Rymarchuk M. Diagnosing and prevention of obstetric and perinatal complications in pregnant women with retrochorionic and retroplacental hematomas.

The thesis deals with the issue of local premature abruption of chorion and placenta that is associated with the development of placental dysfunction, fetal distress, intrauterine growth restriction and constitutes one of the most frequent causes of perinatal morbidity and mortality. The basis of the research lies in the study of new constituent elements of the pathogenesis the improvement of prevention and treatment of metabolic disorders at the stage of preparation and monitoring of pregnancy, the search of diagnostic markers and the development of tests to control treatment effectiveness. This research is the first to study the occurrence rate of various glutathione-S-transferase gene alleles and we have found out that negative perinatal consequences, such as intrauterine growth restriction and fetal distress associated with placental dysfunction, are connected with a high occurrence rate of functionally weakened combinations of these gene alleles. The research results show that local non-progressive abruption of chorion and placenta is associated with disorders in the processes of placental protein synthesis as well as with the increased level of neuron-specific enolase as a possible factor of prognostication of perinatal pathology. All the above mentioned has enabled suggesting and implementing a diagnostic algorithm as well as to decide on the necessity of a preventive complex and the optimization of gestational assistance and labor induction.