Duka Y. Pathogenetic justification of diagnostics, medical tactics and prevention of emergence of system violations at pregnant women with excess body weight.

The thesis is devoted to questions of diagnostics, treatment and prevention of system violations at pregnant women with the excess body weight and obesity. On the basis of inspection of 175 pregnant women with various body weight (120 women with the excess body weight and obesity, and also 55 pregnant women - with normal body weight) mechanisms of development of obstetric complications depending on body weight are specified. The main genotypes aggressors of development of gestational complications and perinatal losses are defined. Importance of inspection on a maternal trombofiliya before pregnancy approach is proved. It promotes improvement of perinatal outcomes at women with the excess body weight and obesity. The diagnostic algorithm which allows to improve early diagnostics of formation of endocrine and metabolic violations at pregnant women with the excess body weight and obesity is offered. The complex program of prevention and treatment of gestational complications taking into account genetic determinancy and a phenotype of the pregnant woman is developed. Comparison of a course of pregnancy, childbirth, the postnatal and early neonatal period was carried out in comparison of similar parameters at 115 pregnant women with the excess body weight and obesity of retrospective group which were conducted according to the existing obstetric protocols. The carried-out comparative analysis proved efficiency of the developed individual approach to conducting pregnancy and childbirth at women taking into account their body weight. Models of forecasting of emergence at pregnant women with the excess body weight and obesity of threat of not incubation of pregnancy, developing of hematomas behind a horion during a gestation are created and are mathematically proved. Introduction of the developed program allowed to increase efficiency of treatment of threat of interruption of pregnancy for 73,4%, to improve perinatal outcomes for 54,3%.