Kusa O. Prevention and Treatment of Obstetric and Perinatal Complications in Women at Risk of Intrauterine Infection

The thesis deals with the problem of significant perinatal infections, the criteria of perinatal morbidity and mortality in their manifestations do not tend to decrease, while placental insufficiency of infectious genesis runs most heavily and is resistant to conventional therapy. Among the large number of known infections the parvoviral one is not studied enough. Therefore, a more profound and comprehensive study of the pathogenesis of this disease, considering its polyethiology and multiple-factor principles is necessary for development of effective methods of prevention and treatment. For the first time is evaluated the impact of mixed forms of viral-bacterial infections, including the influence of parvoviral infectious factor on pregnancy and perinatal consequences. We also studied the interaction between miscarriages and perinatal losses in the second half of pregnancy and infectious parvoviral lesions. We obtained evidence that in the development of the rising infection the leading role belongs to depression of local immunological defence mechanisms in vaginal content and endocervix, as well as reducing bactericidal properties of amniotic fluid. We proved the necessity of a differentiated approach and the local immune correction depending on the degree of immune depression, as well as developed and implemented practical recommendations both at preconception stage and in the dynamics of pregnancy using the immunomodulatory means.