The objective: to determine the optimal prophylactic and therapeutic drug to support and restore the biphasic menstrual cycle against the background of the influence of chronic stress. Materials and methods. A comparative study of the effectiveness of the use of preparations of dry extract of common rod (Vitex Agnus castus ) BNO 1095 and various vitamin complexes with a sedative effect, which contain vitamins of group B, magnesium, folic acid, herbal preparations of valerian, pasiflora, was carried out. The hormonal profile and psychoemotional state in women with dyshormonal disorders in modern conditions were studied. Results. The clinical efficacy and feasibility of using the drug Vitex Agnus castus in women with dyshormonal disorders in conditions of psychoemotional disadaptation due to the harmonizing effect on the concentration of female sex hormones, normalizing the ratio of gonadotropic hormones, eliminating the estradiol / progesterone imbalance against the background of a decrease in prolactin level has been proven. Conclusion. The presented results of the study prove the effectiveness of the use of the phytopreparation Vitex Agnus castus in women with dyshormonal disorders under conditions of chronic stress due to its dopaminergic effect on psychoemotional status as a result of elimination of latent stress-induced hyperprolactinemia, comparable to the effect of synthetic inhibitors of prolactin secretion. In addition, the drug Vitex Agnus castus can be prescribed to prevent the occurrence of phase inconsistency in the secretion of gonadotropic hormones due to the activation of stress-limiting systems and local neuroendocrine modulators, which helps to reduce stress stress. Keywords: dyshormonal disorders, chronic stress, maladjustment.

The aim: To determine the degree of correlation of mass of the fetus and the level of mir-21, mir210 in maternal blood and umbilical cord blood of the fetus in uncomplicated gestation. Materials and methods: 60 pregnant women with a single baby pregnancy in the third trimester (37-40 weeks) were examined. They all were given a general clinical, obstetric and the level of miRNA21-3р and miRNA210-3р were determined in the whole blood of pregnant women (before labor) and in fetal blood obtained from the umbilical artery at birth. The level of miRNAs was determined by the TaqMan method. Results: After examining maternal and fetal plasma samples, we were able to determine 49 samples of hsa-miR210-3p and hsa-miR21-3p from maternal plasma, 44 samples of hsa-miR210-3p and 37 samples of hsa-miR21-3p from the cord blood, which is a satisfactory result of more than 50%. Subsequently, between the results obtained and the birth weight of the fetus Pearson’s correlation coefficient was studied. According to the results obtained, we found no correlation between fetal mass and hsa-miR210-3p level in maternal plasma (r-0,068674), low positive correlation of fetal mass with hsa-miR21-3p level in maternal plasma (r-0,212181 ), an average positive correlation with the level of hsa-miR21-3p in umbilical cord blood (r- 0.363374) and a high positive correlation with hsa-miR210-3p in umbilical cord blood (r-0.528616). Conclusions: Determination of the level of hypoxic miRNAs, in particular hsa-miR210-3p in the umbilical cord blood of the newborn may be a marker of the functional status of the placenta, which programs the normal development of the fetus.

The objective: to evaluate the performance of screening coagulation tests in normal pregnancy. Materials and methods. A study of screening coagulation tests was conducted with the participation of 124 patients with normal pregnancy in terms of 12–14, 20–22, 28–30 and 37–40 weeks of gestation. The control group consisted of 82 patients who were at the pregravid stage of pregnancy planning. Coagulation tests were determined on a HELENA 2000 coagulometer. Namely, the activated partial thromboplastin time, the percentage of prothrombin by Quick and fibrinogen were examined. Results. During normal pregnancy, a dynamic, statistically significant increase in plasma fibrinogen level was determined. This indicator during full-term pregnancy differed from that of non-pregnant women by 1.8 times. During all normal pregnancies, there was no statistically significant dynamics of the activated partial thromboplastin time and the percentage of prothrombin by Quick, but there was a tendency towards these indicators increase in coagulation potential with an increase in the gestation term. Conclusion. When assessing a screening coagulation tests, pregnancy term should be taken into account first of all, rather than comparing the obtained values with reference indices for non-pregnant women. Keywords: screening coagulation tests, hemostatic system, fibrinogen level, prothrombin percentage by Quick, activated partial thromboplastin time.

The article presents the experience and initial results of use of the puncture needle of small diameter with karandashami type of sharpening for amniocentesis in the ІІ trimester of pregnancy. The objective: to determine the effectiveness and safety of use ultrafine needle diameter 29G for amniocentesis in the ІІ trimester of pregnancy. Patients and methods. There was performed a prospective observational study of 80 cases of singleton 3 cases of multiple pregnancies in which amniocentesis was performed in the period from August 2013 to August 2016 at the bases of the Department of obstetrics, gynecology and fetal medicine NMAPE named after P. L. Shupyk medical center «Uniclinic». The study group included women aged from 21 to 42 years in the term of pregnancy from 16 to 20 weeks. Exclusion criteria were: the presence of vaginal bleeding less than two days before the procedure, body mass index above 35, receiving the preparations containing heparin, or aspirin for 12 hours before the procedure. All patients received informed consent for the procedure. In addition, each patient before amniocentesis filled a specially designed questionnaire, in which using a numeric rating (1 to 10) was ability to check criteria of general perception of the procedure, in particular the level of excitement about the potential complications and confidence in the correctness of the choice. Group comparison of the perception of the procedure were 100 patients who completed identical questionnaires before the procedure of the amniocentesis needle with a diameter of 20G, which are conducted at clinical sites in the period 2011-2013. Results. All volumes of amniotic fluid contained a sufficient number of fetal cells to determine the karyotype. In 8 fetus were found pathological changes in the number of chromosomes. Women tolerated the procedure well. No cases of complaints are recorded. Patients noted that the information on noninvasive ultra-thin needle, which was provided during pre-consultation also significantly reduce anxiety before surgery. In one case, diagnosed bradycardia of the fetus, which lasted a few minutes and then spontaneously passed. Within 7 days not recorded any complications. Conclusion. Given technique is adequate and safe alternative to amniocentesis with the use of large diameter needles and allows not only to reduce trauma to the amniotic membranes but also to decrease the level of excitement in women before the procedure and to facilitate the adoption of decisions about invasive prenatal diagnostics. Key words: amniocentesis, atraumatic punction needle, safety of invasive prenatal diagnostic.

The objective: to study the state of the platelet link of hemostasis in pregnant women with placental dysfunction. Materials and methods. A clinical and laboratory analysis of 54 patients with placental dysfunction was carried out. The control group included 30 practically healthy women with a physiological course of pregnancy. Venous blood of the patients was collected for testing using vacuum systems in tubes with 3.8% sodium citrate. The functional activity of platelets was studied on a photooptical aggregometer AP2110 (Solar, Belarus), thrombocytogram was performed on a hematological analyzer H18 LIGHT (SFRI SAS, France), thromboelastometric tests were determined on the ROTEM delta system (Tem Innovations GmbH, Germany). Results. Platelet hemostasis has a significant effect on maximum clot firmness (MCF) according to ROTEM results in patients with placental dysfunction. This indicator can be effective in determination of the hyperreactivity of the platelet unit in patients with placental dysfunction. Although no statically significant difference was found in the optical aggregometry indicators induced by ADP and collagen between the patients with placental dysfunction and the control group, a clear tendency to a sharp reduction in the lag-period of collagen-induced platelet aggregation in patients with placental dysfunction should be mentioned. Conclusions. Disorders in the platelet chain of hemostasis can play a significant role in the formation of a thrombophilic state in patients with placental dysfunction, as well as the damage of the endothelium and coagulation changes. The use of a test based on collagen-induced platelet aggregation may be a perspective method for effective diagnosis of platelet hyperreactivity. The study of the platelet link should become an additional element of the laboratory examination in order to resolve the issue of the need to prescribe antiplatelet agents to prevent the development of placental dysfunction.