Zhabitska L. New aspects of the preterm labour pathogenesis, therapy and prophylaxis

The dissertation is devoted to solution of the theoretical-and-practical problem - lowering the preterm labour rate - by means of improving both this pathology therapy and prophylaxis on the basis of in-depth clearing up the etiopathogenetic mechanisms of preterm labour, in particular a role for nitric oxide as a smooth muscle relaxant. Based on the complex studies, it was established that the development of preterm labour at 22-28 weeks is underlain by imbalance of the mechanisms, which maintain uterine rest status, where a crucial role belongs to nitric oxide. The nitric oxide level was proved to be universal prognostic marker of the preterm labour development, whose value is influenced by hormonal, infectious, immunological and other factors. A reduction of this indicator in the dynamics down to the critical level can serve as a reasonable criterion in forecasting preterm labour with the purpose of its in-time prevention and therapy. A new method was proposed for forecasting preterm labour, which isbased just on this specific for preterm labour indicator, a change in serum nitric oxide concentration. The method allows for in-time corrective therapy to be conducted and prevent the development of pathology. In addition, a new method was worked out for combined, pathogenetically substantiated treatment of preterm labour. It consists in using a transdermal form of nitric oxide donators under the control of nitric oxide level in blood serum of the pregnant. The approbation of this method showed that it was efficacious, safe, convenient, non-invasive method for the treatment of preterm labour, which was well tolerated by pregnant women. The practical use of this method ensures a lowered preterm labour rate and an improvement in perinatal outcomes.