Therapeutic Department

RESEARCH WORK

The research activities include:

• study of the relationship between pregnancy and somatic diseases;
• improvement of methods for early diagnosis of somatic diseases  at the stage of planning pregnancy and at various terms of pregnancy;
• development of rational tactics of management and pharmacotherapy of somatic diseases in women during pregnancy and in patients with gynecological disorders;
• study of the prognosis and risk of complications in pregnancy;
• development of the standards for diagnostics and treatment of somatic diseases in women at different age.

Currently, the scientific research is being conducted in the following areas:

• innovative approach to treatment of cardiovascular diseases in pregnant women (congenital and acquired heart defects, heart rhythm abnormality, arterial hypertension, etc.);
• management of pregnant women with acute and chronic lung diseases;
• optimization of diagnosis and therapy of urinary tract infections in pregnancy and postpartum period;
• differential diagnosis and therapy of chronic diseases of the hepatobiliary system in pregnant women;
• rational management of pregnant women with endocrine conditions (thyroid disease, diabetes mellitus, metabolic syndrome, etc.);
• modern approaches to management of pregnancy in women with blood diseases at the stage of pregnancy planning, gestation and postpartum rehabilitation.

 

The specialists of the Center organize and hold seminars on extragenital pathology for the obstetricians, gynecologists and physicians. They have elaborated a cycle of lectures on cardiovascular, bronchopulmonary pathology, endocrine diseases, gastrointestinal conditions`, kidney diseases, neurological and psychotherapeutic problems, diagnostics of antiphospholipid syndrome, anticoagulant and antiplatelet therapy during pregnancy, as well as preparing women for planned IVF pregnancy.

DIAGNOSTICS AND TREATMENT

The Department provides health care in the following areas:

GASTROENTEROLOGY

• intrahepatic cholestasis;
• gastroesophageal reflux disease;
• constipation;
• chronic cholecystitis;
• pancreatitis;
• hepatitis;
• inflammatory bowel disease (ulcerative colitis and Crohn's disease);
• celiac disease.

CARDIOLOGY

• arterial hypertension;
• congenital and acquired heart defects;
• arrhythmias and conduction disorders;
• ischemic heart disease;
• metabolic syndrome;
• thrombosis and thromboembolism (including antiphospholipid syndrome, thrombophilia).

DIAGNOSTIC PROCEDURES

The Department possesses modern equipment for diagnostics of cardiovascular diseases including:

• electrocardiography (ECG);
• 24-hour Holter monitoring;
• 24-hour outpatient blood pressure monitoring (ABPM);
• Doppler echocardiography;
• Treadmill Test (TMT);
• duplex scanning of lower-limb arteries and veins in the upper and lower extremities, brachiocephalic arteries;
• measurement of  I-M complex thickness;
• retinal vessel grading assessment.

The diagnostics and treatment of cardiovascular diseases is carried out by cardiologists of the Center in cooperation with gynecologists-endocrinologists and obstetricians. This allows a significant increase in the efficacy and safety of treatment.

NEUROLOGY

The Department provides treatment of patients with the nervous system diseases, including pregnant patients with the following diseases:

• vascular diseases of brain and spinal cord (initial manifestations of cerebrovascular insufficiency, repeated transient ischemic attacks (TIA), discirculatory encephalopathy, conditions after acute cerebrovascular accidents);
• migraine and other headaches;
• pain syndromes due to spine disorders;
• myofascial syndromes;
• the injury outcomes and infectious diseases of the nervous system;
• hypertensive-hydrocephalic syndrome;
• diseases of the peripheral nerves;
• dysmetabolic, toxic, demyelinating polyneuropathy.

DIAGNOSTICS

The following procedures are used to diagnose the nervous system diseases:

• brain MRI, including the study of the vascular bed;
• MRI of the spine and spinal cord;
• complex ultrasound examination of extra- and intracranial vessels;
• eye fundoscopy and assessment of the visual field.

The specialists of the Department carry out both medical and non-pharmacologic correction of diseases of the nervous system. If necessary, reflexology and drug blockades are used.

NEPHROLOGY

The specialists of the Department provide healthcare for the patients with kidney pathology during pregnancy and in the early postpartum period; examination and treatment of patients with chronic renal failure; the diagnostics and treatment of a wide range of kidney diseases or kidney damage concomitant to other diseases with the use of the modern techniques:

• immune-mediated kidney diseases (glomerulonephritis, kidney injury associated with connective tissue diseases, vasculitis, amyloidosis);
• urinary infection;
• kidney disease associated with drug therapy;
• renal vascular disease  of atherosclerotic or thrombotic genesis;
• urolithiasis;
• hydronephrosis;
• cystic kidney disease, including polycystic kidney disease;
• diabetic nephropathy;
• dysmetabolic nephropathies.

PHSYCHOTHERAPY

The specialists of the Department have developed a program of psychological preparation of women and men to IVF programs. Improvement of the emotional, hormonal status, normalization of all the main body indicators significantly contribute to an increase in the possibility of pregnancy chances after IVF (ICSI) treatment.

The modern methods of psychotherapy and new psychotherapeutic techniques used in the Department work for psycho-emotional rehabilitation and prevention of mood disorders.

PULMONOLOGY

The specialists of the Department has gained extensive experience in managing the patients, including pregnant women with

• Bronchopulmonary diseases: bronchial asthma; chronic obstructive pulmonary disease (chronic bronchitis).

The diagnostics of diseases of bronchopulmonary system are carried out using flowmetry and spirometry.

ENDOCRINOLOGY

The patients with various endocrine disorders that affect fertility are supervised and diagnosed by the qualified specialists of the Department using high tech equipment and get treated by the modern treatment methods.

FOCUS AREA

The focus area is the diagnostics and treatment of disorders of carbohydrate metabolism – gestational diabetes mellitus, type 1 and 2 diabetes, impairment of carbohydrate tolerance. Specialized treatment of vascular, ocular, renal and other related disorders is carried out using the latest technologies, which allow to prevent myocardial infarction, stroke, blindness, renal failure and other complications.

SERVICES FOR PATIENTS WITH DIABETES

• Insulin pump, establishement, management and follow-up of the patients using pumps for  insulin delivery at any period of their life, including pregnancy planning and during pregnancy
• The Department provides the patients with diabetes a unique opportunity to rent an insulin pump with consumables (catheters, cartridges, cannula needles)
• Daily glucose monitoring (Medtronic Paradigm 722, CGMS system Solutions Software)
• Renting of self-monitoring blood glucose devices

OTHER SERVICES

• treatment of obesity and metabolic syndrome, selection of an individual diets to overweight and obese patients;
• comprehensive diagnostics and treatment of thyroid diseases (hypothyroidism, thyrotoxicosis, thyroid nodules, thyroid cancer, subacute thyroiditis, etc.) before and during pregnancy;
• treatment of rare endocrine disorders: parathyroid diseases, adrenal gland disorders (tumors and congenital dysfunction of the adrenal cortex), hormonally active tumors of the pituitary gland, including hyperprolactinemia of various genesis, osteoporosis;
• preparation of the patients with concomitant endocrine disorders for surgery, postoperative follow-up,  treatment selection and correction therapy.

The Department staff also provides expert medical care in ophthalmology (in collaboration with S. Fyodorov Eye Microsurgery Federal State Institution) and dentistry.