The thesis is devoted to the problem of improving the efficiency diagnostics and prophylaxis of gestational and perinatal complications at thyroid disfunction in female carriers of antibodies to thyroid peroxidase (AB-TPO) by the study of clinical and laboratory, echography changes, features thyroid and cytokine statuses, development and introduction of science-based complex of diagnostic, medical and preventive events. Scientific novelty of the results. For the first time, according to a retrospective analysis, a critical threshold of the initial level of AВ-TPO = 350 IU/ml was established, above which a high risk of gestational complications is predicted: the risk of abortion (p<0.001), OR=1.10 (1.08-1.13); miscarriage of pregnancy (p<0.001), ОR=1.02 (1.01- 1.03); fetal distress (p=0.002), OR=1.02 (1.01-1.03); newborn asphyxiation (p<0.001), OR=1.01 (1.01-1.02). Major gestational and perinatal complications have been identified in women with elevated levels of AB-TPO in the state of euthyroidism and it has been shown that the frequency of this pathology depends on the level of AВ-TPO. The most frequent complications in pregnant women with a baseline AB-TPO of <350 IU/ml and 350 IU/ml were: a threat of abortion (45,1 і 64,4 %), missed pregnancy in the I trimester (7.8 and 13.6 %), preeclampsia (33.0 and 46.0 %), fetal distress (12.8 and 28.0 %), preterm childbirth (11.7 % and 26.0 %). The frequency of pathological childbirths in them was 55.3 % and 68.0 %, respectively. It was found that in women with a baseline AВ-TPO <350 IU/ml and 350 IU/ml, there was a placental dysfunction that was characterized by hyperplasia (16.0 and 42.0 %) and a change in the placenta echostructure (27.7 and 66.0 %), disturbances of utero- placental-fetal circulation (33.0 and 44.1 %), retarded fetal development (11.7 and 30.0 %), fetal distress (12.8 and 28.0 %). It was specified that for newborns from mothers with an initial level of AВ-TPO <350 IU/ml and 350 IU/ml, preterm prematurity (11.7 and 26.0 %), hypotrophy (11.7 and 30.0 %) were characteristic and asphyxia (36.7 and 38.0 %). It has been shown that the level of AB-TPO in the newborn cord blood is directly proportional to the concentration of AB- TPO in the mother's blood (R=0.62, R=0.58, p<0.0001). Scientific data on the functioning of the pituitary-thyroid axis in the dynamics of the gestational period in patients with different levels of AB-TPO is supplemented. In women with a baseline AT-TPO <350 IU/ml and 350 IU/ml there was a high incidence of hypothyroidism subclinical (28.6 and 32.6 %) and manifest (18.00 and 22.0 %). The main results of the dissertation are presented in 11 scientific publications. Of these, six works - articles in magazines in accordance with the "List of professional editions of Ukraine", one - in the foreign scientific periodical publication on the direction from which the dissertation was prepared, received 1 patent of Ukraine for the invention.
