Bichevska R. Features of immunopathogenesis and immunocorrection in women with miscarriage on the background of chronic diseases of the hepatobiliary system

The dissertation summarizes the data of a complex clinical-laboratory and instrumental study of 226 patients of reproductive age with miscarriage on the background of chronic diseases of the hepatobiliary system (GBS). The pathogenetic role of disorders of nonspecific resistance and humoral immunity in patients with chronic GBS in the formation of premature termination of pregnancy has been established. Imbalance of cytokines in blood serum and cervical mucus in women with a burdened premorbid background during pregnancy was revealed. Peculiarities of pregnancy in patients with a history of HB on the background of chronic GBS diseases, accompanied by significant disorders of lipid metabolism, activation of lipoperoxidation, reduction of antioxidant potential of blood, including glutathione, the predominance of anti-inflammatory properties of blood. Pre-pregnancy training of patients with a history of reproductive losses revealed a violation of systemic immunity and metabolic homeostasis, especially in the presence of exacerbation of the inflammatory process in the liver. Pathogenetically substantiated the feasibility of treatment with the immunoactive nucleus in combination with antioxidants (glutargine or mexiprim) in the pre-pregnancy period (first stage) and during the first trimester of gestation (second stage) to continue immunocorrection with subalin-forte or forbine or preparations of essential phospholipids. The proposed treatment complex allowed to stabilize the immuno-metabolic status of patients with a burdened premorbid background, which was clinically manifested by a favorable course of pregnancy. Key words: miscarriage, risk of miscarriage, hepatic steatosis, non-alcoholic steatohepatitis, immunopathogenesis, immunocorrection.