Voronkova N. Optimization of reproductive function restoration of women with a missed miscarriage in the anamnesis and pathology of endometrium.

The thesis work is dedicated to efficiency increase in prophylactic and therapeutic measures on gestation loss prevention for women, who have a missed miscarriage in the anamnesis, by means of improvement of the examination algorithm and a set of measures of pathogenetic therapy. Annual direct reproductive loss comes to 36-40 thousand of unborn children, which equals to 15-30% of total number of pregnancies. 1st trimester is particularly important for gestation process as laying of fetus organs and systems, formation of the fetoplacental complex, extraembryonic structures occurs at this time, therefore any mother's illness or influence of unfavorable external factors may cause changes in the homeostasis of the functional system "mother-placenta-fetus" or the death of the embryo/fetus. The proof of this is existence of interrelation between different body biotopes of women with a missed miscarriage and endometrium pathology: diseases of gastrointestinal tract were found in 33.3%, ENT organs - in 12.1%, arterial hypertension - in 21.1%, diffuse increase of the thyroid gland with euthyroid condition - in 17.8%. The backgrounds serving the formation of repeated pregnancy losses in women with a missed miscarriage in the anamnesis were: inflammatory processes of vagina - 93.3%, of cervical canal - 80%, relative imbalance of FSH during selection of a dominant follicle, which led to a decrease in the estradiol index in the ovulatory phase (p <0.05), and progesterone in the middle of the luteal phase of menstrual cycle, as a result of insufficiency of blood flow in the basal layer of the endometrium, dysfunctional disorders of its tissue receptacle, insufficient secretory transformation. The need for improving the algorithm of preparation for pregnancy for women with a missed miscarriage in the anamnesis is scientifically substantiated.