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The paper is devoted to the study of the course of pregnancy in women with mitral valve prolapse of various severity. With progression of pregnancy (especially the period from II to III trimester) symptoms increase. This is manifested as appearance or intensification of signs of neuro-circulatory dystonia (characteristic for patients with mitral valve prolapse irrespective of pregnancy). However these signs do not interfere with normal delivery.

Aim: To propose optimal policy of pregnancy and labor management in females with solitary kidney., Material and Methods: The study included 102 pregnant women who had contracted or transplanted donor kidney, renal aplasia (17, 3 and 28 females, respectively) or had undergone nephrectomy for different diseases (n = 54). Filtration, concentration, nitrogen-eliminating renal functions, renal hemodynamics, bacteriological picture of the urine were examined. Also, ultrasonography of the kidneys, cardiotocographic monitoring, ultrasonic fetal biometry, dopplerometry of placental blood flow were made., Results: Most of the pregnant women showed declined function of the solitary kidney, but renal insufficiency was a rare finding. Pyelonephritis of the solitary kidney, on the contrary, occurred rather frequently (77.8%) causing intrauterine infection in 46% of the fetuses. Obstetric complications arose more frequently than in women with two kidneys: gestosis--28%, threatened abortion--18%, premature delivery--25%. Hypotrophy was registered in 23% of the newborns. Adequate management of pregnancy reduced stillbirth rate to only 5%. 78% of the neonates were born mature and had normal body mass., Conclusion: Solitary kidney is not contraindication to pregnancy while pyelonephritis exacerbation--to abortion. Pregnancy is contraindicated in chronic renal failure.

Aim: To study clinical efficiency of atenolol in pregnancy hypertension with consideration of its cardiodynamic effects., Material and Methods: The trial included 36 women aged 19 to 41 years on pregnancy week 32 to 38. This study group had gestosis of the 1st and 2nd degree. Control group consisted of 14 healthy women with physiological pregnancy. All the examinees underwent atenolol test: measurement of heart rate, arterial pressure and ECG before, 30 and 90 min after introduction of a single atenolol dose 50 mg. Echo-CG was registered before and 90 min after administration of 50 mg amenolol, and on the treatment day 5., Results: The response to atenolol in combined therapy of gestosis is the highest in gravidae with hyperkinetic type of circulation., Conclusion: Determination of the hemodynamic type is necessary for selection of antihypertensive drugs for treatment of gestosis.

After surgical treatment of uterine myoma 28 patients with cardiovascular diseases experienced disturbances of cerebral, upper limb and small pelvis circulation. The course of transcerebral electrotherapy (short bipolar nonsymmetrical impulses with large amplitude of the negative part) relieved the symptoms as a results of better cerebral and upper limb hemodynamics.

The authors have analyzed the clinical course of late gestosis (LG) in gravidae with alimentary-constitutional obesity (ACO) of the 2nd and 3d degree and hypertension (HT) of the 1st and 2nd degree. In gravidae with combination of ACO with HT development of LG was recorded in 90.36% of the examinees, this occurrence being 1.7-fold and 1.8-fold higher than in those with obesity and hypertension alone, respectively. In 88% of the gravidae LG arose on gestation week 18-30. Mild LG was observed only in 12.05% of the patients, whereas if combined with HP or ACO only LG ran mildly in 14.74 and 38.18% of the gravidae, respectively. Severe LG in association of HT and ACO was resistant to the treatment.

Lipid fatty acid composition and cholesterol levels in platelets, platelet aggregation were investigated in pregnant women with essential or alimentary-constitutional obesity on combined therapy comprising polyunsaturated fatty acids versus those who were treated conventionally. The use of combined therapy allowed to increase the content of polyunsaturated fatty acids in total lipids, to achieve a 32% decrease in platelet cholesterol and a 19% decrease in platelet aggregation. The frequency of late gestosis reduced twice and of severe gestosis 3 times in patients given polyunsaturated fatty acids.

The sympathoadrenal, parasympathetic, and humoral mechanisms of regulation of the autonomic nervous system, as well as the strain and reserve of the adaptive reactions of the body were examined in 57 pregnant women with chronic inflammations of the genitals and their newborns in the early neonatal period. The sympathoadrenal autonomic regulation predominated in pregnant women, whereas in the newborns imperfect adaptive restructuring of the body was observed in the early neonatal period.

Sixty patients with chronic active hepatitis and liver cirrhosis of viral etiology had in the course of the disease a total of 130 pregnancies, that eventuated in labor in 62 (48%), in spontaneous abortions in 13 (10%), and in artificial abortions in 55 (42%) cases. The incidence of preterm labor was 18%, of late gestosis 46%; early detachment of a normally positioned placenta occurred in 2 women, and 3 women suffered an abnormal blood loss. Cesarean sections were carried out in 9% of cases. Perinatal mortality has made up 64.5%. Two babies died within the first months of life of congenital cerebral paralysis. The pregnancy and its outcome did not result in 78% of cases in deterioration of the patients' health status and did not influence the disease development. The authors discuss the policy of management of patients with chronic active hepatitis and liver cirrhosis of a viral origin in pregnancy and labor.

The authors analyze the incidence and structure of acute and chronic visceral diseases in pregnant women and the incidence and structure of maternal death because of extragenital diseases. Causes of maternal mortality are discussed and approaches to reducing maternal morbidity and mortality in visceral diseases outlined.

Due to the fact that therapy of lymphogranulomatosis has recently provided better results, a question has arisen whether pregnancy can be preserved in females suffering from the disease. The paper yields the data available in the literature and their own results. The examination showed that the pregnancy occurring after a long-term remission was not accompanied by a recurrence. Detection of the disease during pregnancy is an indication for its interruption.

In the course of chronic active hepatitis (CAH) 61 patients (CAH of virus etiology in 75% and of obscure etiology in 25%) had 211 pregnancies which terminated in delivery in 80 (38%) cases, spontaneous abortions in 12 (6%) cases, and medical abortions in 119 (56%) cases. In most cases there was successful termination of pregnancies without deterioration resulting from liver disease including patients treated adequately with immunosuppressive drugs. CAH exacerbations associated with pregnancies and their outcomes were noted in 23 (38%) cases. They were more frequent and more severe in patients with liver cirrhosis (LC) unrecognized by the time of pregnancy. There were no mothers' deaths. CAH made a negative effect on the course and outcomes of pregnancies: the frequency of premature delivery was 9%, that of cesarean-5%, perinatal mortality-75%. Of 74 infants born alive 2 died within the first months after birth as a result of congenital liver cirrhosis, a double kidney was detected in one infant, the rest of the infants were healthy. Problems of therapeutic tactics in CAH patients after onset of pregnancy are discussed.

The authors' and literature results concerning the peculiarities of a clinical course, diagnosis and therapy of the upper digestive tract in women during pregnancy were summed up. Exacerbation or first symptoms of diseases like cardiospasm, reflux esophagitis can often occur during pregnancy. Peptic ulcer in most pregnant women has a favorable course, exacerbations are rare. A conclusion has been made that measures aimed at the prevention of exacerbations and complications of these diseases, are recommended to women with chronic diseases of the digestive tract during pregnancy.

The indices of general hemodynamics and renal function were studied in 362 pregnant women (healthy and those suffering from hypertensive disease, glomerulonephritis or nephropathy) and in 20 healthy but not pregnant women. It was found that the hypokinetic type of circulation developed in glomerulonephritis and nephropathy in pregnant women and that the hyperkinetic type changes to eu- and hypokinetic types in pregnant women suffering from hypertensive disease. In all variants of hypertension in pregnancy, the renal blood flow and glomerular filtration reduce, while the resistance to the blood flow in the vessels of the kidneys increases. The role of the sympathetico-adrenal and the renin-aldosterone systems in the changes in hemodynamics and renal function in healthy and sick pregnant women was studied. An opinion is voiced that increased sensitivity of the vascular receptors to vasoactive substances is very important.