Dudchenko L. Prevention of perinatal disorders of tobacco smoking in pregnant women

The work is devoted to the systematic analysis and comprehensive study of pregnant women with tobacco smoking who are at high risk of increasing the incidence of perinatal complications. It is established that the risk factors for the development of perinatal complications in pregnant women with tobacco smoking are psychological features of women's behavior, such as increased anxiety and reduced resistance to stress; changes in the hormonal function of the placenta: decrease in levels of Pg and Pl, increase in the level of E, misbalance of the ratio of Pg / E and hemodynamics of uterine-placental blood flow (increase of resistance in the arteries of the umbilical cord). It is also proved that the development of perinatal complications in pregnant women with tobacco smoking is facilitated by the following factors: persistence of pathogenic and conditionally pathogenic microorganisms of the oral cavity and contamination of the birth pathways by pathogenic microflora, which reaches a high level against the background of immunodeficiency state by cell type: inhibition of T-cell activity, decreased IgG synthesis, increased IgM and IgA levels, and the synthesis of pro-inflammatory cytokines. The standard of perinatal support for pregnant women who smoke tobacco during pregnancy consists of a comprehensive clinical examination, psychological support and correction of prognostic adverse markers of perinatal complications. At 30–32 weeks of pregnancy, ultrasound, doppler and cardiotocography examination of the fetus are performed to assess the condition of the fetus and FPC. The proposed algorithm for complex treatment of pregnant women with tobacco smoking has influenced all the links of development of perinatal complications and has contributed to the reduction of their frequency.