The vaginal microbiota is a primary non-specific barrier that protects against various bacterial, viral and fungal pathogens. A normal microflora of the female genital tract is represented by aerobes, facultative and strict anaerobes. Bacteria of the genus Lactobacillus spp. dominate the majority of women of reproductive age. They have high protective properties against other microorganisms. Lactobacillus spp. prevent an excessive reproduction of opportunistic and pathogenic microorganisms in the vaginal biotope due to the synthesis of short-chain acids that maintain the pH value in the normal range. As a rule, one or two species of Lactobacillus spp. dominate in the vaginal biotope, which are responsible for ensuring homeostasis of the vaginal microflora. At the same time, various Lactobacillus spp. differ in their protective properties. L. crispatus is a marker of the stability of the vaginal microflora. With the dominance of this type of lactobacillus, the authors of the studies observed a low risk of bacterial vaginosis, aerobic vaginitis, and unwanted obstetric complications during pregnancy and in assisted reproductive technology protocols, as well as a reduced risk of infection with sexually transmitted infections and human papillomavirus. L. gasseri and L. iners were more often detected in women with intermediate microflora or with dysbiosis. L. iners, unlike L. crispatus, has reduced protective properties and is widespread in dysbiotic conditions of the vaginal microflora. The detection of L. iners can serve as a prognostic sign of the development of pathological conditions of the vaginal microflora.

Introduction. Primary hypothyroidism is observed in women of reproductive age in 2–3 % of cases. The most common thyroid pathology during pregnancy is subclinical hypothyroidism (SHT), which is caused by newly diagnosed autoimmune thyroiditis (AIT) or severe iodine deficiency. In some regions of the Russian Federation, the population has a mild iodine deficiency, the average concentration of iodine in the urine being found at 78 µg/L (the normal range is 100–200 µg/L). In women with primary hypothyroidism, complications of pregnancy and childbirth include: premature birth, weakness of labor, eclampsia, premature rupture of premature rupture of membranes (PROM), gestational diabetes mellitus (GDM), intrauterine growth retardation syndrome, fetal macrosomia, congenital hypothyroidism in the fetus, etc.Aim: to study the features of pregnancy and childbirth course in women with primary hypothyroidism.Materials and Methods. In a retrospective study, there were analyzed 62 birth histories, of which 37 were for patients with thyroid diseases. Two groups were formed: the main group – 25 patients with primary hypothyroidism, the comparison group – 25 patients without thyroid pathology. During the study, the next parameters were analyzed: age, number of pregnancies, number of births, term of delivery, body mass index, level of thyroid stimulating hormone (TSH), titer of thyroid peroxidase antibodies, newborn body weight, newborn assessment according to Apgar scale.Results. In the main group, the cause of primary hypothyroidism was as follows: newly diagnosed SHT – in 18 (48.6 %), AIT – in 7 (18.9 %) pregnant women. In the first trimester of pregnancy, TSH level in patients with hypothyroidism was 3.06 ± 0.36 mU/L. The following complications of pregnancy and childbirth course were identified: GDM (32.0 %), anemia of the first degree (12.0 %), large fetus (12.0 %), PROM (12.0 %), perineal rupture of the first degree (16.0 %), anomalies of labor activity with ineffective labor stimulation (8.0 %), pelvic-head disproportion (8.0 %).Conclusion. Timely diagnosis and compensation of hypothyroidism with hormone replacement therapy and iodine preparations, prediction of possible complications and correction of identified complications are the main ways to achieve a successful outcome of pregnancy and childbirth for mother and fetus.

Pregnancy is a period of increased demands on all organs and systems of the mother’s body, including the thyroid gland (TG). The productivity of the thyroid gland increases by 30–50%. For continuous and sufficient synthesis of thyroid hormones (TG) requires optimal intake of dietary iodine. The need for a microelement increases significantly during pregnancy, due to increased activity of the thyroid gland. Iodine deficiency of mild or moderate degrees leads to insufficient synthesis of thyroid hormones, despite its compensatory increase. Hypothyroidism in women is one of the causes of infertility. Hypothyroidism in pregnant women significantly increases the risk of preterm birth. Iodine deficiency has a serious impact on the intrauterine development of the fetus, because iodine and thyroid hormones (TG) are actively involved in the development of the fetus, the formation of various organs and the development of the brain. In order to prevent the dangerous consequences of iodine deficiency in the Russian Federation, mass prevention is carried out in the form of the use of iodized salt. During the 1st trimester of pregnancy, each woman undergoes a laboratory test of the level of TSH, total T4 and total T3 as a screening in order to correct the hypofunction of the thyroid gland in  time. In pregnant women, especially in  the first trimester, iodine requirements increase by 50%, which requires not only the mandatory use of iodized salt, but also the appointment of pharmacological preparations of iodine with an accurate dosage. Preventive measures may not be enough, then replacement therapy with levothyroxine is used throughout the pregnancy.

The paper presents the results of the retrospective analysis of data cards and histories of 953 women with an antenatal fetal death during 2010-2016 in the Crimea Republic. The aim of the research was to study the data of parity, gynecological and somatic history, features of pregnancy and childbirth in women with antenatal fetal death to identify significant risk factors for this pathology. According to the results of our study, women with antenatal losses did not reveal significant clinical and anamnestic risk factors for adverse perinatal outcomes. This once again confirms the lack of reliable methods for predicting antenatal fetal death in modern practical obstetrics. In spite of the significant progress made in the emergency protection of the child, the stillbirth is an important, insufficiently studied problem in the obstetrics. The high frequency of cases of antenatal fetal death with an unexplained cause requires further in-depth analysis and study of this problem, searching for the possibility of expanding the diagnostic potential of the methods used.