[Method of Surgical Management of Genital Prolapse with Cervical Elongation].

Objectives: According to different authors, the percentage of genital prolapse among gynaecological diseases that require surgical correction reaches 28−38,9%. Pelvic muscle wasting is a special kind of pelvic prolapse, often leading to cervical elongation and hypertrophy. Contemporary methods of treatment for this condition have the high rate of relapse­ 8,9−22%, thus urging to improve the existing techniques. Purpose: This research was to estimate the effectiveness of novel modification of Manchester operation in comparison with classic Manchester operation in the management of pelvic prolapse with cervical elongation. Methods: We enrolled 83 patients with pelvic prolapse and cervical elongation and divided them into two groups. In GroupI (n=47) we used the novel surgical method, supplementing original Manchester procedure with cervical stump fixation and other improvements. In GroupII we used original Manchester procedure. We compared laboratory measures as well as surgery duration, blood loss, incidence of complications, and duration of post-operational hospital stay. Patients were followed-up for 2years to estimate long-term effectiveness of surgical intervention. Statistical analysis was performed in SPSS 17.0. Results: Surgery duration in GroupII was significantly longer (47,8±26,2 vs 57,5±35,1 minutes, p<0.05). There were no significant differences in lab tests, post-operational hospital stay (5,2±0,9 vs 7,3±1,2) and incidence of post-operational complications (3 vs 4 cases). Over the 2 years of follow-up we registered 1 case of relapse in Group I and 3 cases of relapse in Group II, thus estimating the effectiveness of surgery as 97,9 vs 91,7%, a non-significant difference. We noticed that all relapsed women had signs of systemic dysplasia of connective tissue. Conclusion: Suggested modification of Manchester operation improves duration of surgical intervention itself, while providing a comparable level of effectiveness.

[Serum trophoblastic beta 1-glycoprotein and alpha fetoprotein levels in physiological pregnancy]. / Soderzhanie trofoblasticheskogo beta1-glicoproteina i alpha- fetoproteina v syvorotke krovi pri fiziologicheski protekaiushchei beremennosti.

Measurements of maternal blood serum trophoblastic beta 1-glycoprotein and alpha-fetoprotein, carried out over the course of normal pregnancy, have demonstrated a progressive increase of trophoblastic beta 1-glycoprotein up to the 36th week, though its level somewhat reduced during the 28th and 32nd weeks. After week 39 the level of this protein in maternal blood serum progressively lowered. alpha-Fetoprotein level was increasing over the course of pregnancy as long as up to the 32nd-34th weeks, then lowering the rest of the term up to delivery. These data permit a conclusion that the time course of the afore-said specific protein concentrations in pregnancy sufficiently well reflects the processes of fetoplacental system establishment and functioning, this permitting the use of these protein measurements in monitoring the course of gestation.