[The effectiveness of the spa and health resort treatment for the pre-gravid preparation of the women at high risk of obstetric and perinatal pathology].

Chronic recurrent inflammatory diseases of the small pelvis are known to be responsible for the development of the adhesive process and infertility. Therefore, they require surgical treatment and increase the risk of obstetric and perinatal pathology. The present study was focused on the assessment of therapeutic and prophylactic effectiveness of the application of natural and preformed physical factors for the pre-gravid preparation of the patients presenting with gynecological problems and pregnant women at high risk of obstetric and perinatal pathology based at the spa and health resort facilities of the Krasnodar Krai (region). The treatment included aero-, helio-, and thalassotherapy, transcranial electroneural stimulation, UHF therapy, hydrogen sulfide or iodine-bromine therapy. A total of 267 women were included in the study. Pregnancy was documented in 52% of the 144 patients who comprised the main group and underwent a course of rehabilitative treatment; it developed within 3-5 months after therapeutic and prophylactic laparoscopic procedures. The frequency of obstetric and perinatal pathology in this group significantly decreased in comparison with that among the control patients which allowed to greatly reduce material and financial expenditures.

[The use of restorative medicine technologies for the rehabilitation of the patients presenting with endometriosis of external genitalia].

This paper reports the results of analysis of the psycho-emotional status and pain syndrome in the women presenting with endometriosis of external genitalia treated with a combination of hormonal preparations and balneotherapy. A total of 216 infertile patients were involved in the study. The duration of the infertility period varied from 1.5 to 19 years. All the patients underwent surgical intervention. The influence of rehabilitative therapy on the quantitative vital indices (psycho-emotional adaptation to the social environment and pain intensity) was estimated before and after the treatment. The patients were divided into 3 groups. Those of group 1 received an oral contraceptive (30 mcg of ethinylestradiol plus 2 mg dienogest) as a continuous three-cycle course (63 tablets) followed by its discontinuation for the 7 day menstrual period and the final three-cycle course (total duration of therapy 6 months). The patients of group 2 were treated with injections of agonists of gonadotropin releasing hormone (GnRH) at a dose of 3.75 mg once every 4 weeks (total duration 6 months). In group 3, the injections of GnRH agonists (3.75 mg once every 4 weeks, total duration 6 months) were combined with a course of balneotherapy using radon. All the three rehabilitative modalities produced a well-apparent positive effect. Chronic pelvic pain before treatment was reported by 90,3% of the patients. After the treatment, the number of such women in groups 1, 2, and 3 decreased to 20,8%, 12,5%, and 30,6% respectively Dyspareunia in the pre-treatment period was diagnosed in 66,7% of the patients. After treatment, this pathology persisted only in 23,6%, 18,1%, and 31,9% of the patients in groups 1, 2, and 3 respectively. Psycho-emotional disorders before treatment were documented in 90,3% of the patients compared with 27,8%, 25%, and 30,6% after therapy. It is concluded that all the three therapeutic modalities markedly improved health conditions of the patients presenting with endometriosis of external genitalia, but the combination of GnRH agonists with radon therapy produced the most pronounced clinical effect.

[Non-medicamental correction of the hormonal and psycho-autonomic status in women with pathology of the reproductive system treated at health resort of the Krasnodar Krai (region)].

The authors report the results of the study on the hormonal and psychovegetative status, functional activity of the vegetative nervous system, the level of activity of the protective and adaptive hemostatic mechanisms, and the clinical features of concomitant extragenital pathology in 90 adolescent girls suffering uterine bleeding. All the patients had gone through in-patient and out-patient phases of therapy, sixty of them were selected for the spa and resort rehabilitative treatment. The use of rehabilitative technologies on an individual basis at a spa and resort facility made it possible to ensure rather high efficacy of the combined therapeutic and preventive treatment of reproductive system pathology and concomitant psycho-vegetative disorders. It helped to decrease the frequency of relapses of uterine bleeding and exacerbation of the accompanying extragenital diseases.