Kalinovska I. Placental insufficiency: pathogenesis, early detection, a policy of pregnancy and labor management.

The peculiarities of the functional condition have been demonstrated and the character of the compensatory mechanisms of the mother-fetus complex in case of placental insufficiency has been determined on the basis of a complex study in the dynamics of pregnancy development. The pathogenetic specific characteristics of the formation of placental insufficiency have been determined in gravidas of a high risk of perinatal pathology. 336 expectant mothers with the manifestations of placental insufficiency underwent a complex examination during different gestational periods. Echographic changes of an embryo/fetus and the specific features of the uterine - placental and fetoplacental circulation have been studied by means of ultrasonography. The role of prognostically unfavourable criteria of ultrasonography in the pathogenesis of the development of placental insufficiency was evaluated in the first trimester of pregnancy for the first time and that become a theoretical precondition for an elaboration of newapproaches to an early detection and treatment of this complication of pregnancy. An algorithm of an early recognition of complications of the first trimester of pregnancy in women of the risk group, a differential approach to therapy, depending on the results of an echographic, Doppler ultrasonographic and laboratory examinations during early terms of pregnancy, algorithm of gravidas' management and treatment have been elaborated.