Berezan O. Thrombohemorrhagic complications' prophylaxis of the childbirth of women with varicose disease of veins of the lower extremities

3. Object of the study: Varicose disease of the lower extremities in pregnant, puerpera and parturient women. Purpose of the study: To reduce the incidence and severity of thrombohemorrhagic complications at delivery in women with varicose disease of the lower extremities basing on the study of the risk factors, phlebologic state, hemostasis system, development and introduction of pathogenetically substantiated anti-coagulopathy complex. Methods of the study: Clinical laboratory, hemostasiology, ultrasonography, phlebology, Doppler ultrasound study, cardiotocography, statistical methods. Practical significance: Preventive use of pro- and anti-coagulant substances was improved. The possibility of outpatient storage of freshly frozen autoplasma as well expanding the terms of its storage in pregnant were substantiated. A new protocol of the use of freshly frozen autoplasma was worked out and introduced into clinical practice. The use of the suggested method of prevention al-lowed to reduce the incidence of complications during and after the delivery due to the changes in homeostasis balance and reduction of the organism adaptation capabilities, reduce the use of donor blood and its components. Novelty of the obtained results: For the first time, the use of combination of freshly frozen autologic plasma with Fraxiparin for prevention of THC during delivery in women with VDVLE was substantiated. For the first time, dynamic changes of plasma hemostasis at delivery in women with VDVLE the use of modified with Fraxiparin freshly frozen autoplasma were determined. The expediency of its administration during the delivery was proven. For the first time, the influence of autoplasma on the state of vascular thrombocyte hemostasis during the delivery in women with VDVLE was determined. The necessity of creation of the bank of freshly frozen plasma with the purpose of stabilizing hemostasis system and for prevention of its pathological shifts during delivery in women with VDVLE was proven. The absence of negative influence of discrete plasmapheresis on hemostasis in pregnant, the state of the fetus at fetoplacental insufficiency and the newborn was shown. The efficacy of the suggested method when compared with generally accepted practice of THC in women with VDVLE was proven. Introduction: The suggested method was introduced to the practice of Poltava City Clinical Maternity Hospital, Chernigiv, Kremenchuk City Maternity Hospitals, maternity departments of Poltava, Chernigiv, Myrgorod, Lubny Central District Hospitals. The theoretical concepts of the work were introduced to the teaching process of students, interns, general practitioners of Ukrainian Medical Dental Academy (Poltava). Sphere of application: medicine, obstetrics and gynecology.