Introduction. A comparative analysis of urinary and recombinant gonadotropins is relevant for the enhancement of the effectiveness of assisted reproductive technologies (ART) programs. Of particular interest is the analysis of the pharmacoeconomic efficiency of highly purified human menopausal gonadotropins (HMG) and the identification of individual groups of patients for whom the use of these drugs for ovarian stimulation in the ART program is most feasible and economically justified.

Aim. To conduct a cost-effectiveness analysis of the use of Menopur Multidose at a dosage of 1200 IU for ovarian function stimulation in the standard ART protocols with gonadotropin-releasing hormone agonists and antagonists (GnRH-a and GnRH-ant).

Materials and methods. The retrospective study included 4080 women aged 20 to 43 years. Stimulation of ovarian function in the ART program was carried out according to the GnRH antagonist protocol in 65.8% of patients and according to the GnRH-a protocol using Menopur Multidose at a dosage of 1200 IU supplemented with Menopur at a dosage of 75 IU used for its indications in 34.2% of women.

Results and discussion. The clinical and laboratory data of the patients, stimulated cycle parameters, characteristics of the embryological stage, and the results of the ART program were analysed. The characteristics of the embryological stage met the KPI criteria, reflecting the key performance indicators of the embryology laboratory. Pharmacoeconomic analysis showed high involvement and adherence of patients to the treatment. In addition, it was found that the use of HMG makes efficient use of the budget within the average compulsory health insurance (CHI) tariff and accounts for 12% of the total tariff.

Conclusion. Prescription of highly purified HMG (Menopur Multidose 1200 IU) to stimulate ovarian function in patients of different ages is accompanied by an adequate number of mature oocytes, good quality blastocysts, as well as satisfactory indicators of clinical pregnancy. A cost-effectiveness analysis of the use of Menopur Multidose at a dosage of 1200 IU showed that the prescription of this drug is clinically justified and economically feasible in patients of different age groups.

The main metabolite of lactobacilli, regulating their anti-inflammatory functions, is lactic acid (LA), which maintains the physiological state of the microbiocenosis of the vagina of women of reproductive age. Normocenosis of the vagina is based on a combination of acidic environment and colonization resistance. Pathogenic and conditionally pathogenic pathogens are colonized mainly in  an alkaline environment. LA is an important biological substrate that supports the  vaginal microbiota. Normally, the reaction of the vaginal contents is a pH of 3.8 to 4.5, and only in this case lactobacilli predominate in the biotope, which are able to unite into special communities – biofilms, forming the most powerful factor in protecting the vagina from adhesion and invasion of pathogens: a full-fledged lactobacillary biofilm is often able to prevent adhesion of even STI pathogens. Disruption of the functioning of each of the links of protection of the vaginal microbiome leads to a change in the pH of the habitat and excessive reproduction of conditionally pathogenic microorganisms. A frequent infectious syndrome, accompanied by an imbalance of the vaginal microbiota and the replacement of lactoflora with various types of anaerobic microorganisms (Gardnerella vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, Mobiluncus, Prevotella), is bacterial vaginosis. When prescribing antibacterial treatment, side effects are possible: allergic reactions, hepatotoxic, nephrotoxic, candidiasis. The review presents the possibility of using LA, which is a basis in the composition of the drug Lactodepantol (Femilex®) – vaginal suppositories containing 100 mg of LA, as the main factor regulating the natural composition of the vaginal microbiota and the possibility of using vaginal suppositories based on LA (lactodepantol) for the prevention and treatment of bacterial vaginosis in the form of monotherapy and in combination with antimicrobials.

Obesity and overweight tend to increase in prevalence in the whole world. Obese people have a higher incidence of cardiovascular diseases, stroke, osteoarthritis, diabetes mellitus and reproductive system diseases. This is especially evident in women. Hormonal imbalances is developed among obese women in the hypothalamic-pituitary-ovarian axis, typically there are menstruation disorders, anovulation and female infertility. Adipose tissue is an endocrine organ, with an intricate role in bioactive molecules secrete, in particularly adipokines, which interact differently with a variety of molecular pathways, contribute to the development of insulin resistance, inflammation, hypertension, increased risk of cardiovascular events, disorders of blood clotting, differentiation and maturation of oocytes. In addition, women with obesity and metabolic syndrome have problems with conception at the endometrial level often, a significantly higher risk of having a miscarriage, and worse assisted reproductive technology outcomes. Obesity has negative effects on the endometrium in non-pregnant women, it is increasing the risk of abnormal uterine bleeding. Hormones derived from adipose tissue could be affected on the  function of  the uterus/endometrium and, consequently, affect the amount of menstrual blood loss. Contradictory results are observed in patients with endometriosis. The correlation of body mass index to the risk of endometriosis has not been proven in clinical studies, but there was a direct relationship between the severity of endometriosis and a high body mass index. The review presents possible relationships of diseases of the reproductive system with obesity and overweight, determining their development and pathogenesis of disorders of the formation of the functions of reproductive organs.

 Long-acting reversible contraception (LARC) is recognized as a highly effective and convenient method for preventing unwanted pregnancy. However, in real clinical practice, the level of implementation of LARC remains relatively low, which, presumably, may be related to misconceptions about their contraceptive efficacy and side effects among health professionals and patients. One method of long-acting reversible contraception is the intrauterine device. Hormone-containing intrauterine systems are recognized as one of the most affordable contraceptive methods, characterized by a very low failure rate (less than 1%), which does not depend on the patient’s compliance. A review of the literature focuses on the efficacy and safety of a low-dose levonorgestrelcontaining intrauterine system containing 19.5 mg of levonorgestrel (LNG-IUD 12). We present data on the advantages of this intrauterine system in comparison with its counterparts. Analysis of the literature has shown that adherence to low-dose contraception is observed among women of reproductive age. The smaller diameter of the guide tube is associated with a more successful and less painful insertion of the device into the uterine cavity. This may be an obvious advantage for young, nulliparous women. In addition, the LNG-IUD has a predominantly local progestogenic effect on the endometrium, so there is a relatively low development of systemic effects. Despite its lower levonorgestrel content, the LNG IUD 12 (Kyleena LNG 19.5 mg, levonorge strel-releasing intrauterine system with an average LNG release of 12 µg/24 h in vivo over the first year of use) has a high level of contraceptive efficacy. Thus, LNG-IUD 12 is associated with a favorable efficacy and safety profile regardless of a woman’s age or parity, which has been confirmed by the results of clinical trials.

Infertility is defined as not being to get pregnant for a couple after at least a year of regular sexual life. The condition has become a global health issue affecting about 187 million couples worldwide, and about half of the cases are associated with male factors. There are several external and internal factor infertility. Oxidative stress, which is a common cause of several conditions associated with male infertility is one of the main factors. High levels of reactive oxygen species (ROS) decrease sperm quality through reducing sperm motility and increasing damage to DNA, protein, and lipids. If DNA strand breaks are not repaired, a cell undergoes apoptosis, programmed cell death. The combination antioxidants are considered effective in improving male fertility parameters due to synergistic effects of various components. The mechanism of action of most of them is directed toward reducing ROS concentration, thereby improving sperm quality. In addition, this review considers other natural molecules - myo-inositol and D-chiro-inositol, which improve sperm quality. They are involved in many signalling mechanisms in spermatozoa that regulate cytoplasmic calcium levels, mitochondrial capacity and function. On the other hand, D-chiro-inositol is involved in the inhibition of steroidogenic aromatase enzymes, thereby increasing testosterone levels. In this review, we analyse the processes associated with oxidative stress in male fertility and the mechanisms of action of various molecules, as well as consider treatment options for management of various male reproductive system disorders.

Introduction. Bearing in mind functional features of the reproductive system at every stage of a woman’s life, as it grows and develops, accomplishes its purpose and early fades away, its high vulnerability becomes obvious. Therefore, what emerges is the need for a broader analysis of the causes of reproductive dysfunction, among which termination of unwanted pregnancies plays one of the leading roles.

Aim. To assess the level of awareness of emergency contraception among young women.

Materials and methods. We conducted an anonymous voluntary survey on the awareness of the emergency contraception methods among different age groups of young people in 2014 and 2021. In 2014, 577 respondents participated in the survey, which were divided into two groups. Group 1 included 265 adolescent girls aged 15 to 17 years, group 2 included young women aged 18 to 25 years. In 2021, an anonymous voluntary survey was only conducted among 348 young female respondents.

Results. Analysis of responses from the survey of adolescents and young girls conducted in 2014 shows an extremely low level of awareness of the emergency contraception methods among respondents in both groups. Thus, 211/265 (79.62%) in the group of adolescent girls and 201/312 (64.42%) young women did not know anything about the emergency contraception methods, and 19/312 (6.09%) young women and 9/265 (3.40%) adolescent girls claimed knowledge of the possibilities of emergency contraception using Escapelle. The analysis of a similar survey conducted in 2021 showed that young women’s awareness of modern emergency contraceptive methods had increased. Thus, less than half of 168/348 (48.28%) participants did not know anything about the emergency contraception methods in 2021, and 117/348 (33.62%) respondents were aware of Escapelle, which was 5.5 times more compared with those of 2014.

Conclusions. The results of two surveys we conducted reveal insufficient awareness of the emergency contraceptive methods among young women.

Introduction. The intensive development of the mining industry led to a rapid growth in the population, large-scale migration processes to cities, the construction of numerous industrial facilities, which was accompanied by changes in the ecological, socioeconomic and cultural foundations of the local indigenous population (Khanty and Mansi) caused by the disruption of the usual rhythm of life that exists here. over the centuries

Aim. The study of mass and growth parameters, the state of the biocenosis of the vagina and gastrointestinal tract in pregnant women living in the village and in the city in the Khanty-Mansi Autonomous Okrug-Yugra and correction of violations with metronidazole and miconazole.

Materials and methods. A prospective analysis of complaints, anamnestic, anthropometric, as well as an assessment of the state of the biocenosis of the vagina and intestines in patients selected by the method of continuous sampling was carried out. We examined women from among the  indigenous small-numbered peoples of  the north (indigenous peoples of  the North)  – the Khanty and Mansi, living in the urban-type settlement. Berezovo, in camps and in the city of Khanty-Mansiysk. The comparison group included women from the migrant population (Russians) living in the city of Khanty-Mansiysk.

Results. It was found that the greatest number of violations of the biocenosis of the vagina and intestines was in pregnant women living in the city, both from the indigenous minorities and the migrant population. Half of pregnant women, 50% of women, had normocenosis. Every second had inflammatory changes  – nonspecific vaginitis occurred in  9.1%, vulvovaginal candidiasis in 13.6% and mixed pathogenic flora (bacterial vaginosis and vulvovaginal candidiasis) were in 31.8% of women. Monitoring of the state of the vaginal biocenosis was carried out after 4–5 weeks and at the end of the postpartum period (40–44 days), normobiocenosis was determined. Relapses both before and after childbirth within 42 days were not observed in this contingent.

Conclusion. The use of metronidazole and miconazole intravaginally is an effective trea for bacterial vaginosis in combination with vulvovaginal candidiasis with rapid relief of symptoms and no side effects.

Pregnancy is a period of increased demands on all organs and systems of the mother’s body, including the thyroid gland (TG). The productivity of the thyroid gland increases by 30–50%. For continuous and sufficient synthesis of thyroid hormones (TG) requires optimal intake of dietary iodine. The need for a microelement increases significantly during pregnancy, due to increased activity of the thyroid gland. Iodine deficiency of mild or moderate degrees leads to insufficient synthesis of thyroid hormones, despite its compensatory increase. Hypothyroidism in women is one of the causes of infertility. Hypothyroidism in pregnant women significantly increases the risk of preterm birth. Iodine deficiency has a serious impact on the intrauterine development of the fetus, because iodine and thyroid hormones (TG) are actively involved in the development of the fetus, the formation of various organs and the development of the brain. In order to prevent the dangerous consequences of iodine deficiency in the Russian Federation, mass prevention is carried out in the form of the use of iodized salt. During the 1st trimester of pregnancy, each woman undergoes a laboratory test of the level of TSH, total T4 and total T3 as a screening in order to correct the hypofunction of the thyroid gland in  time. In pregnant women, especially in  the first trimester, iodine requirements increase by 50%, which requires not only the mandatory use of iodized salt, but also the appointment of pharmacological preparations of iodine with an accurate dosage. Preventive measures may not be enough, then replacement therapy with levothyroxine is used throughout the pregnancy.

Introduction. According to domestic and foreign authors, most women have a greater or lesser level of iron deficiency by the end of pregnancy and deplete their depot iron reserves, and anaemia develops by the time of delivery. Erythrocyte destruction occurs in presence of acute inflammation, including that caused by COVID-19, which leads to a chaotic distribution of iron within tissues and a pronounced loss of its reserves and aggravation of the existing deficiency. Due to overlapping changes with underlying novel coronavirus infection, iron deficiency creates favourable conditions for the development of infectious and inflammatory complications in the postpartum period by the time of delivery.

Aim. To assess the features of the postpartum period and hematological status in puerperas with post-COVID anemia, who receive the combination therapy including an anti-anemic ferrous iron drug.

Materials and methods. The prospective study included 30 puerperas (treatment group) in the postpartum period, who had a coronavirus infection with a mild degree of IDA during the gestation period. Group 2 (comparison group) included 15 puerperas with mild IDA, who did not have a coronavirus infection during the gestation period. Group 3 (control group) included 15 conditionally healthy puerperas, who had no novel coronavirus infection and did not suffer from IDA during the gestation period.

Results and discussion. The puerperas, who had COVID-19 in pregnancy, developed infectious and inflammatory diseases significantly more often in the postpartum period. Subinvolution of the uterus, postpartum endometritis and thyroiditis, disruption of perineal stitches and seromas (hematomas) of the suture after cesarean section, vaginal dysbiotic conditions occurred significantly more often in puerperas with IDA, who came through coronavirus infection, than in women from the comparison group and control group (SBI index, p < 0.05).

Conclusion. Women who had COVID-19 in pregnancy should be spinned off into a separate infectious risk group due to the possibility of postpartum complications and timely management of concomitant pathologies and appropriate treatment of IDA.

Introduction. Isthmic-cervical insufficiency (ICI) continues to be one of the main causes of miscarriage and premature birth (PB), contributing to the growth of reproductive losses and directly affecting the indicators of perinatal morbidity and mortality.

Objective of the study – to study the features of the course of pregnancy, childbirth and perinatal outcomes in ICI, depending on the method of delivery.

Material and methods. A retrospective analysis of birth histories (n = 144) with a diagnosis of Isthmic-cervical insufficiency was carried out, for the period from 2015 to 2020. 102 pregnant women who delivered through the natural birth canal (70.8%) made up group 1, and 42 women whose births ended with cesarean section (29.2%) made up group 2. The control groups included patients with a singleton uncomplicated pregnancy, which ended with an emergency delivery through the natural birth canal (group 3 – n = 96) and by caesarean section (group 4 – n = 58). Anamnestic data, peculiarities of the course of pregnancy, childbirth and perinatal outcomes were studied in detail. Statistical analysis was carried out using the programs Excel MS Office Professional and STATISTICA 7.0.

Results and discussion. ICI is more common in repeat-bearing women with a male fetus (p < 0.001), with a burdened obstetric and gynecological history, concomitant extragenital pathology, over the age of 30 years. In PB, conservative management of the birth act prevails against the background of ICI (70.8%) (p >< 0.001). The choice of delivery method in ICI determines the gestation period, fetal condition, the occurrence of urgent obstetric complications and premature rupture of fetal membranes. With ICI, the birth of children in a state of asphyxia prevails (p >< 0.001). With operative delivery, the probability of diagnosing mild asphyxia (1.3 times) and respiratory distress syndrome (2 times) increases. With conservative management of childbirth against the background of ICI in newborns, the frequency of grade I cerebral ischemia increases significantly (by 5 times) (p >< 0.001). Conclusion. The results of the study once again confirmed the significant importance of the ICI in the implementation of PB, which dictates the need for further study of this problem to improve the quality of care for pregnant women and improve perinatal outcomes. >< 0.001), with a burdened obstetric and gynecological history, concomitant extragenital pathology, over the age of 30 years. In PB, conservative management of the birth act prevails against the background of ICI (70.8%) (p < 0.001). The choice of delivery method in ICI determines the gestation period, fetal condition, the occurrence of urgent obstetric complications and premature rupture of fetal membranes. With ICI, the birth of children in a state of asphyxia prevails (p >< 0.001). With operative delivery, the probability of diagnosing mild asphyxia (1.3 times) and respiratory distress syndrome (2 times) increases. With conservative management of childbirth against the background of ICI in newborns, the frequency of grade I cerebral ischemia increases significantly (by 5 times) (p >< 0.001). Conclusion. The results of the study once again confirmed the significant importance of the ICI in the implementation of PB, which dictates the need for further study of this problem to improve the quality of care for pregnant women and improve perinatal outcomes.>< 0.001). The choice of delivery method in ICI determines the gestation period, fetal condition, the occurrence of urgent obstetric complications and premature rupture of fetal membranes. With ICI, the birth of children in a state of asphyxia prevails (p < 0.001). With operative delivery, the probability of diagnosing mild asphyxia (1.3 times) and respiratory distress syndrome (2 times) increases. With conservative management of childbirth against the background of ICI in newborns, the frequency of grade I cerebral ischemia increases significantly (by 5 times) (p >< 0.001). Conclusion. The results of the study once again confirmed the significant importance of the ICI in the implementation of PB, which dictates the need for further study of this problem to improve the quality of care for pregnant women and improve perinatal outcomes.><  0.001). With operative delivery, the probability of diagnosing mild asphyxia (1.3 times) and respiratory distress syndrome (2 times) increases. With conservative management of childbirth against the background of ICI in newborns, the frequency of grade I cerebral ischemia increases significantly (by 5 times) (p < 0.001). Conclusion. The results of the study once again confirmed the significant importance of the ICI in the implementation of PB, which dictates the need for further study of this problem to improve the quality of care for pregnant women and improve perinatal outcomes.>< 0.001).

Conclusion. The results of the study once again confirmed the significant importance of the ICI in the implementation of PB, which dictates the need for further study of this problem to improve the quality of care for pregnant women and improve perinatal outcomes.

This article contains information from modern sources on the topic of early toxicosis, which most often occurs in the trimester, and in some cases can continue until the third trimester of pregnancy. On the occurrence of literature data, it can be said that diseases such as early toxicosis, the appearance of vomiting and nausea in pregnant women, the threat of diseases in pregnant women, neurological disorders, fetal asphyxia, rupture of the esophagus and retinal hemorrhage in the mother, as well as other complications. The pathogenesis of early toxicosis has many theories, for example, the theory of the influence of chorionic gonadotropin or the mechanical theory of the development of vomiting during pregnancy, but none of them can fully explain all cases of the disease. In this case, we can conclude that early toxicosis is multifactorial.

Clinically, vomiting of pregnant women can occur in mild, moderate and severe severity, and in the latter case, the so-called vicious circle is often formed, which includes severe electrolyte disorders, neurological disorders, and alkalosis. Treatment of a mild form of  vomiting of  pregnant women is carried out on an outpatient basis, and moderate and severe  – in  a hospital. Conclusion. Based on the sources, the treatment of early toxicosis is based on an integrated approach. Undoubtedly, the basis for each degree will be diet, replenishment of water and electrolyte balance, as well as symptomatic treatment. Data are given on the use of both homeopathic remedies and drug therapy, as well as psychotherapeutic assistance to pregnant women.

Introduction. The question of the ratio of calcium and magnesium in the body in the scientific community is not discussed as often as the role of each of these elements. Experts pay even less attention to the ratio of minerals in the body of pregnant women.

Aim. To analyze the content of magnesium and calcium in the blood of pregnant women at different gestation periods and evaluate the ratio of magnesium / calcium in order to establish the calculated coefficient.

Materials and methods. 272 pregnant women (age 31.85 ± 5.0 years) at different gestation periods were included in the study. The subjects did not complain, typical for the clinic of magnesium and calcium deficiency. All surveyed gave written consent to the study. A biochemical blood test (determination of the concentration of total calcium, magnesium) was carried out in the laboratory of LLC DNKOM in Moscow. Blood sampling from the cubital vein was carried out according to the standard method in the morning on an empty stomach after 10–12 hours of fasting.

Results and discussion. Concentration of  total calcium in  the serum was (M  ±  SD) 2.28  ±  0.11  mmol/l, total magnesium  – 0.78 ± 0.07 mmol/l, magnesium/calcium ratio – 0.34 ± 0.03. Mean concentrations of calcium and magnesium were significantly lower in women in the II and III trimesters compared with the I trimester (p < 0.001). A decrease in magnesium concentration below the optimal for pregnant women of 0.8 mmol / l was observed in 37.5% of women in the first trimester, in 77.3% and 84.1% in the II and III trimesters, respectively. Serum magnesium concentration less than 0.7 mmol / l, reflecting a profound magnesium deficiency, was detected in the first trimester in 3.6% of women, in the second trimester – in 11.3% of women, in the third trimester – in 15.9% of pregnancies. Hypocalcemia (total calcium concentration less than 2.15 mmol/l) was recorded in 0.9%, 11.3% and 22.3% of pregnant women in the I, II and III trimesters. When calculating the magnesium/calcium ratio, subclinical magnesium deficiency was detected in 96.7% of pregnant women throughout pregnancy. Conclusion. The data obtained indicate the need for pregravid examination and early correction of metabolic disorders.>< 0.001). A decrease in magnesium concentration below the optimal for pregnant women of 0.8 mmol / l was observed in 37.5% of women in the first trimester, in 77.3% and 84.1% in the II and III trimesters, respectively. Serum magnesium concentration less than 0.7 mmol / l, reflecting a profound magnesium deficiency, was detected in the first trimester in 3.6% of women, in the second trimester – in 11.3% of women, in the third trimester – in 15.9% of pregnancies. Hypocalcemia (total calcium concentration less than 2.15 mmol/l) was recorded in 0.9%, 11.3% and 22.3% of pregnant women in the I, II and III trimesters. When calculating the magnesium/calcium ratio, subclinical magnesium deficiency was detected in 96.7% of pregnant women throughout pregnancy.

Conclusion. The data obtained indicate the need for pregravid examination and early correction of metabolic disorders

Determining the role of menopausal hormone therapy in the era of covid infection is an urgent task. The reasons for the lower rate of severe outcomes in women against the background of covid infection compared to men are currently being discussed. This is suggestive of the idea that the female body has the protection that accounts for this advantage. that Scientific literature data were reviewed to select the best combination of estrogen and progesterone when used as menopausal hormone therapy in the present setting. During the analysis of the literature on the use of estrogens and progestins as menopausal hormone therapy published in recent years, we used the following sources: PubMed, E-libary, Scopus. The body of material, which we studied, led us to a conclusion about the preference for the gestagen component when menopausal hormone therapy was prescribed. Gestagen should have the lowest risks in the development of thrombosis, as well as level the pronounced symptoms of peri- and postmenopause. According to the sources we studied and the authors’ own clinical experience, levonorgestrel-containing menopausal hormone therapy preparations have a high safety profileImproving physicians’ literacy about the criteria for prescribing menopausal hormone therapy, including drugs containing two components, estrogen and levonorgestrel in a cyclic regimen, will allow the use of hormone therapy in a wider range of patients in the perimenopausal and postmenopausal periods.

Introduction. As is known, the development of invasive cervical cancer is preceded by cervical intraepithelial neoplasia of varying severity, which is a pathological process in which cells with varying degrees of atypia and impaired differentiation appear in the thickness of the stratified squamous epithelium of the cervix.

Objective. To study the  effect of  complex therapy in  patients with mild HPV-associated cervical intraepithelial neoplasia on the dynamics of local cytokine status and autoimmunity parameters.

Materials and methods. The study included 86 patients aged 35 to 40 years with morphologically verified mild cervical intraepithelial neoplasia. The main group consisted of 52 patients who, along with radio wave destruction of the cervix, were prescribed an immunostimulating drug with antiviral activity “Groprinosin-Richter” 1000 mg 3 times a day for 10 days 10–14 days before destruction and similar 2 courses after 10–14 days after it. The comparison group included 34 patients who underwent only radio wave destruction of the cervix.

Results. An analysis of the outcomes of low-grade squamous intraepithelial lesions after 6 months showed that in the main group, CIN I regression was observed in 92.3% of patients, persistence – in 7.7% of cases, while in the comparison group, CIN I regression was noted in 73,5% of cases, persistence – in 26.5% of patients.

Conclusions. Conducting complex therapy, including radio wave destruction and the use of a drug with immunostimulating and antiviral activity “Groprinosin-Richter” in  patients with low-grade HPV-associated cervical intraepithelial neoplasia, leads to the elimination of the initial imbalance of cytokines and normalization of autoantibody levels, helping to reduce the likelihood of HPV persistence and CIN progression to invasive cervical cancer uterus.

Introduction. Urinary tract infections (UTIs) are one of the most common disease among women.

Aim. To determine the efficacy and tolerability of furazidin in the treatment of patients with exacerbation of chronic recurrent cystitis.

Material and methods. a purpose was to determine the efficacy and tolerance of furazidin in the treatment of patients with chronic recurrent cystitis. In the study 56 female patients were enrolled, 28 of whom received ciprofloxacin (CG) and 28 – furazidin (FG). The patients received furazidin 100 mg three times a day for seven days (FG) or 500 mg of ciprofloxacin twice a day for seven days (CG). As well we analyzed the histories of 37 patients with bladder tuberculosis (TMP) stage 4in order to estimate the negative effect of non-optimal antibiotic therapy for UTI on the timely diagnosis of urogenital tuberculosis.

Results. At the end of antibacterial therapy, dysuria persisted in one patient in the FG and in two in the CG. Urinalysis was normal in both groups in 96.4% of patients. The growth of uropathogens was in one case in each group. For 6 months, there were 5 recurrence episodes in the FG, and there were 11 relapses in the CG (p < 0.05). There were no side effects in the FG, but in the CG, adverse reactions developed in 9 patients (32.1%). Patients with TMP had annually from 4 to 7 exacerbations of cystitis, fluoroquinolones were prescribed to all; none investigations for M. tuberculosis were performed. Conclusion. Immediate results did not show statistically significant differences between the  groups of  patients treated with furazidin and ciprofloxacin, however, the tolerance of ciprofloxacin was lower (p >< 0.01). Long-term results have demonstrated a significant advantage of furazidin in the complex treatment of recurrent cystitis. All cases of stage 4 TMP are iatrogenic; an irreversible disabling complication was developed as a result of non-optimal therapy (primarily fluoroquinolones) for UTIs, which hided tuberculosis. >< 0.05). There were no side effects in the FG, but in the CG, adverse reactions developed in 9 patients (32.1%). Patients with TMP had annually from 4 to 7 exacerbations of cystitis, fluoroquinolones were prescribed to all; none investigations for M. tuberculosis were performed.

Conclusion. Immediate results did not show statistically significant differences between the  groups of  patients treated with furazidin and ciprofloxacin, however, the tolerance of ciprofloxacin was lower (p < 0.01). Long-term results have demonstrated a significant advantage of furazidin in the complex treatment of recurrent cystitis. All cases of stage 4 TMP are iatrogenic; an irreversible disabling complication was developed as a result of non-optimal therapy (primarily fluoroquinolones) for UTIs, which hided tuberculosis.>< 0.01). Long-term results have demonstrated a significant advantage of furazidin in the complex treatment of recurrent cystitis. All cases of stage 4 TMP are iatrogenic; an irreversible disabling complication was developed as a result of non-optimal therapy (primarily fluoroquinolones) for UTIs, which hided tuberculosis.

Mixed vaginitis is closely associated with an increased risk of pelvic inflammatory disease, reproductive failures, preterm births, postpartum infectious and inflammatory complications, and cervical neoplasiae. The article considers the main issues of diagnosis and treatment of the disease, mainly caused by the polyetiological nature of mixed vaginitis and relapse tendencies. Effective techniques of integrated approach and impact on all etiological agents of mixed vaginitis with a minimal effect on the normal vaginal microflora are presented. In the modern obstetrics-gynecology practice, preference is given to combination drugs intended for topical use, and a rational choice of the dosage form ensures maximum patient compliance and treatment efficiency. It is topical dosage forms that contribute to the rapid delivery of the active substance to the inflammation site and do not have systemic effects characteristic of oral dosage forms. A new domestic multicomponent drug to treat vaginitis and prevent its development has been provided a market authorization on the Russian market. Its action is ensured by combined effects of the components in its composition, such as metronidazole (500 mg), chloramphenicol (200 mg), natamycin (150 mg), hydrocortisone acetate (15 mg), due to which the drug provides a wide range of etiotropic and symptomatic effects. The article presents the results of comparative clinical studies on assessment of the efficacy, tolerability and safety of the drug in the treatment of vulvovaginitis of mixed etiology. The Russian studies showed that this combination provides a minimal risk of systemic effects and the most favourable safety and tolerability profile of therapy as compared to the oral dosage forms, which gives grounds to recommend it for use in the clinical obstetrics-gynecology practice.

Introduction. Trichomoniasis is a vaginal infectious and inflammatory disease, which falls into the category of sexually transmissible nosological entities. It is the profile of vaginal microecosystem changes in trichomoniasis that determines the vector of transformation of the vaginal microbiome towards the formation of bacterial vaginosis (BV), namely, a hypercolonized community of anaerobic microorganisms with underlying suppression of the dominant presence of the resident acidophilic microflora.

Aim. To evaluate the clinical and bacteriological efficacy of 5-nitroimidazole drugs secnidazole and metronidazole in the therapy of acute trichomoniasis and concomitant vaginal dysbacteriosis.

Materials and methods. As a comparison object, we used the therapy regimens for acute trichomoniasis with the 5-nitroimidazole drugs secnidazole and metronidazole, involving 2 grams (g) once as a single dose. The study included 64 patients diagnosed with acute trichomoniasis. The average age of the patients was 34 ± 7 years (95% CI 32–37). The patients were divided into two groups: group 1 (n = 32) used Secnidazole, group 2 (n = 32) used Secnidazole 2 g once as a single dose. Metronidazole was used at a dose of 500 mg 2 times a day for 5 days. Patients were observed by a doctor during two visits, and a follow-up assessment of the treatment results was carried out by way of remote interrogation.

Results. The use of the drug therapy ensured removal of Trichomonas from the vagina. Both groups showed relief of clinical symptoms from B1 to B2: discomfort, itching, burning, dyspareunia, hyperemia of the mucosa with underlying tendency towards normalization of laboratory findings of the vaginal microbiocenosis condition. At the same time, it should be noted that the therapy efficiency was higher in group 1 (secnidazole).

Conclusion. Thus, the administration of secnidazole provided greater therapeutic efficacy as compared with the use of the similar therapeutic dose and frequency of metronidazole to treat Trichomonas and, in combination with rehabilitation therapy, determined a more pronounced tendency towards normalization of the composition of the vaginal microflora.