Vygivska L. Perinatal infections in high-risk pregnant (diagnosis, prevention and treatment).

The dissertation deals with the issue of determining new pathogenically grounded approaches to the diagnosis, prevention and treatment of perinatal infections and predicting the likelihood of intrauterine infection in high-risk pregnant. The study showed impairment of cell-mediated mechanisms of immunological regulation in intrauterine infection, depending on its implementation in high-risk pregnant and etiology of perinatally significant infectious agents. The influence of perinatal infections on the main indices of protein, lipid and mineral metabolism, manifested in the development of gamma globulinemia, hyperlipidemia, and multiple micronutrients deficiency, was determined. An increase in the expression of proapoptogenic factors (sFASL, TNF-?, caspase-3) was shown to develop secondary to a decrease in the level of angiogenesis activator (VEGF), which leads to the development of placental dysfunction. Discriminatory level of MMP-2 enzyme, at which intrauterine infection is implemented depending on the etiologic factor, were established. In order to reveal the interrelation between the parameters of the blood vessel spectra of the fetoplacental system, the functional state of the fetus, and the prognosis of perinatal outcomes, a modified placental index was proposed. Mathematical models of predicting the risk of intrauterine infection of various etiologies were elaborated. The schemes of etiotropic and preventive therapy of perinatal infections in high-risk pregnant women were suggested. The complex of diagnostic and treatment-and-prophylactic measures developed on the basis of the obtained new scientific data showed its high efficiency in correction of homeostasis disturbances in high-risk pregnant women in the form of improvement of perinatal outcomes