Chebotarova A. Prediction and prevention of hemostasis disorders in pregnant women with antenatal fetal death

This thesis is devoted to the solution of the urgent issue of prevention of hemostasis disorders in pregnant women with antenatal fetal death (AFD), the development and implementation of a pathogenically based complex of treatment and prevention measures. The problem of reproductive health preservation, maternal and fetalnewborn’s losses reduction goes beyond the boundaries of the medical field and acquires national significance, considering the complex demographic situation that has developed in Ukraine. Total coefficient of natural population growth has halved, therefore one of the priority problems of modern health care is the need for procreation. AFD is a universal, integrated response of the female body to a violation of the homeostasis of the pregnant woman and the fetus and their relationship with the environment. Extragenital diseases, which negatively affect the course of pregnancy and childbirth, and are the cause of 12-20% of maternal mortality and 40% of perinatal morbidity and mortality, play a leading role in the disruption of homeostasis in AFD. To date, there are no clear data on the AFD risk predictors as well as the features of the formation and functional state of the fetoplacental complex, depending on disorders in the hemostasis, the immune systems, and infectious factors. At the same time, despite the preservation of the level of medical care for women with AFD, the issue of a differentiated approach to diagnosis, prevention and directed medical correction of obstetric and psycho-emotional complications remains unresolved, which determines the relevance of a comprehensive approach to solving this problem. The purpose of the study: to reduce the frequency of obstetric complications caused by disturbances in the hemostasis system by improvement of the approaches to the management of the preliminary period, childbirth and the postpartum period in women with antenatal death of the fetus.