Mandrykova A. Optimization of pregnancy tactics and early preterm labor in women after assisted reproductive technologies.

The dissertation is devoted to the reduction of the frequency of perinatal complications in women with early preterm labor after assisted reproductive technologies through the development and implementation of an improved algorithm for diagnostic and therapeutic and prophylactic measures. The role of cytokine imbalance as the main predictor of early preterm labor is scientifically substantiated, its connection with morpho-functional changes of the fetoplacental complex in women with restored reproductive function is clarified. It was established that cytokine imbalance acts as a predictor of early preterm labor in pregnant women after auxiliary reproductive technologies, changing the direction of the immune response when remodeling the immunological tolerance of the parent organism. It is proved that morpho-functional changes of the fetoplacental complex in women after auxiliary reproductive technologies against the background of premature rupture of membranes are localized and become destructive-dystrophic only after the 5th day of waiting obstetric tactics of pregnancy without clinical signs of chorioamnionitis. From the scientific point of view, the choice of the optimal tactics of pregnancy and early preterm labor after assisted reproductive technologies has been substantiated, which made it possible to improve and implement the algorithm of diagnostic and treatment-preventive measures for obstetric care in order to reduce the incidence of perinatal complications. It is proved that pregnancy due to auxiliary reproductive technologies belongs to the group of high obstetric risk.