Poluyanova O. . Optimization of pregravid training for women with scar on the uterus after cesarean section

The dissertation is devoted to the study of clinical features of pregnancy, childbirth and neonatal status at women with uterine scar after cesarean section, defining characteristics of the functional state of the uterus operated before and during pregnancy, the development of an optimal amount of diagnosis of the condition of the reproductive system and algorithm of pregravid training for women of uterine scar after cesarean section. This problem is actual because it is directly related to the issues of reproductive health, maternal and perinatal morbidity and mortality. On the basis of the research of the optimal algorithm of pregravid training at women with scar on the uterus after cesarean section considering connections between clinical, ultrasound, endocrine and microbiological features of their reproductive system and differentiated approach to the correction of diagnosed changes. It is proved that a complex of pregravid training that includes immunostimulating and dissolving, vitamin combined therapy with hormonal correction prophylactic prescribtion of antioxidants (vitamin E), psychological prophylaxis, diagnostic hysteroscopy, physiotherapy course - amplipulsephorese with the medicinal product that contains proteolytic enzyme hyaluronidase, leading to an increase of the number of vaginal births at women with scar on the uterus, reducing maternal and perinatal morbidity, significantly reduce the number of intra-and postnatal complications.