Shurpyak S. Prediction and prevention of fetal loss syndrome in women with complications in reproductive history.

Thesis is devoted to the problem of fetal loss syndrome in modern obstetrics and gynecology. Was performed a retrospective analysis of 9923 births that occurred in 2007-2009 in Lviv regional clinical perinatal center. Identified risk factors for fetal loss syndrome. Was proved the expediency and informativity of determination serum ?-2 microglobulin of fertility levels in the course of pregnancy in women with previous reproductive losses. Shown high sensitivity and specificity of the test for determining the phosphorylated protein-1 in cervical mucus, which makes it possible to determine the risk of labor activity under the threat of premature birth, which allows recommend to perform it before appointment of therapy aimed to maintaining pregnancy after 25 weeks to reduce the incidence of unreasonable medicalization of pregnancy. Especially it should be noted that the combination of transvaginal ultrasound and conduct test to determine the phosphorylated protein-1 in cervical mucus provides the differentiated treatment in advance. Proved that in the absence of planning pregnancy and conception preparation in pregnant women with fetal loss syndrome threatened miscarriage occurs on the background of pronounced dysbiotic changes of vaginal biota that requires measures to restore it for the prevention of fetal infection and abortion. Developed algorithm for prediction of fetal loss syndrome in women with a history of reproductive history. Developed algorithm of pregravid preparation and antenatal care, which is based on the determination of the prevailing factors of previous reproductive loss for each patient and provides individual program conception preparation with the use of micronized progesterone angioprotective drugs and metabolic therapy in patient with markers of threatened abortion. Implementation of the complex of pregravid preparation, diagnostic and therapeutic interventions in pregnant women with fetal loss syndrome has reduced the frequency of miscarriage, adverse perinatal outcome and obstetric complications.