[Risk-factors of cholelithiasis and chronic cholecystitis during pregnancy].

The peak of cholelithiasis formation in women concurs with reproductive period and physiological pregnancy serves as a starter of pathological processes in bile-excreting system. The aim of investigation was to reveal the risk-factors of cholelithiasis and cholecystitis during pregnancy. Investigation was a case-control type. A main group consisted of 30 cases. 2-4 pregnant patients in control group were corresponding with each case from main group. Basic significant prognostic factors of cholelithiasis and cholecystitis were determined. They are: fat-rich diet (OR=5.00), feeding irregularity (OR=5.78), visceral obesity (OR=2.67), artificial abortion (OR=3.25); among notable abdominal symptoms during pregnancy are heaviness sensation in right lateral region (OR=406.0), dull ache sensation in right lateral region (OR=196.0) and heartburn sensation (OR=14.50). Thus, revealing the anamnestic risk-factors related with pregnancy and delivery on any stage of pregnancy will be very useful for prevention of cholelithiasis and chronic cholecystitis. The results need to be confirmed by further investigations.

[Relationship of cholelithiasis with obesity in pregnancy].

The aim of investigation was to study the influence of obesity on the development of cholelithiasis and chronic cholecystitis in pregnant patients. The type of investigation was case-control study. Inclusion criteria were cholelithiasis and chronic cholecystitis. Exclusion criteria were severe maternal diseases (preeclampsy, eclampsy, haemorrhagia) during pregnancy and in past. The main group consisted of 30 cases. For each case 2-4 pregnant patients served as control. Obesity was assessed by body mass index (BMI), and visceral obesity before pregnancy--by waist circumference (WC, criterium of WC>88 cm). In main group obesity by BMI was observed in 19 cases (63.3%), in control group--in 18 subjects (20.0%); therefore statistically significant odds ratio was OR=6.90 (95%CI--2.80/17.07). In main group obesity by WC was observed in 12 cases (40.0%), in control group--in 18 subjects [20.0%; OR=2.67 (95%CI--1.09/6.52)]. Increment of BMI during pregnancy in main group was 7.5+/-1.6 kg/m2; in control group--4.5+/-1.6 kg/m2 (p<0.001). As for WC increment during pregnancy, in main group it was 23.2+/-1.9 cm; and in control--18.1+/-3.8 cm (p<0.001). BMI, WC values and their increment are significantly increased in patients with diseases of gall bladder during pregnancy. Physiological dyslipidemia during pregnancy is more aggravated, but in patients with diseases of gall bladder lipid characteristics are even greater deteriorated.

[Peculiarities of lipid metabolism during pregnancy].

More than 200 mln women become pregnant every year. In most cases outcome of labor is successful. The hormonal status changes during pregnancy initiate various adaptive mechanisms. Among them is "switch" of the energetic metabolism to lipid metabolism. It undergoes essential changes. The aim of our investigation was to study the peculiarities of lipid metabolism during pregnancy. 30 pregnant patients have been investigated based on 2 stage dynamics: I stage--pregnancy period=13.0+/-1.4 weeks; II stage--pregnancy period=35.7+/-0.5 weeks. Total cholesterol, HDL, LDL, triglycerides, VLDL and Index of atherogenic risk have been measured by biochemical analysis. The parameters of lipid metabolism became significantly impaired, except HDL (40.0+/-5.8 vs. 57.5+/-9.4 mg/dl), which increased significantly. They revealed significant both direct and inverse correlations with sex hormones. Obtained results point to the body's adaptive mechanisms expressed in the increase of antiatherogenic fraction of total cholesterol; and the influence of sex hormones as well. With the increase of period of pregnancy physiological dyslipidemia became worse, which might be metabolic basis for the development of "prestage" of gall-stone--cholestasis of gall-bladder.

Pap testing and direct immunofluorescence for Chlamydia trachomatis infection in pregnant women.

The aim of the study was to determine the potential for both Pap testing and direct immunofluorescence assay for detection of chlamydia trachomatis infection in pregnant women. A total of 351 pregnant women (first to second trimesters; age range: 15-30 years) were recruited. The background data relating to social and marital status, age, anamnestic data were recorded. Serum samples were tested for IgM antibodies specific to Chlamydia trachomatis by ELISA. Cervical Pap smears were stained by Papanicolaou and direct immunofluorescence. In the present study the overall rate of C. trachomatis infections in pregnant women was 33%. Pap testing suggested a diagnosis of chlamydia trachomatis infection in 8.5% of cases only, direct fluorescence showed positivity in all patients. The highest incidence of unmarried status was recorded in the patients with mixed chlamydial infection and trichomoniasis, also with chlamydial monoinfection, rare visits to the gynecologists were common in patients with mixed chlamydial infection and trichomoniasis, mixed chlamydial and HPV infections, also with chlamydial monoinfection, multiple lifetime sex partners were reported by the patients with combined chlamydial infection and trichomoniasis, also with chlamydial monoinfection. The prevalence of asymptomatic C. trachomatis infection was lower in women with mixed non-viral infections. The incidence of pelvic inflammatory disease was higher in the patients with mixed chlamydial infection and trichomoniasis, mixed chlamydial and HPV infections, and chlamydial monoinfection, incidence of spontaneous abortions was higher in the patients with mixed chlamydial and HSV infections, also with chlamydial monoinfection, incidence of ectopic pregnancy was higher in the patients with mixed chlamydial infection and trichomoniasis, also with mixed chlamydial and HPV infections. Chlamydial infection including cervicitis was frequently diagnosed in women with mixed chlamydial and HSV infections, also with chlamydial monoinfection.

[Peculiarities of lipid metabolism in pregnant patients with chronic cholecystitis].

Chronic diseases of gall-bladder are found in 3-5% of pregnancies. Lipid metabolism also undergoes essential changes. The aim of our investigation was to study the peculiarities of lipid metabolism in pregnant patients with chronic cholecystitis. 33 pregnant patients with chronic cholecystitis have been investigated. The duration of pregnancy was 36,8+/-0,4 weeks. Control group consisted of 30 practically healthy pregnant patients in the third trimester. All parameters of lipid metabolism have been determined by biochemical analysis. The parameters of lipid metabolism became significantly impaired in patients with chronic cholecystitis in comparison with controls. They revealed significant both direct and inverse correlations with sex hormones. Obtained results point the organism adaptive mechanisms expressed in the increase of antiatherogenic fraction of total cholesterol; also the influence of sex hormones. In pregnancy, physiological dyslipidemia increases, which is metabolic basis for the development of "prestage" of gall-stone--cholestasis of gall-bladder.

Prevalence and risk factors for Chlamydia trachomatis infection in pregnant women.

The aim of this study was to determine the prevalence and risk factors for Chlamydia trachomatis infection in pregnant women. A total of 351 asymptomatic pregnant women (first to second trimesters; age range: 15-30 years) were examined. The background data related to social and marital status, age, anamnestic data were also recorded. Serum samples were tested for IgM antibodies specific to Chlamydia trachomatis by an enzyme-linked immunosorbent assay (ELISA). In the present study the overall rate of C trachomatis infections in pregnant women was 33% including 41 women (38.7%) under 20 years, 39 women (36.8%) in age of 21-25, and 26 women (24.5%) in age of 25-30. The age group under 20 years exhibited higher risk of infection. There was a significant correlation between the Chlamydia trachomatis infection rate and clinical risk factors such as rare visits to the gynecologist, pelvic inflammatory disease, premature delivery, spontaneous abortions, ectopic pregnancies, C. trachomatis-positivity, chlamydial cervicitis in anamnesis. The prevalence of asymptomatic C. trachomatis infection in pregnant women is 72.6%, therefore, we suggest the screening for chlamydial infection of all pregnant women at least once during their pregnancy.

[Ultrasound tomography in the topical diagnosis and evaluation of results in the treatment of patients with stage III and IV ovarian cancer]. / Ul'trazvukovaia tomografiia v topicheskoi diagnostike i otsenke rezul'tatov lecheniia bol'nykh rakom iaichnikov III i IV stadii.

The paper describes an experience with ultrasonic tomography of the abdominal cavity and small pelvis in 34 cases of stage III and IV ovarian cancer who received polychemotherapy. In application of the said procedure, the topography and size of primary and disseminated tumors were ascertained and the immediate effect of medication assessed. The results of ultrasonic tomography were analysed in combination with other methods of research.

[Serum lipids in epithelial ovarian tumor patients]. / Lipidy syvorotki krovi u bol'nykh épitelial'nymi opukholiami iaichnikov.

The report deals with the studies of lipid profile of blood serum and alpha-lipoproteins in 59 cases of epithelial ovarian tumors as well as the effects of surgery and chemotherapy on the serum levels of major lipids. Triglyceride and phospholipid levels In the serum of cancer patients appeared to be much higher than in healthy controls. Serum lipid distribution patterns were normal in patients with benign tumors of ovaries. Serum levels of total cholesterol and alpha-lipoprotein phospholipids in cancer patients were much lower than in healthy controls thus pointing to a considerably decreased level of this fraction of lipoproteins. Surgery was shown to be followed by a noticeable rise in triglyceride levels and a decrease in serum phospholipid concentration in cancer patients. Post-operative polychemotherapy was followed by reversed changes in triglyceride and phospholipid concentrations. It was found that polychemotherapy is not an important factor affecting the serum level of alpha-lipoproteins in untreated patients.