Shchurko D. Optimization of management and delivery of woman with congenital malformation of the fetus

The thesis is devoted to optimization of the management of pregnancy and delivery of women with congenital malformations of the fetus in order to reduce frequency of antenatal death, perinatal morbidity and mortality. A retrospective epidemiological analysis of the congenital malformations in the Southern region of Ukraine is given to determine its prevalence, patterns, spread in the urban and rural areas, seasonal composition. There were determined risk factors of antenatal fetal death in combined congenital malformations and placental dysfunction (PD). There was proved the feasibility of assessment of dopplerometric indices of circulation in the middle cerebral artery in combination with hypercoagulability and activation of fibrinolysis, defined by low-frequency piezoelectric thromboelastography to determine the tactics of delivery in congenital malformations of the fetus. It is shown that in a combination of circulatory disorders in middle cerebral artery with hypercoagulability and activation of fibrinolysis, delivery should be carried out for 2-4 hours, when there is combination of dopplerometric indices in the umbilical artery with coagulation disorders; this period is for 2-3 days.