Payenok А. Mechanisms of disturbances of the system mother-placenta-fetus and their correction in women with thyroid disease.

The work is devoted to the pathogenetic substantiation and development of a complex of prognostic, diagnostic, therapeutic and preventive measures at thyreopatia in pregnant women. For the first time in a comprehensive survey of the pregnancy dynamics features of functional state have been shown the nature of changes in thyroid homeostasis, fetoplacental complex, functioning of the system of nitric oxide and their formation at different types of thyroid disease, depending on the degree of their severity. The changes of emotional state, lipid peroxidation, endogenous intoxication, nucleic acid exchange have been established, as well as their role in the development of the obstetric and perinatal complications. For the first time the relation between the level of L-arhinin and frequency of fetal distress between thyreotropin hormone and the placental lactogen have been detected, which testifies to the preservation of ties between the fetoplacental complex and thyroid gland and cardiovascular disorders. Hemodynamic changes in utero-placental-fetal blood flow have been studied according to the nature of thyroid pathology. Criteria for early diagnosis of fetus disorders have been proposed. Based on the results, new methods of forecasting, prevention and complications treatment including adequate pregravidal preparation, correction of iodine deficiency, mental and emotional pattern, normalization of thyroid homeostasis, fetoplacental complex, nitric oxide exchange and dispensary baby check-up have been developed. It is proved that this system of organizational, therapeutic and preventive measures can significantly reduce the frequency of obstetric and perinatal complications in women with thyreopatia.