Видання іноземною мовою. Кафедра акушерства та гінекології

Possible reasons for failed induction of labor

2026-07-01T06:55:56Z

Possible reasons for failed induction of labor Posokhova, S.; Kucherenko, O.; Parubina, D. The failed induction of labor is associated with a higher rate of maternal and fetal morbidity because it increases the unwanted effect of emergency cesarean section. It is also associated with an increased risk of numerous adverse maternal and perinatal outcomes such as uterine rupture, nonreassuring fetal heart rate tracing, postpartum hemorrhage, stillbirth, and severe birth asphyxia. Objective. To identify the reasons for failed labor induction.

The birth canal as a determinant of vaginal birth outcomes: physiological adaptation, trauma prevention, and recovery strategies

2026-07-01T06:28:10Z

The birth canal as a determinant of vaginal birth outcomes: physiological adaptation, trauma prevention, and recovery strategies Manasova, G.; Shapoval, N.; Stasii, Ya. Perineal trauma complicates up to 70–85% of vaginal births and represents a major contributor to long-term pelvic floor dysfunction. Obstetric anal sphincter injuries (OASI) occur in approximately 3–11% of vaginal deliveries and are associated with chronic pain, urinary and fecal incontinence, pelvic organ prolapse, dyspareunia, and impaired quality of life. Contemporary obstetrics increasingly focuses on preserving pelvic floor integrity as an essential component of safe vaginal birth. Objective. To evaluate current evidence regarding the adaptive capacity of the birth canal and evidence-based strategies for the prevention and rehabilitation of OASI.

Contemporary views on the vaginal microbiome correction and/or restoration

2026-06-30T12:08:59Z

Contemporary views on the vaginal microbiome correction and/or restoration Artyomenko, V.; Kugel, V. Aim: the thesis are devoted to the modern scientific publications review about vaginal microbiome and its correction and/or restorationimportance in obstetrical and gynecological practice, focusing on new and prospective methods.

Features of standardized patient scenarios across different clinical disciplines for OSCE 2026

2026-06-13T09:45:49Z

Features of standardized patient scenarios across different clinical disciplines for OSCE 2026 Pavlovska, O. M.; Savelyeva, O. V.; Pavlovska, K. M. During the OSCE 2026 at the Odesa National Medical University, students completed 10 examination stations. In total, 528 examination tasks were included in the exam, among which 243 were clinical scenarios involving standardized patients. An analysis of the structure of standardized patient scenarios in various clinical disciplines (surgery, internal medicine, obstetrics and gynecology, and pediatrics) was conducted. The largest proportion of examination tasks assessed clinical (professional) competence (41.17%) as well as physical examination and diagnostic skills (23.90%). The proportions of tasks aimed at assessing communicative competence and treatment strategy were approximately equal, accounting for 18.11% and 16.85%, respectively.

Clinical profile of patients with pathological endometrial changes associated with metabolic factors

2026-06-11T12:37:56Z

Clinical profile of patients with pathological endometrial changes associated with metabolic factors Marichereda, V. H.; Drobot, D. I.; Марічереда, В. Г.; Дробот, Д. І. The aim of the study was to characterize the clinical profile of women with pathological endometrial changes associated with metabolic disorders, with an emphasis on disease course, comorbidities, and risk determinants. Materials and methods. The study was conducted at the Multidisciplinary Medical Center of Odesa National Medical University and included 103 women who were examined between 2023 and 2025. Based on clinical and morphological findings, patients were divided into five groups: simple endometrial hyperplasia (n = 39), atypical endometrial hyperplasia (n = 9), endometrial cancer (n = 25), polycystic ovary syndrome (PCOS; n = 16), and a control group of healthy women (n = 14). Diagnosis was verified histologically using biopsy or surgical specimens. Cancer staging was performed according to the 2023 FIGO classification. All patients underwent comprehensive clinical, laboratory, and instrumental evaluation. Results. Mean body weight and body mass index (BMI) in patients with hyperplasia and endometrial cancer corresponded to classI obesity and were significantly higher than in controls (p < 0.05). In the PCOS group, BMI values corresponded to overweight with marked variability. Obesity was prevalent in most women with endometrial pathology. Abnormal uterine bleeding was the leading symptom (69.2–92 %), while pain and urinary or bowel dysfunction were more typical of malignant disease. Cardiovascular and endocrine comorbidities predominated. Ultrasonography revealed progressive endometrial thickening, structural heterogeneity, and increased vascularization associated with disease severity. Conclusions. Endometrial pathology is strongly associated with obesity and metabolic disorders. Ultrasonographic findings demonstrate high diagnostic value. Modifiable risk factors, particularly obesity, play a significant role in disease progression, highlighting the need for early detection and multidisciplinary management.; Мета дослідження полягала у визначенні клінічного профілю пацієнток із патологічними змінами ендометрія на тлі метаболічних порушень для встановлення супутньої патології та факторів ризику. Обстежено 103 пацієнтки, розподілені на групи залежно від морфологічного діагнозу. Встановлено, що середній ІМТ та маса тіла достовірно вищі у всіх патологічних групах порівняно з контролем, найвищі показники – у пацієнток із раком ендометрія. Провідний симптом – аномальна маткова кровотеча. Найчастіше супутніми станами були серцево-судинні й ендокринні захворювання. Ультразвукові зміни корелювали зі ступенем проліферації ендометрія. Отримані дані підтверджують найбільш часту клінічну асоціацію ожиріння та метаболічних порушень із наявністю патології ендометрія та підкреслюють необхідність мультидисциплінарного й персоналізованого підходу до ведення пацієнток групи ризику.

Urinary tract infections in pregnant women from the russian – Ukrainian military conflict regions: A multicenter study (2022–2025)

2026-06-11T09:49:03Z

Urinary tract infections in pregnant women from the russian – Ukrainian military conflict regions: A multicenter study (2022–2025) Salmanov, A. G.; Senchuk, A.; Dzheneti, B.; Suslikova, L. V.; Savchenko, S. Е.; Rud, V. O.; Strakhovetskyi, V. S.; Korniyenko, S. M.; Kovalyshyn, O. A.; Vdovychenko, S. Yu.; Prishchepa, A. P.; Talko, O. V.; Voloshyn, O. A.; Chubatyy, A. I.; Paliga, I.; Artyomenko, V. V. Aim: To estimates of the prevalence rate of urinary tract infections (UTIs) in pregnant women from the Ukrainian-Russian military conflict regions and antimicrobial resistance of causing pathogens. Materials and Methods: Retrospective multicenter cohort study was conducted from April, 2022 to May, 2025.The study population consisted of 2,576 pregnant women from the Ukrainian-Russian military conflict regions. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST guidelines. results: Among 2,576 pregnant women, 1,002 (38.9%) UTIs were observed. The most frequently reported UTI types were cystitis (48.4%) and asymptomatic bacteriuria (39%). Of all UTI cases, 14.6% were defined as acute pyelonephritis. The most common causative agents of UTIs were Escherichia coli (27.6%), Klebsiella pneumoniae (13.9%), Proteus mirabilis (11.2%), Coagulase-negative staphylococci (8.7%), Enterococcus faecalis (8.5%), Enterobacter spp. (7.2%), and Pseudomonas aeruginosa (6.6%). Methicillin-resistance S. aureus (MRSA), vancomycin resistance enterococci (VRE), and extended spectrum beta-lactamases (ESBL) production among Enterobacteriales was found observed in 11.3%, 9.1%, and 29.4% isolates, respectively. Carbapenem resistance was identified in 13.7% of P. aeruginosa strains. Conclusions: This study findings demonstrate the high rate of UTIs in pregnant women from the Ukrainian-Russian military conflict regions and many cases are caused by pathogens that are resistant to antibiotics. Strategies for deterrence include optimal hygiene practices to minimize the risk of bacterial colonization and ascending infection.

Association of armed conflict with extreme preterm birth and pre-eclampsia and eclampsia in Ukraine, 2022–24: a repeated cross-sectional national surveillance study

2026-05-26T09:54:12Z

Association of armed conflict with extreme preterm birth and pre-eclampsia and eclampsia in Ukraine, 2022–24: a repeated cross-sectional national surveillance study Artyomenko, V. V.; Berestovyi, V. O.; Vdovychenko, Yu. P.; Dondiuc, Iu.; Govsieiev, D. O. Armed conflict can affect maternal and neonatal health through disruption of health services, population displacement, psychosocial stress, and deterioration of living conditions. However, population-based evidence obtained during large-scale modern warfare in countries with previously high-functioning maternal–newborn services remains sparse. We aimed to investigate whether rates of extreme preterm birth and pre-eclampsia or eclampsia among recorded facility-based deliveries in Ukraine changed during 2022–24 and whether these changes differed by regional conflict intensity. Methods We conducted a repeated cross-sectional national surveillance study of monthly aggregated facility-based deliveries recorded in Ukraine’s Ministry of Health forms N-21 (maternal outcomes) and N-21A (neonatal outcomes) from Feb 24, 2022, to Dec 31, 2024. Primary outcomes were extreme preterm birth (at 22–27 weeks’ gestation) and pre-eclampsia or eclampsia (defined using ICD-10 codes O14–O15). Secondary outcomes included early neonatal mortality (death at 0–6 days). We analysed temporal changes in outcomes using interrupted time-series models and examined regional contrasts in extreme preterm birth using difference-in-differences analyses comparing regions of high and low conflict exposure. Conflict intensity was defined using documented attacks on health facilities and front-line proximity. Poisson regression was used to estimate risk ratios (RRs), adjusted for maternal age, parity, facility type, urbanicity, and seasonality. Findings Recorded facility-based deliveries declined from 195243 in 2022 to 172230 in 2024. Rates of extreme preterm birth increased from 3·62 cases per 1000 deliveries in 2022 to 4·38 cases per 1000 deliveries in 2024 (adjusted RR 1·21 [95% CI 1·09–1·34]; p=0·0012). Pre-eclampsia or eclampsia increased from 66·7 cases per 1000 deliveries in 2022 to 88·5 cases per 1000 deliveries in 2024 (RR 1·33 [95% CI 1·28–1·38]; p=0·0014). Reported early neonatal mortality was lower in 2024 than in 2022 (1·71 deaths per 1000 deliveries in 2024 vs 2·1 deaths per 1000 deliveries in 2022; RR 0·81 [95% CI 0·70–0·94]). In regions with high exposure to conflict, 8·2 extreme preterm births per 1000 deliveries were recorded during 2022–24, compared with 3·1 extreme preterm births per 1000 deliveries in low-conflict regions (difference-in-differences estimate 2·1 [95% CI 1·4–2·8] per 1000 deliveries). Interpretation Among recorded facility-based deliveries in Ukraine from 2022 to 2024, increases in the rates of extreme preterm birth and pre-eclampsia or eclampsia were noted during the conflict period, with greater rates of extreme preterm birth in regions of high conflict exposure than in those with low conflict exposure. These findings might reflect a possible changing underlying population during wartime, because the number of recorded deliveries decreased from 2022 to 2024, and women who remained in Ukraine might have differed socioeconomically from those who left the country. The number and functionality of health facilities and reporting completeness also fell from 2022 to 2024, making selective under-ascertainment in conflict-affected areas likely, particularly in view of the decrease from 2022 to 2024 in recorded early neonatal mortality. Thus, these findings should be interpreted with caution as hypothesis-generating associations rather than direct estimates of population incidence.

Histological landmarks for choosing a therapeutic route in patients with overlap syndrome of genital endometriosis and benign breast disease

2026-05-22T09:23:56Z

Histological landmarks for choosing a therapeutic route in patients with overlap syndrome of genital endometriosis and benign breast disease Konovalenko, S. V.; Neborets, A. D.; Protsenko, V. V.; Androsov, D. S.; Khmel, A. V.; Lunko, A. S.; Коноваленко, С. В.; Неборець, А. Д.; Проценко, В. В.; Андросов, Д. С.; Хмель, А. В.; Лунько, А. С. Genital endometriosis (GE) remains a very common disease, occurring in 0.5–5 % of fertile women and in 25–40 % of infertile women. Benign breast diseases (BBD) are common throughout life, from early reproductive age to the postmenopausal period, making them a potential health problem for a large number of women. The histological characteristics of endometrial and breast tissues in patients suffering from the overlap syndrome of GE and BBD are of interest, since this condition carries an increased risk of endometrial, ovarian and breast cancer. The purpose was to study and identify the most characteristic features of endometrioid tissue and ductal hyperplasia tissue of the breast in women with overlap syndrome of GE and BBD using light microscopy. Materials and methods. Histological preparations of endometrioid foci and breast hyperplasia tissues of 148 wo-men with overlap syndrome of GE and BBD were studied. The material was obtained by the method of fine-needle aspiration puncture biopsy, which was performed under ultrasound control. Cytological analysis and microphotog-raphy were performed using an Olympus CX23 microscope with different magnifications (×40, ×100 (immersion)). Results. The study showed that in the selected cohort of patients with overlap syndrome of GE and BBD, most histological samples showed proliferative activity of mesothelial cells. At the same time, morphological signs of atypia of cellular elements of atypical ductal hyperplasia were observed in 47.3 % of histological samples of breast tissue. Cells with signs of malignant transformation were not found in any of the provided breast tissue samples. It is important to note that in 15 % of patients, histological signs of malignancy were found in endometrial samples, which led to their immediate referral to a gynecological oncologist for surgical intervention and the necessary adju-vant therapy. Conclusions. In the prognosis of the clinical course of GE and BBD overlap syndrome, histological confirmation of the diagnosis and detection of signs of atypia in biopsy samples play a key role. The finding of atypi-cal cells requires clinical consultation with the participation of a gynecologist, a mammologist and a gynecological oncologist, during which a decision is made regarding surgical intervention and the necessary pharmacotherapy.; Генітальний ендометріоз (ГЕ) зали-шається дуже поширеним захворюванням, яке зустрічається в 0,5–5 % фертильних та 25–40 % безплідних жінок. Доброякісні захворювання молочної залози (ДЗМЗ) поширені протягом усього життя, від раннього репродуктивного віку до постме-нопаузального періоду, що робить їх потенційною проблемою для здоров’я великої кількості жінок. Гістологічні характери-стики тканин ендометрію та молочної залози в пацієнток, які страждають на перехресний синдром ГЕ та ДЗМЗ, станов-лять інтерес, оскільки ця патологія несе підвищений ризик раку ендометрія, яєчників і молочної залози. Мета:вивчити та виявити найбільш характерні особливості ендометріоїдної тканини й тканини гіперплазії проток молочної залози в жінок із перехресним синдромом ГЕ та ДЗМЗ за допомогою світлової мікроскопії. Матеріали та методи.Досліджено гістологічні препарати ендометріоїдних вогнищ і тканин гіперплазії молоч-ної залози 148 жінок із перехресним синдромом ГЕ та ДЗМЗ. Матеріал був отриманий методом тонкоголкової аспіраційної пункційної біопсії, яку проводили під ультразвуковим контро-лем. Цитологічний аналіз та мікрофотографування виконували за допомогою мікроскопа Olympus CX23 із різним збільшенням (×40, ×100 (занурення)). Результати. Дослідження показало, що у відібраній когорті пацієнток із перехресним синдромом ГЕ та ДЗМЗ переважна більшість гістологічних зразків демон-стрували проліферативну активність мезотеліальних клітин. Водночас морфологічні ознаки атипії клітинних елементів ати-пової гіперплазії проток спостерігалися в 47,3 % випадків. Клі-тини з ознаками злоякісного переродження не були виявлені в жодному з наданих зразків тканини молочної залози. Важливо зазначити, що в 15 % пацієнток у зразках ендометрія діагнос-товано гістологічні ознаки злоякісного новоутворення, що призвело до їхнього негайного направлення до гінеколога-он-колога для хірургічного втручання та необхідної ад’ювантної терапії. Висновки. У прогнозі клінічного перебігу перехресного синдрому ГЕ та ДЗМЗ ключову роль відіграють гістологіч-не підтвердження діагнозу та ознаки атипії у зразках біопсії. Вияв лення атипових клітин вимагає клінічної консультації за участю гінеколога, мамолога та гінеколога-онколога, під час якої приймається рішення щодо хірургічного втручання та необхідної фармакотерапії.

Impact of lesion size and localization on symptom severity in intestinal endometriosis

2026-05-19T12:01:42Z

Impact of lesion size and localization on symptom severity in intestinal endometriosis Ocheretna, Yu.; Rozhkovska, N.; Kozhakov, V.; Gladchuk, V.; Shytova, H.; Petrovskiy, Yu.; Gladchuk, I.; Harald Krentel Intestinal endometriosis (IE) often presents with dyschezia, gastrointestinal (GI) dysfunction, dyspareunia, and dysmenorrhea. The impact of lesion localization and size on the severity of symptoms remains insufficiently studied, complicating preoperative diagnosis, treatment planning, and surgical excision. The aim is to assess preoperative symptoms in women with intestinal endometriosis and to evaluate the impact of lesion localization and size according to the #Enzian classification on the severity of pain and GI symptoms. Methods: A retrospective analysis of medical records was conducted for 135 patients with laparoscopically confirmed intestinal endometriosis (IE) at the Multidisciplinary Medical Center of Odesa National Medical University. Lesion localization and size were classified intraoperatively according to the #Enzian classification in a surgically treated cohort of women. The presence and severity of pain (dysmenorrhea, dyspareunia, dyschezia) and gastrointestinal symptoms (constipation, diarrhea, abdominal pain, bloating, nausea, fecal incontinence, hematochezia) were analyzed. Results: Pain and/or gastrointestinal symptoms were present in 121 patients (89.6%), while 14 patients (10.4%) did not report such symptoms. Large rectal nodules (#Enzian C3) were associated with higher severity of dyschezia, hematochezia, and abdominal pain compared with smaller lesions (#Enzian C1–C2) (p < 0.001). Hematochezia was observed only in patients with #Enzian compartment C (C2, C3) involvement. Patients with additional bowel lesions (#Enzian FI) were associated with a higher risk of bloating compared with rectal lesions alone. Combined lesions (#Enzian C and FI) are also associated with more severe hematochezia compared with #Enzian C/#Enzian FI alone (p = 0.002) and dyschezia compared with #Enzian FI alone (p = 0.03). #Enzian FI lesion size did not influence these results significantly but the analysis was likely underpowered for FI size effects. Conclusion: Large rectal lesions (#Enzian C3) are associated with more severe dyschezia, abdominal pain, and hematochezia. The presence of additional intestinal lesions (#Enzian FI) is associated with increased severity of hematochezia and the risk of bloating.

An unusual case of primary fallopian tube cancer

2026-05-01T11:13:52Z

An unusual case of primary fallopian tube cancer Rozhkovska, N.; Sumtsov, D.; Sumtsov, H.; Smiyan, S.; Savenko, T.; Gladchuk, I.; Рожковська, Н. М.; Сумцов, Д. Г.; Сумцов, Г. О.; Сміян, С. А.; Савенко, Т. О.; Гладчук, І. З. Cases with an open ampullary opening among primary fallopian tube cancer (PFTC) are extremely rare, highly malignant, and difficult to diagnose. Primary fallopian tube cancer accounts for 1.8% of female genital cancers and about 4–6% of cancers of the uterine appendages. According to available data, the incidence of this tumour has increased up to 4 times in recent decades. Preoperative diagnosis of the PFTC has been and remains an unresolved problem for cervical cancer, which leads to untimely treatment or treatment in nononcological institutions. Even during surgeries, errors reach 50%, which provokes inadequate surgeries and treatment methods and delays the recovery of patients. Objective: to demonstrate a case of misdiagnosis during surgery, the need for oncological care and a detailed study of the macro preparation in the operating room. Material and Methods: the results of clinical, morphological and immunohistochemical examination of the case of primary fallopian tube tract and analysis of publications in the relevant literature. Results and Discussion: The clinical, morphological and immunohistochemical analysis of an unusual case of primary fallopian tube cancer was performed. The diagnosis was made only after a routine histological and immunohistochemical examination. A broader review of this clinical case will improve cancer screening and diagnosis. Primary fallopian tube cancer remains a rare but challenging problem in terms of diagnosis and treatment. Improving diagnostic accuracy is based on a thorough preoperative examination of patients with any pathological changes in the uterine appendages, including the study of tumour markers of epithelial tumours (CA-125, НE-4, etc.). In recent years, the prevention of cancer of the fallopian tubes, ovaries, pelvic peritoneum and mammary glands by opportunistic salpingectomy has been actively implemented, with cases of primary and metastatic tumours in the fallopian tubes being reported. There have been some reports of malignant tumours developing after ‘preventive’ surgeries, although the cause of such outcomes is unknown, and the question of whether they can be avoided remains open. Conclusion: Only cancer awareness and careful examination of the removed material in the operating room and the use of suboperative morphological diagnostics will allow avoiding such errors during surgery. Abnormal uterine bleeding cannot be the result of a tumour microsite.; Випадки з відкритим ампулярним отвором серед первинного раку маткових труб (ПРМТ) є надзвичайно рідкісним, дуже злоякісним та складним для діагностики захворюванням. Первинний рак маткових труб становить 1,8% раку жіночих статевих органів і біля 4–6% раку додатків матки. За наявними даними, останні десятиліття відбувається ріст захворюваності цією пухлиною до 4 разів. Невирішеною проблемою для ПРМТ була та залишається передопераційна діагностика захворювання, що призводить до несвоєчасного лікування або лікування не в онкологічних закладах. Навіть під час операцій помилки досягають 50%, що провокує неадекватні операції, методи лікування та затримує оздоровлення хворих. Мета дослідження: продемонструвати випадок помилкового діагнозу під час операції, необхідність онконастороженості та детального вивчення макропрепарату в операційній. Матеріал і методи: результати клінічного, морфологічного та імуногістохімічного дослідження випадку первинного траку маткових труб та аналіз публікацій тематичної літератури. Результати та обговорення: Проведений клінічний, морфологічний та імуногістохімічний аналіз незвичайного випадку первинного раку маткових труб. Діагноз виставлений тільки після планового гістологічного та імуногістохімічного дослідження. Широке ознайомлення з цим клінічним випадком покращить онконастороженість і діагностику. Первинний рак маткової труби залишається рідкісною, але складною проблемою в діагностичному та лікувальному відношенні. Покращення точності діагностики полягає у ретельному доопераційному обстеженні хворих з будьякими патологічними змінами додатків матки, включаючи дослідження онкомаркерів епітеліальних пухлин (СА-125, НЕ-4 тощо). В останні роки активно впроваджуется профілактика раку маткових труб, яєчників, тазової очеревини та молочних залоз шляхом опортуністичних сальпінгектомій, при цьому описані випадки виявлення первинних та метастатичних пухлин в маткових трубах. Зустрічаються окремі повідомлення щодо розвитку злоякісних пухлин після «профілактичних» операцій, хоча причина таких результатів невідома, так само відкритим залишається питання, чи можна їх уникнути. Висновок: Тільки онконастороженість і ретельне вивчення видаленого препарату в операційній та застосування субопераційної морфологічної діагностики дозволить уникнути таких помилок під час операцій. Аномальна маткова кровотеча не може бути результатом появи мікроосередка пухлини.