Gervazyuk O. Optimization of thrombohemorrhagic complications diagnosis, prevention and treatment in HIV-infected pregnant and postpartum women.

The dissertation is devoted to the reduction of thrombohemorrhagic complications in HIV-infected pregnant and postpartum women by improving diagnostics, prevention and treatment of these pathological conditions by establishment of new pathogenesis links. The structure and frequency of HIV-infected women maternal mortality in Ukraine, the main pregnancy, childbirth and perinatal complications in HIV-infected women are established.Ultrasound duplex compressive venous angioscanning in 18-22 weeks allowed to reveal a II degree "slag-phenomenon" in HIV-infected patients with risk factors of thrombohemorrhagic complications. Changes in all hemostasis links that progress during pregnancy and become maximal before labors were detected in patients with thrombohemorrhagic complications risks factors and the III clinical stage of HIV infection, and those who started HAART. The study of the immune system in the examined patients revealed laboratory signs of humoral link activation with the cell link suppression. In patients who started HAART during this pregnancy laboratory signs of hepatotoxic drugs effects have been noted.With the progression of the HIV-infection stage, the severity of the histological signs of placental dysfunction increases. Immunohistochemical research showed signs of placental immune disorders (high expression of complement C3 and CD68 positive cells) and confirmed an activation of the vascular-platelet hemostasis link). The proposed diagnostic, prophylactic and therapeutic algorithms have allowed to reduce the frequency of thrombohemorrhagic complications in HIV-infected pregnant and postpartum women.