Nedorezova K. Prevention of perinatal pathology by women with caesarean section in anamnesis.

This thesis is devoted to the reduction of the frequency of adverse perinatal consequences in women with Caesarean section (CS) in anamnesis by improving the algorithm of medical care during pregnancy and in childbirth, based on of complex clinical, ultrasound examination, upgrading of the state of the fetoplacental complex. The importance of the study are determined by the steady increase in the frequency of the operation of the in Ukraine, the need to optimize the tactics of conducting and giving birth to women with CS in favor of vaginal births. Clinical and epidemiologc studies (2013-2017,) showed the possibility of reducing the number of CS by the spread of the practice of vaginal births. Conducting them with a favorable perinatal result is probable at 35-55 %. A gradual increase of more than double the percentage of women with operated uterus for 10 years is stated. It shown that the rates of fetal growth in women with CS in the history of III trimester are limited, from 34-35 weeks. There are signs of centralizing blood circulation. This testifies less favorable conditions for the development of the fetus in the operated uterus, the most expressive in cases of inability of the uterus to implement the birth. The perinatal value of the factor "cesarean section in history" proved, Morphological documentation of this is a complex of intense adaptation reactions in the placental tussue. To prevent perinatal pathology, a number of prognostic-diagnostic and preventive therapeutic measures have been proposed and implemented. This provide a reduction in the need for an urgent cesarean section and satisfactory perinatal results.