Dimassi H. Pathogenetic mechanisms of miscarriages in isthmico-cervical insufficiency and vaginal infections

The thesis is devoted to the questions of improvement of pregnancy outcomes in isthmico-cervical insufficiency and vaginal infections on the basis of studying features of pathogenetic mechanisms of cervical insufficiency development in pregnant women with both vaginosis and vaginitis and implementation of new approaches to predict and prevent both adverse maternal and fetal outcomes. Ultrasonic and biochemical markers for predicting the course of cervical incompetence in conditions of vaginosis or vaginitis are determined. It was established that changes in biochemical parameters correlates with specific ultrasound parameters, which allows their use as markers for predicting the course of isthmico-cervical insufficiency in terms of vaginal infections. Therapeutic actions which are referred to inhibit consequences of oxidative and nitrosative stress in pregnant women with isthmico-cervical insufficiency and vaginal infections to prevent activation of inflammatory promoters and premature remodeling of cervical structure are proposed. Predictive criteria of adverse outcome formation of surgical correction in isthmico-cervical insufficiency after treatment of vaginal infections are established and the adequate management of this category of pregnant women is developed.