Lobastova T. Features of pregnancy and childbirth in women with preeclampsia on the background of hyperhomocysteinemia

The dissertation presented theoretical generalization of a new direction in solution of the problem of pregnancy and childbirth in women with preeclampsia on the background of hyperhomocysteinemia through the development and implementation of pathogenetically based treatment of this pathological condition. As a result of the studies we presented the concept of preeclapsia on the background of hyperhomocysteinemia as a result of protrombogenic, immunological and hormonal disorders, microcirculatory disorders in utero-placental and feto-placental complex. In-depth study of retrospective data showed that the spectrum of complications in women with preeclampsia were: severe preeclampsia, fetal distress, placental abruption, small for gestational age fetuses, placental dysfunction. In the study of hemostatic parameters and hormone-immunological correlations in pregnant women with preeclampsia and hyperhomocysteinemia we found that this pathological condition is characterized by such changes as hyperaggregation in plasma, hypercoagulation, activation markers of intravascular coagulation. As a result of the study the complex treatment of preeclampsia pregnancy involves correcting hyperhomocysteinemia and the associated trombofilic violations, including the usage of sulodexid, folic acid, aspirin and complex B vitamins. The effectiveness of the pathogenic complex preventive treatment demonstrated no significant violations during pregnancy and childbirth, according to clinical and laboratory parameters, as well as reducing prospective clinical manifestations of preeclampsia