Hrytsyshyn B. Prevention and treatment of placental deficiency in the women with thyroid disorders under iodine deficiency

The work deals with the actual problem of obstetrics and gynecology – the study of peculiarities of functioning of fetoplacental complex depending on pathology of thyroid gland of mother andits effect on the condition of the fetus and newborn. Methods of diagnosis and treatment of chronic placental insufficiency in the thyroid pathology were improved. Analyzing the health status of the pregnant women and the factors that shape it, the significant increase in thyroid pathology during the gestation is noted. The dissertation delas with new aspects of the influence of iodine deficiency and some factors of ecological origin for the development of thyreopathies in the pregnant women based on established relationship between hormonal and metabolic disorders balances, morphological functions of the placenta, which gives rise to perinatal pathology in women with thyroid disease. The pregnant women and children are considered the most vulnerable to iodine deficiency and selenium in the environment. New data about the role of the hormonal and metabolic disorders in the development of chronic placental defects in the pregnant women with the thyroid disease were found. Due to the conducted researches, we have received new information about the impact of various types of pathology of pregnant woman’s thyroid, pregnancy, fetal development and newborn condition. A method for predicting the severity of diffuse toxic goiter in the pregnant women and the women who gives birth was developed. New morphofunctional features of placenta are identified, and the basic mechanisms of development of placental insufficiency at different types of pathology of the thyroid gland of the mother are refined. The role of membrane destructive processes in the development of chronic placental insufficiency in thyroid gland diseases is detected. For the first time a comprehensive evaluation of ultrasound, Doppler, cardiotocographic data in the chronic placental defects in the pregnant women with thyroid disease is conducted. The indications for correction of the detected violations in chronic placental insufficiency in the pregnant women with thyroid pathology are determined. It is established that during pathologies of the thyroid gland the signs of lesion, which have the character of alteration, focal sclerosis, and fibrinoid necrosis were present in placenta. There are the signs of immaturity of the villous tree with circulatory disorders in thrombosis. These changes grew in the following sequence: diffuse non-toxic goiter, hypothyroidism, diffusely toxic goiter. This manifestation scoagulopathies are more common in the placenta of women with diffusely toxic goiter.