Background. Undifferentiated connective tissue disease is the subject of research in a large number of medical specialties, as it leads to an aggravated course of various diseases. In the presence of this pathology during pregnancy, the incidence of such complications as preeclampsia, gestational diabetes, and placental abruption increases. Failure to carry a pregnancy to term can be associated with various causes, including the activity of myocytes, while the pathology in question involves the connective tissue of the uterus. In this connection, it seems necessary to study the impact of undifferentiated connective tissue disease on pregnancy outcomes in order to administer timely treatment.

Objectives. To assess how undifferentiated connective tissue disease affects the risk of failure to carry a pregnancy to term.

Methods. An observational cohort prospective study was conducted among pregnant women who were under antenatal care in 2021–2022. The study was performed at the premises of the Clinical Maternity Hospital of Minsk Region (Republic of Belarus). The patients were divided into two groups: an exposed group comprising 59 patients with diagnosed undifferentiated connective tissue disease and a nonexposed group comprising 59 patients without this pathology. Both groups were divided into subgroups according to the obstetric outcome. The exposed group included a subgroup of 17 undifferentiated connective tissue disease patients who had failed to carry pregnancy to term (miscarriage and preterm labor) and a subgroup of 42 undifferentiated connective tissue disease patients with delivery at term. The nonexposed group included a subgroup of five women without undifferentiated connective tissue disease who had failed to carry pregnancy to term (miscarriage and preterm labor) and a subgroup of 54 women without undifferentiated connective tissue disease and with delivery at term. According to ICD-10, abortive outcomes occurred before 21 weeks and six days gestation; labor that occurred at 22–36 weeks and six days gestation was considered preterm, whereas in the case of delivery at term, the baby was born at 37–41 weeks and six days gestation. The obstetric, gynecological, and somatic history, as well as pregnancy outcomes, were analyzed. Statistical processing of data was performed using the following software: Statistica 12.0 (StatSoft, USA), Microsoft Excel 2016, Epi InfoTM 7.2.6.0 (USA), and MedCalc 15.8 (MedCalc Software, Belgium). In hypothesis testing, differences were considered statistically significant at p < 0.05.

Results. In the group of undifferentiated connective tissue disease patients, metrorrhagia was statistically significantly more common than in the patients without undifferentiated connective tissue disease: 18 out of 59 (30.5 %) and six out of 59 (10.2 %), respectively, p = 0.012. The obstetric history revealed no statistically significant intergroup differences, p > 0.05. In the undifferentiated connective tissue disease patients, the following diseases were statistically significantly more common: myopia, spinal scoliosis, lower limb varicose veins, chronic tonsillitis, mitral valve prolapse, and iron deficiency anemia (p < 0.05). The incidence of new cases of failure to carry a pregnancy to term in the cohort during the observation period amounted to 18.6 % for the patients in both groups. The pregnancy ended prematurely in 17 out of the 59 undifferentiated connective tissue disease patients (28.8 %) and in five out of the 59 patients without undifferentiated connective tissue disease (8.5 %), relative risk of 3.4 (95 % CI:1.3–8.6), p = 0.005.

Conclusion. Undifferentiated connective tissue disease increases the risk of failure to carry a pregnancy to term by 3.4 times. Timely diagnosis and treatment of undifferentiated connective tissue disease at the stage of preconception preparation can reduce the incidence of failure to carry a pregnancy to term.

Background. Human papillomavirus refers to one of the most common sexually transmitted infections with the majority of viruses in the host being transient carriers, the so-called latent forms of papillomavirus infection. Persistence of cancer-associated human papillomavirus is fraught with cervical intraepithelial neoplasia, and subsequent cervical cancer. Measures for secondary prevention of cervical cancer in latent forms of papillomavirus infection are yet to be developed, which predetermined the present study.

Objectives. To increase the effectiveness of secondary prevention of cervical cancer by improving the algorithm for managing latent forms of papillomavirus infection in women.

Methods. A randomized controlled trial enrolled 152 patients diagnosed with a latent papillomavirus infection. Patient examination and data analysis were carried out at clinical trial centers of the Department of Obstetrics, Gynecology and Perinatology of Kuban State Medical University (Russia) in 2020–2024. The trial involved patients aged 18 to 35 years. Patients were divided into 2 groups using the sealed code envelope method: Group I (comparison group) (n = 74) — microbiological sanitation of the cervicovaginal zone (as indicated) and observation for 36 months with annual control of viral load, colposcopy and oncocytology; Group II (study group) (n = 78) — microbiological sanitation of the cervicovaginal zone (as indicated) and administration of quadrivalent recombinant human papillomavirus vaccine (types 6, 11, 16, 18) (3 doses intramuscularly: second and third doses were administered 1 and 3 months after the first one). Each patient was analyzed for the effectiveness of preventive therapy according to the dynamics of indicators: colposcopy, cytology (Papanicolau staining), and molecular biological analysis (polymerase chain reaction). The indicators were evaluated after 12, 24, and 36 months. Statistical analysis of the results was carried out using IBM SPSS Statistics 26 (IBM, USA) variation statistics programs.

Results. Vaccination with a quadrivalent recombinant vaccine against human papillomavirus of types 6, 11, 16, 18 against the background of correction of dysbiotic vaginal and cervical disorders in latent forms of papillomavirus infection in women was revealed to cause a 9.3-fold decrease (compared to the study group) in realization of latent persistence of viruses into subclinical (25.7 % in group I vs. 9.0 % in group II) and clinical forms of papillomavirus infection (cervical intraepithelial neoplasia) — 12.1 % in group I vs. 1.3 % in group II, to reduce the persistence of human papillomavirus and the appearance of their new genotypes, the viral load of highly oncogenic types of human papillomavirus (1.9 times —3.2 ± 2.4 geq/ml in group I versus 1.7 ± 2.1 geq/ml in group II).

Conclusion. The trial has shown that human papillomavirus vaccination is associated with a reduced risk of realization of latent forms of papillomavirus infection into clinical forms as cervical intraepithelial neoplasia and, consequently, cervical cancer, thereby being considered promising for secondary prevention of this pathology.

Background. Functional processes in the female organism at the stage of reproductive function failure in menopause attract considerable interest of researchers. The paper presents a study of great medical, biological and social importance into reproductive function failure in women living in the territories with permanent military operations for a long time and, thus, suffering from post-traumatic syndrome, which significantly affects the character of menopause. Objectives. To identify the features of menopausal syndrome in women who have been living under chronic stress (6–8 years) in the zone of ongoing military operations, namely in the Donetsk and Luhansk People’s Republics, and in women from Rostov Oblast — the region free from active military operations.

Methods. An observational cohort study involved 60 women (refugees), long-term residents of the territories with ongoing military operations and 60 long-term residents of the territories without military operations, aged 50–65 years, with clinical manifestations of menopausal syndrome; all women were patients of the Research Institute of Obstetrics and Pediatrics, Rostov State Medical University. In accordance with the Stages of Reproductive Aging Workshop (STRAW+10) classification and clinical manifestations of menopause, two clinical groups (n = 30) were formed from the representatives of each region of residence. Group I included 30 women, aged 50–55, from the Donetsk and Luhansk People’s Republics, who had late menopausal transition (stage -1 of STRAW+10) and menopausal syndrome. Group II involved 30 postmenopausal patients (stages +1 and +2 of STRAW+10), aged 60–65, with menopausal syndrome. Group 1 enrolled 30 residents of Rostov Oblast, aged 50–55, who had late menopausal transition (stage -1 of STRAW+10) and menopausal syndrome, group 2 included 30 postmenopausal patients (stages +1 and +2 of STRAW+10), aged 60–65, with menopausal syndrome. Modified menopausal index was considered as the main indicator of the study. Statistical data processing was carried out by means of Statistica 10.01 (StatSoft, USA), Microsoft Excel 2010 (Microsoft, USA), IBM SPSS 24.0 (IBM, USA), and MedCalc (MedCalc Software, Belgium).

Results. Long-term female residents of the territories with ongoing military operations were reported to develop menopausal syndrome more often. Rostov Oblast female residents in the late menopausal transition revealed a statistically significant prevalence of a mild degree of menopausal syndrome in 63.3 % of cases compared to 36.7 % of a similar severity of menopausal syndrome in residents of the Donetsk and Luhansk People’s Republics. Meanwhile, women from the Donetsk and Luhansk People’s Republics were indicated with moderate menopausal syndrome in 50.0 % of cases in late menopausal transition and severe syndrome in 33.3 % in postmenopause versus 23.4 % and 10 % of women from Rostov Oblast, respectively. The intensity of neurovegetative and psycho-emotional disorders in women of both regions increases with the aging process of the reproductive system and appears most pronounced in the postmenopausal period.

Conclusion. Residents of the Donetsk and Luhansk People’s Republics, who live in the war zone and are exposed to constant threat to life, develop post-traumatic syndrome which significantly intensifies and modulates the already existing functional and hormonal restructuring in the brain subsystems during perimenopause. Non-uniform functional shifts at different levels of the central nervous system under conditions of chronic stress lead to a significant change in intracerebral processes and to an increase in the occurrence and severity of various dysfunctional deviations.

Background. The annual number of new cases of chronic pelvic pain syndrome in women of reproductive age is increasing worldwide. The high prevalence of this condition among the able-bodied female population leads to higher state expenditures on the treatment of this category of patients. New methods of diagnosis and early prophylaxis contribute to reducing economic burden associated with chronic pelvic pain syndrome in women and improving health of the female population as a fundamental demographic factor.

Objectives. To determine somatic, obstetric-gynecological, anatomical, and psycho-emotional predictors of chronic pelvic pain syndrome.

Methods. An observational cohort clinical and ultrasound study involved 60 patients of reproductive age. The study was conducted on the basis of the clinic for women, Voronezh City Outpatient Clinic No. 1 — clinical base of the Department of Obstetrics and Gynecology No. 2, Voronezh State Medical University named after N. N. Burdenko, Russia. According to clinical and laboratory data, the participants were divided into 2 groups. Group 1 (n = 30) included women of reproductive age without clinical manifestations of chronic pelvic pain syndrome; Group 2 (n = 30) enrolled women of reproductive age clinically diagnosed with chronic pelvic pain.

Results. The mean age of the study participants in the main group comprised 27.4 ± 6.30 and 26.3 ± 7.25 years in the control group, p > 0.05. Diseases of gastrointestinal tract, endocrine, cardiovascular, musculoskeletal and urinary systems, as well as neurocirculatory and vegetative disorders prevailed in the structure of somatic pathology in the main group, p < 0.001. Analysis of obstetric and gynecologic anamnesis revealed no statistically significant differences in the incidence of gynecologic pathology in the study groups. However, according to the detailed analysis of the delivery history of the participants, 23 patients of the main group (76 %) and 3 patients (6.6 %) of the control group underwent episiotomy during labor, p < 0.001. The evaluation of the comparison groups in terms of pain component in myofascial syndrome involved the pain rating index, number of selected descriptors, sensory index of the selected descriptors, emotional index of the selected descriptors, and pain intensity. Statistically significant differences were revealed for all of the above indicators, thereby confirming a reliable picture of pathopsychological changes in the compared groups of women. The analysis of the ultrasound parameters of topographic and anatomical relationships demonstrated the relevant change in the following parameters: urethral length, diameter of the external urethral sphincter, angle between the external urethra and the body of the bladder, direct and transverse dimensions of the levator hiatus in the studied groups under the muscle tension.

Conclusion. An issue of early diagnosis and prophylaxis of chronic pelvic pain syndrome in women of reproductive age remains urgent and requires interdisciplinary participation of medical specialists. The development of new approaches to ultrasound evaluation of pelvic floor will increase the effectiveness of therapeutic and prophylactic measures and reduce the economic burden of this nosology in the morbidity structure of the able-bodied female population.

Background. Asymptomatic bacteriuria in pregnant women is not accompanied by visible symptoms; however, it involves the risk of serious complications, including gestational pyelonephritis and/or preterm labor, thereby threatening the health of both mother and child. This condition raises particular concern in light of the growing global problem of antibiotic resistance causing traditional therapies to be less effective or futile. Therefore, a study into alternative medicine approaches to asymptomatic bacteriuria in pregnant women appears highly relevant in terms of developing new solutions for managing this condition while minimizing maternal and child health risks and preventing the spread of antibiotic resistance.

Objectives. To conduct a comparative analysis of the effectiveness of antibiotic therapy and combined administration of antibiotics, lactobacilli, and proanthocyanidins for asymptomatic bacteriuria in young pregnant women.

Methods. 50 pregnant women aged 15 to 17 and diagnosed with asymptomatic bacteriuria participated in a randomized prospective study. Patients were randomly divided into two groups depending on the treatment. Group 1 received standard antibiotic therapy; group 2 received a combination of antibiotics with lactobacilli and proanthocyanidins. Treatment was carried out in the Republican Clinical Perinatal Center, the Republic of Bashkortostan. Patients were enrolled in the study from February 2021 to January 2022. The observation period included several stages: 10 days after treatment (first control), 30 days after treatment (second control), and 2 months after delivery (final control). The condition of the urinary tract was assessed depending on bacterial concentration, with the diagnosis of asymptomatic bacteriuria being made in case of a 105 CFE/mL (colony forming units of bacteria per milliliter of urine). The endpoint of the study was considered to be the cure of pregnant women from asymptomatic bacteriuria, which was determined by the absence of bacteria in the urine 10 days after the therapy, as well as a recurrence-free period for two months after delivery. Statistical data processing was carried out using Statistica 10.0 (StatSoft, USA) for Windows and Microsoft Excel (Microsoft, USA). A statistical level with p ≤ 0.05 was considered significant.

Results. Treatment outcomes showed a significant reduction in bacteriuria and recurrent infection, especially in the group receiving the combined therapy. No bacteriuria was reported in 36 % of patients in group 1 and 76 % in group 2 (Yates’ chi-squared test, p = 0.011). The incidence of preterm labor appeared lower in the combined therapy group (4 % for group 2 and 12 % for group 1). Complications were recorded in 11 young pregnant women of group 1 (44 %) and in 3 women of group 2 (12 %). Statistical analysis indicated significant differences between the groups in terms of complication rate after treatment (Fisher’s exact test, p = 0.015).

Conclusion. Combined therapy including antibiotics, lactobacilli, and proanthocyanidins demonstrates high effectiveness as an alternative to conventional treatments of asymptomatic bacteriuria in pregnant women. Due to this approach, bacteriuria as well as recurrence rate decreases, thereby contributing to a more stable health status.

Background. Endometriosis is distinguished by its high prevalence and significant impact on the quality of life and reproductive health of women; however, its etiology and essential pathogenesis of remain uncertain so far. Modern research is increasingly focusing on immune, hormonal and genetic factors that share a common structure and participate in common metabolism — so-called single nucleotide polymorphisms (SNPs), including stress-induced phosphoprotein 1 (STIP1), which participates in tissue and cellular metabolism through transcription splicing and folding of RNA. The role of this protein, known as heat shock protein (HSP)-organizing protein, is being actively studied in cancer and hyperproliferative diseases. The role of the STIP1 gene and its product in the pathogenesis of adenomyosis appears to be studied insufficiently, thereby determining the relevance of the present study.

Objectives. To evaluate the expression of stress-induced phosphoprotein 1 in eutopic endometrium and myometrium in women with isolated adenomyosis, as well as in combination with other benign hyperproliferative diseases of the reproductive system.

Methods. Clinical study site: Clinical and Diagnostic Department of Ott Research Institute of Obstetrics, Gynecology and Reproductology. Design: an observational case-control study of patients with verified diagnoses of diffuse adenomyosis, uterine fibroids, and external genital endometriosis (main group — n = 55). The study group (n = 43) was divided into three subgroups: patients with isolated diffuse adenomyosis (AM, n = 16), adenomyosis in combination with uterine fibroids (AM + UF, n = 16), adenomyosis in combination with external genital endometriosis (AM + EGE, n = 11)), a comparison group — patients with uterine fibroids (n = 12) and a control group (n = 17) — women of reproductive age without gynecological diseases. The study was conducted from November 1, 2022 to September 30, 2023. The target indicator of the study was the level of relative mRNA (mRNA) expression of STIP1 gene (in RQ (Relative Quantity) units) in the uterus — adenomyosis glands, surrounding myometrium and endometrium. Histological evaluation of the endometrium served as an additional indicator. Statistical analysis of the results obtained, namely the relative level of mRNA expression, was carried out by the ΔΔСt method using the Expression Suit V1.0.3 program. (https://www.thermofisher.com/ru/ru/home/technical-resources/software-downloads/expressionsuite-software.html). The data analysis was performed using the GraphPad Prizm program (Insight Partners, USA). Differences between groups were evaluated by means of single factor ANOVA analysis (followed by post-hoc pairwise comparisons (Tukey test) of the values in each group. The differences were considered statistically significant at p < 0.05.

Results. A high level of STIP1 gene expression was reported in myometrium of patients with isolated adenomyosis (more than 3-fold increase in relation to the comparison group — patients with uterine fibroids). In addition, myometrium of women with adenomyosis combined with uterine fibroids demonstrated a higher expression of STIP1 gene, compared to patients with isolated uterine fibroids (p < 0.01). The evaluation of the expression of mRNA of the STIP1 gene in the eutopic endometrium of patients with adenomyosis and women in the control group revealed no significant differences; however, STIP1 in the endometrium of women with adenomyosis was significantly lower than in the endometrium of both patients with uterine fibroids and women with adenomyosis combined with external genital endometriosis.

Conclusion. Increased mRNA expression of STIP1 gene in myometrium in adenomyosis confirms its role in the pathogenesis of this disease. The role of the expression of the STIP1 gene and the corresponding protein is to be further clarified in order to assess its specificity and sensitivity as a diagnostic marker and to identify new approaches to the treatment of adenomyosis.

Background. The shortage of healthcare human resources is currently one of the most discussed topics in both Russian and global discourse. Along with the study of such important problems in the healthcare system, as its unevenness, a lack of access to health services among the most vulnerable groups, a low quality of the care provided, etc., much attention is currently paid to the professional competence, adaptation, and retention of mid-level specialists in medical organizations. One possible solution to the above problems is seen in the institute of mentorship.

Objectives. To analyze the main approaches to defining the concept of “nursing mentorship” in the foreign and Russian research literature.

Methods. A comparative analysis of literature sources by foreign and Russian authors addressing the definition, content, and implementation of nursing mentorship was conducted using the PubMed and eLibrary.ru databases.

Results. Three main approaches — “dyadic”, “triadic,” and “integrated” (mixed) — to defining the concept of nurse mentorship were identified. The dyadic approach focuses on the analysis of interpersonal interactions between mentor and mentee. Such interactions arise during a specifically planned and goal-oriented activity aimed at a dynamic psychosocial intervention in the mentee’s professional life to bridge gaps in his/her knowledge and skills and to increase self-confidence. Dyadic mentoring can be of individual, group, distance, peer, cascade, and reverse types. The triadic approach implies interaction not only between mentor and mentee, but also involvement of the medical organization as a party. The administrators are interested in personnel stability, improved professional skills of the staff, increased loyalty and commitment to the organization. The main focus here is on the functionality, formalization, and comprehensiveness of mentoring programs, allowing the goals of the medical organization to be achieved. Within the integrated (mixed) approach, the negative experience of mentoring and the possibilities of forming a culture of mentorship are analyzed. The mentorship culture, while reflecting the interests of the medical organization, bolsters “authentic friendship” within the nursing team. Mentorship is considered as a set of activities that influence mentors, mentees, and the medical organization as a whole, passing through various development phases and stages in the interests of the three interacting parties. The contribution of Russian authors to the development of mentorship consists in the elucidation of issues related to the professional development and sociocultural adaptation of young specialists in the healthcare system, as well as in modeling mentorship relations. Mentorship is considered not only in terms of the specifics of interpersonal professional relations that arise in the mentor and mentee interaction, but also as an instrument in labor management. Mentorship programs can increase the personnel’s commitment to their profession and the results achieved.

Conclusion. In the current scientific literature, different approaches to defining the concept of mid-level medical personnel mentorship are presented. The existing experience in organizing mentorship programs may significantly improve their qualitative level, thereby contributing to professional self-realization of both mentors and young nursing specialists.