Compared to children of other ages, neonates especially seriously ill and premature subjects comprise a high thrombotic risk group. A decline in the incidence of neonatal thrombosis may be accounted for by improved treatment of severe conditions in newborns and increased survival of premature infants. Neonatal and adult hemostasis exhibit distinct physiological features: difference in concentration, synthesis rate of blood coagulation factors, metabolic rate, thrombin and plasmin levels. At the same time, neonatal threshold values for natural blood coagulation inhibitors (protein C, protein S, antithrombin, heparin cofactor II) and vitamin K-dependent coagulation factors (FII, FVII, FIX, FX) are quite low, whereas that of FVIII and von Willebrand factor exceeds those found in adults. Thus, newborns have lower plasma fibrinolytic activity. The main risk factors for developing thrombotic complications are as follows: central venous catheters, altered body fluid volume, liver disease, as well as sepsis and inflammatory processes particularly COVID-19. The significance of congenital and acquired maternal and neonatal thrombophilia may pose an additional risk factor for thrombotic complications. Low-molecular weight heparins are the first-choice drugs in treatment and prevention of neonatal thrombosis.

Aim : to identify inherited and acquired thrombophilia as well as features of pregnancy course in women with abnormal placenta location. Materials and Methods . Within the framework of a prospective controlled cohort non-randomized, interventional study there was analyzed pregnancy course in 135 women with abnormal placenta location: group I – 42 patients with abnormal placenta location in history; group II – 61 women with placenta previa detected during ongoing pregnancy; group III – 32 patients with placenta previa detected both in ongoing and previous pregnancy. The control group consisted of 120 pregnant women with normal placenta location without a previous complicated obstetric history. All patients underwent clinical examination of pregnancy course assessing fetus intrauterine growth retardation (IUGR) and fetal biophysical profile; inherited and acquired thrombophilia were identified – analyzing circulating antiphospholipid antibodies (APAs) by ELISA, inherited thrombophilia by polymerase chain reaction to identify mutations in genes encoding 5,10methylenetetrahydrofolate reductase (MTHFR), G20210A mutations in prothrombin gene, V Leiden mutation, polymorphismin fibrinogen and plasminogen activator inhibitor 1 (PAI-1) genes. Results . Inherited thrombophilia was detected in 101 (74.81 %) pregnant woman with abnormal placenta location: group I – in 31 (73.8 %) patients, group II and group III – in 44 (72.1 %) and 26 (81.3 %) patients, respectively. Inherited forms of thrombophilia were detected in 29 (24.2 %) women from control group. Multigenic forms of thrombophilia peaked in group III (14/43.8 %), followed by group I (16/38.1 %) and group II (23/37.7 %). In the control group, multigenic thrombophilia was detected in 16 (13.3 %) women. Selective inherited thrombophilia and АРАs circulation were detected in 30 (22.22 %) women with abnormal placenta location: group I – in 8 (19.0 %) patients, group II – in 13 (21.3 %), and group III – in 9 (28.1 %) cases. In the control group, there were only 8 (6.7 %) such patients. Patients with IUGR signs were identified in all study groups: 4 (9.52 %) in group I, 6 (9.84 %) in group II, 6 (18.75 %) in group III as well as in control group in 6 (6.67 %) women. Conclusion . Pregnancy management in patients with thrombophilia and placental abnormalities should be accompanied by an proper fetal assessment (biophysical profile) and, in some cases, anticoagulant or antiplatelet therapy. However, insufficient number of cases requires to conduct further investigations to assess a relation between thrombophilia, placenta previa and a risk of obstetric complications particularly IUGR.

Medical rehabilitation of oncogynecologic patients is a socially important aspect of current clinical practice; this field of medicine attracts more and more attention of medical professionals around the world. The improved methods of early diagnostics contributed to a significant increase in the number of cancer patients. Today, there is a need for comprehensive rehabilitation programs aimed at restoring the affected body functions, preventing/reducing the disability and mental disorders, as well as timely detecting complications, relapses or tumor metastases. The introduction of medical rehabilitation into oncological practice, implemented on the basis of oncology and rehabilitation centers, will improve the quality o patients’ lives and create the appropriate conditions for social adaptation and integration into the society.

The aim of the study was to search for a connection between the abnormal location of placenta and the presence of genetic and acquired forms of thrombophilia.Materials and methods. A total of 132 women with the aggravated obstetrical history were examined: Group 1 – 42 patients with the history of placenta previa; Group 2 – 60 pregnant women diagnosed with placenta previa in the current pregnancy; Group 3 – 30 pregnant women with the history of placenta previa and the same abnormality in the current pregnancy. The control group included 120 women with no abnormalities in their obstetric history and with normal location of placenta during the current pregnancy. All patients were assessed for the antiphospholipid antibodies using an enzyme immunoassay. The presence of genetic forms of thrombophilia was tested (with polymerase chain reaction and three pairs of oligonucleotide primers) for the following mutations: the C677T mutation in the 5,10-methylenetetrafolate reductase gene, the prothrombin mutation in the G20210A gene, mutations in the Leiden factor V gene, polymorphism 675 4G/5G in the gene of the inhibitor of plasminogen activator type 1, polymorphism 455G/A in the fibrinogen gene.Results. The thrombophilia spectrum in patients with placenta previa during the current pregnancy and those with abnormal placenta location in the past did not significantly differ from each other. However, in patients with both abnormal placental locations in the past and the present pregnancy, there was a greater occurrence of both genetic and acquired forms of thrombophilia. In the control group, much fewer cases of either genetic or acquired thrombophilia were found.Conclusion. The obtained results suggest a connection between thrombophilia and the abnormal location of placenta. Women with the abnormal placenta location either in the past or during the current pregnancy should be routinely tested for the genetic markers of thrombophilia and for hemostasis abnormalities.

Genetic thrombophilia is a risk factor for both thromboembolic and obstetric complications. Patients with a family history of thrombotic and obstetric complications should be examined for the presence of thrombophilia. If a hemostasis problem is confirmed, antithrombotic therapy is recommended to be initiated at early stages of pregnancy. Moreover, this therapy is better to be started at the stage of preparation for pregnancy and continued throughout the pregnancy and during the postpartum period to avoid thromboembolic and obstetrical complications.