Korovay S. The role of integrative systems and endothelial dysfunction in the pathogenesis of preterm birth and ways to prevent them.

The aim of this study was to improve the course and outcome of pregnancy in women at risk of preterm birth by improving the prognosis and application of pathogenetically sound set of preventive and curative measures.It has been established that the central link in the pathogenetic mechanisms of preterm birth is the development of endothelial dysfunction provoked by disorders of integrative systems (neuroendocrine, immune), metabolic processes, including connective tissue, and failure of antioxidant protection, which causes oxidative stress. The complex of interdependent disorders of integrative systems, metabolic processes and endothelial functions is accompanied by a state of psycho-emotional stress in women, depletion of their adaptive mechanisms of pregnancy, affects the central mechanisms of spastic reactions of the uterus, provokes placental insufficiency.A scheme for predicting preterm birth based on a preliminary assessment of clinical and anamnestic parameters, followed by clarification of the probability of the event using a discriminant model (prediction accuracy 95.6%), cervicometry and determination of the ratio sFlt-1 / PlGF (sensitivity 97.7% and specificity of 97.7%). The effectiveness of methods for prevention of premature birth is determined.