Кафедра акушерства, гінекології та дитячої гінекології

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Browsing Кафедра акушерства, гінекології та дитячої гінекології by Author "Gnatenko, Olga"

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    Age-related diagnosis and treatment of ovarian cysts
    (KhNMU, 2017-05-24) Kiebashvili, Solome; Gnatenko, Olga
    Abdominal pain syndrome is one of the most frequent reasons for consulting a gynecologist.The purpose of the work was to improve early diagnosis of the causes of abdominal pain syndrome for timely organ-saving treatment of urgent conditions in girls and young women.Minimally invasive surgical procedure, laparoscopy with organ-saving operations should be considered the treatment of choice with regard to upcoming maternity.
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    Assessment of acute abdomen risk in adolescent and young reproductive age
    (KhNMU, 2017-05-24) Prokopenko, Anastasia; Gnatenko, Olga; Nikolsky, Nikolay
    Recently, more and more reports have appeared in the literature on the increase in the incidence of benign tumors and tumor-like ovarian formations in children, adolescents and young women. Pathological course of pregnancy and childbirth in mothers, complicated premorbid background and presence of inflammatory diseases of the female reproductive system in past history can be attributed to the risk factors for the development of tumors and tumor-like formations of the ovaries in adolescents and young women that trigger acute abdomen. The presence and extent of effusion in the abdominal cavity and the size of tumor-like formation are decisive for choosing the method of treatment in “acute abdomen”.
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    Clinical presentation,diagnosis and treatment of adnexal torsion in children and adolescents
    (2016-05) Gnatenko, Olga; Kiebashvili, Solome
    Actuality. One of the most frequent causes of children admission to the surgical department is conditioned by abdominal pain, which can often result from gynecological diseases, particularly adnexal torsion (in 2-3% of cases). Adnexal torsion develops much more commonly in children and adolescents than in adult women, which is due to anatomical features of internal genital organs (small size of the uterus, a relatively high location of the ovaries in the small pelvis), physiological characteristics (overload of the bladder, juvenile constipation, overactive intestinal peristalsis), as well as more mobile lifestyle inherent to this age group. The aim. To study the incidence of adnexal torsion in children and adolescents. Materials and methods. The study involved clinical and statistical analysis of medical records of patients with diagnosed adnexal torsion, who underwent inpatient treatment at gynecologic department of Kharkiv Regional Children's Clinical Hospital from 2010 to 2016. Results. The assessment of the records for the period under investigation showed that adnexal torsion was diagnosed in 30 patients, including 11 girls under 12 years of age and 18 adolescents. Solitary torsion of the ovary was observed in 12 patients, torsion of an ovarian cyst - in 10, torsion of a paratubal cyst - in 5, torsion of the ovary and fallopian tube - in 2, torsion of ovarian teratoma - in 1. The treatment included 28 surgical operations by laparoscopy and 2 operations by laparotomy. Organ-preserving surgical treatment implied determination of the state of adnexal tissues: patients with intact blood flow and without necrotic changes underwent detorsion while adnexa with absent blood flow and presence of necrosis were removed. Conclusion. All cases of suspected adnexal torsion in children and adolescents need to be comprehensively diagnosed. Minimally invasive organ-preserving laparoscopic intervention should be considered the method of choice.
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    Improvement of diagnosis and treatment efficiency in acute abdomen in young female patients and adolescent girls
    (2016) Gnatenko, Olga; Prokopenko, Anastasia
    Actuality. The term "acute abdomen" is complex. It unites acute conditions of different etiology and clinical presentation. Despite the variety of etiologic factors its symptoms have many common features (I.A. Tuchkina et al, 2013). The aim of the study was to improve diagnosis and treatment efficiency in pubertal patients and young women with gynecologic disorders that triggered acute abdomen. Materials and methods. The study was performed at the Department of Obstetrics, Gynecology and Children Gynecology. It involved examination of 184 adolescents aged 11-18 years and young reproductive age women, who underwent treatment of acute abdomen with differential diagnosis between gynecologic and surgical abnormalities. Results. Acute abdomen in adolescents was due to pelvic tumors - 36%, congenital anomalies of the uterus and vagina - 17%, ovulatory syndrome and ovarian apoplexy - 21%, acute appendicitis - 18%, torsion of adnexa - 8%. Young women most often had inflammatory diseases of the internal reproductive organs - 33%, ovarian apoplexy - 32%, pelvic tumors - 18%, endometriosis - 13%, ectopic pregnancy, menstrual blood reflux, adhesions after surgery on uterine adnexa - to 4%. Acute abdomen in girls and adolescents with ovarian tumors is often caused by torsion of cyst pedicle and uterine adnexa - 37%, hemorrhage into the cyst capsule - 35%, rupture of cyst capsule - 23%, association with acute appendicitis - 5%. The authors developed a diagnostic algorithm involving comprehensive clinical and laboratory examination, assessment of clinical presentation, premorbid background, evaluation of the early history and infectious index, the course of pregnancy and labor, the degree of physical and sexual development, the character of menstrual disorders, gynecological status and functional status of the ovaries. Hormonal profile was studied by the levels of luteinizing and follicle-stimulating hormones, prolactin, estradiol and testosterone. The study also determined physical health (consultation with a pediatrician and specialists in related fields), pelvic echosonography, Doppler study of uterine vessels and ovaries, vaginoscopy and colposcopy by indications and follow-up monitoring by a surgeon and a gynecologist (compulsory at the age under 18, by pediatric gynecologists and surgeons). Conclusion. Symptoms of acute abdomen in adolescents and young women were triggered by pelvic tumors in 36% and inflammatory pelvic diseases in 33% cases. The diagnostic algorithm elaborated in the study promotes early diagnosis and rational therapy with maximum preservation of reproductive organs in surgical interventions.