3. Object of the study: Physiological and pathological course of pregnancy. Purpose of the study: Prognosis and prevention of obstetric pathology based on optimization of follow-up with differentiated approach to pregnancy management depending on HLA-phenotype and the state of neuroimmunoendo-crine system "mother-placenta-fetus", peculiarities of their interaction with the morphofunctional fetus development and perinatal morbidity and mortality. Methods of the study: Clinical, anthropometry, immuno-logical, immunoenzyme methods, polymerize chain reaction, ultrasound study, Doppler study, cardiotocography, histological and statistical methods. Practical significance: Interrelation between definite A, B, DR alleles of locuses of HLA-system and development of obstetric pathology allows to form the respective risk groups at a pre-gestation stage, which provides timely administration of the complex of diagnostic and therapeutic measures aimed at reduction of incidence of obstetric complications. Compatibility of the spouses in one or several A, B, DR alleles of locuses of HLA-system is associated with a high risk of obstetric pathology, the women form a risk group of pregnancy complication and perinatal pathology. Basing on complex examination of the state of neuroimmunoendo-crine system we established prognostic markers of the most frequent obstetric pathology, which allows predicting the risk of miscarriage, late gestosis, anemia, chronic fetoplacental insufficiency, mtrauterine growth retardation in the 1st trimester. A staged algorithm of prognosis characterized by summary of genetic and neu-roimmunoendocrine risks improves the existing methods of follow-up and provides reduction in perinatal and maternal morbidity and mortality. Novelty of the obtained results: For the first time, diagnostic criteria and algorithms of prognosis of obstetric pathology based on staged determining genetic and neuroimmunoendocrine risk factors were worked out. Complex assessment of the role of association of A, B, DR alleles of locuses of HLA-system and the changes in the neuroimmunoendocrine regulation of homeostasis in the system "mother-placenta-fetus" during physiological and pathological pregnancy was done. It was proved that separate alleles of locuses HLA-A, HLA-B, HLA-DR were associated with the incidence of pregnancy complications. Every locus was a separate marker of obstetric pathology risk. Disturbances of neuroimmunoendocrine associations in pregnant are realized in the 1st trimester as deadap-tation of the organism to the pregnancy (changes on the immune reactivity and tolerance to HLA-A, HLA-B, HLA-DR trophoblast antigens, dysregulation of the system hypothalamus-hypophysis-adrenal glands and insulin secretion, formation of primary placen-tal insufficiency. Introduction: The findings of the research were introduced into the work of maternity hospitals No. 3, 4, 5, 9 (Zaporozhye), No. 1 (Odessa), Donetsk regional center for protection of maternity and childhood, Sumy regional center for obstetrics, gynecology, repro-ductology, Regional clinical hospital (Lugansk), City hospital No. 5 (Krivoy Rog). The finding of the research are also used in the teaching process at department of obstetrics, gynecology and re-productology of Zaporozhie State Medical University, department of obstetrics and gynecology of Zaporozhie medical academy for post-graduate training, department of obstetrics, gynecology and perinatology of faculty for post-graduate training of Donetsk State Medical University, department of obstetrics and gynecology of Lugansk state Medical University, department of obstetrics and gynecology of Sumy State University. Sphere of application: medicine, obstetrics and gynecology.
