THE PECULIARITIES OF PSYCHO-EMOTIONAL CONDITION OF WOMEN WITH INFERTILITY AND INTRAHEPATIC CHOLESTASIS

The adverse impact of the difficult socio-economic situation on the processes of birth and early neonatal morbidity and mortality requires focusing greater attention on the study of the role of psychological factors in solving demographic problems. In recent years, 75 «Art of Medicine» ISSN 2521-1455 (Print) ISSN 2523-4250 (Online) 4 (16) жовтень-грудень, 2020 there has been a significant increase in the percentage of women with infertility in anamnesis, who received modern reproductive technologies, and in these patients, pregnancy is not only an obstetric but also a psychological issue. These women present a complex of symptoms of vasomotor and nervous/psychic disorders already at the preconceptive stage. In the modern society, pregnancy often goes with chronic stress related to reproductive disorders in anamnesis, which is intensified by social conflicts, environmental and technological disasters. The search for ways to control the body's reactivity, which are based on the understanding of the mechanisms of development of adaptation and deadaptation processes, opens prospects of working out ways of targeted correction of pathological conditions during gestation. Women with infertility, especially those with a long unfavorable experience of treating it and/or with perinatal losses in anamnesis, present significant psycho-emotional disorders. The aim of this research is to assess the psycho-emotional condition of women with intrahepatic cholestasis who got pregnant owing to assisted reproductive technologies. We have conducted a complex research of 80 women ,who got pregnant owing to assisted reproductive technologies: 40 women with manifestations of intrahepatic cholestasis (basic group) and 40 women without such manifestations (comparison group), 50 women with spontaneous pregnancy and its physiological course made up the reference group. We used questionnaires, tests and projective methods (to identify the type of the psychological component of the gestational dominant, the type of self-perception of pregnancy, to measure the level of reactive (situational) and personal anxiety, depression); the SF-36 Health Survey; the calculation of the Kerdo index and A.M. Wein's questionnaire (to assess vegetative homeostasis). The Spielberg-Hanin scale of reactive and personal anxiety (1976) is the only method that makes it possible to measure anxiety in a differentiated way: as a personal quality and a condition. Taking into consideration the symptoms of intrahepatic cholestasis, which significantly influence the pregnant women's general condition, as well as the established vegetative disorders, sleep disorders, high or extremely high anxiety, signs of depressive conditions, one can presume a decrease in the quality of life of these patients. Women with intrahepatic cholestasis who got pregnant owing to assisted reproductive technologies, require the assessment of their vegetative and psychoemotional condition and the correction of the established disorders, in order to normalize the quality of their life and achieve favorable perinatal results. The pregnant women's psycho-emotional condition is a great extent of the result of interaction of two components: the extragenital one, which includes somatic diseases and individual typological peculiarities of a woman's physical status, and the genital one, i.e. the physiological peculiarities of the reproductive system. The optimization of a woman's psychic condition contributes to a more favorable course of pregnancy and the birth of a healthy child.