Staselovych L. Immunologic and humoral factors in postmaturity prognosis and prohylaxis of postmaturity.

The purpose of dissertation work is a decrease of obstetric and perinatal complications of postmaturity in high risk pregnant women based on unveiling specific etiological and pathogenetical mechanisms and prognostic value of immunological and humoral indexes. Our goal was concentrated on development and implementation of the scientifically based algorithm of prognostication and prophylaxis of postmaturity in the expected term of birth even before the onset of postmaturity itself. We have showed and proposed risk factors for postmaturity screening. Immunological, humoral and receptor condition in women in physiological and postterm pregnancy together with fetal biophysical profile were investigated. We have performed the analysis of pregnancy course, labor, postlabor period and neonatal condition in newborns after postterm labor compared with women, who had physiological course of pregnancy. Changes in ?-receptors of myometrium proved to be significant reason for postmaturity. Indices of ? - adrenoreceptors of red blood cells increased almost twice upto 64,2 IU in 35-37 weeks of gestation and remain at high levels till labor. These indices in postterm are statistically different from indices in physiological pregnancy, which is a prognostic sign for postmaturation. Determination of red blood cells adrenoreceptors is a simple and reliable method for postmaturity prognostication even before the expected delivery date, and may be started from 35 - 37 gestational weeks. Postmaturity is characterized by alterations in humoral, immunological and hormonal parts of pregnant women homoeostasis. We have optimized an array of measures for postmaturity prophylaxis. Immunocorrecting medication Erbisol together with prostin E2 as a combination of pathogenetic prohylaxis of postmaturity allows for normalization of humoral and immune disturbancies and further for term labor with minimization of perinatal and obstetric complications.