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The article gives a scientific and practical justification for the timely detection of maternal thrombophilia at the stage of pregnancy planning taking into account the phenotype of a woman. The objective: analysis of the structure of the revealed gene polymorphisms and their effect on the course of the gestational process and the hemostasis system in pregnant women, depending on the phenotype. Patients and methods. A total of 175 women with a threat of miscarriage at the age of 20 to 41 years were selected, who were recruited and further divided into groups: I clinical group (primary) – 120 (68.6%) women with a threat of miscarriage, body weight, II clinical group (comparisons) – 55 (31.4%) of women with normal body weight (BMI 20-24.9 kg/m2) and with symptoms threatening to bear pregnancy, in which an in-depth study of the state of health was conducted. Results. The carriage of thrombophilia genes in women with miscarriage was revealed in 100% of cases regardless of body weight. However, it was found that the polymorphism of the F2 gene: 20210 G> A and 3-5 times more often in the F5-Leiden gene: 1691 G> A with hetero- and homozygous polymorphism, respectively, was found to be 6 times more frequent in women with excess body weight, respectively. testified to the relationship between the presence of excess body weight in women and the mutation of the clotting factor F5-Leiden. These women belong to the group of extremely high risk of thrombohemorrhagic complications during pregnancy. Conclusion. A study on maternal thrombophilia should be conducted at the pre-vaginal stage in order to conduct timely pathogenetically based treatment, with emphasis on treatment in the fertile cycle, which will improve the perinatal outcomes in these women. Key words: phenotype, pregnancy, loss of pregnancy, obesity, thrombophilia, gestational complications, hemostasis system.

Ю. М. Дука Державний заклад «Дніпропетровська медична академія МОЗ України» ОЦІНКА ПРИЧИН АНОМАЛЬНОГО РОЗТАШУВАННЯ ПЛАЦЕНТИ ЗАЛЕЖНО ВІД МАСИ ТІЛА ВАГІТНОЇОЦІНКА ПРИЧИН АНОМАЛЬНОГО РОЗТАШУВАННЯ ПЛАЦЕНТИ ЗАЛЕЖНО ВІД МАСИ ТІЛА ВАГІТНОЇ. У статті роз-глядаються питання залежності формування аномального розташування плаценти з урахуванням виявлених ендокринно-метаболічних порушень, генетичного поліморфізму в генах тромбофілії та фолатного циклу, а також із урахуванням показників гемостазу з додатковою оцінкою впливу значення індексу маси тіла вагітної на формування вищезгаданої патології. Доказана важливість оцінки фенотипу вагітної жінки. Дано наукове та практичне обґрунтування застосування кожного напрямку в терапії в жінок із загрозою невиношування вагітності, їх важливості у профілактиці акушерських ускладнень.ОЦЕНКА ПРИЧИН АНОМАЛЬНОГО РАСПОЛОЖЕНИЯ ПЛАЦЕНТЫ В ЗАВИСИМОСТИ ОТ МАССЫ ТЕЛА БЕРЕМЕН-НОЙ. В статье рассматриваются вопросы зависимости формирования аномального расположения плаценты с учетом выявленных эндокринно-метаболических нарушений, генетического полиморфизма в генах тромбофилии и фолатного цикла, а также с учетом данных гемостазиограммы с дополнительной оценкой влияния индекса массы телы беременной на формирование подобной патологии. Доказана важность оценки фенотипа беременной женщины. Дано научное и прак-тическое обоснование применения каждого направления в терапии у женщин с угрозой невынашивания беременности, их важности в профилактике акушерских осложнений.ASESSMENT OF CAUSES OF ABNORMAL PLACENTA PLACEMENT DEPENDING ON BODY WEIGHT OF PREGNANT WOMAN. The article adduces questions of dependence of formation of an abnormal arrangement of a placenta taking into account the revealed endocrine and metabolic violations, genetic polymorphism in genes of a trombofiliya and a folatny cycle, and also taking into account data of a hemostasiogram with an additional assessment of influence of body mass index of the pregnant woman on formation of similar pathology. Importance of an assessment of a phenotype of the pregnant woman is proved. Scientific and practical justification of application of each direction in therapy in women with threat of miscarriage of pregnancy, their importance in prevention of obstetric complications is given.Ключові слова: фенотип, вагітність, невиношування, тромбофілія, аномальне розташування плаценти.Ключевые слова: фенотип, беременность, невынашивание, тромбофилия, аномальное расположение плаценты.

The article gives a scientific and practical justification for the expansion of the diagnostic algorithm in pregnant women with the threat of miscarriage, taking into account the woman’s phenotype. The objective: was to study the basic patterns of the formation and disruption of the reproductive system in pregnant women with overweight and obesity and to evaluate possible criteria for the formation of endocrine and metabolic disorders for the timely diagnosis and prevention of perinatal complications in pregnant women, depending on their phenotype. Materials and methods. Clinical groups comprised 175 pregnant women of different body weight (120 women with overweight and obesity, who were observed from a small gestation period on the basis of the department of fetal medicine and the pathology of early pregnancy of the communal institution «Dnepropetrovsk Regional Perinatal Center with a hospital» in the city of Dnepr (I clinical group) and 55 pregnant women with normal body weight (II clinical group – comparison group)). Results. The dependence of the detection of menstrual cycle disorders in women with overweight and obesity is 1.5 times more often than in women with normal weight. The course of early gestation was analyzed. The necessity of lipid and carbohydrate profile estimation in these patients is substantiated. Authentic criteria of violations of carbohydrate metabolism are specified. Сonclusion. It is necessary to move from the assessment of the effects of obesity to the «Body Mass Index-Oriented Approach» to the assessment based on the «complicity approach». This will make it possible to individualize therapeutic tactics in pregnant women depending on their phenotype and reduce the incidence of gestational complications and perinatal losses. Key words: phenotype, pregnancy, loss of pregnancy, obesity, phenotype, carbohydrate profile, lipid profile, hormonal characteristics.