Brazhuk M. The Optimization of the rehabilitation of the woman's reproductive function after the organopreserving surgical treatment of the tubal pregnancy.

Dissertation is devoted to optimize the rehabilitation of women's reproductive function after the organoconserving surgical treatment of the tubal pregnancy. The existing scientific data on the assessment of the reproductive health of women with the secondary infertility has been supplemented. The second infertility is likely caused by the endured ectopic pregnancy. The inflammation of the pelvic organs, anatomical abnormalities in the pelvic organs, hormonal disorders, artificial abortions, spontaneous abortion, missed abortions, have been established. The research data about the clarifying features of microbiota and viral load of the genital tract of women with tubal pregnancy have been specified. The considerable incidence of the formation of the associative forms of the viral-bacterial infection has been registered. For the first time the complications of the epithelium-mesenchymal transformation chorionic structures of the ectopic gestational ovum have been established. They are based on the study of the molecular processes of the proliferation of the trophoblast and mechanisms of the cyto trophoblastic invasion of the ectopic gestational ovum. These malfunctions are the following: the reduction of expression of the proliferative marker Ki-67, the rapid decline or absence of the expression of the endothelial factors CD31 unequally expression of epithelial and mesenchymal markers due to the chronic salpingitis. TThe application of the developed complex phased medical and rehabilitation measures for women after the organopreserving surgical treatment of the tubal pregnancy facilitated the normalization of the indicators of the microbiota of genital tract - 83,7% of patients, the restoration of the tubal patency for all the patients; the generative function - 65,1% of women. The recurrence of the tubal pregnancy hasn't been registered in any case.