Object of the study: iron deficiency anaemia, combined with chronic pathology of the hepatobiliary system (HBS) of a nonviral genesis in pregnancy. Purpose of the study: revealing of peculiarities in the management of pregnancy, delivery and postnatal period in pregnant women with anaemia, combined with chronic pathology of HBS of a nonviral genesis; development of a pathogenetically grounded method of treatment. Methods of the investigation: clinical, biochemical, immunological, instrumental, statistical ones. Theoretical and practical results: risk factors of the development of anaemia of pregnancy (AP) were revealed; they make it possible to foresee the development of obstetrical (preeclampsia, immature pregnancy) and perinatal (foetation delay and distress) complications. A complex was devised for the therapy of pregnant women with anaemia, combined with chronic pathology of HBS of a nonviral genesis; it includes the use of Ukrainian medicines. A high clinical efficacy of the suggested therapy, which has no adverse reactions and complications, was found out. The suggested therapy significantly improves the treatment efficacy; the latter manifests itself by a more rapid achievement of stable long-term remission of the disease and, as a result, reduces the number of bed-days, decreases the rate of complication development, normalizes clinical, immunological and biochemical indices. Novelty: for the first time, on the basis of a complex study, clinical-pathogenetical peculiarities were revealed in AP, combined with chronic pathology of HBS of a nonviral genesis. It was proved, that in order to optimize the treatment of this type of patients one should influence the pathogenetical links of the progression of an inflammatory process in HBS. The expediency of using a combination of an iron-containing drug and a hepatoprotector in a complex of treatment of pregnant women with anaemia, combined with chronic pathology of HBS of a nonviral genesis was pathogenetically grounded with regard for the dynamics of clinical, immunological and biochemical indices. It was found out that this combination of medicines caused the elimination of secondary immunodeficiency and contributed to the restoration of metabolic homeostasis. For the first time, an effective decrease in the expressivity of the syndrome of endogenous metabolic intoxication and lipid peroxidation, the level of autoimmune and immune-complex responses, an ability to control shift in interleukin profile under the effect of the suggested combination of medicines was achieved. Correlations between immune shifts and metabolic disturbances were revealed. The state of the foetoplacentasl complex, the course of pregnancy, delivery and postnatal period in women with AP, combined with chronic pathology of HBS of a nonviral genesis, as well as the course of the early neonatal period in newborns were studied. The obstetrical tactics of managing pregnancy in women with AP, combined with chronic pathology of HBS of a nonviral genesis, was improved by conducting repeated prophylactic courses in the dynamics of pregnancy. Degree of introduction: the scientific results, obtained in the thesis, are used in the teaching process at the departments of obstetrics and gynaecology at Zaporizhzhya, Lugansk, Odesa, Ternopil State Medical Universities, Vinnitsa, Donetsk and Kharkiv National Medical Universities. Materials of the thesis research, were introduced into the practice of maternity homes and units of pathological pregnancy in the cities of Zaporizhzhya (Maternity Home No. 5), Kyiv (Maternity Home No. 4), Lugansk (City Maternity Home), Odesa (City Hospital No. 2), Poltava (City Maternity Home), Kharkiv (City Maternity Home with Neonatal Inpatient Department). BY the materials of the thesis, 2 information sheets, a methodological recommendation and 1 rationalization proposal were devised, published and introduced into the clinical practice. Sphere of application: medicine, obstetrics and gynaecology.
