Demidenko A. Treatment of progressing tubal pregnancy with methotrexate followed by rehabilitation with the use of cryopreserved placenta tissue.

Object of the study: Women with the progressive tubal pregnancy. Purpose:theoretical substantiation and development of conservative approaches to treatment of ectopic pregnancy as well as optimization of rehabilitation of patients after carrying out treatment with the help of heterotopic transplantations of cryopreserved placenta tissues. Methods of investigation and equipment: Clinico-laboratory, functional, immunological and statistical methods. Theoretical and practical results: On the basis of the obtained results the most rational technique of treatment of progressing tubal pregnancy with the help of methotrexate and the developed rational protocol of the following rehabilitation of patients with the given pathology was worked out. The expediency, economic validity and high medical effect of the suggested way of therapy compared with existing on now day techniques was proved. The findings of the work allowed to prove the role and practical value of the conservative approach to treatment of progressing tubal pregnancy with the help of methotrexate with the following rehabilitation by transplantation of cryopreserved placenta tissues, and also to improve results of treatment of patients with the given pathology. Novelty: For the first time the complex the characteristic of efficiency of treatment of progressing ectopic pregnancy with the help of methotrexate intramuscular injections, to the ovum under transvaginal ultrasound control as well ass locally during a laparoscopy were compared. Depending on the term of pregnancy and the place of localization of the ovum the most effective ways of treatment of progressing extrauterine pregnancy were determined. For the first time the patient who underwent conservative treatment of ectopic pregnancy with the help of methotrexate, were applied heterotopic transplantation of cryopreserved placenta tissue which has allowed to avoid a lot of complications arising earlier, to reduce the volume and terms of therapy. The condition of the immune status in patientsafterconservative treatment of tubal pregnancy with the help of methotrexate and after carrying out heterotopic transplantations of cryopreserved placenta tissues was investigated. Degree of introduction: The basic conclusions and positions of the work were introduced in practice of the Kharkov city specialized maternity hospital №5 and are also used in the work of obstetrical establishment of cities of Kharkov and area. Substantive provisions and conclusions of the dissertation are used in teaching process for 4-5th year students and interns in KSMU (faculty of obstetrics and gynecology №1 medical faculties) and post-graduates of KMАPT (faculties of perinatology and gynecology, obstetrics and gynecology №1) Field of application:.medicine, obstetrics and gynecology.