Atamanchuk I. Prevention of hemostasis imbalances in women after implementation in vitro.

The dissertation is devoted to the problem of increasing the effectiveness of diagnosis and treatment of hemostasis disorders in women after the implementation of programs of assisted reproductive technologies through the study of anamnestic, clinical and laboratory, hardware changes, features of the course of pregnancies after the implementation of programs of assisted reproductive technologies, the development and implementation of a scientifically based complex of diagnostic, therapeutic and prophylactic measures. The main risk factors have been determined: aggravated personal and family thrombotic, somatic and reproductive history (involuntary miscarriage, stillbirth, early neonatal mortality, habitual miscarriage of pregnancy, unsuccessful attempts of extracorporal fertilization in history). This factors predicated hemostasis disorders in pregnant women with a risk of miscarriage of pregnancy. On the basis of the comprehensive assessment of the state of the hemostasis system and the laboratory criteria for thrombophilic states, it was determined that among them the most important role in the development of miscarriage of pregnancy is played by genetic polymorphisms of thrombophilia, hyperhomocysteinemia and antiphospholipid antibodies. For the first time on the basis of the conducted research the pathogenetic complex of individual correction of detected thrombophilic disorders in pregnant women with early termination of pregnancy was developed.The proposed complex of correction of thrombophilic disorders allowed to timely solve the issue of further safe conduct and prolongation of pregnancy in such women. A new clinical approach to the onset, development and clinical manifestations of non-pregnancy in the background of hemostasis disorders, as well as the development and implementation of a set of preventive and curative measures has made it possible to reduce the relative importance of complications of pregnancy and significantly reduce the number of reproductive losses.