2020, volume 16

Purpose: to assess the psychosomatic status and quality of life (QOL) of patients undergoing treatment and examination in a cardiac surgery hospital. Material and Methods. The study included 425 patients divided into 243 (57%) men and 182 (43%) women; median age was 61 (54; 66) years. In addition to the standard clinical examination, the quality of life and psychological status of patients were assessed. Patients completed standardized questionnaires of QOL: the Short Form Medical Outcomes Study (SF36), the Minnesota Living with Heart Failure Questionnaire (MLHFQ), Hospital Anxiety and Depression Scale (HADS). Results. Indicators of the psychological component of the questionnaire were statistically significantly lower in women compared with male patients: vital activity (VT) 45 (30; 60) vs 50 (35; 65) p<0.001, social functioning (SF) 63 (38; 75) vs 64 (50; 88) p<0.001, and the level of anxiety and depression were significantly higher in women 9 (6; 12) vs 6 (3; 9) and 7 (4; 10) vs 5 (3; 8) (p<0.001).The values of the physical component of health were also lower in women: physical functioning (PF) 45 (25; 65) vs 55 (35; 80) p<0.001; bodily pain (BP) 41 (41; 74) vs 51 (41; 74) p<0.001. Low QOL scores and high levels of anxiety and depression were not due to the severity of the disease, men had more severe nosological status. Conclusion. Most of the patients entering the cardiac surgery hospital have clinically expressed anxiety and depression, which have negatively effect on the quality of their life. This is more typical for female patients.

The review is devoted to the assessment of the effectiveness of measures to improve the outcome of preterm birth. An analysis of randomized multicenter studies from 2014 to 2019 of the database of the National Library of Medicine PubMed was carried out. Information is presented on the effectiveness of the prevention of respiratory distress syndrome, tocolytic therapy, neuroprotection of the fetus, systemic antibacterial therapy.

The aim of the review is to analyze the complications of cesarean section (CS), the associated maternal and perinatal mortality, taking into account the economic development of the country, indications for CS, urgency, methods of surgery and anesthesia, and preventive measures. For a systematic review, a search was conducted on electronic research databases reporting maternal or perinatal morbidity and mortality associated with CS. The analysis included 167 studies, including 5,100,161 operations of CS and 8216 cases of maternal mortality meeting the inclusion criteria. The prevalence of complications associated with CS was calculated, the odds ratio (OR) and the relative risk (RR) with confidence interval (Cl) 95% were calculated. The risk of death for women in low- and middle-income countries who had CS was 7.6 per 1000 [95% Cl: 6.6-8.6]; in highly developed countries 0.6 per 1000 [95% Cl: 0.08-0.9]. In low-income countries, perinatal mortality was 84.7 per 1000 CS [95% Cl: 70.5-100.2]. Perinatal mortality in high-income countries is 12.7 per 1000 cops [95% Cl: 6.85-18.3]. The most common perioperative complications in CS were: bleeding (OR=0.52 [95% Cl: 0.48-0.57]), infection (OR=13.4 [95% Cl: 9.7-22.3]) and venous thromboembolism (OR=1.4 [95% Cl: 1.2-3.5]). Low-income countries have high maternal mortality and require optimized conditions for CS. A significant increase in the incidence of CS in high-income countries did not lead to a corresponding decrease in neonatal morbidity and mortality, but it increased the risk to the health and life of women.