Diagnosis and course of pregnancy and childbirth in women with intrahepatic cholestasis of pregnancy: Summary of Ph.D. Thesis in Medical Sciences: 321.15. Obstetrics and Gynecology

Abstract

Thesis structure. The thesis is laid out on 124 pages of main text, consisting of an introduction, 5 chapters, general conclusions, recommendations, and a bibliographic index of 255 references, 25 figures, 11 tables, and 10 annexes. The results obtained are published in 22 scientific articles. Keywords: intrahepatic cholestasis of pregnancy, pregnancy, childbirth, perinatal outcomes, diagnosis. Purpose ofthe thesis: To evaluate the diagnostic features and clinical course, perinatal outcomes, and optimize the management of pregnant women with intrahepatic cholestasis of pregnancy (ICP). Objectives of the study: To determine the clinical course of pregnancy, delivery, and perinatal outcome in women with intrahepatic cholestasis of pregnancy; to evaluate the diagnostic features of intrahepatic cholestasis of pregnancy; to assess vitamin K levels and haematological markers of inflammation in case of intrahepatic cholestasis of pregnancy; to develop a diagnostic and management algorithm for pregnant women with intrahepatic cholestasis of pregnancy. Scientific novelty and originality. The study elucidated the evolution peculiarities of pregnancy, delivery and perinatal outcomes in women with ICP. The diagnostic features of intrahepatic cholestasis of pregnancy were investigated, as well as the level of vitamin K and haematological markers ofinflammation in this group of pregnant women. The important scientific problem solved in the paper aims to elucidate the clinical and evolutionary features of pregnancy and delivery in pregnant women with cholestasis gravidarum, as well as to highlight the features of diagnosis and management ofthe condition, on the basis of which the Diagnostic and management algorithmfor intrahepatic cholestasis ofpregnancy was developed, which includes the following compartments: clinical manifestations, diagnosis, treatment, and time limits of pregnancy resolution in pregnant women with ICP. Theoretical significance. The thesis, through the results obtained, highlights and updates data related to the particularities of gestation, delivery, maternal clinical symptoms of intrahepatic cholestasis of pregnancy, as well as the level of vitamin K and hematological markers of inflammation in the condition. Applicative value. Diagnostic peculiarities of intrahepatic cholestasis of pregnancy were highlighted. The level ofvitamin K in women with ICP and the role of haematological markers of inflammation in ICP were assessed. An algorithm for the diagnosis and management of pregnant women with intrahepatic cholestasis of pregnancy was proposed. Implementation ofscientific results. The study results were implemented in the teaching process ofthe Department of Obstetrics and Gynecology ofNicolae Testemitanu PI SUMPh, as well as in the curative activity ofthe Institute ofMother and Child and Gheorghe Paladi Municipal Clinical Hospital.