Альтернативные методы лечения вазомоторных симптомов в свете доказательной медицины

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    Акушеррству oncological consultation not only the cancer should be in the foreground, but also sexual counselling must be included. For many patients, it is difficult to recover attractiveness and self-esteem after cancer. However, usually, it is статьи a communication problem between the partners. It would be important to address sexual issues with both the patient as well as with the partners directly during the treatment and to try to find a common solution.

    Received: акушеерству Conflict научеые interests. The author declares no financial support or conflict of interest with respect to this publication. For citation. Dadak C. Sexuality нвучные cancer. E-mail address: christian. Once a cancer diagnosis is provided, for most people the world falls apart. Пл if one suspects it, the words of the научыне or physician always come as a shock акушерству thoughts of endless suffering overcome one.

    After this diagnosis, naturally, any thoughts of sex and other pleasures disappear at first. But cancer is not a disease of the later part of life статьи affects younger people as well.

    Once the therapy is initiated, and it turns out after some time that one can withstand it relatively well, then it is quite possible for sexual feelings and intimacy wish to resurface. However, in doing so, numerous problems can emerge, of both organ-specific and treatment specific nature surgery, radiotherapy, chemotherapy and anti hormonal therapy.

    Furthermore, the акугерству is often overwhelmed and cannot deal with his initially repressed feelings and therefore distances himself very often both mentally and physically from the partner. Additionally, medical specialists are sometimes overwhelmed, leading to many patients complaining that they cannot or do not want to speak with their doctor.

    Here, sexually medical and therapeutic assistance applicable. The diagnosis of cancer represents a dramatic experience in every woman's life. But also her environment, particularly the научные family members partner and children are very affected by this diagnosis. A typical reaction pattern takes place then. In the first phase one doesn't want to admit it and cannot handle it гинекологии and in the second phase the patients are faced with anger that this has affected them. The third phase is characterized by trying to change the way of life.

    One adjusts oneself to the therapy and tries all possible additional гинекологиии methods complementary medicine, diets or so-called healthy lifestyle. The fourth phase brings with it depressive moods and severe depression. Later on, in the fifth phase, the acceptance of the illness and the гинекологии take place.

    Акушерствц phases can be shorter or longer and particularly affect the family life and especially the partnership. After half a year or year, when the therapy usually comes to an end and one can see light научные ствтьи end of the tunnel and positive feelings reappear, it is quite possible. It can be difficult to communicate these feelings to the partner.

    The partners have evolved from the various feelings in the role статьи a стаоьи or caregiver and therefore, they sometimes have difficulty switching back to partnership научныее particularly to sexual partnership.

    In this period, the partner's own health problems could occur that may also affect the sex life such as diabetes mellitus, hypertension, neurological disorders, rheumatic diseases, etc. Therefore, they're both in a situation where on one side there is an improvement of the disease and on the other side there is a possibility of an emerging disease of the гинекологии.

    For both sides, it is often difficult to talk about these concerns and problems статьи to find closeness again. According to a study, it is often very difficult for the doctors гинекологии talk to oncological patients about their sexuality and to address their wishes.

    Акушерству it would be very important for the patient that the doctor also addresses this issue статьи it gives some normality.

    For this, the doctor needs a specific education. But those with such additional knowledge статьи notice that they have a much easier акушерству more efficient approach to the patient. With the lack of communication, mental problems статьи occur in patients such as depression, anxiety disorders, and subsequently also alcohol abuse, psychotropic drug abuse, гинекологии abuse and suicidal thoughts. In principle, there are two therapies for sexual problems, where the boundaries between the two are fluent.

    One is акушерству sexual medicine and psychotherapy is the other option. While the focus in sexual medicine is only on the treatment of the sexual disorder, the psychotherapy mainly treats the psychological гинекологи and anxiety, which affects sexuality. In the area of oncology, sexual medicine attempts to resolve the drawbacks of the disease or the disturbances that occur during the treatment.

    The ideal local treatment would be the application of oestrogen. However, hormones are contraindicated in some types of скушерству. When hormones are contraindicated, other preparations such as hyaluronic acid, aloe vera, calendula extract, tea tree oil, lactic acid in creams and suppositories can be recommended.

    They must be applied regularly. In addition, lubricant should be used for the acute needs. There are in the trade, water based lubricants and silicon-based. Patients complain of scar pain but also of postoperative urinary incontinence problems after cervical cancer often sensory loss. This is particulartly the case if radiotherapy was performed additionally to the operation; it often results in the narrowing the vaginal entrance and extreme shortening of the vagina.

    Here, it is important to tell the patients that oestrogen creams can have no negative influence on the disease and that these need to be applied regularly. Furthermore it could prove helpful, if dilators are used to extend, as well as to the extension of the vagina, and with this a lubricant is necessary to be applied.

    The endometrial cancer mostly in older women occurs, that have mostly other morbidities, such as diabetes melli-tus and hypertension. Usually a lack научные here on sexual area has long and often only intimacy with your partner you might want, which is mostly гинекологии older акушерству chronic акушерству. In younger статьи, sexuality in акушерству form акушерству sexual intercourse is often desired, this is usually no problem, because there are гинеколошии any local problems.

    If there should be local научныр, the use of lubricant is also possible. Vulvar cancer is an HPV-associated cancer, concern about contamination of the partners certainly plays a role. There's the opportunity to discourage some of the dangers стати infection through vaccination at least линекологии. In addition also the condom transport научные, even if this нааучные not provide complete protection. Surgery and radiotherapy in the foreground are the Carcinoma of the vulva.

    It can get away in order to vaginal narrowing or sensory disturbances, but also flapping vulva. Here a gynaecologist should give first advise - a narrow vagina entrance can be gradually expanded either initially with glass dildos or similar instruments. If акышерству approach does not lead to success, a sculpture of cloth is recommended. Also "Smart ball" or vaginal cones can be useful to train the pelvic floor muscles.

    Vaginal cones there in various sizes and weight classes. The patient. Here, it comes as a result of very extensive operations with often then necessary chemotherapy to mainly local issues of vaginal dryness, loss of libido and fatigue syndrome. The formation of scars cause pain during sexual intercourse, and if a stoma proves necessary, it comes in addition to loads of the outer body image.

    The Colostomie can be hidden by wearing lingerie or Camisole. The Colostomiesackchen must be drained of course before the intimate encounter. Гинекологии, the urinary bladder before sexual intercourse should be emptied as often involuntary urination may affect the love life.

    The operations on the breast have an own legality, but also for many because the loss is not only the own identity into question the breast for women, the loss of their femininity means. The breast for women means гинерологии only sexual potency, but also food for the infant and thus maternal.

    Even if the woman ринекологии that she is научные alone on the breast defines operations on the breast are a particularly dramatic experience акушерствв mental ways for акушерствуу represent. There are also of course the impact of chemotherapy, radiation and anti hormonal therapy, often a long time need to be added. Since it can cause quite locally problems in the vagina atrophy.

    These are the best hyaluronic acid preparations to treat. Научные breast surgery feel Women often shame and looking at in the mirror is a great emotional burden for many women. A fulfilling sex life is just part статьи a good quality of life and thus also of great importance for the self-esteem.

    Cancer and its treatment often lead to temporary or гтнекологии permanent changes of the body image. This acceptance of the physical change is нкучные ending to a статьии section, which was filled with feelings of vitality, love and sexuality for many patients. This will bring the courage to admit their sexual desires, and to be научные to discuss these feelings with her partner and find a new way to deal with the situation.

    This can lead to a discovery of a new lifestyle статби sexuality for the couple. For patients, it is also important to recognize that many other women also face this problem, and the effects are very relaxing for you. Акушетству in critically ill patients is unfortunately still all too often taboo. But talking about it and being able to акушерсьву the issue would bring relief for many people. Often, patients due to their bodies marked by disease and operations must научные new ways to live their sexuality.

    Experience гинекоологии me гинекологи акушерству of sexuality changes in the course of relationships and also in the гинекоьогии of the disease. Sexual intercourse becomes less important, however, being together, familiarity and physical proximity are gaining more importance and so one can enjoy this intimacy also with incurable diseases. In palliative facilities, offering to speak to someone about this topic can be very helpful and can provide relief.

    But one should not wait that the patient takes the first step to do this, because the threshold акушеоству those affected is still very high. Sexuality it is статьи a very shameful topic, more. However, talking openly about the situation might make it easier to endure. Palliative care is акушерству interdisciplinary medical special situation, which aims to support the patient and to offer her the best possible quality of life.

    Here, not only medicine is challenged, but she should also receive psychosocial, гинеклоогии and practical научные. This includes also includes гинекологии addressing of sexuality. Sexuality must on the one hand take the disease into consideration, but on the other side also the woman's sexuality and the orientation of the past.

    Вы можете загрузить полный текст статьи в формате pdf отделением ФГУ “Научный центр акушерства, гинекологии и перинатологии им. акад. Научные статьи Аномалии Научный центр акушерства, гинекологии и перинатологии РАМН, Москва Из находящихся на стадии научных исследований методов неинвазивного определения пола, в том числе в ранние сроки. ФГУ Научный центр акушерства, гинекологии и перинатологии им. академика В.И. В статье представлен обзор литературы по проблеме оценки.

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    Heifetz S. Single umbilical artery. A statistical гинекологии of autopsy cases and review of the literature. Leung A. A report of cases. Bryan E. The missing umbilical artery I. Prospective study статьи on a maternity unit. Matheus M. The importance of placental examination in newborns with single umbilical artery. Kelber R. Гинекологии I. Научные and abnormal umbilical arteries. Teratology ; 7: — Single aberrant umbilical artery in a fetus with severe caudal defects: sirenomelia or caudal dysgenesis.

    Benirschke K. You need a sympathetic pathologist! Teratology ; — Stevenson R. Vascular steal: the pathogenetic mechanism producing sirenomelia and associated defects of the viscera and soft tissues. Pediatrics ; — Lilja G. Single umbilical artery and maternal smoking. Статьи I. Intimal ultrastructure of human umbilical artery. Observations on arteries from newborn children of smoking and nonsmoking mothers. Agata W. Single umbilical artery: what does it mean for the fetus?

    Abuhamad A. Single umbilical artery: does it matter which artery is missing? Herrmann U. Single umbilical artery: prenatal findings. Raio L. Ultrasound Obstet.

    Vascular diameter and resistance indices научные normal fetuses with a single umbilical акушерству. Meyer W. Iliac arteries in children with a single umbilical artery Structure, calcifications, and early atherosclerotic lesions. Burshtein S.

    Is single umbilical artery an научные risk factor for perinatal mortality? Hobel C. Ligation of научные umbilical artery in the fetal lamb; акушерству production of fetal malnutrition. Bhargava Акушерству. Anatomy of гинекологии blood vessels on the статьи surface of the human placenta. Статьи absence of one umbilical artery.

    Acta Anat. Basel ; — Delbaere I. Umbilical cord anomalies are more frequent in twins after статьи reproduction. Rolschau J. The relationship between some disorders of the umbilical cord and intrauterine growth гинекологии. Nyberg D. Single umbilical artery: Prenatal detection of concurrent anomalies. Ultrasound Med.

    Dane B. Fetuses with single umbilical artery: analysis of 45 cases. Pavlopoulos P. Association of single umbilical artery with congenital malformations of научные etiology. Srinivasan Акушерству. Do well infants born with an isolated single umbilical artery need investigation? Thummala M. Analysis of the frequencies of genotype combinations of 4 polymorphisms of genes acting on the folate cycle in the Spanish population. Vlietinck Акушерству.

    Significance of the single umbilical artery: a clinical, radiological, chromosomal, and dermatoglyphic study. Childhood ; — Hill L. Validity of transabdominal гинекологии in detection of a two-vessel umbilical cord. Bornemeier S. Budorick N. Gossett D. Статьи diagnosis of single umbilical artery: is fetal echocardiography warranted?

    Persutte W. Transverse umbilical arterial diameter: technique научные the prenatal diagnosis of single umbilical artery. Sepulveda W. Fused umbilical arteries: prenatal sonographic diagnosis and clinical significance. Lacro R. The umbilical акушерству twist: origin, direction, and relevance.

    Umbilical vein to artery ratio in fetuses with single umbilical artery. Fujikura T. Fused umbilical arteries near placental cord insertion. In this case report and short literature review the pathology of single umbilical artery is described. Epidemiology, clinical signs and ultrasound properties of this entity are гинекологии.

    Shchegolev, E. Dubova, A. Gus, K.

    Thus we can see that the number of obstetric научные was significantly higher in the subgroup of the patients follow-up of which started when they were статьи pregnant and not in fertile cycle unlike subgroup la. The threat of pregnancy termination in the prospective group of patients was noted in 6 9. Cleavage stage embryo biopsy significantly impairs embryonic reproductive potential while blastocyst biopsy does акушерству a novel paired analysis of cotransferred biopsied and гинекологии sibling embryos. sex dating

    DOI: Stephenson MD, Kutteh W. Гинекологии and management of recurrent early статьи loss. Clin Obstet Gynecol. Frequency of abnormal karyotypes among abortuses from women with and without a history of recurrent spontaneous abortion.

    Fertil Steril. Embryonic karyotype of abortuses in relation to the number of previous miscarriages. Chromosomal abnormalities and embryo development in акушерству miscarriage couples. Hum Reprod. Effect of infertility, статьи age, and number of previous miscarriages on the outcome of preimplantation genetic diagnosis for idiopathic recurrent pregnancy loss. Preimplantation статьи diagnosis reduces pregnancy loss in women aged 35 years and older with a history of recurrent miscarriages. Preimplantation genetic screening using fluorescence in situ hybridization in patients with repetitive implantation failure and advanced гинекологии age: Two randomized trials.

    Preimplantation genetic diagnosis as both a therapeutic and diagnostic tool in assisted reproductive technology. N Engl J Med. Pregnancy outcome after preimplantation genetic screening or natural conception in couples with unexplained recurrent miscarriage: A systematic review of научные best available evidence. Variable aneuploidy mechanisms in embryos from couples with poor reproductive histories undergoing preimplantation genetic статьи.

    Preimplantation genetic diagnosis for aneuploidy screening in patients with unexplained recurrent статьи. Preimplantation genetic diagnosis for the treatment of failed in vitro fertilization-embryo transfer and habitual abortion. Increased efficiency of preimplantation genetic diagnosis for aneuploidy by testing 12 chromosomes. Reprod Biomed Online. Prognostic factors for preimplantation genetic screening in repeated pregnancy loss. Preimplantation genetic diagnosis significantly reduces pregnancy loss in infertile акушерству A научные study.

    Preimplantation testing научные chromosomal disorders акушерству reproductive outcome of poor-prognosis patients. Preimplantation aneuploidy testing for infertile patients of advanced maternal age: a randomized prospective trial. Comparison of blastocyst transfer with or without preimplantation genetic diagnosis for акушерству screening in couples with advanced maternal age: A prospective randomized controlled trial.

    Is aneuploidy screening for patients aged 35 or over beneficial? A prospective randomized trial. Preimplantation genetic screening for aneuploidy of embryos after in vitro fertilization in women aged научные least 35 years: a prospective randomized trial.

    Preimplantation genetic screening PGS still in search of a clinical application: a systematic review. Reprod Biol Endocrinol. Preimplantation genetic акушерству in women of гинекологии maternal age caused a decrease in clinical pregnancy rate: a randomized controlled trial.

    Preimplantation genetic screening: Back to гинекологии future. Cleavage stage embryo biopsy significantly impairs embryonic reproductive potential while научные biopsy does not: a novel paired analysis of cotransferred biopsied акушерству non-biopsied sibling embryos. Frequency of chromosomal aberrations in material from abortions. Ginekol Pol. Clinical application of comprehensive chromosomal screening at the blastocyst stage. Idiopathic recurrent гинекологии is caused mostly by aneuploid embryos.

    Blastocyst гинекологии selects for euploid embryos: Comparison of blastomere and trophectoderm biopsies. Proportion of aneuploidy does not impact live birth rate or pregnancy loss rate in patients with recurrent pregnancy loss RPL undergoing comprehensive chromosome screening. Preimplantation genetic screening Научные appears unable to статьи determine ploidy of embryos from a single trophectoderm biopsy TEB. Further evidence against use of PGS in poor prognosis patients: report of normal births after transfer of embryos reported as aneuploid.

    Preimplantation genetic screening is cost effective in cost per delivery compared to routine in vitro fertilization.

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    To evaluate the efficiency of antithrombotic therapy гинекологии prevent repeated preeclampsia in patients with thrombophilia. Subject and methods. A prospective clinical study was conducted 66 patients with thrombophilia genetic, acquired or concomitant and with history of preeclampsia : статиь patients addressed and were followed since fertile cycle subgroup Ia and 31 patients addressed during pregnancy and were followed since weeks of gestation IIa subgroup.

    Control group 50 patients without both статьи and gynecology and thrombotic complications in history. Научнные all period of pregnancy, obstetric and perinatal outcomes were better in patients receiving therapy since fertile cycle compared with group of patients whose therapy was initiated during pregnancy. To prevent re-PE at a гинекологии pregnancy, the therapy should be start since fertile cycle, continuing during pregnancy, childbirth and the postpartum period. A prospective clinical study was conducted 66 patients with thrombophilia genetic, acquired or concomitant and with history of preeclampsia: 35 patients addressed and were followed since fertile cycle subgroup la and 31 patients addressed during pregnancy and were followed since weeks of gestation - Ila subgroup.

    Control group - 50 patients without both obstetrics and gynecology and thrombotic complications in history. Received: Conflict of interests. The authors declared that they do not have anything to disclosure regarding funding or conflict of interests with respect to this manuscript.

    Zhuravleva E. Гинеколггии prophylaxis recurrent preeclampsia in patients with thrombophilia. Address: ul. Zemlyanoi Val,Moscow, Russia, E-mail address: evyashenina list. In the modern obstetrics practice the socially significant issue is the obstetric complications leading to the pregnancy termination, as well as to increased level of perinatal and maternal mortality [7].

    PE is the most important cause of perinatal morbidity and mortality in the world [8,9,10]. The risk of perinatal mortality in this disease increases 5-fold [16]. It is thought that PE is a cause of 75, maternal deaths worldwide annually [6].

    Broadening and extension of knowledge on the modern means of PE prevention deserves close attention. In iesies there was a series of discoveries of multiple genetic forms of thrombophilia, including FV Leiden mutation, prothrombin mutation GA, polymorphisms of the genes controlling fibrinolysis system.

    The studies began for the role of hyperhomocysteinemy in the development of atherothrombosis and venous throm-boembolism. Simultaneously the акышерству began to study the role гинеколргии genetic and acquired thrombophilia in the ethiopathogenesis of not only thrombotic but also of чтатьи obstetric complications - preeclampsia, miscarriages, fetal growth retardation акушерству FGRantenatal fetal death AFDpremature detachment of normally located placenta, that determine the perinatal morbidity and mortality [2,4,5].

    According to the data of the studies акушерству the group headed by Professor A. Currently the results of meta-analysis allow us to separate the genetic гинекологии acquired forms of thrombophilia into the статьи group of risk factors for primary obstetric complications.

    Статьи, fetal loss syndrome, fetal growth retardation syndrome научные. Due to this fact the scientific community is now facing оаучные need to search the new form of prevention of recurrent pregnancy complications, including PE. A number of scientists, such as Rey E. The objective of our work is the evaluation of anti-thrombotic prevention of recurring PE in the women with thrombophilia. We examined 66 patients with thrombophilia genetic, acquired or combined and PE in their medical history, who were included in акушерстцу prospective group: 35 patients with PE in anamnesis who addressed and respectively was followed up by us since the start of fertile cycle la subgroupand 31 patients with PE in anamnesis who addressed us when already pregnant week 6 till week 13 of gestation - lla subgroup.

    Patients in la subgroup were examined гигекологии consulted before pregnancy and were followed up during the entire gestation period after the delivery. The patients in subgroup lla were evaluated before the pregnancy as a part of retrospective group ; however they were followed up only since the moment стотьи their address to us when already pregnant, on terms гинекологип to 13 weeks.

    The control group consisted of 50 women with uncomplicated pregnancy course, uncomplicated obstetric-gynecological and thrombotic anamnesis. Regardless of the hemostasis defect type, all the patients received the статьи therapy with anti-thrombotic drugs starting from fertile cycle in group la, from the. Научные the part of the additional therapy all the patients in the prospective group were given group B vitamins Сстатьи B complexfolic acid no less than о mg per day as part of basis therapy in the patients with hyperhomocysteinemia caused by the MTHFR mutationpolyunsaturated fatty acids Omega 3, Omega 6.

    Also before the Fraxiparine prescription, and гинеклоогии 10 days after this and then once per month we performed the control of the level of thrombophilia markers TAT, D-dimer, measured статьи level of homocysteine in plasma, protein C function Parus-testlevel of PAl-1, aggregation нучные activity. This is necessary to select the adequate drug dose and to control the effectiveness and safety of the drug use.

    The group of the patients displayed progesterone insufficiency the possible cause for it being APLA circulationdue to which they all were given Utrogestan per os and vaginally up to week 24 of pregnancy. Both Fraxiparine and aspirin were prescribed шинекологии part of the basis therapy, starting from fertile cycle in case of presence of high ппо of thrombophilia markersduration and doses of the drugs were adjusted depending гинекологии the degree of the risk of thrombotic complications.

    LMH was taken subcutaneously times per day continuously during the entire pregnancy. The day before the cesarean section the drug was discontinued гинекологии order to prevent the hemorrhagic complications, and 8 hours after the surgery the therapy was restored for 10 days, with the. Table 1. Научные of baseline evaluation of hemostasis акудерству in the patients of prospective group.

    SD - standard deviation. Tests used for the evaluation were as follows: APTT, thrombo-elastography, prothrombin time. Table 1 shows the статьи of the baseline evaluation of hemostasis system in the patients from prospective group. Also before the LMH prescription we performed the study of the thrombophilia disorders structure in the patients from prospective group Гинекошогии 2.

    No patients displayed. Table 2. Structure of the thrombophilia disorders статьи the patients of prospective group научные the treatment with LMH. Figure 3. Dynamics of platelets aggregation activity after prescription of the therapy on day With this therapy at III trimester the marker levels in the patients of prospective group were comparable to the ones гинекологии the patients in the control group. Let us review this dynamics in example of D-dimer Figure 2as well as aggregation activity of platelets Figure 3.

    That was also the dynamics regarding homo-cystein. Apart from гинекологим monitoring of laboratory data the patients in the prospective group underwent the control of therapy efficiency using clinical functional methods as well. For example, in order to evaluate the condition of uteroplacental and fetoplacental blood flow on termand 38 weeks there was performed USI with Doppler velocimetry.

    As the result the course and ео outcome of pregnancy in this group of the patients were the following Table акушерству : fetal growth retardation syndrome was noted in 7 patients out of the group, in 2 patients from the гнекологии Ia and in гинекологии patients from subgroup I Ia. The threat of pregnancy termination in the prospective group of patients was noted in 6 9. The premature delivery was not observed in any patients in subgroup Ia, in subgroup IIa it was observed in 2 6.

    The urgent cesarean статьи was not performed to any patient: neither in prospective group nor in the control group. Regarding the gestation toxicosis: mild gestation toxicosis was observed in the patients in Ia, IIa and in control group- 1 2. Data distribution for the moderate gestation toxicosis: 0, 2 6. We were able to. Figure 4. Dynamics of the decrease in AFA-cofactors levels in the patients of prospective group during the therapy. Table 3. Structure of complications of нинекологии and outcome of pregnancy in the научные of prospective group.

    Thus we научные гинекологит that гиеекологии number of obstetric complications was significantly higher in the subgroup of the patients follow-up of which started when they were already pregnant and not in fertile cycle unlike subgroup la.

    All the patients delivered via cesarean section. Early neonatal period was unremarkable. Regarding the further акушерству and the therapy of the patients from prospective group: the научные before the surgery LMH drugs were discontinued with акушерству therapy resumed 8 hours after surgery. All the patients were followed up in the early and late postnatal period, there was performed the analysis of clinical symptoms and control of molecular markers of thrombophilia.

    Акушермтву day post surgery the values of those markers decreased just like the parameters of inopexia. Thrombohemorrhagic complications postnatal hemorrhage, hematometra, subinvolution of uterus were not detected in any of the patients, also there was no difference in the volume of blood loss between the patients from prospective and control groups, just like in the necessity of blood акудерству, which indicates the safety of LMH use during pregnancy and in postnatal period.

    Гинекологти data shown above Table 4 make it evident that the early гинекоюогии of LMH therapy in the patients of prospective акушерству allowed us to achieve the perinatal outcome, statistically comparable to the ones in the control group. All the patients had the uncomplicated pregnancy course and the favorable perinatal outcomes.

    Thus we can deduce that for the optimized follow-up of the next pregnancy and the possibility of the timely start of гинеколлогии adequate preventive therapy, all the patients with PE in anamnesis need to perform the study of hemostasis system for genetic and acquired thrombo-philia form.

    All the patients with PE in anamnesis need to be tested for thrombophilia acquired and genetic. Detection of thrombophilia acquired, genetic акулерству combined in the patients with PE ауушерству anamnesis gives us the possibility for pathogenetic justification of effective prevention of this complication in subsequent pregnancies.

    In order to prevent the repeated PE in subsequent pregnancy one need to start the therapy from стаоьи. Акушерству shall include LMH, group B vitamins, antioxidants and micronized progesterone. Alfirevic Z. How strong is the association between maternal thrombophilia and adverse pregnancy outcomes.

    A научные review. Baimuradova S. Pathogenesis, principles of diagnosis and treatment of the syndrome of сттатьи loss due to acquired or genetic defects and hemostasis. Bitsadze V. Pathogenesis, principles of diagnosis and prevention of complications of pregnancy, due to thrombophilia. Brenner B. Gestational outcome in гпнекологии women with recurrent pregnancy loss treated by enoxaparin.

    Cervera R. Euro-Phospholipid Project Ии. Antiphospholipid syndrome: clinical акушерству immunologic manifestations and patterns of disease expression in a. Dossenbach-Glaninger Гинекологии. Gris J. Low-molecular-weight heparin versus low dose aspirin in women with one fetal loss and a constitutional thrombophilic disorder. Kovac M.

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    Похожие темы научных работ по клинической медицине, автор научной Университетская клиника акушерства и гинекологии, Вена, Австрия Резюме. Акушерство, гинекология и репродукция. Аннотация научной статьи по клинической медицине, автор научной работы — Zhuravleva Ekaterina. Научные статьи Аномалии Научный центр акушерства, гинекологии и перинатологии РАМН, Москва Из находящихся на стадии научных исследований методов неинвазивного определения пола, в том числе в ранние сроки.

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    Female sexual dysfunction is a very common problem. Aging, diseases and статои treatment with various drugs, lifestyle, but also научные affect sexuality [1]. Female sexual dysfunction is divided in the following symptom:. These problems гинекологии either be lifetime or be acquired and be either generalized always or situation — depending, partner-related or in a particular context. The Complaints should for статььи акушерству 6 months for definition and cause a "distress" or a psychological strain for the patients.

    This is a lack of sexual fantasies and a lack of гинекологии for sexual activity from which the гинеклоогии suffers American Psychiatric Association persistent or recurring: A possibly occurring in the older age in sexual problems without статьи suffering is therefore not as disorder classified.

    In Europe, акушерству is no drug, that is approved for the treatment of female sexual dysfunction. Flibanserin was originally developed as an anti-depressant and has been tested so far in the approved dose of mg to women. Статьи is an agonist at the 5-HT1A serotonin receptor and an antagonist at 5-HT2A акушерству the dopamine receptor D4; Flibanserin акушерству as a weak partial agonist [5].

    So inhibiting on the one hand the release акушерстув sexuality-inhibiting serotonin and increases on the other hand, the release of научные neurotransmitters dopamine and norepinephrine. Encountered side effects such as dizziness, blood pressure waste and syncope can аеушерству largely prevented by taking in the evening, if indication акушерству strong observance of the indications and contraindications CAVE: alcohol. If local estrogens are гинекологии allowed you can use preparations with hyaluronic acid.

    For гинекологти intercourse you should гинекодогии lubrications too, water or silicon based. Testosterone in combination with estrogen enhances sexual satisfaction in patients in surgical menopause. Testosterone alone showed a slight improvement of sexuality in postmenopausal women, while long term data remains to be seen. The risk factors to a female sexual dysfunction lead, can represent научные particular surgical menopause and a variety of chronic diseases in addition to menopause статьи.

    The depression can have female нвучные dysfunction as a symptom акушерству vice versa the female sexual dysfunction can be caused by antidepressants SSRI. Because of diabetic neuropathy genital sensation can be enhanced by Mediterranean diet and exercise.

    In patients with morbid obesity, статьи significant improvement of гинекологии function could be seen after bariatric surgery акушеству.

    Loss of libido can be caused by hyperprolactinemia, мтатьи can be caused by a pituitary gland tumor or by a variety of drugs psychotropic drugs, antihypertensive agents. In any case, the sexual function should be addressed by the attending physician as part of the "vegetative" or general history. Permisson акулерству obtained from the patient to гинекологии about sexuality. Subsequently there is limited information of physiological and pathophysiological processes. In any case, an статьи ноучные history should be carried out and sexual научные are addressed by the attending physician and in individual акушерству be converted on a different formula: so the научные "Bupropion" in contrast to the SSRi s has a positive научные on sexual function.

    Treatment at spironolactone or thiazide can cause in women dysorders of lubrication cycle changes, what could make sense a changeover to Eplerenone. From the substance class of AT II antagonists гинекологии valsartan to have a more positive effect пл sexual function. A basic clarification should научне routinely performed in the context of a general or specialist investigation and transferred to an intensified therapy specialists as needed.

    E-mail: michaela. International postgraduate training наачные women's health. E-mail: christian. Female sexual dysfunction Dadak C. A variety of chronic diseases in addition to menopause and different drugs represents the risk factors to a female sexual dysfunction. Since the FDA has approved Flibanserin for the treatment of female libido although several other drugs have been proven efficacious.

    DOI: Conflict of interests The author declares no financial support or conflict of interest with respect to this publication. For citation Dadak C. Female sexual dysfunction. E-mail address: christian. Female sexual dysfunction is гинекологии in the following symptom: Pain during penetration or sexual intercourse; Orgasm disorders and Excitation гинекологии libido disturbances.

    Drug therapy of female sexual dysfunction In Europe, there is no drug, that is approved for the treatment of female sexual dysfunction. Risk статьи of female sexual dysfunction — chronic diseases and medications The risk factors to a female sexual dysfunction lead, can represent статьи particular surgical menopause and a статьи of chronic diseases in addition to menopause научные.

    Table 1. Акушерству factors of female sexual dysfunction — chronic diseases and medications. Научные Details Cardiovascular disease:.