[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). Risk factors are previous diseases of female reproductive organs- intracellular infection (OR-1,08), sexually transmitted diseases (OR-1,25), nonspecific inflammatory diseases (OR-1,009), interruption of pregnancy (OR-1,26), artificial abortions (OR-1,11), the most specific signs of Genital Tuberculosis is a pain in the stomach area (P-0,023), dysmenorrhoea (P-0,00001), intestinal obstruction (P-0,0006), heat (P-0,00001), liquid presence in posterior vault (P-0,007), hydrosalpinx (P-0,00001), Fallopian tubes deformation (P-0,000003), oophoritic cyst (P-0,067), adhesive process in small pelvis (P-0,0006). Lab tests used to study material showed high specificity of cytological (Sp - 78,05%), bacteriological (Sp - 96.4%) and morphological (Sp - 98.78%) methods, as a result of their low sensitivity (Se - 28.03%, 96.4%, 98.78%, respectively). As for PCR diagnostics, in this case both the sensitivity and specificity is of high level (Se - 77.98%, Sp - 82.11%).

[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 (80.2%), pathologic prematurity of chorionic vili in 48 cases (12.6%), hydatidiform mole in 28 cases (7.4%). As most cases of pregnancy loss has been reported at 7-9 weeks /172 cases/, we compared histomorphologic data revealed at 7-8 (71 cases) weeks to 5-6 (135 cases) and 10-12 weeks of gestation. Morphologic research data confimed, that at 7-8 weeks compared to 5-6 weeks leading reason ofpregnancy loss was inflammatory changes (OR-1,584), what can be cause of 110 pregnancy losses at 1000 pregnant women (AR-0.11). Data comparing7-9 weeks to 10-12 weeks pregnancy losses, confirm the priority of pathologic immaturity (OR-1,279) and hydatidiform mole (OR-1,557) and could be the risk of 100 cases of pregnancy termination at 1000 pregnant women (AR-0.10).Existing results are of great importance for the preconceptional preparation of women.

[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. The control group comprised 125 pregnant women who experienced no stress during pregnancy. An examination of the psycho-emotional status of pregnant refugee women revealed high percentage indicators (82%) for hypochondria, depression, psychopathy, hysteria and psychoastenia in contrast to the control group. The deterioration of psycho-emotional status and biochemical indicators in pregnant refugee women was directly proportional to the worsening of functional and clinical conditions in fetuses. Prolonged stress is the cause of increased morbidity and mortality during pregnancy and child birth in refugee women. Infants born to refugee women also faced increased risks and belong to the group of special premature care and observation.

[Efficacy of antihypertensive drugs in pregnancy].

In this trial we investigated the efficacy of short-term mono therapy and combined therapy of arterial hypertension among pregnant women. 44 pregnant women with arterial hypertension, with age range 24-36 years were investigated. The degree of arterial hypertension was determined by criteria of the "Goith National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure" (2003) and "The National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy" (2001). Trial proved efficacy of all variants of antihypertensive therapy with usage of retard forms of nifedipine, modipine and combination of nifedipine with other antihypertensive drugs. We revealed the advantage of the combined therapy in patients with II degree of arterial hypertension.

[Syndrome of arterial hypotonia in pregnancy].

Arterial hypotonia and pregnancy is one of the most problematic issues of the current obstetrics. The aim of the study was to investigate the progress of pregnancy and childbirth in women with arterial hypotonia, which was considered as the complication of the pregnancy. Control group consisted of healthy pregnant women of 20+/-1,3 years of age, while the main group consisted of remaining 36 pregnant women of up to 20 weeks of pregnancy with arterial hypotonia (age 24+/-2). State of intra cardiac and central haemodynamics was studied. It was proved that in the presence of this pathology hypodynamic syndrome of blood circulation is developed, which according to the clinical classification corresponds to the heart insufficiency.

[Hemodynamics during arterial hypertension in pregnant women].

The aim of the study was to evaluate hemodynamic profile of arterial hypertension during pregnancy. The study group consisted of 84 pregnant women with arterial hypertension (age 29+/-3,6 years), control group included 21 healthy women (age 20+/-1,3 years). In the study group the following subgroups were identified: chronic arterial hypertension (24 cases), preeclampsia (22 cases), combination of preeclampsia with chronic arterial hypertension (18 cases), gestational hypertension (20 cases). The status of hemodynamics was evaluated by Doppler echocardiography (Sonoline-elegra-Siemens, Germany). It was proved, that in the pregnant women with chronic hypertension, preeclampsia, combination of preeclampsia with chronic hypertension and gestational hypertension, high-output hemodynamic syndrome has been developed. Significant differences in diameter of the root of aorta, thickness of the posterior wall of the left ventricle and end-diastolic volume of the left ventricle was revealed, those correlated with age of the arterial hypertension.