Zadorozhny O. Pathogenetic approaches to prevention and treatment of obstetrical and perinatal complications in pregnant -women with pulmonary tuberculosis complicated with iron deficiency anemia

The dissertation is devoted to solving actual scientific problem, which has social and health value, - reducing of obstetrical and perinatal complications in pregnant women with pulmonary tuberculosis (TBL), complicated by iron deficiency anemia (IDA). With integrated research system "mother-placenta-fetus" in women with pulmonary tuberculosis in the background IDA it was established the second degree of dysfunction of the placenta, poor performance MFP violation of utero-placental-fetal circulation, abnormal indicators colpocytogrames (mostly estrogen type), pathological immaturity placentas cases, hemocirculator disorders, inflammatory and involutive-degenerative processes. Compensatory formed by reaction of terminal villi hyperplasia and vascular them to form syncytiocapillar membranes. Pregnant women with pulmonary tuberculosis in supporting IDA have a hemic, circulatory and tissue hypoxia, metabolic acidosis (lowering of blood parameters - pH, pO2, increased pCO2 and BE), which is an important factor in the development of perinatal complications. The most significant changes are detected in women with the active form of fibro-cavernous and infiltrative pulmonary tuberculosis who have severe anemia in the third trimester of gestation.The proposed method of complex treatment helps to improve hematological parameters, to increase serum iron, ferritin, to improve the functions of placenta, fetal biophysical profile parameters, to reduce expression of metabolic acidosis. It is possible to improve treatment, reduce the incidence of obstetric and perinatal complications, improve morphofunctional state of newborns.