[The role of health resort factors in preconception preparation of patients with reproductive disorders]. / Rol' sanatorno-kurortnykh faktorov v pregravidarnoi podgotovke patsientok s narusheniyami reproduktivnoi funktsii.

Reproductive dysfunction is a multifactorial problem, for the correction of which the most difficult are cases of pathology comorbidity. Individual preconception preparation, taking into account risk factors, is recognized as an effective measure to increase the chances of conception and prevent reproductive losses. OBJECTIVE: Optimization of treatment and rehabilitation measures at the preconception stage in patients with reproductive disorders. MATERIAL AND METHODS: The effectiveness of the use of natural and preformed physical factors in the preconception preparation of 180 women who underwent medical and rehabilitation measures in the health resort of the Altai Territory - the resort town of Belokurikha (Group 1, 79 patients) and outpatient conditions in the city of Barnaul (Group 2, 101 patients). Comprehensive spa treatment included climatotherapy, a combination of various methods: balneotherapy, peloidtherapy, physiotherapy and a prolonged course of herbal medicine. RESULTS: In patients of the 1st group, who underwent a course of rehabilitation treatment in a sanatorium-resort environment, compared with patients of the 2nd group, early reproductive losses were less common during pregnancy (7.1% and 20.7%, respectively; p=0.04) and more frequent term deliveries occurred (92.8% and 77.2%, respectively; p=0.02). The most significant predictors of the ineffectiveness of preconception preparation were the presence in patients of: chronic cystitis and autoimmune thyroiditis with hypothyroidism; oligomenorrhea at the time of pregnancy planning; aggravated by early reproductive losses and long-term wearing of intrauterine contraception history; burdened heredity for violation of carbohydrate metabolism. CONCLUSION: Comprehensive preconception preparation in the sanatorium-resort conditions of Belokurikha helps to increase the fertility of patients with reproductive disorders, the trophostimulating effect in the genital organs and the restoration of endometrial reception, which makes it possible to recommend this method for use in clinical practice.

[Reference ranges of matrix metalloproteinase-1, -2, -9 and tissue inhibitor of matrix metalloproteinases-1 concentrations in amniotic fluid in physiological pregnancy].

The aim of this study was to determine reference values of matrix metalloproteinase-1 (MMP-1), MMP-2, MMP-9 and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in the amniotic fluid at the first stage of labor in physiological pregnancy. 89 women at the first stage of term labor have been examined. Samples of amniotic fluid were taken at the first period of labor by vaginal amniotomy. Concentrations ofMMP-1, MMP-2, MMP-9, and TIMP-1 were investigated in amniotic fluid by ELISA kits. We have determined normal concentration ranges for MMP-1, MMP-2, MMP-9, TIMP-1, and ratios of concentrations of MMPs and TIMP-1 (MMP-1/TIMP-1, MMP-2/TIMP-1, MMP-9/TIMP-1) in the amniotic fluid at the first period of labor in physiological pregnancy. These included: MMP-1--5.1-16.8 pg/mg of protein, MMP-2--238.3-374.1 pg/mg of protein, MMP-9--66.1-113.3 pg/mg of protein, TIMP-1--4.7-13.6 pg/mg of protein, ratio of MMP-1/TIMP-1--0.1-2.2, ratio of MMP-2/TIMP-1--19.9-55.7, ratio of MMP-9/TIMP-1--4.2-17.2.

[The concentration of lactate in amniotic fluid in delivery under physiological course of pregnancy].

The study was carried out to establish admissible range of concentrations of lactate using standard biochemical method in amniotic fluid at first period of delivery under physiologically progressing pregnancy. The sampling included 44 women examined during first period of urgent delivery. The samples of amniotic fluid were taken during the first period of delivery using vaginal amnitomy. The concentration of lactate in samples of amniotic fluid was established using enzymatic amperometric technique. The reference values of concentration of lactate were established in the following admissible limits: 4.4-9.4 mmol per l; ratio lactate/creatinine - 17.7-79.4; ratio lactate/protein - 0.044-0.692. The admissible range of concentration of lactate and ratio lactate/creatinine and lactate/protein in amniotic fluid at first period of delivery under physiologically progressing pregnancy was established.