Trohimovych O. Early pregnancy losses: pathogenetic aspects, diagnostic and therapeutic measures.

The dissertation is devoted to the study of the pathogenic aspects of reproductive losses, of the principles of early diagnosis and rational approaches to the tactics of complicated pregnancy of early gestation to reduce the frequency of early pregnancy losses by optimizing the methods of diagnostic and differential pathogenetically substantiated treatment. On the basis of complemented studies the existing data on the pathogenesis of complications of pregnancy based on the study of the characteristics of clinical course, microbiocenosis, viral infection, hormonal and immune homeostasis, anatomical and functional, morphological and immunohistochemical features of target organs, genetic factors. As a result of the molecular genetic study of the estimates of the frequency distribution of polymorphic variants of genes ESR1, PGR and MDR1 of Ukrainian population women of threatening miscarriage of early gestation, established the role of genetic determinants in the pathogenesis of complicated pregnancy and early reproductive losses. The presented concept of pathogenic mechanisms of early reproductive losses and established the role of violation of uterine hemodynamics and formation of placental blood flow, as one of the key factors for complications of pregnancy. Based on the results was developed and scientifically based new approach to comprehensive treatment of threatening miscarriage during early gestation, considering etiopathogenetical aspects and proved its effectiveness.