Introduction. Placental abruption continues to be one of the leading causes of bleeding during pregnancy and delivery, posing a direct threat to the health and life of both mother and fetus, making a significant contribution to the structure of maternal and neonatal morbidity and mortality. The study of predictors and prediction of the severity of the consequences of this complication is one of the areas of scientific research.

The purpose of the study is to expand the possibilities of predicting massive bleeding, which is a consequence of premature placental abruption, based on the analysis of prenatal laboratory parameters of the hemostasis system as a universal tool for optimizing the choice of treatment tactics.

Material and methods. A retrospective assessment of the relationship between the volume of bleeding and prenatal laboratory parameters of the hemostasis system was carried out in 46 patients with premature detachment of the placenta delivered by caesarean section in Sverdlovsk Regional Children Clinical Hospital, Ekaterinburg in 2020 using the methods of statistical analysis of quantitative indicators.

Results and discussion. When comparing the volume of blood loss with prenatal indicators of hemostasis, prognostic significance was revealed and paired linear regression equations were constructed for the following parameters: platelet level, plateletcrit, prothrombin time, Quick prothrombin time, activated partial thromboplastin time. And no relationship was found between the volume of blood loss and MPV (p = 0.231), PDW (p = 0.121), P-LCR (p = 0.205), thrombin time (p = 0.79), fibrinogen value (p = 0.07).

Conclusion. The results of the study can be used in building a decision-making algorithm and medical tactics of a multidisciplinary team during care for a patient with premature placental abruption, however, further research is required in this direction to build a universal formula for predicting bleeding volume in placental abruption.

Introduction. Dental implantation is getting more popular with patients who require total dental rehabilitation. Patients note that possibility of immediate loading based on dental implants is more favorable treatment option due to active social life. Low bone density, often occurred in the maxilla, frequently presents challenges for clinicians to achieve successful implant primary stability for predictable immediate loading.

The aim of our study was to increase the efficiency of treatment of patients who require dental implantation in the maxilla.

Materials and methods. Twenty-seven patients aged from 27 to 66 years with missing teeth in the alveolar process of maxilla were treated. All patients in this randomized clinical trial were divided into two groups. We used two methods for implant site preparation: the standard technique according to manufacturer’s recommendations in the first group (n = 13) and the Osseodensification technique via Densah drills (n = 14) in the second. All patients were treated by Astra Tech dental implants with the same dimensions (diameter 4 mm, length 9 mm). Immediately after implant placement the data of the frequency-resonance analysis of the implant stability and insertion torque were installed and obtained. Furthermore, a comparison of the operation time was carried out. Clinical evaluation and patient appreciation of pain, edema and hyperemia of the mucosa were evaluated using a questionnaire at 1, 3, 5 and 7 days after surgery. The measurement of the values of the stability quotient of the implants was repeated and carried out after six months.

Results. Higher values of implant primary stability (insertion torque and implant stability quotient during surgery) were showed in the osseodensification group (IT — (45,0±5,8), ISQ — (71,8±2,9)) in comparison with standard technique (IT — (27,7±3,8), ISQ — (62,8±3,2)); p < 0,05.

Discussion. Osseodensification technique promotes compaction of a low density bone in direct contact with the implant, which leads to higher implant primary stability due to the physical interaction between bone and implant.

Conclusion. The obtained results allow us to consider that the osseodensification method is progressive for improving the effectiveness of implantological treatment on maxilla.

Introduction. The optimal method of obtaining and application a stromal-vascular fraction (SVF) of adipose tissue in the treatment of donor wounds in burned patients has not been determined.

Objective — to compare the effectiveness of the stromal-vascular fraction of adipose tissue in the treatment of donor wounds, depending on the method of obtaining (mechanical and enzymatic) and the injection (subdermal, intradermal) into the tissue.

Material and methods. Wistar rats (n = 30) were divided into 2 investigated groups: in the first group (eSVF) enzymatic processing of adipose tissue (n = 10) was used, in the second group (mSVF) mechanical processing was used (n = 10). Another 10 rats were used as adipose tissue donors’ group. A deep burn was created in all animals, and after 4 days two more donor wounds were created by taking a split thickness skin autograft: the stromal-vascular fraction was injected intradermally into one of the wounds, subdermally into the other. After 14 days, the area of epithelialization, the microcirculation index and the histological microstructure of the skin were evaluated.

Results. The proportion of completely epithelized donor wounds in the eSVF-group was 85 %, in the mSVF-group — 55 % (p < 0.05). The index of microcirculation significantly decreased after intradermal injections in the eSVF-group (p < 0.01), and after subdermal injections — in the mSVF-group (p < 0.05). According to histomorphometry, with intradermal injections of eSVF, the thickness of the epidermis and the layer of granulation tissue is less than in the mSVF group (p < 0.01). At the same time, the relative density of collagen fibers in the granulation tissue was significantly higher after the injections of eSVF than after mSVF (p < 0.01). Comparison of injections of the stromal-vascular fraction showed: no significant differences were found when using eSVF; when using mSVF, the subdermal injections are preferable, since it was accompanied by a significantly lower thickness of granulation tissue (p < 0.01).

Conclusions. The enzymatically obtained stromal-vascular fraction of adipose tissue has advantages over the mechanically obtained one: the efficiency of eSVF is equally high when used with intradermally and subdermally injections, which are confirmed by the structure and blood circulation in the newly formed skin. When using mSVF, intradermal injections are the least effective, and subdermal injections are accompanied by a moderately pronounced positive dynamic in the microstructure of the skin of donor wounds.

Purpose of the study to study the role of serum glycoproteins CA 19–9 and CA 125 as a potential non-invasive biomarker of progressive fibrosis in interstitial lung diseases.

Materials and methods. The study included 77 patients with interstitial diseases. Based on the presence/absence of signs of progression over the previous 6 months, patients were divided into 2 groups. All patients underwent forced spirometry, body plethysmography, diffusion test, computed tomography of the chest, and a study of serum concentrations of CA 19-9 and CA 125.

Results. In the group of patients with a progressive fibrotic phenotype of interstitial lung diseases (ILD), higher levels of CA 19-9 and CA 125 were detected. A correlation of the studied level of tumor markers with parameters of pulmonary function and the severity of interstitial changes in lung changes according to computed tomography of the chest was shown (Warrick test).

Conclusion. The data obtained demonstrate the capabilities of non-invasive diagnosis of PF-ILD and require further research and prospective observation to assess the diagnostic and prognostic role of the studied biomarkers, as well as determine their place in clinical practice.

Introduction. Myocardial remodeling is a consequence or predictor of several cardiovascular diseases. The key process in myocardial remodeling is the degradation of collagen fibers, mediated by the activity of matrix metalloproteinases and their tissue inhibitor.

The aim of this study was to evaluate serum levels of matrix metalloproteinase type 9 and tissue inhibitor of matrix metalloproteinase type 1 in female patients with arterial hypertension, myocardial remodeling, and diastolic dysfunction.

Materials and methods. A cross-sectional study that included 84 postmenopausal women. All patients underwent echocardiography. Left ventricular remodeling was assessed according to Ganau classification, and diastolic function was evaluated using transmittal flow parameters. Serum analysis included the determination of MMP-9 and TIMP-1 levels using an enzyme-linked immunosorbent assay.

Results. The median concentration of MMP-9 in the sample was 2 295.00 (923.60–4 114.00) ng/ml, TIMP — 1–17 010.00 (16 780.00–17 170.00) ng/ml. When evaluating the echocardiographic parameters of the patients included in the study, changes were revealed that indicate structural and functional remodeling of the LV and DD. 29 patients (35 %) had normal geometry, 6 patients (7 %) had concentric myocardial remodeling, 21 patients (25 %) had concentric myocardial hypertrophy, 28 cases (33 %) had eccentric myocardial hypertrophy. Statistically significant changes in the activity of MMP-9 and TIMP-1 were revealed in patients with various structural and geometric variants of remodeling. DD was detected in all patients included in the study: I degree was detected in 25 patients (30 %), II degree was determined in 59 cases (70 %). Using one-way analysis of variance, statistically significant differences in the level of MMP-9 in patients with grades I and II DD were determined. MMP-9 and MMP-9/TIMP-1 in patients with grade II DD are significantly higher than in patients with grade I.

Discussion. Under pathophysiological conditions, the proteolytic properties of MMP-9 contribute to the stimulation of the immune response, initiating pathogenesis and aggravating the progression of the disease. Evaluation of the activity of MMP-9 and TIMP-1 in patients with arterial hypertension may be a marker of myocardial remodeling.

Conclusion. An increase in the activity of matrix metalloproteinase type 9 and a decrease in the activity of a tissue inhibitor of matrix metalloproteinases type 1 were revealed in patients with arterial hypertension, myocardial remodeling and LV diastolic dysfunction. The level of MMP-9 is associated with the degree of diastolic dysfunction and the structural-geometric type of LV remodeling.

Introduction. Assessing the risk of intraoperative bleeding is of great importance in the treatment of patients with infected pancreatic necrosis.

The aim of the study — determine the role of transfistula ultrasound in assessing the risk of intraoperative bleeding in patients with infected pancreatic necrosis.

Materials and methods. From 2015 to 2019, 193 people with infected pancreatic necrosis were treated at Regional Clinical Hospital No. 2 (Krasnodar). At stage 1, drains of various diameters were installed in all patients; at stage 2, necrotic tissue was removed using transfistula videoscopic necrosequestrectomy in 48 patients (24.9 %). Before performing instrumental necrosequestrectomy, a developed diagnostic method was used — transfistula ultrasound scanning — to determine the relationship between the location of foci of necrosis in the pancreas and blood vessels in 22 patients (11.4 %; group 1); the method was not used in 26 people (13.5 %; group 2).

Results. The number of accesses created into the omental bursa was as follows: 141 patients (73.1 %) had 3 accesses, 52 people (26.9 %) had 2 accesses; into the retroperitoneal space: 102 patients (52.8 %) had 2 accesses, 51 people (26.4 %) had 1 access. Transfistula videoscopic necrosequestrectomy was performed 35 and 37 times in groups 1 and 2, respectively (p > 0.05). Transfistula ultrasound scanning to assess the risk of intraoperative bleeding was used 33 times in patients in group 1. In group 1, intraoperative bleeding was observed in 5 patients (23.8 %), in group 2 — in 7 patients (26.9 %) (p > 0.05). The volume of blood loss was (436.0±83.6) and (887.0±41.8) ml in groups 1 and 2, respectively (p < 0.05). There were no cases of death due to intraoperative bleeding in either group.

Discussion. Transfistula ultrasound scanning makes it possible to stratify patients: into a high-risk group (with intimate adjacency of necrosis to vessels), medium (at a distance of up to 15 mm) and low-risk (with a distant location). In this regard, interventions in high-risk patients were carried out in the X-ray operating room to allow for endovascular hemostasis, which made it possible to reduce the volume of blood loss, as well as to create a supply of transfusion media in advance to replenish the volume of blood volume.

Conclusion. The developed method of direct transfistula ultrasound scanning makes it possible to assess the risk of intraoperative bleeding in patients with infected pancreatic necrosis to achieve timely hemostasis and compensate for acute blood loss.

Introduction. Acute post-manipulation pancreatitis (APP) is a common complication of endoscopic interventions on the major duodenal papilla of the duodenum. Moderate acute pancreatitis develops more often than severe acute pancreatitis.

The purpose of the work is to determine the effect of compound L-17 of the group of substituted thiadiazines on the severity of the inflammatory reaction in moderate severity APP.

Materials and methods. The severity of the inflammatory reaction in experimental APP after surgery in rats using the compound L-17 was studied. During this study, laboratory indicators of the severity of the inflammatory reaction were assessed, including the leukocyte count and the level of increase in the concentration of the major interleukins. Furthermore, morphological data was analyzed to allow an assessment of the dynamics of the cellular composition of the inflammatory infiltrate of the pancreas in the APP in the experiment.

Results. A decrease in the severity of the inflammatory reaction was shown according to leukocyte count, cytokine concentration, and a morphological study of the inflammatory infiltrate of the pancreas.

Discussion. The effectiveness of the proposed surgical technique for the formation of APP has been proven by the development of acute pancreatitis in all animals operated. Most experimental methods for acute pancreatitis have no such effectiveness. The data obtained confirm the opinion of numerous authors that interventions on the major duodenal papilla are a risk factor for the development of APP. The study used the compound L-17, which is a representative of a new group of organic compounds, substituted thiadiazines, which have a disaggregant and anticoagulant effect. The effect of compound L-17 on the hemocoagulation parameters of blood is associated with the anti-inflammatory mechanism of action of compound L-17.

Conclusion. Administration of compound L-17 in moderate-severity experimental APP can reduce the severity of the inflammatory reaction.

Introduction. Magnesium and its alloys are used as biodegradable bone implants due to their high biocompatibility, however, the problem of use is rapid biodegradation with loss of strength.

The purpose of the study. Experimental evaluation of bioresorbable Mg-Ca-Zn alloy implants in vitro and in bone tissue in vivo, in order to determine the optimal rate of biodegradation, biocompatibility and reparative response of bone tissue.

Materials and methods. Samples from the obtained Mg-Ca-Zn alloy were coated in a microarc oxidation bath (MDO), and to further determine the optimal phase composition and surface properties, the samples were kept in an electrolyte. The biodegradation of implants was assessed by the loss of mass of samples in vitro, and the release of gas into bone tissue in vivo, and the biocompatibility and reparative response of bone tissue density.

Results. All Mg-Ca-Zn coated samples show reduced weight loss compared to the uncoated sample. Magnesium samples with a 20-minute exposure in electrolyte, in the context of its application in anatomically unloaded areas, showed the optimal rate of biodegradation, biocompatibility and reparative response of bone tissue.

Discussion. In our study using the microarc oxidation for control the corrosion resistance samples of magnesium alloy shows good biocompatibility and low corrosion rate. We found 5-fold increase in corrosion resistance in coated implants, compared with uncoated samples.

Сonclusion. The results of an experimental evaluation of bioresorbable Mg-Ca-Zn alloy implants in vitro and in bone tissue in vivo showed that Mg-Ca-Zn coated samples demonstrate low weight loss during biodegradation, with minimal gas release into the bone.

Introduction. The spread of the delta strain of the SARS-CoV-2 virus during the third and fourth waves of the pandemic led to the fact that a large cohort of pregnant women and maternity women needed respiratory support, standard treatment methods had no effect, and negative outcomes for the mother and fetus has increased.

Purpose of the study. The aim is to determine clinical and laboratory features and maternal outcomes in pregnant women with the coronavirus disease 2019 (COVID-19) and critical lung damage.

Materials and methods. A comparative study was conducted, followed by a retrospective analysis of clinical and laboratory features, maternal outcomes in 56 pregnant women with COVID-19 treated in this maternity hospital in the first-fourth wave of the pandemic. The research method is continuous, sequential. The first group (main) consisted of 28 women with severe or extremely severe form of the course of COVID-19 and critical lung damage (more 75 %); The second group (comparison) — 28 pregnant women with a moderate form of the disease and lung damage of 25–50 %. Screening assessment of the degree of endogenous intoxication was carried out. The severity of the disease was determined by the evaluation scale National Early Warning Score (NEWS).

Results. Laboratory parameters of patients at admission and at the height of the disease have statistically significant differences in the general blood test, such as higher levels of leukocytes, eosinophils, rod-shaped neutrophils, hemoglobin, as well as lymphopenia and monocytopenia in women of the main group at the height of the disease. At the same time, the hematological indices of intoxication in the main group exceed the value of these indicators in the comparison group by two times. Patients of both groups had high levels of acute-phase markers of inflammation — C-reactive protein and ferritin, — an indicator of tissue destruction of lactate dehydrogenase, however, both at admission and at the height of the disease, these indicators were statistically significantly higher in the group of women with critical lung damage. In general, 20/28 patients (71.4 %) of group 1 had an extremely severe course of the disease, 8/28 (28.6 %) had a severe course. In second group, 28/28 patients (100 %) had moderate-severe NCI (p = 0.000), while recovery was noted in all of them. Outcomes of COVID-19 in women with critical lung damage: recovered — 25/28 (89 %); 3/28 (10.7 %) the patients died from complications of COVID-19 of an extremely severe degree.

Discussion. The most frequent laboratory anomaly was leukocytosis and a rod-shaped shift in the midst of the disease in women with critical lung damage, as well as a statistically significant increase in the level of C-reactive protein, lactate dehydrogenase, D-dimer. Pulmonary complications (parapneumonic pleurisy, pneumothorax, pneumomediastinum, hydrothorax, lung abscess) and extrapulmonary complications (encephalopathy, panic attacks, acute liver injury, sepsis, thromboembolic complications) were observed only with critical lung damage.

Conclusion. In the laboratory, at the height of the disease, in the group of pregnant women with critical lung damage, leukocytosis and stab shift are statistically significantly more common. Hematological indices of intoxication, leukocyte and hematological, confirm endogenous intoxication at the height of the disease. A statistically significantly higher level of aspartate aminotransferase, lactate dehydrogenase, C-reactive protein, D-dimer is determined upon admission to the hospital and at the height of the disease as markers of systemic inflammatory response and cytolysis, which demonstrates the defeat of several organ systems simultaneously.

Introduction. Developmental disorders acquire an extensive group of diseases, including congenital forms in inheritance variants, as well as secondary acquired forms due to skin or systemic manifestations.

The purpose of this publication is to demonstrate the features of the differential diagnosis of skin hyperpigmentation to identify the clinical manifestation of notalgia paresthetica.

Materials and methods. A review of foreign and domestic literary sources was carried out using the search engines eLibrary.Ru, Scopus, PubMed. On the basis of the patient’s voluntary informed consent, an analysis of medical documentation was carried out, taking into account clinical and anamnestic data and the results of laboratory and instrumental examination. Results. The article presents a review of the literature, as well as a clinical case of notalgia paresthetica in a patient with degenerative-dystrophic changes in the thoracic spine.

Discussion. Notalgia paresthetica belongs to a large group of cutaneous dysesthesias and is a sensory neuropathy characterized by localized unilateral itching and hyperpigmentation of the skin of the back in the zone of innervation of the cutaneous branches of the thoracic spinal nerves, affecting more often adult and elderly women. The nonspecificity of skin manifestations of notalgia paresthetica and the low awareness of doctors about this disease can lead to diagnostic and tactical errors. Skin itching of varying intensity is the main symptom of the disease, leading to an accentuation of its disease and a decrease in the quality of life of patients.

Conclusion. Given the interdisciplinary nature of the pathology, the article may be of interest to neurologists, neurosurgeons, dermatovenereologists, general practitioners, general practitioners, oncologists, and endocrinologists.

Introduction. Hip replacement in the last century was called the most successful operation in orthopedics. Replacement of the destroyed joint tissues with an implant allows to relieve a person from pain, restore motor activity and ensure a long-term improvement in the quality of life without disability. Endoprosthetics is indicated both for diseases of the hip joint, which according to the literature are affected by about 35 % of the adult population, and for fractures of the femoral neck. As a rule, the age of patients undergoing endoprosthetics is older than 60 years.

The purpose of this publication is to demonstrate the successful experience of subtotal hip replacement with bipolar endoprosthesis in a patient with an ungrown fracture of the neck of the left hip in conditions of metalosteosynthesis with screws with migration of metal structures and violation of fracture consolidation.

Materials and methods. Description of a clinical case and a brief analysis of the literature on this topic. The experience of subtotal endoprosthetics of the left hip joint with a bipolar endoprosthesis is presented. The effectiveness of treatment was evaluated based on the data of X-ray examination methods, as well as when assessing the function of the limb and the amplitude of movement in the hip joint.

Results. As a result of hip replacement with a bipolar endoprosthesis, complete restoration of limb function and activity of the patient was achieved.

Discussion. The choice of a bipolar endoprosthesis with acetabular roof plasty was due to the need to restore joint function and the desire to maintain a greater potential for revision arthroplasty of the patient, which is very likely given the age. Along with the use of augments and individual implants, the method showed a good result of treatment with less trauma.

Conclusion. Based on the given clinical example, it can be concluded that both preoperative planning for femoral neck fractures with risk assessment and expanding the range of metal structures, including the least traumatic for bone tissue, is important, as well as the need to improve continuity in the treatment of patients and individualize the postoperative plan. management, socialization and activation of the patient

Introduction. Mycosis Fungoides (MF) is a primary epidermotropic T-cell lymphoma characterized by clonal proliferation of small and medium-sized T-lymphocytes with cerebriform nuclei. MF accounts for ≥ 50 % of all cutaneous lymphomas.

The purpose of the study — description of a rare clinical observation of the debut of the development of Mycosis Fungoides in a patient in adolescence.

Materials and methods. To verify the diagnosis, pathomorphological and immunohistochemical examination of a skin biopsy from the most infiltrated tumor-like lesion was used. The patient, born in 1978, turned to the clinic of Ural Research Institute of Dermatovenerology and Immunopathology with complaints of rashes on the skin of the trunk, accompanied by itching and soreness. Patient had been ill since the age of 16, when he first noticed the appearance of red spots on the skin of the chest without subjective sensations. In the last year he noted a significant deterioration of the disease: an increase in the number of spots, an increase in the intensity of itching, the appearance of tumor-like elements on the skin of the buttocks. In December 2022, he visited a dermatovenerologist and, in order to clarify the diagnosis, was sent to the Ural Research Institute of Dermatovenerology and Immunopathology.

Discussion. The etiopathogenesis of the disease and the analysis of the few literature sources on the topic allows us to see the difficulty in early diagnosis and diagnosis in patients with early clinical manifestations of GM.

Results. This clinical case demonstrates the possibility of the debut of GM in adolescence, the complexity of diagnosis in the early stages of development.

Conclusion. The clinical case demonstrates the debut of GM in adolescence, emphasizes the need for clinical oncological alertness among dermatovenerologists.

Introduction. Novel coronavirus infection (COVID-19) is a respiratory infectious disease caused by the novel severe acute respiratory syndrome 2 coronavirus (SARS-CoV-2). It is characterized by a heterogeneous course of the disease from asymptomatic and mild forms to more severe and fatal outcomes. There are many risk factors for a severe course of a new coronavirus infection, in most cases, a severe course of the disease is associated with the individual characteristics of the patient, especially with dysregulation of the immune response. In this article, we reviewed the main prognostic factors for the severity of the disease.

The aim of the study is to determine the unfavorable prognostic factors associated with the severe course of a new coronavirus infection caused by the SARS-CoV-2 virus in foreign and domestic literature sources.

Materials and methods. To achieve this goal, scientific publications on the new coronavirus infection caused by the SARS-CoV-2 virus were analyzed in the scientometric databases PubMed, National Center for Biotechnological Information (NCBI), Cochrane, Web of Science, Scopus, MEDLINE (2019–2022), and Russian specialized journals on infectious diseases (2019–2022). Particular attention was paid to factors influencing the severe course of a new coronavirus infection.

Results. Risk factors for a severe course of a new coronavirus infection include: lipid spectrum, advanced age, hemostasis system, changes in the leukocyte count, serum markers. Mathematical models of the course of a new coronavirus infection have also been developed.

Discussion. In most studies, scientists note that the uncontrolled course of COVID-19 disease is associated with a dysregulated immune response. One of the main methods of influencing the immune system is vaccination.

Conclusion. There are many factors that contribute to the development of severe forms of the disease of a new coronavirus infection. However, thanks to universal vaccination against a new coronavirus infection, the frequency of severe forms of the disease and deaths has significantly decreased. Novel coronavirus infection (COVID-19) is a respiratory infectious disease caused by the novel severe acute respiratory syndrome 2 coronavirus (SARS-CoV-2).

Introduction. Operations under general anesthesia carry risks to the patient’s health, require appropriate equipment of the operating room, additional personnel in the team. This was the impetus for the active dissemination of local anesthesia technologies in the obstetric and gynecological community. The purpose of the study is to determine the current state of the issue of the use of local anesthesia in gynecology in outpatient settings during operations on the cervix, vagina and vulva.

Materials and methods. Publications freely available from databases were used to prepare the work еLibrary.Ru, PubMed, in Russian and foreign specialized journals on obstetrics and gynecology, anesthesiology, textbooks, the predominant period of publication 2016–2023.

Results and discussion. In the XIX century, scientists actively worked on the issue of finding an effective anesthetic and a method of anesthesia, the XX century shows that research continued in the direction of identifying the safest drug for anesthesia. In the XXI century, an obstetrician-gynecologist has a huge arsenal of anesthesia techniques, in which it is enough only to choose those techniques that can be used effectively, safely and financially affordable in his medical institution. The literature review shows the high efficiency of infiltration anesthesia during cervical biopsy, excision and conization, as well as a reduction in the number of complications associated with anesthesia. At the same time, for a small volume cervical biopsy, application anesthesia (10% lidocaine aerosol) can be used, but for conization with curettage of the cervical canal (and maybe even with aspiration biopsy), regional anesthesia (paracervical blockade) can be used — the technique of which is described in detail. Local anesthesia of the vagina can be performed using both infiltrative and application anesthesia. Local anesthesia of the vulva is replete with information about the widespread use, effectiveness and safety of application methods of anesthesia, not only in diagnosis, but also for the purpose of treatment.

Conclusion. Despite the wide variety of techniques of local anesthesia, as well as the exclusion of adverse events associated with anesthesia, any obstetrician-gynecologist should understand that local anesthesia can also lead to various complications, and be ready to eliminate them.