Chybisova I. Chronical pathology of hepathobiliary system among pregnant (clinical-pathology characteristics, treatment, obstetricional tactic).

. Object of the study: Pregnant with chronic pathology of the hepatobiliary system at the stage of moderate exacerbation or un-stable remission. Purpose of the study: To improve obstetric tactics in women with chronic pathology of the hepatobiliary system using clinical pathogenetic substantiation of administration of erbisol and silica enterosorbents in the complex of treatment of these patients. Methods of the study: General clinical, obstetric, biochemical, immunological, immunoenzyme, instrumental, statistical. Practical significance: The findings of the research expand the ideas about the features of the immunity state and metabolic homeostasis in pregnant with chronic pathology of the hepatobiliary system; describe the pathogenetic role of immune and metabolic disorders in development of complications of pregnancy, delivery and postnatal period. The revealed association between the type of gall bladder dyskinesia and immunotoxicosis syndromes and SMI allows to consider the immunological and biochemical parameters as markers of dyskinetic disorders in-patients with CNC. The obtained findings suggest positive influence of combination of erbisol and silica enterosorbents on the state of the fetoplacental complex, the course of pregnancy, delivery and post-natal period in pregnant as well as post-natal period in the newborns. This can be used to improve obstetric tactics in pregnant with the described pathology by administration of repeated courses of enterosorption with erbisol in the second and third trimesters as well as to carry out rehabilitation in the post-natal period. Novelty of the obtained results: For the first time, the expediency of the use of combination of erbisol and silica enterosorbents (silard P and enterosgel) in treatment of pregnant with chronic pathology of the hepatobiliary system was substantiated with the consideration of the dynamics of immunological and biochemical parameters. Effective reduction of SMI and LP, the level of autoimmune and immune-complex reactions, possibility of correction of interleukin profile shifts under the influence of erbisol and silica eterosorbents was achieved. The association between the character of CNC and disturbances of metabolic homeostasis and immune state in the pregnant was determined. The state of fetoplacental complex, course of the disease, delivery and post-natal period in pregnant with CNC as well as the course of early neonatal period in the newborns were determined. Obstetric tactics in women with chronic hepatobiliary pathology was improved by means of repeated courses of enterosorption with erbisol. Introduction: The findings of the research were introduced in the work of regional and city maternity hospitals and outpatient hospitals of Lugansk and Lugansk region, Donetsk Regional Center of Maternity and Child-hood, Sumy maternity hospital No. 1, Zaporizhzhia maternity hospital No. 5, department of pregnancy pathology of Odesa regional clinical hospital. Main theses of the work are used in the teaching process of department of obstetrics and gynecology No. 1 of National Medical University named after Bogomolets, departments of obstetrics and gynecology No. 1 and 2 of post-graduate training faculty of Lugansk State Medical University, de-partment of Obstetrics, Gynecology and Perinatology of Lviv National Medical University, department of obstetrics and gynecology No. 1 of Kharkiv Medical Academy for Post-graduate Training. Sphere of application: medicine, obstetrics and gynecology.