[IMMUNE DISORDERS AND THEIR ROLE IN ABORTION].

Objective of the study - to identify the relationship of immunological parameters and their role in termination of pregnancy. 28 women, with a history of 2 or more miscarriages in their medical history, were examined immediately after the termination of pregnancy up to 12 weeks. The control group consisted of 20 healthy non-pregnant women.

Scoping maternal care through the lens of maternal deaths: A retrospective analysis of maternal mortality in Georgia.

Introduction: Reduction of the maternal mortality ratio (MMR) to 12 per 100,000 live births by 2030 is a priority target in Georgia. This study aims to assess and classify MM in Georgia by direct and indirect causes of death from 2014 to 2017, using data from the national surveillance system and in accordance with internationally approved criteria.

Material And Methods: In this secondary study, MM data was retrieved from the Maternal and Children's Health Coordinating Committee and validated with data from the Vital Registry System and the Georgian Birth Registry.

PHENOTYPIC CHARACTERISTICS OF TROPHOBLASTIC HYPERPLASIA AND MICROENVIRONMENT ALTERATIONS IN CHORIONIC VILLI IN SPONTANEOUS ABORTIONS.

Hydatidiform mole represents the major cause of the molar pregnancy, which is a special cause of spontaneous abortions. We analysed phenotypic characteristics of epithelial hyperplasia and tumor microenvironment alterations in different types of hydatidiform moles. Standard immunohistochemistry was used for the detection of Ki67, Cyclin D1, p53, BCL2, E-cadherin, p63, Vimentin, CD34, CD3, CD4, CD8 and CD68.

PHENOTYPIC CHARACTERISTICS OF CHORIONIC VILLI DURING GESTATIONAL TROPHOBLASTIC DISEASES.

Differential diagnosis of gestational trophoblastic diseases (GTP) using standard micromorphological examination is complicated and less reliable. Therefore, the aim of our study was to investigate the immunohistochemical phenotype of chorionic villi during GTP, as well as in physiological cases. Study included five groups: I group - normal chorionic villi, II group - chorionic villi with hydropic changes, III group - Partial mole, IV group - Complete mole, V group - early Complete mole.

[RISK FACTORS AND SPECIAL ASPECTS FORGENITAL TUBERCULOSIS DIAGNOSTICS].

Was examined 453 women, who applied to National Center for Tuberculosis and Lung Diseases for genital tuberculosis diagnostics. GTB was detected in 289 cases, in 164 cases GTB results was negative (control group). In 10 cases GTB was combined with pulmonary tuberculosis (OR-1,13).

[IDENTIFICATION OF CAUSES OF EARLY PREGNANCY LOSSES ACCORDING TO HYSTOMORPHOLOGIC FEATURES].

Retrospective analysis of the early spontaneous abortions has been conducted (486 cases). Histomorphologic analysis of the curettage material contents erveledinvolutive-regressive developmental chsnges in 108 (22,28%) cases, in 370 cases (77.78%) pathologic changes, like inflammatory changes of deciduas and chorionic villis in 302 cases (80.

CESARIAN SECTION - HIGHER RATE AND HIGHER CHALLENGES.

There is evidence that perinatal morbidity and mortality has not changed - caesarean section rate increased and data remained stable and rate of intro and post operative complications was increased. There is another view of the picture: the right of patient to choose mode of delivery and the reality, that the number of patients with prior caesarian section and number patient and physician prefer caesarean section. The following topics are discussed as well: age of pregnant woman, macrosomia and intrauterine growth restriction, malpresentation, multiple gestation, preeclampsia, BMI, role of assisted reproductive technologies, electronic monitoring of fetal heart rate in labor, induction of labor.

[Benchmarking study of effectiveness of simultaneous and isolated surgeries].

Benchmarking study was conducted on effectiveness of simultaneous and isolated surgeries in practice of obstetrics and gynecology. In terms of the work, data were analyzed on the isolated and simultaneous surgeries with the patients with combined gynecological and surgical pathologies, requiring operative treatment. Man group included 254 patients with combined abnormalities, who underwent simultaneous surgeries; control group included 122 patients who underwent surgical treatment for combined diseases consecutively in two stages, in different times.

[Blood antioxidant enzyme activity during physiological and preeclampsia syndrome complicated pregnancy].

The aim of the study was determination of the role of oxidative metabolism in the pathogenesis of preeclampsia. It is established that in the blood of women during physiological pregnancy, catalase and glutathione reductase (gr) activity does not change significantly, compared with the same parameters in healthy nonpregnant women, superoxiddismutase (SOD) activity slightly increases, which indicates on the intensification of the oxidative processes in late term pregnancy. Intensification of oxidative processes during physiological pregnancy reviles the activation of the regulatory processes in the body directed to the induction placental cells proliferation and differentiation.

The EPR study of nitric oxide in placenta during preeclampsia.

The aim of the study was to establish alteration of nitric oxide (NO) metabolism in placenta and its role in pathogenesis of physiological and complicated with preeclampsia (PE) pregnancy. Fifty women with preeclampsia and 30 control pregnant women were studied. The control group was selected from healthy pregnant women; the preeclamptic group consisted of women who were normotensive before pregnancy and during the first 20 weeks of gestation, and developed hypertension associated with new onset proteinuria.

[Some considerations of immune metabolism at preeclampsia].

The goal of the work is to determine several aspects of abnormalities and a part of immune metabolism in preeclampsia. In peripheral blood serum of all pregnant women at 20th week of gestation relative content of T-lymphocyte subpopulations, active T-lymphocytes and natural killers (NK) were detected by the method of indirect immunofluorescence and in cyto-toxic test using monoclonal antibodies to CD4 and CD84, CD 16 (T-cell markers of HLA-DR antigen of second class of MHC (marker of active T-lymphocytes, "ICN Pharmaceutical", USA). According study results it can be concluded that at preeclampsia a content of NK cells in peripheral blood of pregnant women increases in the end of the second and early in the third trimesters on the background of significant decrease of general CD4 lymphocyte subpopulation.

[Predictive value of some parameters of immune balance in preeclampsia].

The goal of our research was to reveal correlation between pro- and anti-inflammatory cytokines in preeclamptic women. The research was conducted on pregnant women with physiologic pregnancy and with preeclampsia. Parameters of immune system - pro-inflammatory cytokines (IL-2; TNF-α) and anti-inflammatory cytokine (IL-10) were measured in venous blood by ELISA.

[Evaluation of the effectiveness of the modified method of cesarean section operation with the method of ultrasonography research].

On the basis of retrospective analysis of 160 clinical cases, the effectiveness of the modified method of cesarean section operation with the ultrasonography and immunological technique has been evaluated. Clinical-ultrasonography analysis proved that evolution rate after using of traditional method of cesarean section is markedly behind in comparison with the results received in the patients of main group. At the same time, the changes in echo-parameters prevailed the clinical manifestations which allow to carry out preventive measures in proper time and correspondingly to avoid the possible complications.

[Original method of cesarean section operation and its role in the prevention of obstetric complications].

The authors made an analysis of archival material of 1577 case histories of the patients who were subjected to cesarean section operation at Tbilisi Experimental Maternity Hospital and at "The House of Health" during 1999-2000 years. The case histories were divided into two groups: 1474 patients made 1--main group which were subjected to the operation of cesarean section according to modified method offered by Professor A. Koridze, while 103 patients operated according to traditional method accepted at present time made the 11--control group.

[Principles of the immune modulation therapy against papilloma virus infections].

The aim of the study was to investigate the effect of Immudone on local immune responses of cervical mucous in patients with papilloma virus cervicitis. 80 women of reproductive age with chronic cervicitis, 60 women with no signs of infection and 70 bioptates obtained from the base of vaginal section of the cervix. Colposcopic, bacterioscopic, patho-histological and immunohistochemical investigations have been performed.

[The evaluation of bioavailability and pharmacokinetic parameters of a new antimicrobial preparation trichomikocid].

Antimicrobial preparations are not effective enough for the normalisation of vaginal microflora, regeneration of it's mucosal layer and thus there are still conditions Amaintained for recidives or reinfection of the disease. In addition, there is a limited arsenal of combinations of trichomikocidal preparations. It is very important problem of modern medicine and pharmacology to create new drugs, especially of natural origin, to treat urogenital trichomonias and trichomona-fungal infections.

[Efficacy of EEG investigation in clinical diagnostics of high-risk newborns with nervous disturbances].

The aim of the article is to establish the correlation between pregnancy, delivery, newborns clinical diagnosis and the data of neonatal electroencephalography. 1500 full term newborns have been examined, 90 of them have been studied in catamnesis up to 3 months. Obtained data indicate that EEG investigation performed in the first days of life reflects the functional state of central nervous system of the newborn and detects pathological cases, which can later cause different nervous diseases.

[Perinatal results of delayed intrauterine development of fetus].

We have studied the course of early neonatal period in the newborns with delayed intrauterine development syndrome (DIUDS). Clinical neurological and electroencephalographic (EEG) studies of 208 neonates with DIUDS have been performed. Control group consisted of 234 newborns with normal height-weight values.

[Molecular mechanisms of regulation uterine contractile activity during pregnancy and labor in mammals].

Main purpose of the investigation was to study basic mechanisms of regulation uterine contractile activity on various stages of gestation, labor and to determine nature of substances activating, inhibiting and modulating myometrium contractility. The study was carried out on 115 pregnant and not pregnant women, and women in labor, and on 45 newborns. The experiments analyzed hypothalamus and uterus of 100 white rats and brain of 45 newborn rats.

[The expectancy-stress factor in pregnant refugee women].

Our study revealed that refugee status increases the risks and worsens the outcome of pregnancy among Georgian refugees. 125 Georgian refugee women participated in this study. The study included examinations of the psychological status of expecting mothers, clinical development of pregnancy, complications of labor, functional status of the fetus, and EEG and neuro-ultrasound data of newborns.

[Analysis of premature labor and its causes in the Republic of Georgia].

The premature labor is the main index of perinatal morbidity and mortality of mother and newborn. The aim of our trial was, to study the real situation on premature labor in the Republic of Georgia, to determine the specific gravity of stress factors in epidemiology of this problem and to find optimal preventive measures. It is found that in those regions, which are close to military conflict areas, where people are under permanent "expectancy-stress", the rate of premature labor is significantly higher.

[Influence of prenatal and perinatal risk factors on the outcome of pregnancy].

During the recent years a great number of negative social-economical problems (e.g. emotional stresses during the pregnancy, malnutrition, physical labor, etc.

[Pregnancy and iron, ferritin and IL-3 in the blood].

In Georgia, we were first who tried to study adolescent pregnant women with anemia (age group 14-18ys). We studied the reasons which have caused anemia in the pregnant women of this age. This gave us the opportunity to chose correct methods of treatment and establish that adolescents are at increased risk of anemia, especially at younger ages (14-16 years).

[Possibilities of colposcopy in the diagnostics of cervical Chlamydia-mycoplasmatic infections (population prospective study)].

Possibilities of colposcopy in the diagnostics of cervical chlamydia-mycoplastic infections are less investigated. The aim of given work was the study of this problem. Colposcopic examination was performed in 952 women (age - from 16 to 67) asked to clinics for examination and more precise definition of diagnosis because of different complaints.

[Some psychological characteristics of pregnant teenagers in the first trimester of pregnancy].

The goal of our study was the investigation of emotional state in teenage and adult pregnancy (fears, anxiety), social relation (definitions of terms) in first trimester of pregnancy. The results of the study demonstrated that 1) the number of women who develop any kind of fears were from the group of pregnant teenagers and developed fears were different by intensity and frequency in comparison with adult pregnant women, 2) based on anxiety database, teenage pregnancy can be considered as a risk factor, 3) pregnant teenagers evaluate "baby" with lower scores and the difference between the evaluation of "real me" and "ideal mother" is higher in this group, 4) teenage and adult pregnant women have different desire of planning pregnancy, and they have some concerns about lactation and delivery. It is clear that pregnant teenagers represent the risk group by emotional state in relationship to the adaptation to the new social role of "mother" in I trimester.