Dissertation work is devoted to the decline of frequency of placenta
disfunction and perinatal pathology for women with the different forms of
retrochorial haematomas on the basis of study clinical-and-instrumental and
laboratory researches, and also improvement of algorithm of diagnostic and
treatment-and-prophylactic measures. For the decision of the put purpose the
followings tasks were certain: to define the leading factors of risk of recurrent
retrochorial haematomas; to set the terms of development, location and sizes of
different forms of retrochorial haematomas; to estimate the results of biochemical
prenatal screening at the different forms of retrochorial haematomas and their
correlation with the obstetric and perinatal consequences of delivery; to rotin
frequency and features of placenta disfunction and delay of development of fetus
at the different forms of retrochorial haematomas; to perfect and estimate efficiency
of algorithm of diagnostic and treatment-and-prophylactic measures for women
with the different forms of retrochorial haematomas. A research object is placenta
disfunction, perinatal pathology. The article of research is motion of pregnancy and
births at the different forms of retrochorial haematomas. Research methods –
clinical, echographic, cardiotocographic, doppler, morphological and statistical.
Set women have new aspects of pathogeny of placenta disfunction and perinatal
pathology with the different forms of retrochorial haematomas, which consist in
the decline of level of human chorionic gonadotropin; plasma albumen A
associated with pregnancy; unconjugated estriol and alpha-fetoprotein in I and
II trimesters, that correlates with a clinic the threats of breaking, premature births,
placenta disfunction, delay of development of fetus and unfavorable perinatal
consequences. It is rotined that at recurrent the early beginning (to 32 weeks) of
placenta disfunction prevails a retrochorial haematoma with the high level of delay
of development of fetus of II-III of degree, and also violation of circulation of
blood both in an uterine artery and in combination with a blood stream in the
umbilical cord of fetus. The substantial role of indexes to hemostasis (level
of homocysteine and D-dimer) is presented in clinical motion of pregnancy and
perinatal consequences of delivery of women with a reccurent retrochoorial
haematoma. Findings allowed scientifically to ground the necessity of improvement
of algorithm of diagnostic and treatment-and-prophylactic measures for women
with the different forms of retrochorial haematomas on the basis of the use of the
directed medicinal correction. It is studied clinical-and-anamnestic features for
women with the different forms of retrochorial haematomas and the leading factors
of risk are set. Influence of different forms of retrochorial is rotined haematomas
on clinical motion of pregnancy, births and perinatal consequences of delivery. The
most informing markers are presented system to hemostasis and endocrine status
with the purpose of control after efficiency of treatment-and-prophylactic measures
in the different trimesters of pregnancy. The algorithm of diagnostic and treatmentand-prophylactic measures is improved and inculcated for women with the
different forms of retrochorial haematomas in relation to the decline of frequency
of placenta disfunction and perinatal pathology. Planning and leadthrough of all
researches is executed for period from 2018 to 2022 It is conducted an author
clinical-and-laboratory and functional inspection 140 women of genesial age, from
what 110 were with the different forms of retrochorial haematomas, which got
different diagnostic and treatment-and-prophylactic measures. 30 expectant mothers
made a control group. Independently done fence and preparation of biological
material. An author all sections of dissertation, formulated conclusions, are written
with, the algorithm of treatment-and-prophylactic measures is improved. An author
is execute statistical treatment of the got results. Materials of candidate for
a degree in scientific labours, published independently, and also in that part of acts
of introduction, which touch a scientifical and practical novelty.
The results of the conducted researches testify that by the leading factors of
risk of recurrent retrochorial haematomas gynaecological anamnesis is burdened
(63.3%); motion of previous pregnancies is complicated (60.0%); genesial losses
are in anamnesis (53.3%); scar on an uterus (30.0%) and auxiliary genesial
technologies (30.0%). Terms of development of primary retrochorial haematoma
there are to 8 weeks (68.0%) and from 8 to 13 – 32.0%; reccurent – 51.7% and
48.3% accordingly. Supracervical a primary retrochorial haematoma is located
in 68.0% cases, and recurrent – in 51.7%. Frequency of exposure of presrntation of
chorion/placenta is 23.3% and 26.0% resppectively.
