HPV infects epithelial tissues regardless of their location and penetrates into the cell through microscopic cuts. The clinical manifestations of HPV-associated diseases are diverse and equally relevant for women and men. Despite the fact that exophytic condylomas are regarded as a benign disease and establishing diagnosis does not cause difficulties, a clinician should always have oncological alertness, especially with regard to diffuse, long-lasting condylomatosis.

Stress urinary incontinence (SUI) is a common disease. It is 2 times more common among women than in men. The causes of SUI are the insufficiency of the closing function of the sphincter of the bladder and/or hypermobility of the urethra. For this reason, methods aimed at improving the closing function of the urethra, i.e., the use of volume-forming agents are justified for the treatment of this disease. Side effects and time-limited relief of symptoms of urinary incontinence after the application of volumeforming agents, or at the other hand complications after surgery lead to the search for alternative treatments that can restore the natural physiological mechanism of urinary retention. This study demonstrates that administration of platelet-rich autologous plasma in combination with hyaluronic acid in the periurethral region is a safe and effective method of treatment of SUI in women.

The article deals with the clinical case of a patient with giant uterine myoma. It presents the features of surgical intervention and postoperative management of the patient. In the publication, the authors discuss the issues concerning the scope of the surgery in patients with large and giant uterine myomas and prognosis of reproductive outcomes in this cohort of women.

The occurrence and development of such complications of pregnancy as preeclampsia, placental insufficiency, fetal growth restriction can be mediated by the systemic vascular damage. Understanding the pathophysiological mechanisms in the mother-placenta-fetus system contributes to the improvement of diagnostic methods and the selection of pathogenetically valid therapy for certain obstetric complications. In the systemic inflammatory response syndrome accompanying obstetric complications, the uncontrolled and excessive activation of proinflammatory mediators occurs, which leads to generalized tissue damage and development of multiple organ failure.

The use of antiplatelet agents at a preventive dose in pregnant women with high risk of placental insufficiency and fetal growth restriction contributes to the reduction of systemic and placental blood flow disorders by affecting the vascular endothelium, increasing the synthesis of prostacyclin and nitric oxide, thereby implementing its angioprotective properties and increasing blood flow in the arteries and existing collaterals.

The obtained data showed that adding of dipyridamole to the algorithm for managing pregnant women with high risk of placental insufficiency and fetal growth restriction, starting from the II trimester of gestation allows to reduce the risk of endotheliopathy and thrombophilia, improve obstetric and perinatal outcomes. 

The combined hormonal contraceptives are now one of the most effective methods of preventing unwanted pregnancies. They provide high contraceptive reliability, accessibility and ease of use, reversibility of effects, safety of use. Modern hormonal contraceptives provide additional therapeutic and prophylactic effects in various conditions. A new combined oral contraceptive Qlaira® was developed in the course of thorough scientific studies. The article presents the experience in using a combined hormonal contraceptive containing estradiol valerate and dienogest – Qlaira® (E2V/DNG). The observations showed high contraceptive effectiveness, acceptability and tolerability.

Purpose: presentation of modern data on the pathogenesis of menstrual cycle disorders (NMCs) associated with ovulatory dysfunction, and the effectiveness of their treatment with medication.

Basic provisions. It is shown that NMC is the result of violations of the cyclic production of gonadotropic and sex hormones. Among the hormonal drugs for the treatment of NMCs, combined estrogen-progestational oral contraceptives (COCs), especially those with drospirenone (DRSP), are advantageous. The introduction of calcium levomefolate - biologically active form of folatein the composition of COCs containing 30 μg of ethinylestradiol and DRSP has a potentiating effect associated with their noncontraceptive effects due to antiandrogenic and antimineralocorticoid activity. It was shown that calcium levomefolate, which participates in human body metabolism, as a component of COC, has a protective effect on the cardiovascular system (due to a decrease in the level of homocysteinemia) in the syndrome of polycystic ovaries, contributes to reducing obesity.

Conclusion. The combination of 30EE/DRSP promotes the normalization of the menstrual cycle and has non-contraceptive effects associated with antiandrogenic and antimineralcorticoid action, and fortification with calcium levomefolate also has a positive effect on the hormonal profile and lipid metabolism, has a protective effect on cardiovascular diseases in women with the metabolic syndrome in polycystic ovaries, contributes to the normalization of weight. 

The article provides a summary of the evaluation of efficacy of folate-containing oral contraceptive (Yaz® plus) containing gestagen with antiandrogenic and antimineralocorticoid effect, which, neutralizes the symptoms of primary dysmenorrhea in addition to preventing unwanted pregnancies, and also has registered indications for the treatment of acne.

The identification of the immune system disorders along with the impact on the causative agent and correction of such disorders is of great importance in the therapy of patients with endometritis. It has been established that the infectious agents are eliminated by the phagocytic system cells, therefore the optimal choice for the activation of anti-infective immunity are the immunomodulators acting on the monocyte-macrophage system cells. Use of immunomodulators: recombinant human interleukin-2 (Roncoleukin®, IL-2) and Interferon alfa-2b + Taurine + Benzocaine (Genferon®) in combination with the standard therapy showed its safety and efficiency in treating patients with endometritis after caesarean section.

Purpose of research. To analyze reproductive outcomes and relapses of endometriosis in women after surgical treatment of colorectal endometriosis depending on hormonal therapy.

Materials and methods. The article includes data on reproductive outcomes and recurrence of endometriosis in women undergoing surgical treatment for colorectal endometriosis in the surgical department of Kulakov National Medical Research Centre for Obstetrics, Gynaecology and Perinatology from 2014 to 2016. As an anti-relapse therapy, the first group of women received dienogest (DNG) at a dose of 2 mg/day, the second group included women who received a combined oral contraceptive containing DNG 2 mg + ethinyl estradiol (EE) 0.03 mg for the period of rehabilitation or prior to planning of pregnancy. The comparison group consisted of women who did not receive hormonal drugs in the postoperative period. Data on side effects and tolerability of the drug are also described.

Results. During the follow up period from 12 to 48 months, 51 patients were selected for this study, 14 patients were included in the first group, 18 patients were in the second group, 19 patients were in the comparison group. There were no differences in the overall rate of pregnancy depending on the choice of tactics of postoperative management. The highest number of pregnancies (92.3%) occurred during the first year after surgery, which suggests the effect of the duration of hormone therapy on the probability of pregnancy. The lowest number of relapses was registered in the group of long-term monotherapy of DNG. In the group of DNG monotherapy a greater number of side effects were noted, which in most cases did not cause significant discomfort to patients.

Conclusion. Long-term administration of DNG at a dose of 2 mg/day after surgical treatment of colorectal endometriosis is an effective means of preventing relapses with good tolerability. However, in some women planning a pregnancy, it may be rational to abandon hormone therapy in favor of earlier pregnancy planning. 

Annually, about 500 thousand people get new genital herpes (GH) infections. The incidence of GH in Russia was 13.5 cases per 100 thousand people in 2015. According to the WHO (2015), 67% of population is infected with herpes simplex virus. The numerous studies in general population showed that women were infected more often than men with the same number of sexual partners during life, and the highest incidence of GH was recorded in the age group between 20 and 29 years, and the second peak incidence was recorded at the age of 35–40 years [1–3].

Purpose of the study: Rational for the use of folates for the prevention of fetal growth restriction on the basis of the identification of a MTHFR polymorphism.

Material and methods: 200 patients (case-control) were enrolled in the study. The (main) group I included 100 patients with fetal growth restriction (FGR), the (control) group II included 100 conditionally healthy patients. The features of the anamnesis, the initial clinical characteristics, the course of pregnancy, childbirth and the postpartum period in patients with placental insufficiency were studied in detail, and the features of the early neonatal period were analysed comprehensively. At the second stage, the polymorphism of the MMP2, MMP3, MMP9, and MTHFR genes was studied and their dependence with the development of the FGR was established. Statistical processing of the results was carried out on a personal computer using the SPSS Statistics 17.0 for Windows software package.

Results: The clinical risk factors for the development of FGR include: chronic pyelonephritis, medium degree myopia, varicose veins, threat of abortion, ultrasound-detected subchorionic hemorrhage in the I trimester of gestation, anemia. Along with clinical risk factors for ZRP, the carriage of MTGFR (677 C> T) polymorphism is also considered, which justifies its identification in patients at risk.

Conclusion: The data obtained make it possible to use the identification of MTHFR polymorphism as a predictor of placental abnormalities during pregnancy and to start taking folic acid supplements at the preconception stage in good time. Femibion 1 vitaminmineral complex has proved to be an effective product that is suitable for women in the period of preparation for pregnancy and in the first trimester of gestation, reducing the risk of fetal malformations and endothelial dysfunction caused by a violation of folic acid metabolism. 

The article presents the findings of the studies evaluating the efficacy of gestagens in the treatment of the threatened and habitual miscarriage. It summarizes a number of meta-analysis related to the comparative evaluation of the use of various gestagens during pregnancy. The foreign societies’ guidelines for the treatment of reproductive disorders and the management of early pregnancy in women with the threatened and habitual miscarriage are outlined.

The frequency of anaemia in pregnant women varies from 15 to 30%, iron deficiency anaemia (IDA) is the most common disorder, it accounts for about 90% of all anaemia. Iron deficiency adversely affects the course of pregnancy, childbirth, the postpartum period, the condition of the fetus and the newborn. The main complications of pregnancy in IDA are threatened miscarriage (20–42%); preeclampsia (40%); premature separation of placenta (25–35%); intrauterine growth restriction (25%); premature birth (11–42%).

Daily intake of iron-containing drugs is more effective in preventing anaemia in mothers, and in reducing the risk of giving birth to children with low body weight. Daily iron supplementation in preventive programs may reduce the risk of anaemia in the mother at the time of delivery by 70%. It is preferable to take supplements that contain bivalent iron and possess a high degree of absorption, good tolerance by patients and minimal risk of side effects. Complex supplements containing vitamins and microelements are recommended for the treatment and prevention of IDA in pregnant women. Sorbifer Durules is one of such supplements. The Sorbifer Durules therapy of IDA in pregnant is highly effective treatment of therapy, which leads to normalization of hemogram parameters, improvement of the general condition of patients, reduction of obstetric and neonatal complications. 

Iron deficiency anaemia (IDA) is one of the most common complications in pregnancy. It is known that IDA has an adverse effect on the condition of the mother, fetus and new-borns. The article presents modern views of the aetiology, pathogenesis, prevalence of iron deficiency anaemia, describes the clinical manifestations of this condition. The rational of treatment of IDA with modern ferric iron supplements is substantiated. It is shown that IDA therapy in pregnant and puerperal women with Maltofer is highly effective, leads to normalization of hemogram parameters, improvement of general condition, and reduction of obstetric and neonatal complications.

Insufficient nutrition is an urgent problem of modern healthcare. According to WHO, more than 2 billion people suffer from essential vitamin and mineral deficiencies, in particular vitamin A, iodine, iron and zinc [1]. The hypovitaminosis, as well as hypoelementosis pose the greatest threat to pregnancy and lactation, contributing to the development of miscarriages, intrauterine growth restriction, maternal mortality, labor complications, infectious pathology and adverse course of the neonatal period.

Objective of the study: evaluation of the efficacy of the vitamin and mineral complex in correcting the nutritional status of patients during gestation.

Materials and methods of the study: 33 pregnant women with threatened miscarriage of various genesis, who were admitted to the department of gynaecology, underwent a clinical and laboratory examination and treatment. In addition to the general clinical examination, all patients were assessed for plasma vitamin E and folic acid concentrations, which play a key role in embryogenesis. In addition to therapy aimed at prolonging pregnancy, all pregnant women received nutritional support in the form of a multivitamin drug.

Results of the study: During the observation period, the condition of pregnant women improved significantly: signs of threatened miscarriage were eliminated, complaints of weakness, fatigue and sleep disturbance disappeared. All patients showed significantly higher plasma vitamin E and folic acid concentrations after the treatment. 

Living in large cities, environmentally unfriendly background, smoking during pregnancy are associated with increasing number of complications, such as premature birth, intrauterine growth restriction, stillbirth and low birth weight. Pathogenetic mechanisms of these complications include oxidative stress, which can be combated by adding vitamin supplements with antioxidant activity to the daily routine of a pregnant woman. Smokers have a lower serum level of such important antioxidants as vitamins E, C and omega-3 fatty acids. The additional intake of vitamin complexes containing omega-3 fatty acids by pregnant women living in large megacities, adverse ecological regions and/or abusing smoking, has a preventive effect and can reduce the risk of premature delivery and fetal growth restriction among this cohort of patients.

Objective: evaluation of the efficacy and safety of the use of probiotic Vagilac® in the prevention and treatment of vaginal dysbiosis in pregnancy.

Material and methods: 140 pregnant women admitted to the Obstetric Probationary Ward of Moscow Regional Research Institute of Obstetrics and Gynecology of the Ministry of Health of Moscow at 36–39 weeks of gestation were examined and treated. All patients underwent complex clinical and laboratory examination. The patients were divided into 2 groups: I – 60 pregnant women with the established diagnosis of «bacterial vaginosis» (BV) and II – 80 pregnant women, who received antibacterial therapy due to exacerbation of infectious extragenital diseases. Of 140 pregnant women, 100 (60 from Group I and 40 from Group II) received oral probiotic Vagilac® for 10–14 days before delivery: 60 women to treat bacterial vaginosis, and 40 to prevent vaginal dysbiosis against the background of systemic antibiotic therapy. The remaining 40 pregnant women from Group II did not receive the probiotic, for which reason the second group was divided into two subgroups (IIa and IIb).

Results: the drug has proved itself as a probiotic that is capable to restore vaginal microflora after various disorders, maintain and keep a healthy balance of bacteria that normally live in the vagina, prevent any disorders associated with antibiotic therapy. During vaginal delivery, traumatic injuries of the birth canal tissues were more common in patients who did not receive Vagilac®. The newborns who were born by the mothers who received Vagilac®, had no manifestations of severe forms of infectious and inflammatory diseases.

The conclusion. The conducted studies showed that the treatment of bacterial vaginosis in pregnant women with probiotic Vagilak® was effective, did not adversely affect the fetus/child; in the group with and without BV no candidiasis vulvaginitis was detected. 

Topicality: vulvovaginal candidiasis (VVC) is a common disease caused by the infectious damage of the vulva and vagina by yeast-like fungi from Candida genus. According to the literature, a VVC episode occurs in 75% of women, and 5-8% of them get a recurring course of the disease. Frequent recurrences of the disease may result in the psychosexual disorder and reduce the women’s quality of life and recurrent vulvovaginal candidiasis (VVC) therapy is still a very difficult task.

Purpose of the study: evaluate the efficacy of fluconazole (150 mg) in acute and recurrent vulvovaginal candidiasis.

Materials and methods: A total of 89 women of reproductive age with acute and recurrent HCV were enrolled in the study, which were subdivided into 2 groups: the first group included women with acute vulvovaginal candidiasis (AVVC) (n = 51), and the second group - women with recurrent vulvovaginal candidiasis (RVVC) (n = 38). The Group I (AVVC) received fluconazole 150 mg once. Depending on the prescribed therapy, the second group (RVVC) was subdivided into two subgroups: patients in the IIa subgroup received fluconazole 150 mg intravenously, three times, at intervals of 2 days, and women in the IIb subgroup received fluconazole 150 mg for a period of 6 months in addition to the three-fold intake of fluconazole weekly. The follow-up period was 6 months after the end of therapy, during which the frequency of VVC recurrence and the effectiveness of the therapy was evaluated.

Results of the study: our data showed that all patients with acute VVC had a discontinuation of symptoms of the disease and a normalization of laboratory parameters after treatment with fluconazole, and after the anti-relapse therapy course the incidence of VVC recurrences was significantly lower compared to the period before anti-relapse therapy (p = 0.038). It was shown that all the investigated strains of C. albicans (100%) were sensitive to fluconazole, and resistance was detected only in 1 strain of C. glabrata and 1 strain of C. krusei. 

The aim of the study was to improve the results of treatment of chronic cervicitis with the help of the drug benzidamine (rose Tantum) solution for douching.

Material and methods – 76 patients of reproductive age with chronic cervicitis were included in the study. The criteria for the effectiveness of treatment were the disappearance of clinical symptoms and normalization of laboratory parameters.

Results. Clinical and laboratory efficacy of therapy increased modestly to 86.8%. Insufficient effectiveness or ineffectiveness of the therapy was recorded in 13,2%. The average number of white blood cells was 12 in the field of view, there was an eradication of Gardnerella vaginalis and E. coli. In the whole group, no serious side effects were registered in the assessment of safety and tolerability of the drug.

Conclusion. Therapy with a combined preparation of benzidamine (rose Tantum) with a solution for douching, in the treatment of chronic cervicitis has shown its high efficiency. 

This article discusses the natamycin therapy outcomes in 50 patients with a combination of chronic recurrent vulvovaginal candidiasis (CRVC) and intestinal candidiasis dysbiosis (ICD) and analyses the features of the clinical manifestations of CRVC against the background of the ICD, the species composition and sensitivity patterns of Candida cultures isolated from women with vaginal and intestinal discharge to various antimycotics.

This review of literature discusses modern data on the diagnosis and treatment of the acute cystitis. Epidemiology and etiology of acute cystitis are described. The basic and alternative treatment protocols for the acute cystitis are presented from the documented medicine viewpoint.

In order to improve the diagnosis and treatment of bacterial vulvovaginitis (VV) in preschool children with urinary tract diseases, we conducted the prospective controlled study of 86 patients aged 3–6 years, of which: group 1 (n = 21) – VV; group 2 (n = 20) – VV against the background of chronic pyelonephritis with exacerbation; group 3 (n = 20) – VV against the background of acute pyelonephritis; group 4 (n = 25) – VV with dismetabolic nephropathy. Depending on the method of correction, the patients were divided into those that received standard treatment and those that received combined treatment with the use of a bacteriophage complex. It was revealed that chronic forms of VV prevailed in all groups, but when combined with urinary tract diseases (groups 2, 3, 4), the incidence of synechia of the labia minora was significantly increased. It was established that the number of relapses of VV after the combined treatment is significantly lower than after the standard treatment.

Inflammatory urogenital diseases in girls are characterized by a high rate of relapse. The combination therapy of VV, including the use of a bacteriophage complex, improves the condition of the vaginal biotope, prevents the persistence of the infection. 

Despite the considerable success in managing the medical process and medical screening of women of childbearing age, the treatment of vaginal infection remains an urgent problem that requires periodic correction of the prescribed therapy. This made the authors conduct a study, which was aimed at investigating the optimization aspects of the comprehensive therapy regimens for vaginal infections (VI) that combine the use of etiotropic drugs with the extract of Aloe Barbadenis Multi-Gyn ActiGel and systemic enzyme therapy as compared to the prescription of monotherapeutic etiotropic regimen. The study evaluated the effectiveness of different treatment regimens of VIs based on the dynamics of clinical and laboratory parameters, as well as the safety and tolerability of different therapies based on the registration of adverse events.

Based on the study results, we would advise to include the plant extract of Aloe Barbadenis Multi-Gyn ActiGel and Wobenzym into the therapy of patients with VIs induced by the  vaginal dysbiosis and caused by bacterial vaginosis and candidiasis vulvovaginitis-associated microorganisms to improve the elimination of the pathogen and provide a normal titre of lactobacilli with preservation of their functional activity, which eventually restores the impaired vaginal microcenosis and maintains a normal vaginal flora and simultaneously provides a high safety and good tolerability of the proposed treatment regimen. 

Loss of medical control over infections that were previously considered harmless or easy managed in most patients can be considered a challenge for the modern medicine. Along with the intensification of pathogenic properties, opportunistic pathogens acquire resistance factors to antimicrobial agents - antibiotics. At the same time, the prevalence of pelvic inflammatory diseases (PID) accounts for about 50 to 65% among women of childbearing age and has no tendency to decline. On top of that, non-specific chronic diseases of the genital tract are more common than infections caused by absolute pathogens. Ineffective therapy of acute forms of the disease leads to the emergence of resistant forms of pathogens, recurrence of the disease and chronic inflammation. The development of secondary immunodeficiency characterized by improper cellular and humoral immune functions plays an important role in the pathogenesis of chronic inflammatory diseases of the urogenital tract. That is why the treatment of chronic inflammatory diseases of the genital tract should be complex and include etiotropic chemotherapeutic agents aimed at eliminating the pathogens, and the immunomodulating agents aimed at normalizing the functional activity of the patient’s immune system.

Data on 16 components of the anti-age system for the diet enriching with the Famvital are presented. Information about fundamental and clinical researches on the anti-aging role of the complex components are presented. The anti-age effects of plant extracts, vitamins and trace elements included in the morning and evening capsules of the Famvital system are analyzed in detail.

Data are presented on the stages of aging of the female reproductive system and the symptoms developing in these age periods. It is noted that the pathogenesis of development of urogenital disorders are connected with decrease in the level of estrogens in the peri- and postmenorausal period. Effective therapy for women with vaginal atrophy is the administration of estriol preparations (Оvestin) in the form of a cream or vaginal suppositories.

The article highlights the concept of the mechanisms of formation of intrauterine synechia, which represents an important medical and social problem. Its relevance is due to the violation of the reproductive function of women and in severe forms of the disease has irreversible consequences. Surgical intervention remains the leading method of treatment for such patients. However, in complex clinical situations, its application is associated with the formation of a vicious circle, aggravating the severity of the pathological process. Therefore, today, high hopes are placed on the application of methods for the prevention of the disease and its relapse. Our data on this issue allow us to optimize the use of non-surgical high-tech methods for the prevention of Asherman’s syndrome. The use of anti-adhesive resorbable gel Antiadhesin is described and its pathogenetic application is justified.

Venous thromboembolic complications (VTEC) manifested as pulmonary embolism (PE) or deep vein thrombosis (DVT) are a serious and potentially fatal disease. Treatment and prevention of VTEO in obstetric practice is complicated by the need to take into account the condition of the fetus, as well as maternal risk factors in making tactical decisions. Despite the fact that the absolute VTEC indices in this population are small, obstetric-associated VTEC are an important cause of maternal morbidity and mortality. This problem is even more important in gynaecology. Based on the evidence-based medicine data and the author’s practical experience, the article presents clinical recommendations on the prevention and treatment of VTEC related to obstetric and gynaecological practices based on existing guidelines and expert opinions.

The phosphate (infection-induced) urolithiasis is one of the most common forms of urinary stone disease. Infection-induced urinary stones usually recur, and patients with this form is a very complicated category of patients with urolithiasis that requires constant monitoring. It involves not only a systematic examination, but also a comprehensive treatment. The study was aimed at evaluating the effect of phytolysin on the infectious inflammatory process and the metabolic stone-forming condition in patients with phosphate (infection-induced) urolithiasis.

Materials and methods. We examined 55 patients with recurrent phosphate (infection-induced) urolithiasis – 37 women and 18 men, age range 31–68 years. The biochemical examination showed that the functional state of the liver and kidneys of patients was normal. The common urine examination showed leukocyturia in all patients and phosphate crystalluria and triphyl phosphates in the vast majority of cases. The bacteriological urine analysis detected bacteriuria in all patients. Urease-producing strains Ps. aeruginosa, Proteus mirabilis, Proteus vulgaris were identified: the titre was 104 to 106 CFU/ml. The overwhelming majority of biochemical tests were performed using chemistry kits and Labsystems automatic analyzer; the common urine examination was performed using Aution Max Ax-4280 device and light microscopy, the bacteriological urine analysis was made by the common standard method. Statistical data analysis was carried out using Student’s t-test and the results were considered reliable at p-value ≤ 0.05. The drug was used at a dose of 1 teaspoon diluted in half a glass of sweetened water, 3 times a day after meals. The duration of 1 course of treatment with phytolysin ranged from 1 to 2 months. In addition to phytolysin, all patients were prescribed a diet that limited intake of citrus fruits, dried fruits and foods with a high content of stone-forming substances or their precursors, and a water intake of at least 2 litres/day. The effect of the drug on the patient’s condition was assessed using 15 blood and urine chemistry values and by 3 urine common examination values. The examination showed that 70 leukocytes per field in patients with leukocyturia decreased up to 20–40 leukocytes per field.

Results. The examination showed that 70 leukocytes per field in patients with leukocyturia decreased up to 20–40 leukocytes per field. Urine pH A decreased from 6.75 ± 0.29 to 6.44 ± 0.18 in 72.7% of cases. Phosphate crystalluria persisted, but calcium crystallium phosphates (rather than triphyl phosphates) prevailed. Renal excretion of uric acid increased from 3.88 ± 0.14 to 4.46 ± 0.23 mmol/day in 83.6% of cases.

Conclusions. It was found that the use of phytolysin did not change the functional state of the liver and kidneys, which remained within the normal limits. The activity of the infectious-inflammatory process in the urinary system decreased. No effect on the metabolism of potassium, sodium, calcium, inorganic phosphates was detected. Renal excretion of uric acid was identified. 

The article considers the causes for the development and modern methods of managing dysmenorrhea. The conservative therapy includes the use of combined hormonal contraceptives, physiotherapy procedures, vitamins and symptomatic drugs. The authors stress the significance of Nimesil® in the first-line therapy of primary dysmenorrhea of the syndrome along with the combined hormonal contraceptives and symptomatic agents. The use of this drug is characterized by rapid onset of effect, strong analgesic effect and good tolerability.

Purpose of the study. Perform a brief review of the published works devoted to the evaluation of the effectiveness and safety of drotaverine hydrochloride in the treatment of abdominal cramping caused by primary dysmenorrhea, and an analysis of the use of obtained data in the clinical obstetrician-gynecologist practice.

Materials and methods. The authors performed PubMed searches to find foreign and domestic articles using the keywords “dysmenorrhea”, “spasmolytic therapy”, “drotaverine”, “spasm”, “pain”. The analysis of the clinical studies showed the effectiveness of spasmolytic therapy of primary dysmenorrhea with drotaverin hydrochloride.

Conclusion. Drotaverine hydrochloride can be recommended as an effective and safe first-choice drug to treat primary dysmenorrhea. 

Multidisciplinary approach in the treatment cervical ectopic pregnancy has been developed, it includes the systemic use of methotrexate, the embolization of uterine arteries and follow-up fetal egg remove. The new method of combination treatment of cervical pregnancy of one-stage use of embolization uterine artery and temporary balloon occlusion of the internal iliac arteries was applied for the first time in Russia. This algorithm helps to preserve the reproductive function of women.