Ukrainian Journal «Health of Woman»

Global disparities and trends in cervical cancer morbidity and mortality

V.V. Shulhina — 2026-02-27

Cervical cancer remains one of the leading causes of morbidity and mortality among women worldwide, despite the availability of effective prevention methods such as human papillomavirus (HPV) vaccination and screening programs. High-income countries have seen significant declines in recent decades, while the burden of disease remains critically high in low- and middle-income countries, underscoring global health inequalities.

Aim - to analyze global trends in morbidity and mortality from cervical cancer, as well as to assess regional disparities and factors affecting their formation.

A systematic literature review was conducted using the Scopus, PubMed, and Web of Science databases for the period 2000-2025. The search was carried out using the keywords "cervical cancer", "incidence", "mortality", "epidemiology", and "global trends". The analysis included peer-reviewed articles in English that contained epidemiological data at the global or regional levels. The selection of studies was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, followed by a qualitative synthesis of the results. The analysis showed significant unevenness in the distribution of morbidity and mortality from cervical cancer. In high-income countries, rates have declined with the introduction of HPV screening and vaccination. At the same time, low- and middle-income countries, particularly in Africa and Southeast Asia, continue to have high rates of morbidity and mortality. Determining factors include limited access to health services, low vaccination coverage, and socio-economic barriers.

Conclusions. Cervical cancer remains a significant global problem with marked regional disparities. There is a need to expand HPV vaccination programs, increase the availability of screening, and implement effective early diagnosis strategies, especially in low- and middle-income countries.

No conflict of interests was declared by the authors.

Key «red flags» in the aetiology of recurrent pregnancy loss: latest recommendations and an analysis of emerging «conflicts» (a literature review)

Yu.M. Duka — 2026-02-27

Recurrent pregnancy loss (RPL) remains one of the most complex and controversial issues in modern reproductive medicine, due to the multifactorial nature of its pathogenesis and the significant proportion of idiopathic cases. Differences and discrepancies in the definitions of recurrent miscarriage lead to difficulties in assessing its true prevalence. The incidence of recurrent miscarriage may be underestimated, as few countries require pregnancy loss to be recorded as a separate indicator in national health databases. All these factors contribute to an underestimation of the prevalence of recurrent miscarriage in some regions of the world.

Aim - to analyse the evolving understanding of the aetiopathogenic factors underlying recurrent pregnancy loss (RPL) and the current diagnostic algorithms for its management.

This paper provides an overview of the current medical literature regarding the evolution of views on the diagnostic criteria for recurrent pregnancy loss (RPL) and presents an analysis comparing the diagnostic criteria for recurrent pregnancy loss established by international societies. The analysis indicates that doctors are currently advised to rely on their own clinical judgement and to order a comprehensive examination following two first-trimester miscarriages if there is a suspicion that the miscarriages are pathological rather than sporadic in nature. It is now recommended that the examination should include screening for genetic factors (parental karyotype) and antiphospholipid syndrome (screening for lupus anticoagulant, anticardiolipin antibodies and antibodies to β2-glycoprotein I), an assessment of uterine anatomy (sonohysterography, hysterosalpingography and/or hysteroscopy), determination of hormonal and metabolic factors (screening for thyroid dysfunction or prolactin levels), as well as lifestyle factors. Screening for hereditary thrombophilia is recommended to be carried out within the framework of a research study due to the high cost of such testing worldwide.

No conflict of interests was declared by the authors.

Impact of chronic war-related stress on female reproductive function and adaptive capacity in women of reproductive age (literature review)

O.O. Berestovyi — 2026-02-27

Chronic psychoemotional and somatic stress under conditions of prolonged war may influence neuroendocrine regulation in women, leading to reproductive dysfunction and reduced adaptive capacity. Understanding the mechanisms of the general adaptation syndrome (GAS) is essential for analyzing these processes.

Aim - to analyze current scientific literature on the impact of chronic war-related stress on female reproductive function and adaptive capacity in women of reproductive age, with a focus on the general adaptation syndrome, psychoemotional disorders, and stress assessment methods.

A systematic review of scientific literature was conducted using databases PubMed, Scopus, Web of Science, and Google Scholar for the period 1936-2026. The search included keywords: "stress", "general adaptation syndrome", "infertility", "anxiety", "ovarian reserve", "war", "Ukraine". A total of 52 sources were selected for analysis. The literature analysis demonstrates that chronic stress leads to activation of the hypothalamic-pituitary-adrenal axis, increased cortisol and prolactin levels, and suppression of gonadotropin-releasing hormone, luteinizing hormone, and follicle-stimulating hormone secretion. Stress-induced oxidative stress causes oocyte DNA damage and reduced ovarian reserve. Among women with infertility, the prevalence of stress reaches 78.8%, depression 31.6%, and anxiety 45.5%. Women with high stress levels have 30-40% lower assisted reproductive technology success rates. The war in Ukraine has created an unprecedented stress load: anxiety disorders among Ukrainian women increased threefold, depression 2.5-fold. Studies record increased frequency of menstrual cycle disorders, decreased anti-Müllerian hormone (levels, and reduced antral follicle count.

Conclusions. Chronic war-related stress negatively affects female reproductive function through neuroendocrine mechanisms. The combination of objective stress load and subjective anxiety reaction determines the phase of GAS. The identified gaps include insufficient data on integral stress assessment and the need for adaptation coefficient calculation.

The authors declare no conflict of interest.

Post-COVID syndrome and its effects on a woman's body

A.S. Biduchak — 2026-02-27

The article is devoted to the study of post-COVID syndrome (PCS) as a current medical and social problem and its consequences for the human body, in particular, the female body. Based on the analysis of modern scientific sources, the main clinical manifestations, pathogenetic mechanisms, and the most common symptoms after COVID-19 have been considered. It has been established that PCS is a multisystem condition with long-term manifestations that significantly affect physical, psychoemotional and reproductive health, reduce the quality of life and working capacity of patients.

The aim is to generalize and analyze modern scientific data on clinical manifestations, pathogenetic mechanisms, and long-term consequences of PCS, as well as to assess its impact on the functional state and health of the female body, taking into account physical, psychoemotional, and reproductive aspects.

As a result of the analysis of scientific publications, it was established that PCS is characterized by multisystem damage to the body with a predominance of asthenic, neurological, cardiorespiratory, and psychoemotional manifestations. In women, PCS is more often accompanied by chronic fatigue, sleep disorders, anxiety and depression, autonomic dysfunction and decreased performance. A connection has been found between the development of PCS and prolonged immune activation, endothelial dysfunction and hormonal imbalance, which can lead to menstrual cycle disorders, deterioration of reproductive health and exacerbation of concomitant somatic and gynecological pathologies. The data obtained indicate a significant negative impact of PCS on the quality of life of women and their social activity.

Conclusion. PCS is a complex multifactorial condition with long-term consequences for the female body, which requires a comprehensive, interdisciplinary approach to diagnosis, treatment, and rehabilitation. Taking into account the gender characteristics of the course of PCS is a necessary condition for increasing the effectiveness of medical care. Further research should be aimed at clarifying the mechanisms of development of post-COVID complications in women and developing standardized patient management protocols to improve long-term clinical outcomes and quality of life.

The authors declare the absence of a conflict of interest.

The ability to self-regulate emotional state as the basis of the professionalism of social workers

N.V. Shui — 2026-02-27

The ability to self-regulate the emotional state as the basis of the professionalism of social workers is becoming an urgent problem.

Aim - to conduct a theoretical analysis of scientific sources that characterize the ability to self-regulate the emotional state as the basis of the professionalism of social workers.

The task of self-regulation of the emotional state of social sphere specialists is to relieve social workers, their ability to control their own emotions, a component of the emotional competence of a modern social sphere specialist, the basis of their professional health and a psycho-corrective tool. The ability to self-regulate the emotional state as the basis of the professionalism of social workers is considered as self-control, self-programming and self-correction of the behavior of social sphere specialists and is a purposeful self-regulation of processes at the level of mental states, which leads to the optimization of their state, regulates relationships, activities, behavior and functional state.

Women working in the social sphere (and there are significantly more of them than male specialists) must be able to solve most of the complex specialized tasks and applied problems in the social sphere. The difficult life circumstances of clients in the social sphere often become factors that determine their social undemandingness and can cause both material and social and psychological problems. The lack of ability to self-regulate the emotional state of social workers leads to increased anxiety and emotional discomfort. This actualizes the need to update the professional competencies of Ukrainian social workers in such areas of social work as: education, medicine, law enforcement, psychiatry.

Focusing on the formation of empathy, stress resistance and communication skills, practical skills for creating situations of success is a component of both mastering the techniques of cognitive-behavioral therapy and independent training in self-regulation of social workers.

The authors declare the absence of a conflict of interest.

Trends and dynamics of HIV infection among the female population in 2016-2024

O.V. Feger — 2026-02-27

Human immunodeficiency virus (HIV) remains one of the leading medical and social problems of our time, characterized by the steady circulation of the pathogen and the uneven dynamics of morbidity among different population groups. Special attention is paid to the female population, in which the epidemic process has specific socio-biological features related to demographic, behavioral and availability of medical services, factors affecting the level of detection and spread of infection, as well as the effectiveness of preventive measures and early diagnosis, timely treatment, and control of the course of the disease.

Aim - to analyze the trends and dynamics of registered cases of HIV infection among the female population in Ukraine in 2016-2024.

Materials and methods. A retrospective descriptive epidemiological study was conducted based on official statistical data of the Public Health Center of the Ministry of Health of Ukraine. Methods of descriptive statistics, comparative and dynamic analysis with assessment of absolute indicators and rates of their changes in the temporal aspect were used.

Results. It was established that in the years 2016-2022, there was a tendency towards a gradual increase in the number of registered HIV cases among women from 62,576 to 72,714 cases, reaching a peak value in 2022. In 2019, a slight decrease in the indicator was noted, which may indicate a temporary stabilization of the epidemic process. In 2023, a slight decrease in the number of cases was recorded, while in 2024, there was a sharp decrease in the indicator to 62,968. The revealed dynamics have a wave-like character with periods of growth, stabilization, and decline.

Conclusions. The obtained results indicate the presence of an unstable epidemiological situation regarding HIV infection among the female population, with an upward trend in 2016-022 and a further sharp decrease in 2024. The identified changes can be due to both real shifts in the epidemic process and the influence of external social and organizational factors, which require further comprehensive analysis.

No conflict of interests was declared by the authors.

Elastography as a screening method for fibrosis in metabolic-associated steatosis during pregnancy

A.B. Рrуlutska — 2026-02-27

Aim - to evaluate the potential of two-dimensional shear wave elastography (2D-SWE) in the detection and staging of liver fibrosis in pregnant women with risk factors for metabolic dysfunction-associated steatotic liver disease (MASLD) to optimize early diagnosis of this nosology in obstetric practice.

Materials and methods. The study involved ultrasound examination and 2D-SWE of the liver using the Samsung Medison V7 ultrasound machine in 76 pregnant women, who were divided into groups: I - 46 pregnant women with mild hepatic steatosis (main group), and II - 30 healthy pregnant women (control group). To detect and stage liver fibrosis in pregnant women, the non-invasive 2D-SWE of the liver from Samsung ((2D-SWE) S-Shearwave Imaging) method was used. This technology displays tissue elasticity in real time as a color map. By measuring the shear wave velocity, liver stiffness was quantified in kilopascals (kPa), followed by statistical analysis of the obtained results.

Results. Based on the conducted study, it was determined that in pregnant women with mild hepatic steatosis, liver fibrosis is observed, the stage of which depends on both the severity and course of the diseases against which MASDL occurs (obesity, type 2 diabetes mellitus, arterial hypertension, gestational diabetes, dyslipidemia) and their combination. Therefore, to reduce the occurrence of obstetric and perinatal complications associated with this pathology, it is recommended to perform both steatometry and elastography in the early stages of pregnancy to identify a high-risk group for the development of fibrosis in MASLD, and this is the goal of our further research.

Conclusions. In pregnant women with hepatic steatosis, it is advisable to perform elastography in the early stages of pregnancy, which will allow for timely detection and staging of fibrosis in MASLD, with the determination of further rational tactics of pregnancy, childbirth and the postpartum period, thereby reducing obstetric and perinatal complications.

The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of women was obtained for the study.

The authors declare no conflict of interest.

Dynamics of the frequency of HIV transmission from mother to child according to early PCR diagnostics in Ukraine and its regions in 2016-2024

Yu.O. Randiuk — 2026-02-27

Transmission of human immunodeficiency virus (HIV) from mother to child remains an urgent public health problem, as it determines the formation of new cases of infection among children. Early diagnosis by polymerase chain reaction (PCR) is a key tool for detecting infection in newborns and assessing the effectiveness of preventive measures.

Aim - to analyze the dynamics of the frequency of HIV transmission from mother to child based on the results of early PCR diagnostics in Ukraine and its regions in 2016-2024.

Materials and methods. A retrospective analysis of statistical data of the Public Health Center of the Ministry of Health of Ukraine on the frequency of mother-to-child transmission of HIV expressed per 100,000 live births was conducted. Methods of descriptive epidemiology, analysis of dynamic series, and comparative regional analysis were used. The data were generated on the basis of official reporting and the HIV infection monitoring system in Ukraine.

Results. A decrease in the frequency of mother-to-child transmission of HIV in Ukraine was established from 14.4 per 100,000 live births in 2016 to 8.5 in 2020. In 2021, the indicator remained relatively stable (8.8); however, in 2022-2023, its growth was observed to be 10.7 and 10.0, respectively. In 2024, a sharp decrease in the indicator to 3.5 was noted. A significant interregional variability of indicators was revealed with the presence of both high values and numerous zero levels, which may be related to the effect of small numbers and uneven coverage of early diagnosis.

Conclusions. In Ukraine, there is a general tendency to decrease the frequency of HIV transmission from mother to child, but in 2022-2023, a destabilization of indicators was noted. Significant regional variability and the presence of zero values may indicate a limitation of access to early PCR diagnostics. The obtained results emphasize the need to strengthen the system of monitoring, early detection, and prevention of HIV transmission from mother to child.

No conflict of interests was declared by the authors.

Comparative assessment of postoperative recovery and complications after different surgical methods for the treatment of genital prolapse in women

V.V. Kaminskyy — 2026-02-27

Assessment of postoperative complications and the quality of recovery in women after surgical correction of genital prolapse is an important criterion for the implementation of multimodal, evidence-based protocols aimed at improving and accelerating postoperative rehabilitation.

Aim - to evaluate the quality of postoperative recovery and the frequency of complications after different surgical treatment options for genital prolapse in women to compare the effectiveness and safety of these methods.

Materials and methods. The following parameters were analyzed: duration of surgery, intraoperative blood loss volume, intensity of postoperative pain, length of hospital stay, time and quality of postoperative recovery, complications, and recurrence rate in 389 women. Among them, 239 patients underwent vaginal surgery (Group I), and 150 women underwent laparoscopic surgical interventions (Group II). Postoperative recovery was assessed using the Quality of Recovery 15-item questionnaire (QoR-15). Statistical data processing was performed using SPSS 21 software.

Results. Laparoscopic surgical interventions for the correction of genital prolapse were associated with lower intraoperative blood loss volume, reduced pain intensity, and a shorter hospital stay, but were accompanied by a longer overall operation time. A significantly lower incidence of postoperative hematomas, vaginal mucosal erosions, dyspareunia, and disease recurrence was observed after laparoscopic surgical interventions compared to vaginal surgeries for the correction of genital prolapse in women.

Conclusions. Laparoscopic reconstruction for pelvic organ prolapse positively affects the quality of postoperative recovery in patients.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institutions. Informed consent was obtained from all patients.

The authors declare no conflict of interest.

Dynamics of early detection of HIV infection among children born to HIV-positive mothers in Ukraine in 2016-2024

A.Ya. Velyka — 2026-02-27

Vertical transmission of human immunodeficiency virus (HIV) from mother to child remains an urgent public health problem, even in the conditions of widespread implementation of mother-to-child transmission prevention programs (prevention of mother-to-child transmission - PMTCT). Early diagnosis of HIV infection in children under 2 months of age using the polymerase chain reaction (PCR) is one of the key indicators of the effectiveness of these programs, as it allows timely detection of infection and initiation of antiretroviral therapy.

Aim - to assess the dynamics of early detection of HIV infection among children under 2 months of age born to HIV-positive mothers, in Ukraine, in 2016-2024.

Materials and methods. A retrospective analysis of statistical data of the Public Health Center of the Ministry of Health of Ukraine regarding the number of HIV-positive children born to HIV-positive mothers and examined by the PCR method at the age of 2 months was conducted. The study covered the period 2016-2024. The methods of descriptive statistics, comparative analysis and assessment of regional features of the indicator were used.

Results. A clear trend towards a decrease in the number of HIV-positive children detected at an early age has been established: from 57 cases in 2016 to 6 cases in 2024, which corresponds to an overall decrease of 89.5%. The highest values of the indicator during the studied period were observed in the Dnipropetrovsk and Odesa regions, as well as in the city of Kyiv. In most regions in 2022-2024, isolated cases or their complete absence were recorded, which indicates a decrease in regional variability. At the same time, in the period after 2022, the impact of military actions on the completeness of data collection, access to health services, and coverage of testing is possible.

Conclusions. The obtained results indicate a positive trend in reducing the early detection of HIV infection among children born to HIV-positive mothers, which may be related to the improvement of the effectiveness of PMTCT programs in Ukraine. However, the results of recent years require careful interpretation, taking into account the possible undercounting of cases and the influence of external factors. Further monitoring of the indicator is necessary for an objective assessment of the epidemic situation and planning of public health measures.

The authors declare no conflict of interest.

Ultrasound predictors of gestational complications in pregnant women with chorionic detachment

T.G. Romanenko — 2026-02-27

The high risk of pregnancy complications and adverse outcomes in the presence of retrochorial hematoma (RCH) necessitates the search for effective early ultrasound predictors, which remains a relevant task in modern obstetrics.

Aim - to determine the ultrasound features of the embryo, chorion, extraembryonic structures, and RCH in patients with chorionic detachment which are predictors of early pregnancy complications.

Materials and methods. А сlinical observation of 164 pregnant women (main group, MG) with RCH and 48 pregnant women (control without RCH in the first trimester (control group – CG) was conducted. In all pregnant women (n=212), an analysis of ultrasound characteristics of the chorion, retrochorial hematomas, embryo, and extraembryonic structures was performed during the first trimester.

Results. Logistic regression and ROC analysis showed a significant relationship between the lag of сoccygeal-parietal size (CPS) from the gestational age by more than 7 days and non-developing pregnancy up to 12 weeks; between the early term of RCH formation (up to 8 weeks) and non-developing pregnancy up to 12 weeks, hematoma volume more than 1.5 cm³ and non-developing pregnancy. And the chance of non-developing pregnancy in patients with RCH is 2.66 times higher with the development of RCH up to 8 weeks, 2.5 times higher with the detection of a lag of CPS from the gestational age by more than 7 days; 2.92 times higher with the detection of a hematoma with a volume of more than 1.5 cm³.

Conclusions. Retrochorial hematoma increases the risk of non-developing pregnancy by 2.6 times, while embryonic and extraembryonic predictors of early losses in pregnant women with retrochorial hematomas are: coccygeal-parietal size lag of more than 7 days from the gestational age, retrochorial hematoma volume of more than 1.5 cm³.

The authors declare no conflict of interest.

Uterine leiomyomas of FIGO types 0, 1, and 2 in women of reproductive age: an analysis of clinical and fertility indicators

M.S. Kochetkov — 2026-02-27

Uterine fibroids are one of the most common pathologies among women of reproductive age, which can affect fertility and the course of pregnancy and childbirth.

Aim - to investigate the prevalence and clinical-anamnestic characteristics of FIGO types 0-2 fibroids and to evaluate their impact on the fertility of women of reproductive age in order to rationalize surgical treatment of this pathology in patients with reproductive plans.

Materials and methods. A cohort study was conducted involving 3,455 women of reproductive age (20-45 years) who received primary outpatient consultation during 2020. The retrospective part of the study analyzed the prevalence of FIGO types 0-2 submucosal uterine fibroids; the prospective part analyzed reproductive outcomes in women diagnosed with uterine leiomyoma of FIGO types 0, 1, and 2. Statistical data processing was performed using the SPSS 21 programme.

Results. The prevalence of uterine leiomyomas among women of reproductive age was 41.8%, with FIGO types 0, 1, and 2 accounting for 8.4% of cases. In 95% of cases, uterine leiomyomas in women of reproductive age were symptomatic, presenting with heavy, prolonged, or frequent menstruation (69.4%), intermenstrual uterine bleeding (44.6%), pelvic pain (28.9%), anemia (15.7%), and infertility (11.6%). A significantly higher incidence of infertility and early spontaneous miscarriage (before 12 weeks of gestation) was observed in women with FIGO types 0, 1, and 2 leiomyomas compared to women without uterine leiomyomas.

Conclusions. The findings of the present study indicate that FIGO types 0, 1, and 2 uterine leiomyomas have a significant impact on women’s reproductive health, particularly on the incidence of infertility and pregnancy outcomes.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. Informed consent was obtained from patients for examination and treatment.

The authors declare no conflict of interest.

The role of perinatal risk factors in the development of necrotizing enterocolitis in preterm infants

A.M. Aliyeva — 2026-02-27

Necrotizing enterocolitis (NEC) is one of the most severe perinatal diseases and is associated with high mortality among preterm infants.

Aim - to investigate the role of perinatal risk factors in the development of NEC.

Material and methods. The study involved 69 infants with NEC treated in the Neonatal Intensive Care Unit and the Preterm Infants Unit (study groups I and II). The control (III) group consisted of 31 conditionally healthy infants. The diagnosis of NEC was established according to Bell’s criteria. In turn, each group was subdivided into two subgroups: infants weighing less than 1500 g and those weighing more than 1500 g. In order to determine the role of antenatal risk factors in the development of NEC among the infants included in the study, genital and extragenital pathologies, as well as the course of pregnancy and delivery, were evaluated in 100 mothers and analyzed across the study groups.

Results. Thus, based on the results of the present study, in mothers of infants in Groups I and II, turbid amniotic fluid (p<0.001), intrauterine infection (p<0.001), and birth asphyxia (p<0.001), as well as in mothers of infants in Group II, arterial hypertension (p<0.05), preeclampsia (p<0.05), and operative delivery (p<0.001), are significant ante- and intranatal risk factors for the development of NEC. In addition, respiratory distress syndrome (p<0.05) and hypoxic-ischemic encephalopathy (p<0.05) were identified as postnatal risk factors for the development of NEC in low birth weight newborns.

Conclusion. The findings of the present study demonstrate that both antenatal and intranatal factors play a significant role in the development of NEC in newborns, particularly in low birth weight infants.

The study complied with the principles of the Declaration of Helsinki and was approved by the institutional Ethics Committee. Informed consent was obtained from the patients prior to participation.

The authors declare no conflict of interest.

Morphological and histological signs of placental abnormalities in women with preeclampsia giving birth for the first time

А.V. Chernov — 2026-02-27

Studying morphological and histological abnormalities in the placenta of women with preeclampsia (PE) who give birth for the first time is relevant and modern for the prediction and prevention of this complication.

Aim - to analyze morphological and histological changes in the placenta in women with PE giving birth for the first time, to predict and optimize obstetric tactics in them.

Materials and methods. A histological study of placentas was conducted in 58 women giving birth for the first time: the main group (MG) - 36 placentas from women with PE, the comparison group (CG) - 22 placentas from women without PE. For the morphological analysis of structural changes in the placenta, the following research methods were used: organometric, macroscopic, general histological.

Results. The average mass of placentas in MG was 391.21±11.82 g with a maternal surface area of 228.22±4.81 cm², in CG - 487.02±16.42 g, the maternal surface area was 284.16±8.16 cm², with linear dimensions of 16.2×14.1×2.2 cm and 17.4×16.3×3.8 cm, respectively, which reflects a significant decrease in organometric parameters in preeclampsia. The main structural changes in MG were recorded in the villous chorion: the predominance of signs of branched angiogenesis in the terminal villi of the chorion was determined; in the intervillous space of 6 (16.7%) placentas of MG women, there was a significant increased deposition of fibrinoid masses of different sizes and shapes; villi pathology - 7 (19.4%) cases; in 24 (66.7%) placentas there were pronounced syncytiocapillary membranes, there are a lot of them and they are combined with fibrinoid deposits, infarctions and are a clinical sign of chronic placental insufficiency.

Conclusions. Morphological and histological signs of placental disorders in the studied placentas and the degree of their severity indicate a significant impairment of placental blood flow, which initiates the development of adaptation and compensation processes; their sharp severity suggests the fact of insufficiency of compensatory and adaptive reactions in the placenta during PE in women giving birth for the first time.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the patients was obtained for conducting the studies.

No conflict of interests was declared by the authors.

Spectrum of urogenital infections in pregnant women with fetal growth restriction

U.M. Siracli — 2026-02-27

Urogenital infections during pregnancy may contribute to placental dysfunction, fetal growth restriction (FGR), and adverse perinatal outcomes, though their impact on maternal-placental-fetal circulation is not well understood.

Aim - to evaluate the prevalence of urogenital infections in pregnant women with FGR and their impact on Doppler parameters, cardiotocography (CTG), and perinatal outcomes.

Materials and methods. A prospective cohort study was conducted from 2023 to 2025, including 90 pregnant women: 45 with FGR and 45 with uncomplicated pregnancies. Assessments included laboratory testing for Ureaplasma spp., Mycoplasma spp., Chlamydia trachomatis, and human papillomavirus; Doppler ultrasound of uterine, umbilical, and fetal middle cerebral arteries; cerebroplacental ratio (CPR); CTG; and perinatal outcomes. Statistical analysis used t-tests, χ² tests, and odds ratios (OR) with 95% confidence intervals; p<0.05 was considered significant.

Results. Urogenital infections were more common in the FGR group, but differences were not statistically significant. Monoinfections predominated (28.9%). Infected women showed higher uterine (1.34±0.27 vs 1.11±0.22) and umbilical artery pulsatility indices (0.98±0.17 vs 0.81±0.15), lower CPR (1.49±0.36 vs 1.96±0.41), and more frequent CTG abnormalities (33.3% vs 8.7%). Perinatal outcomes were worse: lower birth weight (2450±310 g vs 3220±280 g), higher preterm birth (20% vs 6.7%), and low birth weight (<2500 g, 24.4% vs 4.4%).

Conclusions. Urogenital infections may cause placental dysfunction and fetal hypoxia. Infected women showed Doppler and CTG changes, highlighting the need for early detection and treatment to improve perinatal outcomes.

The authors declare no conflict of interest.

Clinical predictors of unsuccessful assisted reproductive technology attempts in women with chronic endometritis

O.V. Tsmur — 2026-02-27

The relevance of the infertility problem determines the need to address issues related to improving diagnostic methods, increasing the effectiveness of treatment and prevention of infertility, as well as searching for prognostic criteria for the effectiveness of assisted reproductive technologies (ART) in chronic endometritis (CE).

Aim - to analyze the premorbid background (hormonal status, ultrasound and hysteroscopy data) in women with CE in infertility to identify clinical predictors of unsuccessful outcome of ART programs.

Materials and methods. A clinical statistical analysis of hormonal status (luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), estradiol (E2), testosterone (T), cortisol (K), thyroid-stimulating hormone (TSH), free thyroxine (T4b), dehydroepiandrosterone (DHEA-S)), ultrasound and hysteroscopy data in 128 women with tubal factor infertility participating in ART programs. The main group (OG) - 63 women with infertility on the background of HE, the comparison group (CG) - infertility without HE, consisted of 65 people, the control group (CG) - 45 healthy fertile women.

Results. Indicators of FSH, LH, prolactin, E2, TSH and T4v were comparable in all groups and indicated the absence of thyroid pathology. The presence of a heterogeneous endometrial contour in OG was significantly higher by 5.1 times, increased endometrial echogenicity by 5.8 times, and expansion of the uterine cavity by 13.7 times. The OG had the maximum number of women with a thinned, weakened mucous membrane - 22 (34.9%) and the presence of intrauterine synechiae - 10 (15.9%), which also affects the effectiveness of ART programs.

Conclusions. Clinical predictors of unsuccessful ART programs in women with infertility due to ectopic pregnancy may be reliable features of endometrial pathology.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The informed consent of the patients was obtained for conducting the studies.

The authors declare no conflict of interest.

The effect of smoking on the macro- and microelement composition of oral fluid in adolescent girls

I.S. Lisetska — 2026-02-27

Saliva is a sensitive medium that reflects changes in elemental composition and can be used for the early diagnosis of pathological processes.

Aim - to investigate the effect of smoking on the macro- and microelement composition of oral fluid in adolescent women, and to identify potential biomarkers of adverse effects on the body for the early diagnosis of pathological changes.

Materials and methods. The macro- and microelemental composition of saliva (calcium, iron, copper, zinc and manganese, measured using atomic absorption spectrophotometry) was studied in 72 young women aged 18 to 24 years, who were divided into groups: Group I comprised 16 cigarette smokers; Group II comprised 14 users of electronic cigarettes (vapes); Group III comprised 16 users of tobacco heating devices (IQOS); and Group IV comprised 26 non-smokers.

Results. It was found that in women in Group I, the level of copper in oral fluid increased twofold, whereas in Groups II and III it increased by a factor of 1.3 (p<0.05). Iron levels in Group I decreased by a factor of 1.8, and in Groups II and III by a factor of 1.2 (p<0.05). Zinc concentration also decreased: by 2.4-fold in Group I, and by 1.4- and 1.3-fold in Groups II and III, respectively (p<0.05). A similar trend was observed for manganese: the decrease in Group I was 2.1-fold, and in Groups II and III - 1.4-fold each (p<0.05). At the same time, calcium levels increased: in Group I - 1.4-fold, and in Groups II and III - 1.3-fold (p<0.05).

Conclusions. Smoking causes an imbalance of macro- and microelements in saliva, which is most pronounced in cigarette smokers. Indicators of the elemental composition of saliva can be used as early markers of the negative impact of smoking on oral health.

The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patients was obtained for conducting the studies.

The authors declare no conflict of interest.