scholarly journals PSYCHOEMOTIONAL CHARACTERISTICS OF PREGNANT WOMEN AS A RESULT OF THE ASSISTED REPRODUCTIVE TECHNOLOGIES APPLICATION

Author(s):  
Antonina Kotenok ◽  
Liliya Vygivska ◽  
Іgor Maidannyk ◽  
Viktor Оleshko

                                  The issue of preserving the reproductive health of the nation in Ukraine is very acute. The psycho-emotional state of a woman is of particular importance for the prolongation of pregnancy and the normal course of labor. Violation of adaptive mechanisms which are aimed at restructuring the functional systems of the body during pregnancy and on the eve of childbirth, as well as the state of chronic stress contribute to the increase in the of obstetric and perinatal complications frequency and have an adverse effect on the course of pregnancy. The aim of the reaserch was to study the dynamics of psycho-emotional state features in pregnant women after assisted reproductive technologies (ART) application in order to improve the tactics of antenatal surveillance. To achieve this goal, 299 pregnant women were comprehensively examined in the dynamics of prospective observation, which were distributed as follows – the main group included 249 women whose pregnancy occurred as a result of the ART application. The control group consisted of 50 pregnant women with spontaneous pregnancy and its physiological course, which were registered for pregnancy at 6-8 weeks. The women of main group whose pregnancy occurred as a result of ART application were divided into three groups, depending on the factor that caused infertility. The first group included 94 women with tubal-peritoneal factor of infertility, the second group was formed by 87 women with endocrine factor of infertility, the third group included 68 women whose infertility was caused by the male factor. Pregnant women of the study groups by age, marital and social status, place of residence were representative, which allowed further to judge the differences caused by etiological factors of infertility. In order to determine the psycho-emotional state of pregnant women in the study groups in the screening mode, a clinical interview was conducted by filling out questionnaires that contained the constituent questions of the STAI tests in the modification of Yu. L. Khanin and the "Pregnant Attitude Test" by the method of I. V. Dobryakov. The obtained test results indicate that the average score of reactive anxiety in pregnant women of the main group exceeded the same indicator of the control group and was: 49 - pregnant women with tubal-peritoneal type of infertility, 56 - pregnant women with endocrine type of infertility, 44 - pregnant women with male factor of infertility, 24 - control group. According to the results of testing, a significant difference was revealed in the indicators of personal anxiety. The values of indicators of personal anxiety were: 51 - pregnant women with tubal-peritoneal type of infertility, 54 - pregnant women with endocrine type of infertility, 31  -pregnant women with male factor of infertility, 31 - control group. Low level of personal anxiety was observed in 26 (27,6%) pregnant women of I group, 29 (33,3%) pregnant women of II group, which is significantly less in comparison with the indicator of pregnant women of the control group – 33 (66,0%) and III group - 33 (48,5%) (p < 0,05). Moderate type of personal anxiety was observed in 46 (48.9%) pregnant women of group and 40 (45.9%) pregnant women of II group compared to the indicator of the control group – 11 (22, 0%) (p < 0,05). Moderate type of personal anxiety was determined in 25 (36,7%) cases in pregnant women of III group and did not differ significantly from the indicators of I, II and control groups (p > 0,05). A high level of personal anxiety was observed in 22 (23,5%) pregnant women of group I, 18 (20,8%) pregnant women of group II, which is significantly higher in comparison with the indicator of pregnant women of the control group – 6 (12,0%) (p < 0,05). Thus, the study of the psycho-emotional state of pregnant women after the application of ART deviations in the level of personal and reactive anxiety and pathological types of gestational dominant, which are inherent in pregnant women of the main group. Taking into account the above, we consider it appropriate to involve a psychologist to work with the examined pregnant women in order to correct the identified abnormalities.

2021 ◽  
Vol 26 (4) ◽  
pp. 131-138
Author(s):  
V.O. Beniuk ◽  
V.G. Ginzburg ◽  
L.M. Vygivska ◽  
I.V. Maidannyk ◽  
O.O. Chorna ◽  
...  

To determine the role and effectiveness of the proposed the­rapeutic and preventive complex in the correction of psychoemotional state in the dynamics of pregnancy in pregnant women after assisted reproductive technologies (ART) application in order to improve the tactics of antenatal obser­vation and prevention of obstetric and perinatal complications. 299 pregnant women were comprehensively examined and a set of therapeutic and preventive measures was carried out: the main group included 249 women whose pregnancy occurred as a result of ART application. The control group consisted of 50 pregnant women with spon­taneous pregnancy. The complex of measures for pregnant women after ART application included: micronized pro­gesterone, magnesium oxide, folic acid, L-arginine aspartate, Omega-3 polyunsaturated fatty acids and long-term psychological correction – before ART program, at 8-10 weeks of pregnancy, at 16-18 weeks of pregnancy and at 28-30 weeks of pregnancy. Introduction of the proposed complex of psychoemotional correction contributed to the formation of reactive anxiety and personal anxiety levels at a moderate level in women of subgroups IA-44 (89.8%) and 43 (87.6%), IIA – 43 (89.6%) and 44 (91.7%) and IIIA – 30 (83.3%) and 26 (72.2%), which is considered to be an adaptive, physiological type during pregnancy. The positive effect of the proposed complex of psychoemotional correction demonstrates the improvement of processes of formation of type of component gestational dominant, its return to the optimal type in women of subgroup IA – 41 (83.6%), IIA – 39 (81.3%) and IIIA – 26 (72.2%) that is close to the physiological course of pregnancy and contributes to the reduction of perinatal and obstetric complications among pregnant women of these subgroups.


2018 ◽  
pp. 118-121
Author(s):  
L.M. Vygivska ◽  
◽  
I.A. Usevych ◽  
I.V. Maidannyk ◽  
V.F. Oleshko ◽  
...  

The article represents the results of a prospective clinical and paraclinical examination of women with a history of infertility, pregnancy in which occurred as a result of the assisted reproductive technologies application. The objective: was to study the dynamics of pregnancy features of the psycho - emotional state and the concentration of stress-associated hormones in the serum of pregnant women after the application of assisted reproductive technologies in order to improve the tactics of antenatal care and prevention of obstetric and perinatal complications. Materials and methods. The main group consisted of 80 pregnant women with endocrine infertility, in which pregnancy occurred as a result of therapeutic cycles of ART, control – 50 first-pregnant women with spontaneous fertilization, taken in an arbitrary order of clinical, statistical and laboratory and instrumental studies. In pregnant women of the study groups, in order to determine the psycho emotional state in the screening mode, a clinical interview was conducted by filling out questionnaires that contained the Spilberger test questions in modification of Y.L. Hanina and «Test of relationof pregnant» by the method of I.V. Dobryakova. In the dynamics of pregnancy, the concentration of prolactin (PRL) and cortisol (K) was determined by the enzyme immunoassay on the Reader-MSR-1000 apparatus using test systems manufactured by Hema-Medicament (Russia). Results. Pregnant women with infertility in past history were characterized by a state of chronic stress. According to the results of the Spielberger test in modification Y .L. Hanina every second pregnant of main group had a high level of reactive and every fourth personal anxiety. Almost 90.0% of pregnant women after art are characterized by the presence of pathological PKGD, among which an alarming and depressive type was registered in every sixth and twelfth pregnant woman, respectively. The obtained data are confirmed by the results of the study of the level of K and PRL. For women with a history of infertility and pregnancy, which is the result of therapeutic cycles of ART, inherent in increasing concentrations of stress-associated hormones – cortisol and prolactin, which is one of the reasons for the complicated course of pregnancy and requires reasonable pathogenetic correction. Conclusion. For women who are pregnant as a result of the use of therapeutic cycles of art characterized by a high level of personal and reactive anxiety and PKGD, which confirm the presence of neuropsychiatric and afferent disorders. Increasing the concentration of stress-associated hormones is one of the causes of complicated pregnancy and requires a reasonable pathogenetic correction. Key words: pregnancy, infertility, assisted reproductive technologies, psychological status, cortisol, prolactin.


Author(s):  
O.M. Perkhulyn

Introduction. Today, the frequency of infertility is increasing worldwide. Infertility, associated with anovulation, is especially challenging for the medical correction especially. The leading aspect of this problem is hormonal disorders in the body of a woman. The aim of this study was to assess the level of estradiol and progesterone in the blood serum of pregnant women with cervical insufficiency and infertility associated with anovulation in the history. Materials and methods. The main group included 30 pregnant women with the II trimester of pregnancy, who had cervical insufficiency and infertility associated with anovulation in the past medical history. They got pregnant after assisted reproductive technologies. The control group included 30 pregnant women without cervical insufficiency and with physiological gestation. Estradiol and progesterone levels in blood serum were determined at 20-22 and 30-32 weeks of gestation. Results. The average age of the women in the basic group was statistically higher relative to the control one – 31.30±1.16 and 27.30±0.92 years, respectively (p=0.02). There was no difference in the number of pregnancies in women between both groups. In the main group, 73.33% of the persons were primagravida, 10.00 % of patients had two pregnancies, and 16.67 % - three pregnancies. 56.67 % of the women in the control group were primagravida, 26.67 % had two pregnancies, 16.66 % - three pregnancies. Although primaparas predominated in both groups, the number of such women was in 1.47 times higher in the main group (93.33 %) than in control (63.33 % of patients; χ2=6.28, p=0.01); 6.67 % and 26.67 % women had two labors respectively and 10.00 % of healthy patients - three labors. The concentration of estradiol at the 20-22 and 30-32 weeks of pregnancy in women of the main group almost corresponded to physiological parameters. However, the progesterone level in women with cervical insufficiency and a history of infertility was by 13.44 % lower than in healthy pregnant women at 20-22 weeks, and by 17.02% at 30-32 weeks (p=0.003). Conclusions. In pregnant women with cervical insufficiency and infertility associated with anovulation, the level of estradiol in the II and III trimesters of gestation mainly corresponds to the level of physiological pregnancy. However, they have the decrease in progesterone concentration in the III trimester of pregnancy relative to healthy pregnant women (p<0.003).


2021 ◽  
Vol 8 (3) ◽  
pp. 149-154
Author(s):  
Tat’yana A. Kamaeva

PURPOSE: improving the efficiency of diagnosis of placental insufficiency using modern diagnostic methods. MATERIALS AND METHODS: The analysis of individual cards, analysis of the gynecological history and somatic morbidity of 426 pregnant women who did not have somatic pathologies and underwent screenings in accordance with the current regulations were performed. The main group of them consisted of 290 women, who showed signs of chronic placental insufficiency at different stages of pregnancy. The control group consisted of 136 women who had no signs of placental insufficiency throughout their pregnancy. RESULTS: It was revealed that the main reasons for the development of chronic placental insufficiency of the main group are preeclampsia (68.4%), the threat of termination of pregnancy (34.7%), burdened obstetric and gynecological history (32.5%), isoserological incompatibility (25.6%), pyelonephritis during pregnancy (14.2%) and anemia of pregnant women (13.2%). It was revealed that visualization of the fetoplacental complex and measurement of peripheral resistance in the umbilical artery during the second trimester of pregnancy are not very informative. To reduce the negative impact of fetoplacental insufficiency and its timely diagnosis, it is necessary to use radiation methods for examining the motherplacentafetus system. CONCLUSIONS: For timely diagnosis of fetoplacental insufficiency and reduction of its negative impact, it is necessary to use radiation methods of studying the mother-placenta-fetus system.


Author(s):  
E. N. Nenashkina

Introduction. The presence of somatic diseases during pregnancy leaves a serious imprint on the emotional state of a woman, significantly worsens the quality life indicators and affects the clinical characteristics of pregnancy. One of these diseases is chronic pyelonephritis. There are a fairly large number of recommendations for the treatment of this pathology. However the focus is mainly on drug therapy. At the same time the existing restrictions on the number of drugs using during pregnancy, the problem of polypragmasia, and the increase in the number of allergic complications of drugs using dictate the need to search alternative methods of treatment, primarily non-drug ones. Moreover, the problems of pregnant women life quality with chronic pyelonephritis during complex drug therapy are often not given due attention.The goal of research — to assess the impact of osteopathic correction on the psycho-emotional state and life quality of pregnant women with concomitant pathology of the urinary system.Materials and methods. A prospective controlled randomized study was conducted in the period 03.2016– 01.2018 on the basis of medical clinics of LLC «Mokhov Institute of osteopathy» and LLC «Vasileostrovskaya clinic of reproduction and genetics». There were observed work 48 pregnant women with chronic pyelonephritis aged 25–45 years, with a gestation period 13–27 weeks. During the processing of the clinical material, 8 patients were eliminated. As a result of the selection process, a group of 40 people was formed. All pregnant women with chronic kidney disease, depending on the used treatment method, were divided into two groups using a simple randomization method with a random number generator. There was formed the main group (20 people), and the control group (20 people). Patients of the main group received medication and osteopathic correction (3 procedures with an interval of 7–10 days). Patients in the control group received only traditional drug therapy. All pregnant women with chronic pyelonephritis had an osteopathic examination before and after treatment with forming an osteopathic conclusion, and the assessment of the pain syndrome severity by a visual analog scale (VAS), the general psycho-emotional state (the method of rapid assessment of health, activity and mood — HAM), and the level of life quality (Questionnaire Medical Outcomes Study — Short Form).Results. Pregnant women with chronic pyelonephritis were characterized by a weak pain syndrome, a psychoemotional state violations in the categories «well-being» and «activity», and a decrease in both the physical and mental components of life quality. After the complex treatment including the additional to traditional drug therapy osteopathic correction methods, the statistically significant decrease of the pain severity degree (p=0,001), increase of psychoemotional state rates in the category of «activity» (p=0,05) and the increase of physical and mental components of life quality (p=0,02) were observed in the main group compared with the control.Conclusion. Chronic pathology of the kidneys during pregnancy affects the emotional state of a woman, significantly worsens life quality indicators. The use of osteopathic correction as a part of the complex therapy of pregnant women with chronic pyelonephritis can improve the emotional state and life quality; reduce the pain severity, and so can be used to improve medical care for this population category. 


2020 ◽  
pp. 52-55
Author(s):  
Babashova Fidan Mahmud kizi ◽  

The objective: peculiarities of pregnancy in women with common worm infestations in Baku. Materials and methods. During the period from 2015 to 2017, 152 women with common worm infestations were examined, in the gestation period from 16 to 40 weeks in the age group from 18 to 38 years. Depending on the nature of the infestation, 2 main groups were formed: the 1st main group included 84 women who had monoinvasia of helminths, and the 2nd main group included 68 women who had mixed helminth infestation. The control group consisted of 42 women who were pregnant without helminthiasis. All women were examined at 16–22, 23–29, 30–36 and 37–40 weeks of pregnancy. Helminthosis diagnostics was performed by detecting helminth eggs in faecal smears, pinworm eggs in scraping from perianal folds, and visual detection of helminth eggs or pinworms in faeces and vomit. Results. Common symptoms of early toxicosis are nausea, hypersalivation, and vomiting. A rare form of morning sickness treat dermatosis pregnant women, pregnant bronchial asthma, tetany, acute yellow atrophy of the liver, osteomalacia. Symptoms of toxicosis were evaluated in 152 pregnant women. The main symptoms of early toxicosis–nausea, hypersalivation and vomiting–were more common in pregnant women with helminthiasis than in women of the control group. In women with helminthiasis, a symptom complex similar to the manifestations of early toxicosis may persist throughout pregnancy, despite ongoing toxicosis therapy. Since persistent nausea and vomiting can be etiologically caused by helminthic-protozoic intoxication, the frequency of nausea and vomiting in different groups in the second and third trimesters was compared. In the second half of pregnancy, women with complaints of nausea and vomiting were present in all study groups, but they were more common in pregnant women with helminthiasis than in women in the control group. Conclusions. The data obtained on the more frequent manifestation of early toxicosis in pregnant women with helminthiasis and its demonstrated resistance throughout pregnancy prove that helminth infestations negatively affect the course of pregnancy. Key words: helminth-protozoal invasion, placental insufficiency, pregnancy.


2021 ◽  
Vol 17 (7) ◽  
pp. 562-569
Author(s):  
S.M. Tkach ◽  
T.L. Miliutina

Background. Depressive disorders are quite common in patients with diabetes mellitus (DM). Depression is associated with worsening glycemic control. Attempts to improve it through the use of synthetic antidepressants in complex therapy have had mixed results. The study was aimed to evaluate the prevalence of depressive disorders in patients with diabetes mellitus treated in the endocrinology department and to evaluate the effect of combined herbal medicine Sedariston containing standardized extracts of Hypericum perforatum (100 mg) and Valeriana (50 mg) (Esparma GmbH, Germany) on carbohydrate metabolism and psycho-emotional state of diabetic patients with the anxiety-depressive syndrome. Materials and methods. The study included 122 patients with type 1 and 2 DM, 103 women and 19 men, aged 18 to 75 years. Thirty-three of them with anxiety-depressive syndrome participated in a 3-month study, 16 of which additionally received Sedariston 2 capsules twice a day for 2 months. Prior to, as well as 2 weeks, 1, 2, 3 months from the beginning of the observation, the psycho-emotional state was assessed with a determination of the severity of the depressive syndrome on the PHQ-9, Beck scales, as well as the state of personal and reactive anxiety on the Spielberger-Hanin’s scales. Glycated hemoglobin was determined before and 3 months after the start of monitoring. All patients received insulin therapy and/or hypoglycemic oral medications at constant doses during the observation. Results. Depressive disorders were identified in 80.3 and 67.2 %, respectively, according to the PHQ-9 and Beck scales. Most patients experienced mild and moderate depression. High personal anxiety was found in 66.4 %, high reactive anxiety in 50.8 % of patients. Patients in the Sedariston basic group reported significant improvement in depressive symptomatology with a decrease in PHQ-9 scores from 13.7 ± 1.6 to 9.3 ± 1.4 (p < 0.05) after 1 month of treatment, and on the Beck’s scale from 23.9 ± 1.8 to 18.2 ± 1.9 points (p < 0.05) after 2 months of treatment, in contrast to patients in the control group without Sedariston: 11.9 ± 1.2 and 10.8 ± 1.1 points (p > 0.1) on the PHQ-9 scale and 19.7 ± 1.7 and 18.9 ± 2.3 points (p > 0.1) on the Beck’s scale, respectively. The achieved improvement of the psycho-emotional state of patients after the end of treatment with Sedariston was maintained after 3 months from the beginning of monitoring: 7.1 ± 1.3 points on the PHQ-9 scale and 16.1 ± 2.1 points on the Beck’s scale (p < 0.01). After 2 months of Sedariston therapy in the group of patients with the anxiety-depressive syndrome, unlike the patients of the control group, personal anxiety decreased from 59.5 ± 2.2 to 53.5 ± 1.9 points on the Spielberger-Hanin’s scale (p < 0.05), in patients with high reactive anxiety, after 2 months of treatment significantly decreased its level from 57.4 ± 2.5 to 49.3 ± 2.7 points and remained so until the end of observation. Against the background of the positive dynamics of depressive symptoms in patients receiving Sedariston, a significant decrease in glycated hemoglobin occurred 3 months after the start of therapy: from 9.4 ± 0.5 to 8.1 ± 0.2 % (p < 0.05), unlike the patients of the control group. Conclusions. An anxiety-depressive syndrome is defined in 63.1 % of patients of the diabetology department, with depressive disorders mainly of mild and moderate severity, high personality and reactive anxiety, and 19.7 % of patients experienced a depressive syndrome without disturbance of anxiety, which indicates their diagnosis and conducting appropriate treatment. The combined phytopreparation Sedariston in the complex therapy of patients with diabetes mellitus, against the backdrop of the positive and long-lasting effect on anxiety-depressive symptoms, contributes to the improvement of carbohydrate metabolism, with a decrease of 1.3 % of glycated hemoglobin in 3 months. This indicates that Sedariston may be used not only for the treatment of anxiety-depressive syndrome but also to improve carbohydrate metabolism in patients with DM.


2021 ◽  
pp. 26-31
Author(s):  
V.O. Beniuk ◽  
L.M. Vygivska ◽  
I.V. Maidannyk ◽  
T.V. Kovaliuk ◽  
O.O. Chorna ◽  
...  

Study objective: to determine the role and effectiveness of the proposed therapeutic and preventive complex and psychoemotional correction of hormonal disorders in the pregnancy dynamics after assisted reproductive technologies (ART) to improve the antenatal observation and prevention of obstetric and perinatal complications.Materials and methods. The study included 299 pregnant women: the main group included 249 women whose pregnancy occurred as an ART result; the control group included 50 pregnant women with spontaneous pregnancy. Therapeutic and prophylactic complex for pregnant women after ART included: micronized progesterone, magnesium oxide, folic acid, L-arginine aspartate, ω3-polyunsaturated fatty acids and long-term psychological correction on the eve of the ART program, at 8–10, 16–18 and 28–30 weeks of pregnancy. Results. There was a significant increase in the β-chorionic gonadotropin (β-hCG) level in women of the study groups in the first trimester of pregnancy against the background of the proposed treatment. Mean β-HCG value at 7–8 weeks of gestation in the subgroup IA exceeded the subgroup IB by 37% (p <0.05), in subgroup IIA it exceeded the subgroup IIB by 33% (p <0.05). The mean β-hCG value in subgroups IIIA and IIIB did not have a significant difference in the dynamics of the first trimester compared with the control group and among themselves (p >0.05).Mean progesterone value at 7–8 weeks of gestation in subgroup IA increased by 38% in comparison with pregnant women who received the conventional treatment complex (p <0.05), in subgroup IIA it was 73% higher than in subgroup IIB (p <0.05). There was no significant difference in the progesterone level in subgroups IIIA and IIIB in the dynamics of the first trimester.The average cortisol value at 23–24 weeks of pregnancy in subgroup IA decreased by 42% (p <0.05), in pregnant women with endocrine infertility against the background of the proposed treatment complex it was 62% less than in subgroup IIB (p <0.05). The average cortisol level in women with a male factor of infertility was 63% lower than in subgroup IIIB against the background of the proposed complex (p <0.05).Conclusion. Advanced therapy with micronized progesterone in combination with magnesium saturation, L-arginine aspartate, folic acid, ω-3 polyunsaturated fatty acids, as well as long-term psychoemotional correction is appropriate and effective compared to conventional therapy for pregnant women.


2017 ◽  
pp. 50-53
Author(s):  
I.E. Basiuga ◽  

The objective: to improve the treatment of placental dysfunction in pregnant women with oligohydramnios regarding their psychological condition. Patients and methods. Survey was conducted in 120 pregnant women with oligohydramnios the gestational age of 27-29 weeks (main group) and 30 physiologically healthy pregnant women (control group) on the basis of the city clinical hospital of Ivano-Frankivsk. Results. During the study of psychological features we have not yet determined significant differences in the level of personal anxiety with oligohydramnios as compared with pregnant women with physiological gestation. Also, was found the division of examined for low, medium, and high levels of this indicator between the two pregnant groups. In particular, approximately half of the individuals had an average level of personal anxiety – 14 (46.67±9.11%) and 57 healthy pregnant women (47.50±4.56%) with oligohydramnios, third – highest, respectively 11 (36.67±8.80%) and 39 (32.50±4.58%), the lowest level recorded in 5 (16.67±6.80 per cent) and 24 (20.00±3.65%) patients. A comprehensive approach to correction of the condition of water shortage has been applied in women of the main group, which included: psychological support for couples with sessions with a psychologist to control emotions. Establishing emotional contact with a woman, trust relationships, discussion of physical and emotional changes is a part of pregnancy. Conclusion. In the result of the researches, the approach proposed by us to the treatment of pregnancy with oligohydramnios, allowed to reduce the stress of compensatory mechanisms of the fetoplacental unit, which contributed to the reduction of anxiety in pregnant and have improved not only obstetric but also perinatal outcomes in women of the main group. Key words: pregnancy, placental dysfunction, oligohydramnios, Cytoflavin.


2016 ◽  
pp. 79-81
Author(s):  
A.S. Mandrykova ◽  

The objective: the study of morphofunctional changes of the fetoplacental complex at 28–33 weeks of gestation in women with early preterm delivery after the application of ART. Patients and methods. We have examined 130 patients whose pregnancy occurred after the use of ART. This is the woman who gave birth at 28–33 weeks of gestation. Of these, 80 women had early premature births in the background premature rupture of fetal membranes, 50 – patients with early preterm delivery and timely rupture of fetal membranes (control group 2). The main group included 4 groups of 20 women with regard to the duration of anhydrous interval: 1.1 – anhydrous interval 5–6 hours (main group 1); 1.2 – anhydrous span 24 hours; 1.3 – anhydrous interval 45–48 hours; 1.4 – anhydrous period 5 days after PRFM. Results. Thus, the results of the research indicate that the main cause of early preterm birth in women after using ART are structural dezorhanization changes of collagen fibers of the connective tissue amnion and chorionic which lead to the appearance of microscopic defects – delamination its surface, causing premature rupture of fetal membranes the launch stage localized focal immediate type hypersensitivity reactions and restructuring epithelial cell membranes. Neutrophil macrophage properties in this case reduced and programmed to perform a cycle of incomplete phagocytosis, which increases the synthesis of inflammatory cytokines in the area of rupture of fetal membranes. Сonclusion. Reduced activity of neutrophils increases the effect of abuse and cytokine balance in favor predictor of early spontaneous labor at 28-33 weeks of gestation. Key words: morphological changes of the fetoplacental complex, early preterm birth, expectant tactics of childbirth.


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