Object of the study: osteopenia and osteoporosis in pregnant women and those in labour. Purpose of the study: to reveal peculiarities of clinical-biochemical characteristics, mineral and bone metabolism in pregnant women and those in labour, who have the osteopenia syndrome (OPS), and to develop a complex of medical-prophylactic measures (CMPM). Methods of the investigation: clinical, laboratory, biochemical, immunoenzyme, immunoelectrochemiluminiscent, instrumental, statistic ones, questioning. Theoretical and practical results: the influence produced by pregnancy and labour on the state of the osteoligamentous apparatus (OLA) in pregnant women with OPS and those with injuries of their pelvic joints during childbirth was studied. The anamnestic risk factors for the appearance of OPS were revealed, they include: the woman’s age before 18 and over 35 years, disorders in the menstrual cycle, chronic inflammatory diseases and surgical interventions on the adnexa, extragenital diseases (anaemia, diseasesof the gastrointestinal tract, urinary system, prolapse of the mitral valve, varicosis), as well as operations and injuries in the locomotor system (LMS), particularly injuries of the pelvic joints during childbirth. The OPS risk factors, which appear during pregnancy and labour, are as follows: a narrow pelvis, early gestosis, premature labour, preeclampsia, a foreseen big foetus, and clinical manifestations of the LMS pathology. On the basis of the obtained data, indications were worked out for applying combined therapy, aimed at the normalization of the bone tissue metabolism, stabilization and improvement of the OLA parameters, therewith opening prospects for opportune diagnosis of the above pathology during pregnancy. The use of a CMPM, which contains a combined calcium drug preparation, makes it possible to increase the efficacy of treating OPS in pregnancy. Novelty: for the first time, an algorithm of OPS diagnosis in pregnancy and labour was suggested; its first stage consists in ultrasonographic densitometry of the calcaneus during the 2nd trimester of pregnancy in pregnant women of the risk group or after revealing clinical signs of the OLA pathology at any terms of gestation, as well as the study of mineral metabolism, level of calcium-regulating hormones, bone metabolism markers and agrecane proteoglycane. If necessary, the pelvic bones are to be subjected to radiography during the postnatal period. For the first time, on the basis of complaints and objective signs of the LMS pathology, assessment tables in points are suggested, thereby making it possible to unify the approach to the pelvic pain problem in pregnancy and in women with injuries of their pelvic joints during childbirth by doctors of different specialities, as well as to exercise a noninvasive dynamic control over the treatment efficacy. Degree of introduction: by the materials of the thesis research, “The diagnosis and ways for correcting clinical-metabolic disturbances in women with osteopenia syndrome during pregnancy and labour” (Kyiv, 2008) methodological recommendations were worked out. Results of the research are used in the practice of a consulting polyclinic, gynaecological and maternity departments of clinical maternity homes Nos 3 and 5 and maternity homes Nos 4 and 9 of the City of Zaporizh’a, maternity home of the City of Melitopol. The obtained data on the diagnosis and treatment of OPS are used in the educational process at the Department of Perinatology and Gynaecology of Kharkiv Medical Academy of Postgraduate Education in teaching the corresponding sections of obstetrics. Sphere of application: medicine, obstetrics and gynaecology.
