Badziuk N. Postpartum complications prevention and reproductive health recovery in women with long intergenic intervals.

Based on the studies, the state of health, obstetric and gynecological history, features of the course of pregnancy, childbirth, the postpartum period and the condition of newborns in women with a long intergenetic interval were studied. As a control, age-old primiparous and women with the optimal intergenetic interval were examined. In addition, the state of internal organs, thyroid gland, and mammary glands was determined using ultrasound. The frequency of precancerous pathologies of the cervix uteri was determined. An assessment of the bacterial load and local immunity of the birth canal, cytological data, histological and immunohistochemical characteristics of the placenta was made. The thesis contains a new approach to solving the urgent task of modern obstetrics - reducing the frequency of complications of the postpartum period and improving the quality of reproductive health restoration in women with a long intergenetic interval by developing an algorithm for therapeutic and preventive measures. As a result of the studies, it was found that 65% of women with a large intergenetic interval had a burdened gynecological history, complicated pregnancy: threatening abortion in the first trimester - 51.8%; early gestosis - 25.9%; the threat of premature birth - 57.6%; preeclampsia - 27%. In childbirth there was an anomaly of labor activity - 14.5%; premature discharge of amniotic fluid 20.3%; fetal distress - 11.6%. The frequency of complications in the postpartum period in women with a large intergenetic interval was 24.7%. A study of the psychoemotional state of women with a large intergenetic interval showed its violation in the vast majority of women: the stress resistance index was low in 60% of women; high level of anxiety at 69.4%. Studies have shown that the mechanisms of immunological resistance of the mucous membranes of the cervical canal are inhibited on the eve of childbirth. Among pregnant women with a large intergenetic interval, 54% of women had manifestations of various forms of mastopathy, 22.5% of precancerous pathologies of the cervix uteri. An analysis of the vaginal biocenosis in the examined women with a large intergenetic interval indicates that microorganisms were detected in 93.3% of women, and in 90% of them there were two and three species. In the postpartum period, in women with a large intergenetic interval, certain complications of uterine involution were revealed: a delay in the formation of an angle between the neck and body; bloody clots in the uterine cavity were significantly more common; cases of placental residues. Studies conducted during the year after childbirth showed that women with a long intergenetic interval have: short lactation, menstrual dysfunction, bacterial load and a high frequency of cervical pathology, and unreliable methods of contraception are used. The proposed complex of treatment and prophylactic measures, taking into account the results obtained, made it possible to obtain an adequate correction of the revealed violations and the informed use of more modern methods of contraception.