Introduction. Early-onset neonatal sepsis (EONS) remains the leading cause of serious mobility and mortality worldwide. At the present time, the impact of the COVID-19 pandemic on the incidence of other infections is of particular interest.
Aim: to conduct a comparative analysis of the features of the course of EONS in newborns before the COVID-19 pandemic (2018) and during the COVID-19 pandemic (2021).
Materials and Мethods. A retrospective cohort single-center continuous study included 73 newborns born and hospitalized in the Regional Kaluga Perinatal Center (PC) based on Kaluga Regional Clinical Hospital. The data for the period of stay in the PC from January to October 2018 and the same period in 2021 were analyzed and compared. Newborns were divided into two groups: group 1 (n = 26) – in 2018, and group 2 (n = 47) – in 2021. The following parameters of EONS severity were selected: the need for the use of norepinephrine, surfactant and fresh-frozen plasma (FFP).
Results. The incidence of EONS in 2021 (n = 47) was significantly higher than in 2018 (n = 26): odds ratio (OR) = 3.27; 95 % confidence interval (CI) = 1.57–6.40; p = 0,001. Gestational age and Apgar score at the 1st and 5th minutes were significantly higher in group 1 than in group 2: 36.2 [33.3; 38.0] weeks vs. 33.3 [28.5; 36.1] weeks (p = 0.016); 7.0 [5.0; 7.0] vs. 5.0 [3.0; 7.0] (p = 0.019) and 9.0 [6.8; 8.0] vs. 6.0 [5.0; 8.0] (p = 0.012), respectively. Newborns with EONS in 2021 compared with 2018 showed a significant increase in norepinephrine administration of (42/47 vs. 16/26 newborns, respectively; OR = 5.25; 95 % CI = 1.58–17.44; p = 0.007), FFP transfusions (47/47 vs. 19/26 newborns, respectively; OR = 36.54; 95 % CI = 2.05–649.84; p < 0.001) and surfactant therapy (32/47 vs. 7/26 newborns, respectively; OR = 5.79; 95 % CI = 2.04–16.45; p = 0.001). Mortality among patients with EONS in 2021 compared to 2018 was significantly higher: 13/47 (21.3 %) vs. 2/26 (7.7 %) newborns, respectively (OR = 9.56; 95 % CI = 1.22–74.96; p = 0.014).
Conclusion. Among the newborns of the Kaluga region there is a significant rise in the incidence and mortality of EONS on the background of the COVID-19 pandemic. In 2021 there is a significant increase in the need for surfactant administration, use of vasopressors, and transfusion of FFP in infants with EONS.

Aim: to reveal morphological features of paraurethral tissue in postmenopausal women with stress urinary incontinence (SUI).

Materials and Methods. A prospective cross-sectional trial was conducted, which included 30 women with SUI combined with POP-Q (Pelvic Organ Prolapse Quantification) stage I–II cystocele, aged 55 to 75 years. All patients underwent surgical treatment such as anterior colporrhaphy, cystocele plasty with own tissues, urethropexy with synthetic loop followed by morphological study of histological samples.

Results. Profound alterations in architectonics of the connective tissue were revealed. Structural changes occurring in the paraurethral tissue are characterized by fragmentation of collagen and elastin fibers as well as their critically lowered thickness and volume, and destruction of strong inter-fiber bonds. This indicates about disintegration of the collagen-elastin skeleton being a part of the ligamentous apparatus involved in urinary retention.

Conclusion. The study of the morphological aspects related to stress incontinence including use of immunohistochemical research methods will provide deeper insights into pathogenetic mechanisms behind such pathological condition. Thus, it will be possible to implement a personalized approach to the tactics of management and the choice of therapeutic method for patients with SUI aimed to increase in its effectiveness.

Aim: to assess features of placental transcriptome in patients with complicated pregnancy course and outcome.

Materials and Methods. A prospective observational comparative study in parallel groups was carried out by examining 44 patients divided into three groups: group 1 included 13 pregnant women with moderate and severe preeclampsia (PE), group 2 consisted of 12 patients with fetal growth retardation (FGR), control group included 19 clinically healthy women with uncomplicated pregnancy and delivery. All women enrolled to the study underwent a comprehensive examination, including history collection, general and obstetric-gynecological examination, laboratory and instrumental studies. Special research methods were used during the study, which included placental tissue sampling followed by analyzed expression profile of 12 microRNAs using real-time polymerase chain reaction (PCR).

Results. The PCR data indicated about lack of expression for analyzed miR-210-3p, miR-320-3p, miR-1304-5p and miR-375-5p in placental tissue samples in FGR patients. No significant differences in placental miRNA levels were observed in FGR vs. PE and control group. Analysis of placenta-specific microRNAs in women with PE vs. control group showed a significantly down modulated expression level for miR-517a-3p (p = 0.025), miR-517c-3p (p = 0.036), miR-574-5p (p = 0.015) along with upregulated expression of miR-20a-5p (p = 0.046).

Conclusion. The data obtained evidence that pregnancy-related complications are characterized by specific molecular changes at placental transcriptome level.

Aim: to evaluate therapeutic efficacy and modulated steroidogenesis after radon therapy in experimental chronic endometritis model.

Materials and Мethods. A therapeutic effect related to radon mineral waters was studied experimentally. The water radon concentration was 5.4–6.2 nCi/dm³. The experimental endometritis was induced in laboratory Wistar line rats (n = 40) inoculated with intra-uterine self-fecal suspension. Experimental group animals (n = 10) received a wide-spectrum antibiotic Ceftriaxone within 7 days followed by applying 10 procedures of radon therapy one a day and from day 41, the first procedure lasting 5 minutes, the second – 8 minutes, the third – 10 minutes, with all other procedures – for 15 minutes. Comparison group I animals (n = 10) received antibacterial therapy, radon therapy and 10 procedures of peloid therapy with natural salt-saturated medium sulfide silt therapeutic mud according to a radon therapy regimen. Сomparison group II (n = 10) received antibacterial and peloid therapy according to comparison group I regimen. Control group (n = 10) received no treatment. Inflammatory signs were assessed by endometrium histology study. The venous steroid hormones levels were analyzed by enzyme-linked immunosorbent assay.

Results. In experimental vs. control group, it was found that endometrial diffuse infiltrate was of lower density comprising 125.4 ± 8.1 vs. 180.7 ± 9.0 immunocompetent cells (by 30.7%; p = 0.002), whereas in comparison group I, density of inflammatory infiltration was minimal (reduced by 88.7 % compared to control group; p < 0.001) and reached 20.5 ± 1.8 cells. In the experimental group as well as comparison groups I and II vs. control group, a significant increased level of serum progesterone was observed after treatment (p = 0.008). When using a radon therapy in experimental group, it resulted in a more prominent rise in progesterone level compared to peloid therapy in comparison group II. Radon balneotherapy was found in main control group to elicit a significant declined estradiol level (p = 0.008), but not in comparison groups I and II featured with no significant change in estradiol level compared to control group.

Conclusion. Radon therapy exerts an anti-inflammatory effect in experimental chronic endometritis model. Radon therapy combined with peloid therapy has a potentiated effect. The use of radon balneotherapy is accompanied by significantly increased progesterone and decreased estradiol level suggesting to conduct clinical trials for confirming its effectiveness in patients with reproductive dysfunction including diseases accompanied by hyperestrogenism.

The review presents data on the evolution of combined oral contraceptives (COCs), related most frequent and dangerous side effects including venous thromboembolism (VTE). The issue of VTE upon administration of COCs is highlighted, and the risks of such complication in patients receiving hormonal contraception are determined. The issues of the basic demands of women choosing COCs are considered as well as current opportunities to meet such requests by using novel drug groups with a high profile of efficacy and safety. Particular cases of optimal COCs choice for patients with specific comorbidities such as obesity, hirsutism, seborrhea, alopecia, acne, polycystic ovary syndrome (PCOS), fibrocystic mastopathy, endometriosis as well as in case of gynecological surgical interventions are analyzed. The options of contraceptive therapy are proposed by taking into account individual female wishes (lack of weight gain, decreased libido, etc.).

Cancer prevalence particularly for cervical cancer (CC) has been steadily increasing tending to rise among young women. Vigorous antitumor treatment approaches employed in CC management have detrimental effects on various aspects of a woman's life. In addition to causing morphofunctional alterations in diverse host organs and systems, such treatment protocols result in psychological and emotional disturbances, sexual dysfunction, and social maladjustment, which collectively profoundly reduce the quality of life (QoL). Integrating timely rehabilitation programs into comprehensive care of such patients can effectively alleviate or minimize complications related to antitumor treatment, improve QoL, and restore a woman's desire for satisfying sexual and social engagement.

The article discusses the historical features of the clinical formation of the diagnostic criteria of the Silverman-Andersen scale in the assessment of respiratory distress syndrome in preterm infants. The epidemiology and clinical picture of the respiratory distress syndrome of newborn (infantile respiratory distress syndrome,) is given. The international practical experience of the clinical application of the rating scale in neonatology and neonatal resuscitation is presented. Modern aspects of further improvement of the neonatal scale in the primary and/or repeated visual assessment of the clinical picture of IRDS during monitoring of vital functions and intensive care of premature infants in the early neonatal period are analyzed. The important clinical and prognostic significance of the primary use of the Silverman-Andersen scale in the rapid assessment of the clinical course of ADRS in premature infants is emphasized with a targeted choice of tactics for starting respiratory support in the intensive care unit for newborns in the maternity hospital of the perinatal center of Yudin City Clinical Hospital (Moscow).

Neonatal sepsis still remains a serious problem of modern health care, being one of the main causes of neonatal and infant mortality, as well as disability in surviving children. Due to the high risk of adverse outcomes, the problem of early neonatal sepsis (ENS), especially in preterm infants, attracts special attention. At the same time, if in the previous decades the main causative agents of ENS were Escherichia coli and Streptococcus group B, then in recent years it has been noted that while maintaining the leading value in the etiological structure of Escherichia coli, the frequency of detection of Haemophilus influenzae began to increase. The article contains a review of modern publications on the role of Haemophilus influenzae in the formation of perinatal losses, as well as the significance of this pathogen in the development of neonatal sepsis. The article also presents a clinical case report of ENS caused by Haemophilus influenzae. Particular attention is paid to the issues of timely diagnosis of ENS, which is possible only with a comprehensive analysis of the results of clinical and laboratory-instrumental examination.

The article presents paintings by famous artists on "maternal death": Edvard Munch "The Dead Mother and Child", Pablo Picasso "Motherhood", Egon Schiele "Pregnant Woman and Death" and "The Dying Mother", Frida Kahlo "My Birth", Gustav Klimt "Death and Life" as well as their description.