Feyta Y. Risk assessment and prevention of postpartum purulent-septic complications in women with complicated pregnancy and childbirth.

The dissertation is devoted to the reduction of frequency of postpartum purulent-septic complications in women with complicated pregnancy and childbirth, a new solution to the current problem of modern obstetrics and gynecology by optimization of the tactics of the management of pregnant women with high infectious risk by developing and implementing differentiated diagnostic-preventive and therapeutic measures on the basis of determination microbiota state of the vagina, features of humoral immunity, cytokine profile and vitamin D level. The new aspects of the pathogenesis of postpartum purulent-septic complications are presented, which consist of cumulative negative effects of high frequency of dysbiotic processes of the lower genital tract in the third trimester of gestation, significant level of transmitted dyshormonal and inflammatory diseases of reproductive organs and the existing extragenital pathology, complications of pregnancy and childbirth, late diagnosis of postpartum complications and irrational use of antibiotic therapy. The application of the proposed complex of diagnostic and therapeutic-prophylactic measures showed a significantly higher efficiency in the elimination of pathogens (78,9% at 45,7% in the comparison group). In the uncomplicated flow of the postpartum period, the effectiveness of treatment was 96,4% at 84,5% in the comparison group. The overall clinical and laboratory efficacy of differentiated therapeutic and prophylactic measures was 81,8% at 60,3% in the comparison group.