Olshevska O. Preeclampsia in pregnant women with chronic pyelonephritis (pathogenesis, treatment and prevention o f complications).

The thesis is devoted to the problems of decreasing of the frequency of obstetrical complications at preeclampsia in pregnant women with chronic pyelonephritis by working out of therapeutic preventive measures due to investigations of peculiarities of preeclampsia pathogenesis at with chronic pyelonephritis. The state of the mother-placenta-fetus system due to the hormonal profile and pathogenic data of uteroplacental-fetal blood flow worsening are determined. Pathogenic role of steroid and thyroid hormone disbalance in pregnant women in vascular disregulation and haemodynamics worsening in the mother-placenta-fetus system, in kidney functioning disorder and in the preeclampsia development at chronic pyelonephritis is revealed. Peculiarities of mineral metabolism are investigated. Pathogenic data of subclinical hypoparathyreosis in the preeclampsia development at chronic pyelonephritis are determined. Microbiocenosis of kidneys and vaginal biocurrent is studied, gram-negative microflora in a form of disbiosis is revealed as etiological marker of preeclampsia. It is stated that parturient women have insufficient endocrine system possibilities. The state of fetoplacental comlex, thyroid state and pituitary adrenal system of fetus according the parameters of cord blood are evaluated. Disorders of endocrine status in parturient woman are determined. Relying on the determined pathogenic preeclampsia indices, therapeutic preventive measures for pregnant women with chronic pyelonephritis at preeclampsia and women after delivery are worked out to improve microciculations, endocrine status, mineral metabolism, microecological state. Application of these measures allows decrease the frequency of obstetrical and perinatal complications.