Siusiuka V. Clinical and pathogenetic aspects of obstetric and perinatal complications in women with regard to psycho-emotional state and their medical and psychological correction.

The thesis deals with decrease of frequency of obstetric and perinatal complications in women with psycho-emotional disorders based on development and introduction of scientific, well-grounded and complex program of medical and psychological correction. In the thesis there was made the complex psycho-emotional state assessment of 512 pregnant women in ІІ and ІІІ trimesters (screening) with determination of individual, psychological properties and emotional, volitional sphere of women, their attitude towards pregnancy, unborn baby and maternity. For the first time there was proposed multi-vector psycho-diagnostic protocol of disqualification of abnormal levels of anxiety during assessment of psycho-emotional state of pregnant women. New additional data as to psycho-reactive aspects of psychoemotional state of women during pregnancy in context of personological determinant was obtained. Based on complex psychological research the functional and motivational aspects of psycho-emotional disorders in women in gestation period in context of anxiety were determined. Complex of techniques for assessment of psychological state of women during pregnancy with regard to psychosomatic component was proposed. New additional data as to special features of pregnancy course, obstetric and perinatal complications of labour of pregnant women with psycho-emotional state disorders during pregnancy is given in this thesis. It was determined that course of pregnancy and labour of women with psycho-emotional disorders stipulated by anxiety are characterized by statistically and significantly (p < 0.05) higher frequency of complications namely threat of premature delivery, hypertension disorders, abnormalities of labour process and fetus distress which increases frequency of operative labour process and has direct influence on rise of perinatal pathology percentage. Assessment of homeostasis and mechanisms of adaptation with regard to psycho- emotional state permitted to determine the main pathogenetic disorders of pregnant women. During assessment of vegetative balance of pregnant women with regard to state anxiety level there was determined the depression of parasympathetic regulation which promotes increase of sympathetic influence on the heart rate. Thus indices, depending on influence of parasympathetic branch of regulation, decrease and indices, depending on sympathetic branch of regulation, increase. In the thesis for the first time there were performed complex assessment of stress- realizing and stress-limiting systems (sympathoadrenal system; hypophysial and suprarenal system; hypophysial and thyroid system) as well as assessment of biochemical homeostasis (markers of oxidative stress, GABA-ergic system, system of nitrogen oxide and state of antioxidative system including thiol-disulfide system) of pregnant women with regard of psycho-emotional state.