Dyndar О. Prediction and prevention of perinatal pathology in women with miscarriage on the background of overweight and metabolic syndrome

The thesis is devoted to the problem of optimization of diagnosis, prevention and treatment of obstetric and perinatal complications in women with miscarriage in anamnesis against the background of overweight, obesity and metabolic syndrome by identifying new pathogenesis aspects of placental dysfunction and homeostasis during pregnancy. Effect on overweight, obesity and frequency of metabolic syndrome components were studied systematically, together with the influence of carbohydrate’s and lipid’s metabolism indexes, analyses of pituitary-thyroid functional activity and glucocorticoid systems and hormonal homeostasis on the reproductive health of women with miscarriage in anamnesis. On the background of application of mathematical and statistic methods, the program of prognostication of obstetric and perinatal complication in women due to the body mass index value and frequency of metabolic syndrome components was developed. The features of changes in the lipid and carbohydrate metabolism, the hemostasis system state, the systemic immune system, the severity of endothelial dysfunction, production of components of the renin-angiotensin-aldosterone system, the functional state of the fetoplacental complex, placentation and vasculogenesis, the lactation state in pregnant women with miscarriage in anamnesis were determined due to the body mass index value, frequency of metabolic syndrome and performed medical-preventive activities. The necessity for implementation of algorithm of differential stage system management of women with miscarriage of pregnancy in anamnesis against the background of overweight, obesity and metabolic syndrome counting modern methods of hemostasis condition diagnostics and application of pathogenetically reasonable methods of correction was proved and scientifically objectivated, and this allowed to decrease the frequency of obstetric and perinatal complications.