The scientific work was carried out to find a new solution to the problem of modern obstetrics and gynecology - prognostication and decrease of incidence and severity of gestational diabetes mellitus and perinatal complications in women of the risk group of gestational diabetes mellitus (GDM) under natural iodine deficiency by implementation of scientifically based prophylactic and treatment measures. We've found 7 main risk factors of GDM: excessive weight gain during pregnancy, big fetus in history, spontaneous abortions in history, perinatal loss in history, diabetes type II in relatives of the first degree, age above 30 years, body mass index (BMI) >25 kg/m? due to the clinical and statistical analyses. We've carried out a mathematical formula of calculation the risk of GDM during current pregnancy. In case the sum of points was up to 1,9 the probability of GDM was app. 0%; 2,0 - 4,2 points - 30%; 4,3 - 5,8 points - 50%; 5,9 - 7,3 points - 70%; 7,4 - 9,6 points - 90%; above 9,7 points - more than 90%. We've developed an algorithm to form risk groups of women with higher probability of GDM during pregnancy. We've found that pregnancy in case of GDM in complicated by threatened abortion in 42,00%, polyhydramnios in 48,00%, preeclampsia in 34,00%, gestational pyelonephritis in 22,00% of the investigated women based on the clinical, endocrinological, mathematical, statistical and functional methods investigations. The pregnant of this group were characterized by excessive weight gain during pregnancy. Preterm labor occurred in 28,00% of the pregnant, the operative labor in 58,00%. The main indication for urgent Cesarean section was fetal distress. We've analyzed the carbohydrate metabolism of the pregnant and the functional state of the thyroid gland and diagnosed dysfunctional diseases of the thyroid gland in 32,00% of the investigated. We've found higher incidence of placental dysfunction in women with GDM living in the area with natural iodine deficiency that manifested in higher s/d ratio, PI and RI during Doppler investigation, decrease of the average STV index. 42,00% of newborns from women with GDM had macrosomy, 34,69% were born in the state of asphyxia, diabetic fetopathy was diagnosed in 25,50%. We've developed preventive measures to decrease the incidence and severity of GDM during current pregnancy and also obstetrical and perinatal complications among these women living in the area of natural iodine deficiency. The offered preventive and treatment method of prophylaxes of GDM during pregnancy in case of natural iodine deficiency made it possible to significantly reduce the incidence of GDM by 28,00% and to normalize the glycemic parameters without insulin therapy, increase iodine supply and normalize the functional state of thyroid gland, decrease the incidence of gestosis, threatened abortion and threatened preterm labor, Cesarean section and diabetic fetopathy.
