Деякі аспекти патогенезу венозного тромбоемболізму у вагітних

Nowadays, the issue of adverse influence of extragenital pathology of vascular genesis with the development of systemicdisorders of hemostasis, thrombophilic conditions, and changes in hemodynamics in the fetoplacental complex in pregnantwomen is one of the most topical problems of modern obstetrics.The aim of the study was to reduce obstetric and perinatal complications in pregnant women with varicose veins of thelower extremities.Based on the study of medical records, a retrospective analysis was performed, it was determined that varicose disease ofthe lower extremities in pregnant women is manifested in 32.7%, with an increase of clinical manifestations before the thirdtrimester up to 69.1%. Leading factors include maternal and paternal heredity (OR=6.9), placental dysfunction in previouspregnancies (OR=6.3), endocrine-metabolic disorders (OR=2.5), overweight (OR=4.8), thrombotic conditions (OR=10.8).There were examined 120 women with varicose lower limb disease who were divided into the main group, with the appointmentof elastic compression, a mixture of bioflavonoids, a donor of nitric oxide and therapy aimed at the correction of hemostasiologicalindices, and a comparison group where pregnancy monitoring was performed according to the generally acceptedstandards.On the eve of delivery, the activation of the anticoagulant system and predictors of thrombotic complications, such as hyperfibrinogenemia,decrease of platelet number and impairment oftheir aggregation capacity, decrease of antithrombin III level 1.4-fold and increase 1.7-fold of D-dimers. With the progression of pregnancy, the hormonal parameters changed:hyperfunction in 38.3%, dysfunction in 11.7%, imbalance of estriol and cortisol in 50.0% of observations.The use of therapeutic-prophylactic measures allowed us toreduce the proportion of preterm births 2.2-fold; preeclampsia,placental dysfunction and fetal distress – 2.0-fold; fetal growth retardation – 1.8-fold, decrease of post-hypoxic encephalopathy– 2.0-fold. Key words: varicose disease of the lower extremities, placental dysfunction, functional state of the fetoplacental complex, prognosis, treatment.