Matvienko I. Condition of Fetoplacental complex at pregnant women with an endocrine pathology.

Object of the study: Diabetes mellitus, thyroid pathology in pregnant. Purpose of the study: To improve the diagnosis of the disorders in the state of fetoplacental complex in pregnant with diabetes mel-litus and thyroid pathology followed by development of algorithm of pregnancy management to reduce perinatal complications. Methods of the study: Clinical, ultrasound study, Doppler ultrasound, MRI, study of biophysical fetus profile, radioimmune methods, statistical methods. Practical significance: Based on the findings of the performed research, the system of examination for early diagnosis of the state of the fetus in pregnant with endocrine pathology was improved. MRI parameters which characterize the state of the amniotic fluid and placenta in healthy pregnant and in those with IDDM and DTG were determined. A new method of diagnosis of placental dysfunction in women with IDDM was worked out. The methods, which allow to control the efficacy of the administered treatment and predict the outcome of the pregnancy for the mother and the fetus, which can reduce perinatal pathology and mortality, were suggested. Novelty of the obtained results: For the first time, the findings of complex clinico-instrumental study of the fetoplacental complex was used to determine the approach to establishing the causes of complications of pregnancy, delivery as well as high perinatal morbidity and mortality in pregnant with IDDM and DTG. The peculiarities of clinical functional interrelations in the fetoplacental complex of the pregnant with endocrine pathology were determined. The consequence of inhibition of biophysical parameters of the fetus state in mothers with IDDM and DTG was determined. MRI picture of physiological pregnancy as well as that at IDDM and DTG was investigated. Complex characteristics of the state of uterine-fetal-placental circulation was made. Significance of vascular disorders in patients with IDDM as well as the influence of DTG on the uterine-fetal circulation was proven. Comparison of the findingsof ultrasound, Doppler examinations and MRI allowed to reveal a number of characteristic changes against a background of compensation-adaptation reactions of the fetoplacental complex, to work out a new method of FPI diagnosis in women with IDDM. Modern methods of early diagnosis, treatment and prevention of perinatal complications in women with the described endocrine pathology were improved. Introduction: The improved methods of diagnosis of the state of FPC in pregnant with endocrine pathology were introduced to the work of pregnancy pathology departments of maternity hospitals NO. 1, 4, 5, 7 (Kharkv), Ukrainian Scientific Practical Medical Center for Obstetrics, Gynecology and Reproductology. Theoretical ideas of the research were introduced to the teaching process in Kharkiv State Medical University and Kharkiv Medical Academy for Post-graduate Training. Sphere of application: Medicine, obstetrics and gynecology