[New methods of surgical correction of the puerperal anal sphincter insufficiency].

Treatment results of 612 patients aged from 17 to 71 years, with benign perineal diseases were analyzed. The rectovaginal fistula was diagnosed in 84 (13,7%), puerperal anal sphincter insufficiency - in 88 (14,4%) and rectocele was diagnosed in 139 (22,7%) of patients. 237 (38,7%) cases of perineal ruptures were analyzed retrospectively and 64 (10,5%) acute ruptures were analyzed prospectively. The suggested modified levatoroplasty includes the dissection of the proper fascia of the puborectal muscle, followed by the placation of the anterior muscle wall of the rectum and the posterior fascial sheet. After secure fixation of the first suture line, the second line sutures are applied on muscle tissue using monofilament resorbable material. The third line of the sutures connects anterior sheets of the proper fascia of the levators. Long-term follow up results were obtained in 80 (95,2%) of the operated patients. 63 patients reported excellent results, sphincter function had improved in 15 patients and operation had no effect in 2 cases.

[The characteristics of the endocrine function of the fetoplacental system in pregnant women with chronic pyelonephritis and nephropathy]. / Nekotorye osobennosti éndokrinnoi funktsii fetoplatsentarnoi sistemy u beremennykh s khronicheskim pielonefritom i nefropatie.

A follow-up study of 100 pregnant women with chronic pyelonephritis and superimposed nephropathy has shown that the major determinant of placental insufficiency is late toxemia of pregnancy, not the underlying disease. Estriol levels correlated with severity and duration of gestosis and thus provided the best predictor of fetoplacental insufficiency. Findings on placental lactogen production were less helpful since the production of this hormone was decreased only in severe nephropathy. The onset and progression of placental insufficiency were associated with rising progesterone concentrations in blood, which appeared to be a compensatory placental event.

[Status of the utero-placental blood circulation in pregnant women with chronic pyelonephritis and nephropathy]. / Sostoianie matochno-platsentarnogo krovotoka u beremennykh, bol'nykh khronicheskim pielonefritom i nefropatiei.

Dynamic scintigraphy was employed in studying of uteroplacental blood flow in 75 pregnant females with variety of nephropathic severity and duration developing in presence of chronic pyelonephritis. Hemodynamic disorders in the mother-placental system in females with associated gestosis were found to depend both on its severity and duration. In females with continuous severe nephropathy the most pronounced hemodynamic impairment was revealed at the late pregnancy, (37-38 weeks of gestation). The earlier the treatment of placental insufficiency started, the sooner uteroplacental blood flow recovered.