Object of the study: a disturbed state of the reproductive system (RS) in pregnant women and gynaeological patients of the adolescent age with extragenital pathology. Purpose of the study: an increase in the level of reproductive health of children and adolescents with obstetric-gynaecological and somatic pathology by working out and using a system of stage-by-stage rehabilitation on the basis of modern technologies of diagnosis and revealing of pathogenetic mechanisms of its for-mation. Methods of the investigation: clinical-laboratory, biochemical, genetic, immunoenzyme, immunomorphological, radiographic, supersonic (including dopplerometric) ones, computed tomogra-phy, magnetic resonance imaging; statistic ones. Theoretical and practical results: it was revealed that the adolescents with extragenital pathology, requiring obstetric-gynaecological aid, should be isolated in high risk groups of de-veloping obstetric and perinatal complications of pregnancy and disturbances in sexual development and menstrual function (MF) in puberty in order to prevent reproductive health disturbances in future. Diagnostic and prognostic algorithms were worked out for adolescents with obstetric-gynaecological pathology with underlying somatic diseases. A complex stage-by-stage system of rehabilitation for female minors during their pregnancy and after childbirth was created; the system includes new combined medical schemes, psychoprophylactic and social work, and contraception. A complex stage-by-stage system was elaborated for the rehabili-tation of adolescent girls with gynaeological pathology, taking into account peculiarities in its character and the state of the somatic health, with inclusion of new techniques of multicomponent medicinal and physiotherapeutic treatment in the conditions of sanatoria and health resorts and outside them. A higher efficacy in the activity of treatment of adolescent female patients, when using the author’s techniques versus the traditional ones, was proved. The standard three-stage medical aid to adolescent girls was optimized through the perfection of its stage-by-stage giving with introduction of the fourth (rehabilitative) stage of the specialized obstetric-gynaecological service of paediatric and adolescent gyaecology. Introduction of the results to health practice makes it possible to improve the system of dispensary medical examination for young pregnant women and gynaecological patients with extragenital pathology, to increase qualitative management of young women from the early terms of their pregnancy, to prevent development of severe complications of pregnancy and labour, to increase the clinical efficacy of the therapy for gynaecological disorders in adolescent girls, to improve the state of their somatic and gynaecological health. Novelty: new data were received about the rate and structure of extragenital pathology, peculiarities in the course of pregnancy and childbirth, gynaecological diseases, and about pathogenetical mechanisms of disorders in the state of foetoplacental andneuroendocrine relations depending upon their character in pregnant minors and adolescents with gynaecological disorders. A pathological effect, produced by extragenital diseases on the formation of the female sexual system in the puberty, as well as a significant increase of the risk of obstetrical and perinatal complications in the presence of pregnancy were proved. New data were obtained about significant disruptions in the functioning of the foetoplacental complex (FPC) in pregnant minors and of the hypothalamus-hypophysis-adrenal-ovary system in adolescents having pathology of sexual development and MF. It was found out that a significant part in the pathogenetical mechanisms of their formation was played by hormonal insufficiency, caused by disorders at different levels of RS. For the first time, the part of leptin in pubertatogenesis pathology in adolescent girls was shown. It was proved that the content of leptin depended upon the character and depth of gynaecological disorders and hormonal imbalance,rather than the age, as it is in healthy girls. MF was in full measure connected with the content of leptin and its relationships with the body mass, estrogens and gonadotropins, this fact being an important link in the pathogenesis of pubertal pathology. For the first time, on the basis of modern colour doppler charting, a complex dopplerometric characteristic of haemodynamic disorders in FPC during pregnancy and of the sexual system in gynaecological diseases depending upon the peculiarities in their course and the extragenital background in puberty was given. For the first time, as a result of revealing the most significant clinical-anamnestic signs, algorithms of differential diagnosis of pubertal pathology and systemic prognosis for developing complications in pregnancy and childbirth in minors with regard for peculiarities in the somatic background were suggested. Ways for decreasing the rate of ob-stetric and perinatal complications owing to stage-by-stage reha-bilitation, therewith ensuring optimization in the management of pregnancy and childbirth. A technique of using the stage-by-stage multicomponent rehabilitation for young pregnant women and gy-naecological patients of the adolescent age with somatic diseases was worked out, scientifically substantiated and approbated (with an assessment of its clinical-laboratory efficacy); the therapeutic schemes included new methods of pathogenetic medicamental and physiotherapy under the conditions of sanatoria and health resorts and outside them. Degree of introduction: practical recommendations, established on the basis of the conducted research, were introduced into the work of the Kharkiv Regional Centre of Obstetrics, Gynaecology and Sexual Education of Children and Adolescents on the basis of the Regional Children’s Hospital, maternity homes Nos 1 & 5, Regional Children’s Hospital No. 1, rooms of paediatric and ado-lescent gynaecology of the Kharkiv Region, Okhmadit Ukrainian Children’s Specialized Hospital of the Ministry of Health of Ukraine, the Institute of Urology of the Ministry of Health of Ukraine, Donetsk Regional Centre of Protection of Motherhood and Childhood, Dniepropetrovsk Regional Children’s Hospital, Pobeda sanatorium (Yevpatoriya). Sphere of application: medical ones, obstetrics and gynaecology
