlation of the insulin-like factor content with the indices that determine the severity of the skin process and the quality of life of patients was closer than that of the total testosterone. A lower concentration of insulin-like growth factor-1 was noted in the blood of acne patients who followed a diet with restriction of milk and dairy products, foods rich in easily digestible carbohydrates and saturated fats. The level of insulin in patients with acne did not differ from that in the control group.
 Conclusion. In women suffering from acne, an increase in the content of insulin-like growth factor-1 in the blood plasma was revealed; at the same time, its level has a closer relationship with the severity of the course of dermatosis and the quality of life of patients in comparison with the indicator of total testosterone.

Issues of preparation for implementing uterine transplantation in clinical practice

The absolute uterine factor infertility is a non-treatable cause of female infertility. Surrogacy has become the only option that allows this group of patients to achieve genetic, although biological motherhood. According to statistics there are more than 30 thousand women of fertile age in Russia who cannot get pregnant due to the absolute uterine factor infertility. The recently emerged possibility of uterine transplantation has become the only treatment for this kind of female infertility.Prior to the very first clinical study of human uterine transplantation which was carried out in 2013 in Sweden, scientists had conducted systematic studies in animals (rodents, pigs, cattle and primates). The first clinical trial with the uterine transplantation performed resulted in a live birth in September 2014. Currently, cases of successful uterine transplantation in humans have been reported in Sweden, Brazil, USA and Italy. Experience and practice in animal research played a key role in the success of the first clinical study on uterine transplantation. The application of this method is fundamental in the introduction of the scientifically grounded technology of uterine transplantation in Russia.Aim. Analysis of the problems of the clinical application of the uterine transplantation based on a literature review.

Does the Polydimethylsiloxane Urethral Injection (Macroplastique®) Improve Sexual Function in Women, in Fertile Age, Affected by Stress Urinary Incontinence?

Background and Objectives: Stress urinary incontinence (SUI) negatively affects women's quality of life, including sexual function. The aim of the current study was to evaluate the effect of polydimethylsiloxane (Macroplastique®) on sexual function in women of fertile age affected by SUI. Materials and Methods: Single-center prospective study. Sexually active women of fertile age with symptoms of pure SUI, which were urodynamically proven, were submitted to intraurethral Macroplastique® injection. At 6-months follow-up, their sexual function was evaluated with Female Sexual Function Index (FSFI), while the SUI cure rate was objectively assessed through a negative stress test and subjectively by a Patient Global Impression of Improvement (PGI-I) score < 3. The difference of coital incontinence prevalence was assessed between the baseline and the 6-month follow-up. Peri- and postoperative complications of Macroplastique® injection were recorded and classified according to the Clavien-Dindo system. Results: Twenty-one women fulfilled inclusion criteria and were submitted to Macroplastique® procedure. The concerning sexual function, desire, satisfaction, and overall FSFI score significantly improved. Since other domains were less impaired at the baseline, we could not assess significant improvement for all of them. We observed a complete regression of coital incontinence (0/21, 0%) in comparison with the baseline (5/21, 23.8%; p = 0.04). The objective SUI cure rate was 76% (16/21), while the subjective SUI cure rate was 80.9% (17/21). One woman developed de novo overactive bladder, and two women developed postoperative voiding dysfunction (self-solved in 24 h). Conclusions: The Macroplastique® urethral injection was demonstrated to be safe and effective in improving sexual function in sexually active women of fertile age affected by pure SUI, urodinamically proven at 6-months follow-up.

Seroprevalence of Toxoplasma, Rubella and Cytomegalovirus in Women of Fertility Age in Our Region

Toxoplasma gondii (T. gondii), Rubella and Cytomegalovirus (CMV) infections can cause severe morbidity in the fetus when transmissed during pregnancy. In our study, it was aimed to examine the seropositivity rates for T. gondii, Rubella and CMV infections in women of childbearing age who applied to our hospital. Anti-Toxoplasma IgG, anti-Toxoplasma IgM, anti-Rubella IgG, anti-Rubella IgM, anti-CMV IgG and anti-CMV were studied in women of childbearing age (18-49 years old) who applied to our hospital's outpatient clinics between January 2018 and December 2020. The tests were performed in our microbiology laboratory using the ELISA method on Architect i2000 (Abbott, USA) and COBAS e601 (Roche, Germany) devices. As a result of the data obtained, the percentages of IgM and IgG positivity for anti-Toxoplasma were calculated as 1.4% and 30.9%, respectively. Anti-Rubella IgM positivity was 0.7%, anti-Rubella IgG positivity was 91%, anti-CMV IgG positivity was 98.8%, and anti-CMV IgM positivity was 2%. Having its own seroprevalence for each region has is important in terms of planning pregnancy screenings. The seropositivity rates in our region are in line with other studies in the country. Since CMV seropositivity is very high in the population and there is no effective treatment or vaccine, screening may not be not necessary. T. gondii and Rubella screenings can be recommended due to the lower immunity rates and the availability of vaccine and treatment options.

COMPARATIVE CHARACTERISTICS OF MODERN HERNIOPLASTY METHODS IN WOMEN OF FERTILE AGE

In the traditional treatment of external abdominal hernias in women of fertile age in the early postoperative period, the frequency of surgical complications was 13.4%, in the long-term period, 8.5% of patients had a recurrence of hernia. The conducted critical analysis revealed that the unsatisfactory results were due to the shortcomings of tactical approaches in the possibility of performing alloplasty in women of reproductive age.

An Exploration of the Causes of Women’s Reduced Fertility Intentions Under the Three-child Policy in the Context of Liberal and Radical Feminism in China

Under the implications of Chinese government’s three-child policy, the fertility intentions of the women of fertility age present a declining trend. This essay, therefore, investigates the possible influences of feminism on women’s fertility intentions. This study collected and researched previous studies about radical feminism and liberal feminism, then analyzed their possible influences on the fertility intentions. As a result, the theoretical results indicated that with the awakening of female consciousness, the fertility intentions would decrease. Finally, this essay concluded that the female consciousness and feminism would reduce the fertility intentions and proposed several suggestions for future institutional framework about fertility policies. For the past relative studies, few researchers had noticed the influences of feminism and female consciousness, which contributed to this essay’s research motivation. A study of the reasons for women’s reduced fertility intentions from the perspective of female consciousness would help to fill a gap in this field.

The outcome of pregnancies after bariatric surgery: an observational study of pregnancies during 2004–2016 in Finland

PurposeOverweight and obesity are major risk factors for perinatal morbidity and mortality, and the need for bariatric surgery (BS) among fertile-aged women is increasing. This study evaluates the outcome of post-BS pregnancies and deliveries.MethodsAll 20–45-year-old patients delivering between 2004 and 2016 in Finland were included. Patients with previous BS were identified from the hospital discharge register, and the medical birth register was queried for data on pregnancies, deliveries, and perinatal outcomes. The data were matched using personal identification codes, and the outcomes of women with previous BS were compared with those of other pregnancies.ResultsWomen with previous BS (n = 314) constituted the bariatric group. When compared with the non-bariatric group (n = 750,019), they were older (p < 0.001), heavier (p < 0.001) and had more previous pregnancies (p < 0.001). The overall incidence of pregnancy-induced hypertension (p = 0.002), gestational diabetes (GDM) (p = 0.018), pre-term contractions (p = 0.023), pre-term delivery (p = 0.003), labour induction (p < 0.001), planned (p = 0.001) and unplanned (p = 0.036) caesarean sections and low birthweight infants (p < 0.001) were significantly higher in the bariatric group. When compared with body mass index–specific categories, the main outcomes were increased incidence of GDM and small for gestational age (SGA) newborns in the bariatric group.ConclusionBS can be considered a safe and advisable treatment for obesity among fertile-aged women. The pregnancy outcome is associated with post-BS weight, but the risk for GDM and small for gestational-age newborns is increased.

Appendectomy during pregnancy: rates, safety, and outcomes over a five-year period. A hospital-based follow-up study

Introduction Appendicitis is the most common acute abdominal complication during pregnancy. If appendix perforation occurs there is an increasing risk of preterm delivery and other pregnancy complications. Objective To assess the outcome of pregnancy after appendectomy, the mode of surgery used, appendectomy rates, and complications. Methods A prospective cohort study of pregnant women with, or without, appendectomy at South Stockholm General Hospital, December 2015 to February 2021 in a setting where pregnant women are prioritized for surgery and laparoscopic surgery was standard of care in first half of pregnancy. Data on preoperative imaging, surgical method, intraoperative findings, microscopic findings, hospital stay, pregnancy, and 30-day complications were prospectively recorded in a local appendectomy register. A non-pregnant control group was gathered comprising women of fertile age in the same study interval. Results During the study period 50 pregnant women, of whom 44 gave birth, underwent appendectomy of 38 199 women giving birth. There were no differences between women with or without appendectomy in proportion of preterm delivery (4.5% vs. 5.6%), small-for-gestational age (2.3% vs. 6.2%), or Cesarean delivery (18.2% vs. 20.4%). The rate of appendix perforation was 19% in non-pregnant control group compared to 12% among pregnancy. There was no case of perforated appendix in the second half of pregnancy. However, women with gestational age > 20 weeks more frequently had an unaffected appendix compared to those operated ≤ 20 gestational weeks (4/11 vs. 2/39, p = .005). Laparoscopic surgery was used in 97% of non-pregnant control group, 92% of appendectomies ≤ 20 weeks gestation, and in 27% >20 weeks. As compared to first half, the appendectomy rate was three times lower during the second half of pregnancy. Pregnant women had priority for surgery < 6 h compared to < 24 h among non-pregnant women, this resulted in a shorter time-to-surgery among pregnant women (p < .001) Conclusion Routine laparoscopic surgery and time priority for pregnant surgery is associated with a low risk of perforation, preterm birth and other complications. However, a low threshold for surgery may increase the risk of a negative exploration.

Preoperative misoprostol in reducing blood loss during myomectomy

Background and aim Uterine myomata are by far the most common benign tumors in women of fertility age. Myomectomy can be used to treat manifested uterine myomas while maintaining the ability to become pregnant. The most serious operative risk is uncontrolled intraoperative bleeding with life-threatening complications, making the procedure more dangerous than hysterectomy and necessitating the services of an experienced surgeon. Several ways are being applied to alleviate this complication. The study aim was to evaluate the role of sublingual misoprostol (prostaglandin E1, 400 μg) administered 60 min preoperatively for reducing blood loss during abdominal myomectomy. Patients and methods This randomized prospective controlled study was applied on 40 women with manifested uterine myomas, who were subsumed for myomectomy. Among women subsumed for abdominal myomectomy surgery, 60 min before the surgery women in the study group (n=20) were administered a single dose of sublingual misoprostol (400 μg) while those in the control group (n=20) were administered placebo. Results Postoperative blood loss, postoperative hemoglobin, and hospitalization time mean (252.5±170.5 ml, 10.8±1.02 g/dl, and 1.8±0.4 day, respectively) were significantly reduced (P=0.003, 0.032, and 0.004, respectively) in patients given preoperative sublingual misoprostol, and so there were consequently higher postoperative values of hemoglobin in these patients. As regards the operation time, intraoperative blood loss, and blood transfusion there was a decreased need in the study group but not statistically significant P-value (0.065, 0.077, and 0.311, respectively). Conclusions A single preoperative dose of sublingual misoprostol may be a simple, easily applicable, and cozy method for reducing intraoperative blood loss during abdominal myomectomy.

Resilience among Women of Childbearing Age from Arequipa, Peru: Psychometric and Associative Analysis

Resilience is one of the most important variables in the development of healthy pregnancies although there have been limited investigations within local contexts. The present study had a double purpose: first, to analyze the psychometric properties of the Wagnild and Young Resilience Scale, and second, to evaluate the sociodemographic and obstetric variables associated with resilience in fertile-age women from Arequipa City. This is an instrumental and associative study, in which a sample of 248 women who attended a health center located in Alto Selva Alegre district, were assessed using the Wagnild and Young Resilience Scale, and a sociodemographic survey. The results suggest that the resilience scale is valid and reliable. Moreover, 46.8% of the women were assessed as having low resilience. It was also found that resilience was associated with age, educational attainment, marital status, productive activities, the desire for pregnancy, and domestic violence during pregnancy. Educational attainment and domestic violence during pregnancy had a positive impact on resilience.

Наружный генитальный эндометриоз: клинико-анамнестические факторы риска у женщин репродуктивного возраста

Aim. To identify clinical and anamnestic risk factors for the development of external genital endometriosis. Design. Prospective cohort study. Materials and methods. As part of the study, 80 women of fertile age were examined: 54 patients with external genital endometriosis, confirmed by laparoscopy and histological examination (main group), and 26 women of the control group without external genital endometriosis. All participants were interviewed and examined in accordance with the applicable regulatory documents. Results. There were no significant differences in average age, level of education, body mass index, menstrual and reproductive functions, frequency of smoking and the structure of surgical interventions between two groups. However, the endometriosis patients were distinguished by a higher frequency of the digestive system diseases, namely chronic gastritis (p = 0.019); anemia (p = 0.174); benign breast dysplasia (p = 0.304); adhesions in the abdominal cavity (p = 0.095). On the contrary, the frequency of chronic inflammatory diseases of the uterine appendages was higher in the control group (p = 0.0000), which can be explained by the inclusion criteria in this group (planned laparoscopy due to infertility and/or chronic pelvic inflammatory disease). Patients of both groups are characterized by a low parity — on average, less than 1 birth per woman, which can partly be explained by the high frequency of infertility in the studied cohort: 38.8% of all examined, 24.1% of women with external genital endometriosis and 69.2% of women in the control group with a statistically significant predominance in the latter (p = 0.0001). Conclusion. Insufficient diagnostic effectiveness of existing methods of noninvasive verification of external genital endometriosis dictates the need to develop techniques based, among other things, on the consideration of clinical and anamnestic risk factors for the disease development. In addition, the elimination of the detected risk factors can contribute to the prevention of endometriosis development and recurrence after its treatment. Key words: external genital endometriosis, risk factors, noninvasive diagnostics.

Определение референсных значений тестов ротационной тромбоэластометрии у беременных женщин

Study Objective: To evaluate the indicators of rotational thromboelastometry tests (ROTEM) in pregnant women in the third trimester and determine their reference values. Study Design: Prospective study. Materials and methods. Examination of 49 patients in the third trimester of pregnancy was conducted. The comparison group included 25 women of fertile age without concomitant somatic pathology. The study evaluated the results of INTEM, EXTEM, FIBTEM tests of rotational thromboelastometry on the ROTEM Delta analyzer. Study Results. Significant differences in all parameters of thromboelastometry in the INTEM, EXTEM and FIBTEM tests were obtained between the control group and women in the third trimester of pregnancy (p &lt; 0.05), demonstrating physiological, chronometric and structural hypercoagulation, which must be taken into account when conducting therapy in obstetric practice. Conclusion. The data obtained can be used by practitioners of perinatal centers and maternity hospitals in everyday clinical practice, in the diagnosis and intensive care of coagulopathic obstetric bleeding. Keywords: rotational thromboelastometry, pregnancy, hemostasis, coagulopathy, hypercoagulation.

Human papillomavirus vaccination: news and perspectives

Cervical cancer occupies the second place, after breast cancer, regarding the types of cancer that affect women of fertile age (15-44 years old) in Romania. The resumption of the vac­ci­na­tion program in Romania is a success, but the vac­ci­na­tion rate is so low that Romania does not even ap­pear in international statistics. The example of Rwanda, which makes excellent use of community resources, offers us a new approach and, on the other hand, evidence emer­ging in recent years has shown that the one-dose vac­ci­na­tion sche­dule also offers a high degree of protection similar to established schedules. A more coherent and sustained in­volve­ment of all partners in the vaccination process is necessary to recover the lost start, and to be among the top countries in the finish line of the global strategy for the elimination of cervical cancer in 2030.