The dissertation is devoted to reducing the frequency of obstetric and perinatal complications of pregnant women with threatened abortion (ThrA) in the first and second trimesters, who have the status of internally displaced persons (IDPs), by developing and implementing a scientific, well-grounded and complex program of medical and psychological diagnosis, treatment and prevention. A dynamic prospective comprehensive examination of 343 pregnant women in the first and second trimesters of pregnancy who were hospitalized regarding ThrA, as well as outpatient care in hospitals in Luhansk region in 2015-2017 was conducted.
At the first stage, a comprehensive examination of 87 women with IDP status (group I) was conducted, and women without IDP status formed group II (192 persons). The control group (group III) consisted of 64 pregnant women with non-complicated obstetric anamnesis and physiological course of pregnancy with similar gestational period of pregnancy and place of residence. At the second stage, the effectiveness of 2 treatment strategies was evaluated – in accordance with the generally accepted recommendations set out in the current regulations of the Ministry of Health of Ukraine, and the proposed improved treatment and prevention system. At the third stage, a comprehensive program of medical and psychological diagnosis, treatment and prevention to prevent obstetric and perinatal complications in IDPs pregnant with ThrA in the I and II trimesters was implemented and evaluated the effectiveness.
The psychoemotional state, hormonal homeostasis, micronutrient status, features of the microbiocenosis of the reproductive tract, quality of life were determined, the role and place of headache represented by tension headache and migraine in the clinical picture and pregnancy were shown. The necessity of determining the psycho-emotional status is shown, the complex assessment of significance is carried out and the character and density of interrelations between clinical-obstetric, laboratory-instrumental and psychometric characteristics are established. Understanding of the relationship between psycho-emotional characteristics and hormonal status, micronutrient status in IDPs pregnant was deepened. Scientific data on the formation of risk groups for miscarriage in IDPs women in comparison with the clinical course of pregnancy, psycho-emotional state, hormonal and micronutrient profile, the state of the microbiocenosis of the reproductive tract have been supplemented.
The use of the algorithm for diagnosis, treatment and prevention of obstetric and perinatal complications in IDPs pregnant with ThrA in the I and II trimesters, taking into account the identified features of the pathogenesis was justified.
