Demidova N. Obstetric aspects of inborn defects and hereditary diseases of the fetus.

The thesis presents substantiation and new decision of the scientific problem of current obstetrics regarding perinatal, neonatal morbidity and mortality by improving the efficiency of methods of prenatal diagnosis and primary prevention of inborn defects and hereditary diseases of the fetus. There were proposed and substantiated diagnostic algorithms of prenatal diagnosis that improve the efficiency of detection of inborn defects and hereditary diseases of the fetus. There was developed and implemented quinary biochemical screening of inborn defects and hereditary diseases; there was performed analysis of its effectiveness. There were determined risk factors of inborn defects and hereditary diseases of the fetus on the basis of which there can be identified risk groups of inborn defects of the fetus during the examination of pregnant woman. There was developed and implemented a range of measures aimed at prevention of inborn defects and hereditary diseases that includes the use of balanced complex of vitamins and minerals with proven clinical efficacy with the addition of an iodine, eicosapentaenoic and docosahexaenoic acids, complex of amino acids and precursors of collagen. It is significantly more effective than generally accepted principles of management of pregnant women from the high risk group that is proved not only by favourable pregnancy and birth outcomes, but low indices of perinatal mortality, absence of natimortality, favourable remote results of conservative and surgical treatment of inborn defects. The suggested complex of diagnostic and preventive measures can be applied in all maternity departments, antenatal and family planning departments.