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Тератомы яичников у девочек с позиции хирурга
Тератомы яичников у девочек с позиции хирурга
Буралкина Н.А., Чупрынин В.Д., Голицына Ю.С. и др. Тератомы яичников у девочек с позиции хирурга. Гинекология. 2017; 19 (3): 68–72.
DOI: 10.26442/2079-5696_19.3.68-72
DOI: 10.26442/2079-5696_19.3.68-72
DOI: 10.26442/2079-5696_19.3.68-72
________________________________________________
DOI: 10.26442/2079-5696_19.3.68-72
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Аннотация
Среди опухолей яичников герминогенные опухоли встречаются в 25,9% случаев. Они развиваются из полипотентного высокоспециализированного герминогенного эпителия гонад. Большинство герминогенных опухолей являются зрелыми (доброкачественными) кистозными тератомами (95%), злокачественные герминогенные опухоли встречаются всего в 3–5% случаев. Единственный обоснованный метод лечения данных новообразований – оперативное вмешательство, что сопряжено с потерями овариального резерва. В статье представлена клинико-анамнестическая характеристика девочек в возрасте от 7 до 17 лет с тератомами яичников, описана структура проведенных оперативных вмешательств (доступ, объем операций) с анализом гистологического заключения удаленных образований.
Ключевые слова: герминогенная опухоль, тератома, ультразвуковое исследование органов малого таза, лапароскопия, лапаротомия, резекция яичника, аднексэктомия, гистологическое исследование.
Key words: germination tumor, teratoma, ultrasound examination of small pelvis organs, laparoscopy, laparotomy, resection of ovarian, adnexectomy, histological examination.
Ключевые слова: герминогенная опухоль, тератома, ультразвуковое исследование органов малого таза, лапароскопия, лапаротомия, резекция яичника, аднексэктомия, гистологическое исследование.
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Key words: germination tumor, teratoma, ultrasound examination of small pelvis organs, laparoscopy, laparotomy, resection of ovarian, adnexectomy, histological examination.
Полный текст
Список литературы
1. Стрельцова О.Н. Герминогенные опухоли яичников (диагностика, лечение, факторы прогноза) Автореф. дис. … канд. мед. наук. М., 2009; с. 37. / Strel'tsova O.N. Germinogennye opukholi iaichnikov (diagnostika, lechenie, faktory prognoza) Avtoref. dis. … kand. med. nauk. M., 2009; s. 37. [in Russian]
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3. Rogers EM, Allen L, Kives S. The recurrence rate of ovarian dermoid cysts in pediatric and adolescent girls. J Pediatr Adolesc Gynecol 2014; 27 (4): 222–6.
4. Селезнева Н.Д., Железнов Б.И. Доброкачественные опухоли яичников. М.: Медицина, 1982. / Selezneva N.D., Zheleznov B.I. Dobrokachestvennye opukholi iaichnikov. M: Meditsina, 1982. [in Russian]
5. Нейштадт Э., Ожиганова И.Н. Опухоли яичника. СПб.: Фолиант, 2014. / Neishtadt E., Ozhiganova I.N. Opukholi iaichnika. SPb.: Foliant, 2014. [in Russian]
6. Sella A, Naggar A, Ro JY. Evidence of malignant features in histologically mature teratoma. J Urol 1991; 146: 1025–8.
7. Измайлов Р.М. Клинико-диагностическое значение цветного допплеровского картирования при новообразованиях яичников. Вопр. гинекологии, акушерства и перинатологии. 2002; 1 (1): 52–5. / Izmailov R.M. Kliniko-diagnosticheskoe znachenie tsvetnogo dopplerovskogo kartirovaniia pri novoobrazovaniiakh iaichnikov. Vopr. ginekologii, akusherstva i perinatologii. 2002; 1 (1): 52–5. [in Russian]
8. Давыдова И.Ю., Кузнецов В.В., Карселадзе А.И., Губина О.В. Незрелые тератомы яичников (клинико-морфологические особенности, лечение). Опухоли женской репродуктивной системы. 2007; 1–2: 54–8. / Davydova I.Iu., Kuznetsov V.V., Karseladze A.I., Gubina O.V. Nezrelye teratomy iaichnikov (kliniko-morfologicheskie osobennosti, lechenie). Opukholi zhenskoi reproduktivnoi sistemy. 2007; 1–2: 54–8. [in Russian]
9. Бережная Н.М., Чехун В.Ф. Иммунология злокачественного роста. Киев: Наукова думка, 2005. / Berezhnaia N.M., Chekhun V.F. Immunologiia zlokachestvennogo rosta. Kiev: Naukova dumka, 2005. [in Russian]
10. Кутушева Г.Ф., Урманчеева А.Ф. Диагностика и лечение опухолей яичника: пособие для врачей. СПб., 2011. / Kutusheva G.F., Urmancheeva A.F. Diagnostika i lechenie opukholei iaichnika: posobie dlia vrachei. SPb., 2011. [ [in Russian]
11. Урманчеева А.Ф., Кутушева Г.Ф., Ульрих Е.А. Опухоли яичника: клиника, диагностика и лечение. М.: Эко-Вектор, 2012. / Urmancheeva A.F., Kutusheva G.F., Ul'rikh E.A. Opukholi iaichnika: klinika, diagnostika i lechenie. M.: Eko-Vektor, 2012. [in Russian]
12. Alammari R, Lightfoot M, Hur HC. Impact of cystectomy on ovarian reserve: review of the literature. J Minim Invasive Gynecol 2017; 24 (2): 247–57. DOI: 10.1016/j.jmig.2016.12.010
13. Chun S, Cho HJ, Ji YI. Taiwan Comparison of early postoperative decline of serum antiMüllerian hormone levels after unilateral laparoscopic ovarian cystectomy between patients categorized according to histologic diagnosis. J Obstet Gynecol 2016; 55 (5): 641–5. DOI: 10.1016/j.tjog.2015.06.016
14. Somigliana E, Marchese MA, Frattaruolo MP et al. Serum anti-mullerian hormone in reproductive aged women with benign ovarian cysts. Eur J Obstet Gynecol Reprod Biol 2014; 180: 142–7. DOI: 10.1016/j.ejogrb.2014.06.009
15. Roman H, Quibel S, Auber M et al. Recurrences and fertility after endometrioma ablation in women with and without colorectal endometriosis: a prospective cohort study. Hum Reprod 2015; 30 (3): 558–68. DOI: 10.1093/humrep/deu354
16. Sarmadi S, Sadat Ahmadi F, Ejtemaei Mehr S et al. Histopathologic and sonographic analysis of laparoscopic removal ovarian nonendometriotic cyst: the evaluating effects on ovarian reserve. Acta Medica Iranica 2014; 52 (5): 341–4.
17. Candiani M, Barbieri M, Bottani B et al. Ovarian recovery after laparoscopic enucleation of ovarian cysts: Insights from echographic short-term postsurgical follow-up. J Min Invasive Gynecol 2005; 12: 409–14.
18. Li CZ, Liu B, Wen ZQ, Sun Q. The impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cysts: a prospective clinical study of 191 patients. Fertil Steril 2009; 92: 1428–35.
19. Campo S, Campo V. A modified technique to reduce spillage and operative time: laparoscopic ovarian dermoid cyst enucleation “in a bag”. Gynecol Obstet Invest 2011; 71: 53–8.
20. Kondo W, Bourdel N, Cotte B et al. Does prevention of intraperitoneal pillage when removing a dermoid cyst prevent granulomatous peritonitis? Br J Obstet Gynaecol 2010; 117: 1027–30.
21. Шабанов М.А. Роль эмбриоидных телец в развитии сложных герминогенных опухолей и тератом. Арх. патологии. 1991; 53 (8): 16–22. / Shabanov M.A. Rol' embrioidnykh telets v razvitii slozhnykh germinogennykh opukholei i teratom. Arkh. patologii. 1991; 53 (8): 16–22. [in Russian]
22. Low JJ, Perrin LC, Crandon AJ, Hacker NF. Conservative surgery to preserve ovarian function in patients with malignant ovarian germ cell tumors. A review of 74 cases. Cancer 2000; 89 (2): 391–8.
23. Bonazzi C, Peccatori F, Colombo N et al. Pure ovarian immature teratoma, a unique and curable disease: 10 years' experience of 32 prospectively treated patients. Obstet Gynecol 1994; 84 (4): 598–604.
24. Вишневская Е.Е. Детская онкогинекология. Минск: Вышэйшая школа, 1997; с. 123–47. / Vishnevskaia E.E. Detskaia onkoginekologiia. Minsk: Vysheishaia shkola, 1997; s. 123–47. [in Russian]
25. Гончарова С.В. Особенности формирования репродуктивного потенциала у девочек-подростков, родившихся с задержкой внутриутробного развития. Автореф. дис. … канд. мед. наук. Челябинск, 2011. / Goncharova S.V. Osobennosti formirovaniia reproduktivnogo potentsiala u devochek-podrostkov, rodivshikhsia s zaderzhkoi vnutriutrobnogo razvitiia. Avtoref. dis. … kand. med. nauk. Cheliabinsk, 2011. [in Russian]
26. Корсак В.С., Парусов В.Н., Кирсанов А.А., Исакова Э.В. Влияние резекции яичников на их функциональный резерв. Пробл. репродукции. 1996; 2 (4): 63–7. / Korsak V.S., Parusov V.N., Kirsanov A.A., Isakova E.V. Vliianie rezektsii iaichnikov na ikh funktsional'nyi rezerv. Probl. reproduktsii. 1996; 2 (4): 63–7. [in Russian]
27. Nargund G et al. The impact of ovarian cystectomy on ovarian response during IVF cycles. Hum Reprod 1996; 11: 81–3.
28. Shulman A, Marom H, Oelsner G et al. The effect surgery on the ovarian response to stimulation in IVF. EJOG 2002; 103: 158–62.
29. Gelbaya T, Nardo L, Fitzgerald C et al. Ovarian response to gonadotropins after laparoscopic salpingectomy or the division of fallopian tubes for hydrosalpinges. Fertil Steril 2006; 85: 1464–8.
30. Morelli M. Safety and efficacy of dermoid mesial incision. Fertil Steril 2012.
2. Ozhiganova I.N. Morfologiia raka iaichnikov. Prakticheskaia onkologiia. 2014; 15 (14): 143–52. [in Russian]
3. Rogers EM, Allen L, Kives S. The recurrence rate of ovarian dermoid cysts in pediatric and adolescent girls. J Pediatr Adolesc Gynecol 2014; 27 (4): 222–6.
4. Selezneva N.D., Zheleznov B.I. Dobrokachestvennye opukholi iaichnikov. M: Meditsina, 1982. [in Russian]
5. Neishtadt E., Ozhiganova I.N. Opukholi iaichnika. SPb.: Foliant, 2014. [in Russian]
6. Sella A, Naggar A, Ro JY. Evidence of malignant features in histologically mature teratoma. J Urol 1991; 146: 1025–8.
7. Izmailov R.M. Kliniko-diagnosticheskoe znachenie tsvetnogo dopplerovskogo kartirovaniia pri novoobrazovaniiakh iaichnikov. Vopr. ginekologii, akusherstva i perinatologii. 2002; 1 (1): 52–5. [in Russian]
8. Davydova I.Iu., Kuznetsov V.V., Karseladze A.I., Gubina O.V. Nezrelye teratomy iaichnikov (kliniko-morfologicheskie osobennosti, lechenie). Opukholi zhenskoi reproduktivnoi sistemy. 2007; 1–2: 54–8. [in Russian]
9. Berezhnaia N.M., Chekhun V.F. Immunologiia zlokachestvennogo rosta. Kiev: Naukova dumka, 2005. [in Russian]
10. Kutusheva G.F., Urmancheeva A.F. Diagnostika i lechenie opukholei iaichnika: posobie dlia vrachei. SPb., 2011. [ [in Russian]
11. Urmancheeva A.F., Kutusheva G.F., Ul'rikh E.A. Opukholi iaichnika: klinika, diagnostika i lechenie. M.: Eko-Vektor, 2012. [in Russian]
12. Alammari R, Lightfoot M, Hur HC. Impact of cystectomy on ovarian reserve: review of the literature. J Minim Invasive Gynecol 2017; 24 (2): 247–57. DOI: 10.1016/j.jmig.2016.12.010
13. Chun S, Cho HJ, Ji YI. Taiwan Comparison of early postoperative decline of serum antiMüllerian hormone levels after unilateral laparoscopic ovarian cystectomy between patients categorized according to histologic diagnosis. J Obstet Gynecol 2016; 55 (5): 641–5. DOI: 10.1016/j.tjog.2015.06.016
14. Somigliana E, Marchese MA, Frattaruolo MP et al. Serum anti-mullerian hormone in reproductive aged women with benign ovarian cysts. Eur J Obstet Gynecol Reprod Biol 2014; 180: 142–7. DOI: 10.1016/j.ejogrb.2014.06.009
15. Roman H, Quibel S, Auber M et al. Recurrences and fertility after endometrioma ablation in women with and without colorectal endometriosis: a prospective cohort study. Hum Reprod 2015; 30 (3): 558–68. DOI: 10.1093/humrep/deu354
16. Sarmadi S, Sadat Ahmadi F, Ejtemaei Mehr S et al. Histopathologic and sonographic analysis of laparoscopic removal ovarian nonendometriotic cyst: the evaluating effects on ovarian reserve. Acta Medica Iranica 2014; 52 (5): 341–4.
17. Candiani M, Barbieri M, Bottani B et al. Ovarian recovery after laparoscopic enucleation of ovarian cysts: Insights from echographic short-term postsurgical follow-up. J Min Invasive Gynecol 2005; 12: 409–14.
18. Li CZ, Liu B, Wen ZQ, Sun Q. The impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cysts: a prospective clinical study of 191 patients. Fertil Steril 2009; 92: 1428–35.
19. Campo S, Campo V. A modified technique to reduce spillage and operative time: laparoscopic ovarian dermoid cyst enucleation “in a bag”. Gynecol Obstet Invest 2011; 71: 53–8.
20. Kondo W, Bourdel N, Cotte B et al. Does prevention of intraperitoneal pillage when removing a dermoid cyst prevent granulomatous peritonitis? Br J Obstet Gynaecol 2010; 117: 1027–30.
21. Shabanov M.A. Rol' embrioidnykh telets v razvitii slozhnykh germinogennykh opukholei i teratom. Arkh. patologii. 1991; 53 (8): 16–22. [in Russian]
22. Low JJ, Perrin LC, Crandon AJ, Hacker NF. Conservative surgery to preserve ovarian function in patients with malignant ovarian germ cell tumors. A review of 74 cases. Cancer 2000; 89 (2): 391–8.
23. Bonazzi C, Peccatori F, Colombo N et al. Pure ovarian immature teratoma, a unique and curable disease: 10 years' experience of 32 prospectively treated patients. Obstet Gynecol 1994; 84 (4): 598–604.
24. Vishnevskaia E.E. Detskaia onkoginekologiia. Minsk: Vysheishaia shkola, 1997; s. 123–47. [in Russian]
25. Goncharova S.V. Osobennosti formirovaniia reproduktivnogo potentsiala u devochek-podrostkov, rodivshikhsia s zaderzhkoi vnutriutrobnogo razvitiia. Avtoref. dis. … kand. med. nauk. Cheliabinsk, 2011. [in Russian]
26. Korsak V.S., Parusov V.N., Kirsanov A.A., Isakova E.V. Vliianie rezektsii iaichnikov na ikh funktsional'nyi rezerv. Probl. reproduktsii. 1996; 2 (4): 63–7. [in Russian]
27. Nargund G et al. The impact of ovarian cystectomy on ovarian response during IVF cycles. Hum Reprod 1996; 11: 81–3.
28. Shulman A, Marom H, Oelsner G et al. The effect surgery on the ovarian response to stimulation in IVF. EJOG 2002; 103: 158–62.
29. Gelbaya T, Nardo L, Fitzgerald C et al. Ovarian response to gonadotropins after laparoscopic salpingectomy or the division of fallopian tubes for hydrosalpinges. Fertil Steril 2006; 85: 1464–8.
30. Morelli M. Safety and efficacy of dermoid mesial incision. Fertil Steril 2012.
2. Ожиганова И.Н. Морфология рака яичников. Практическая онкология. 2014; 15 (14): 143–52. / Ozhiganova I.N. Morfologiia raka iaichnikov. Prakticheskaia onkologiia. 2014; 15 (14): 143–52. [in Russian]
3. Rogers EM, Allen L, Kives S. The recurrence rate of ovarian dermoid cysts in pediatric and adolescent girls. J Pediatr Adolesc Gynecol 2014; 27 (4): 222–6.
4. Селезнева Н.Д., Железнов Б.И. Доброкачественные опухоли яичников. М.: Медицина, 1982. / Selezneva N.D., Zheleznov B.I. Dobrokachestvennye opukholi iaichnikov. M: Meditsina, 1982. [in Russian]
5. Нейштадт Э., Ожиганова И.Н. Опухоли яичника. СПб.: Фолиант, 2014. / Neishtadt E., Ozhiganova I.N. Opukholi iaichnika. SPb.: Foliant, 2014. [in Russian]
6. Sella A, Naggar A, Ro JY. Evidence of malignant features in histologically mature teratoma. J Urol 1991; 146: 1025–8.
7. Измайлов Р.М. Клинико-диагностическое значение цветного допплеровского картирования при новообразованиях яичников. Вопр. гинекологии, акушерства и перинатологии. 2002; 1 (1): 52–5. / Izmailov R.M. Kliniko-diagnosticheskoe znachenie tsvetnogo dopplerovskogo kartirovaniia pri novoobrazovaniiakh iaichnikov. Vopr. ginekologii, akusherstva i perinatologii. 2002; 1 (1): 52–5. [in Russian]
8. Давыдова И.Ю., Кузнецов В.В., Карселадзе А.И., Губина О.В. Незрелые тератомы яичников (клинико-морфологические особенности, лечение). Опухоли женской репродуктивной системы. 2007; 1–2: 54–8. / Davydova I.Iu., Kuznetsov V.V., Karseladze A.I., Gubina O.V. Nezrelye teratomy iaichnikov (kliniko-morfologicheskie osobennosti, lechenie). Opukholi zhenskoi reproduktivnoi sistemy. 2007; 1–2: 54–8. [in Russian]
9. Бережная Н.М., Чехун В.Ф. Иммунология злокачественного роста. Киев: Наукова думка, 2005. / Berezhnaia N.M., Chekhun V.F. Immunologiia zlokachestvennogo rosta. Kiev: Naukova dumka, 2005. [in Russian]
10. Кутушева Г.Ф., Урманчеева А.Ф. Диагностика и лечение опухолей яичника: пособие для врачей. СПб., 2011. / Kutusheva G.F., Urmancheeva A.F. Diagnostika i lechenie opukholei iaichnika: posobie dlia vrachei. SPb., 2011. [ [in Russian]
11. Урманчеева А.Ф., Кутушева Г.Ф., Ульрих Е.А. Опухоли яичника: клиника, диагностика и лечение. М.: Эко-Вектор, 2012. / Urmancheeva A.F., Kutusheva G.F., Ul'rikh E.A. Opukholi iaichnika: klinika, diagnostika i lechenie. M.: Eko-Vektor, 2012. [in Russian]
12. Alammari R, Lightfoot M, Hur HC. Impact of cystectomy on ovarian reserve: review of the literature. J Minim Invasive Gynecol 2017; 24 (2): 247–57. DOI: 10.1016/j.jmig.2016.12.010
13. Chun S, Cho HJ, Ji YI. Taiwan Comparison of early postoperative decline of serum antiMüllerian hormone levels after unilateral laparoscopic ovarian cystectomy between patients categorized according to histologic diagnosis. J Obstet Gynecol 2016; 55 (5): 641–5. DOI: 10.1016/j.tjog.2015.06.016
14. Somigliana E, Marchese MA, Frattaruolo MP et al. Serum anti-mullerian hormone in reproductive aged women with benign ovarian cysts. Eur J Obstet Gynecol Reprod Biol 2014; 180: 142–7. DOI: 10.1016/j.ejogrb.2014.06.009
15. Roman H, Quibel S, Auber M et al. Recurrences and fertility after endometrioma ablation in women with and without colorectal endometriosis: a prospective cohort study. Hum Reprod 2015; 30 (3): 558–68. DOI: 10.1093/humrep/deu354
16. Sarmadi S, Sadat Ahmadi F, Ejtemaei Mehr S et al. Histopathologic and sonographic analysis of laparoscopic removal ovarian nonendometriotic cyst: the evaluating effects on ovarian reserve. Acta Medica Iranica 2014; 52 (5): 341–4.
17. Candiani M, Barbieri M, Bottani B et al. Ovarian recovery after laparoscopic enucleation of ovarian cysts: Insights from echographic short-term postsurgical follow-up. J Min Invasive Gynecol 2005; 12: 409–14.
18. Li CZ, Liu B, Wen ZQ, Sun Q. The impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cysts: a prospective clinical study of 191 patients. Fertil Steril 2009; 92: 1428–35.
19. Campo S, Campo V. A modified technique to reduce spillage and operative time: laparoscopic ovarian dermoid cyst enucleation “in a bag”. Gynecol Obstet Invest 2011; 71: 53–8.
20. Kondo W, Bourdel N, Cotte B et al. Does prevention of intraperitoneal pillage when removing a dermoid cyst prevent granulomatous peritonitis? Br J Obstet Gynaecol 2010; 117: 1027–30.
21. Шабанов М.А. Роль эмбриоидных телец в развитии сложных герминогенных опухолей и тератом. Арх. патологии. 1991; 53 (8): 16–22. / Shabanov M.A. Rol' embrioidnykh telets v razvitii slozhnykh germinogennykh opukholei i teratom. Arkh. patologii. 1991; 53 (8): 16–22. [in Russian]
22. Low JJ, Perrin LC, Crandon AJ, Hacker NF. Conservative surgery to preserve ovarian function in patients with malignant ovarian germ cell tumors. A review of 74 cases. Cancer 2000; 89 (2): 391–8.
23. Bonazzi C, Peccatori F, Colombo N et al. Pure ovarian immature teratoma, a unique and curable disease: 10 years' experience of 32 prospectively treated patients. Obstet Gynecol 1994; 84 (4): 598–604.
24. Вишневская Е.Е. Детская онкогинекология. Минск: Вышэйшая школа, 1997; с. 123–47. / Vishnevskaia E.E. Detskaia onkoginekologiia. Minsk: Vysheishaia shkola, 1997; s. 123–47. [in Russian]
25. Гончарова С.В. Особенности формирования репродуктивного потенциала у девочек-подростков, родившихся с задержкой внутриутробного развития. Автореф. дис. … канд. мед. наук. Челябинск, 2011. / Goncharova S.V. Osobennosti formirovaniia reproduktivnogo potentsiala u devochek-podrostkov, rodivshikhsia s zaderzhkoi vnutriutrobnogo razvitiia. Avtoref. dis. … kand. med. nauk. Cheliabinsk, 2011. [in Russian]
26. Корсак В.С., Парусов В.Н., Кирсанов А.А., Исакова Э.В. Влияние резекции яичников на их функциональный резерв. Пробл. репродукции. 1996; 2 (4): 63–7. / Korsak V.S., Parusov V.N., Kirsanov A.A., Isakova E.V. Vliianie rezektsii iaichnikov na ikh funktsional'nyi rezerv. Probl. reproduktsii. 1996; 2 (4): 63–7. [in Russian]
27. Nargund G et al. The impact of ovarian cystectomy on ovarian response during IVF cycles. Hum Reprod 1996; 11: 81–3.
28. Shulman A, Marom H, Oelsner G et al. The effect surgery on the ovarian response to stimulation in IVF. EJOG 2002; 103: 158–62.
29. Gelbaya T, Nardo L, Fitzgerald C et al. Ovarian response to gonadotropins after laparoscopic salpingectomy or the division of fallopian tubes for hydrosalpinges. Fertil Steril 2006; 85: 1464–8.
30. Morelli M. Safety and efficacy of dermoid mesial incision. Fertil Steril 2012.
________________________________________________
2. Ozhiganova I.N. Morfologiia raka iaichnikov. Prakticheskaia onkologiia. 2014; 15 (14): 143–52. [in Russian]
3. Rogers EM, Allen L, Kives S. The recurrence rate of ovarian dermoid cysts in pediatric and adolescent girls. J Pediatr Adolesc Gynecol 2014; 27 (4): 222–6.
4. Selezneva N.D., Zheleznov B.I. Dobrokachestvennye opukholi iaichnikov. M: Meditsina, 1982. [in Russian]
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Авторы
Н.А.Буралкина*1, В.Д.Чупрынин1, Ю.С.Голицына1, Е.В.Уварова1, А.Ю.Журба2, А.А.Куземин1, А.В.Асатурова1, Н.В.Зайцев1, В.В.Кометова1, С.С.Луньков1
1. ФГБУ «Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова» Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4;
2. ФГБОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*natalyaburalkina@yandex.ru
1. V.I.Kulakov Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4;
2. I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*natalyaburalkina@yandex.ru
1. ФГБУ «Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова» Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4;
2. ФГБОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*natalyaburalkina@yandex.ru
________________________________________________
1. V.I.Kulakov Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4;
2. I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*natalyaburalkina@yandex.ru
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