The aim of the study is to development of an algorithm for managing pregnancy and childbirth by studying the functional state of the mother-placenta-fetus system in pregnant women who have undergone COVID-19 in different trimesters of pregnancy.
The object of the study was 105 pregnant women who, were treated at the Samarkand Regional Perinatal Center and a specialized maternity center for pregnant women with COVID-19
Тhe scientific novelty of the research consists of the followings: for the first time in pregnant women infected with COVID-19, a relationship was established between the course of pregnancy, childbirth, the postpartum period and the development of complications depending on the trimester and severity of the disease; a direct correlation has been established between the state of the vessels of the mother-placenta-fetus system (resistance and pulsation indices, Endothelin-1 indicators), disorders in the hemostasis system (D-dimer, platelet aggregation) and the clinical course of the disease in pregnant women who underwent COVID-19; it has been established for the first time that the developed scale for assessing risk factors for non-developing pregnancy in women infected with COVID-19 (age, BMI, obstetric history, gestation period, hemostasis system status, endothelial function and severity of the disease) can serve as a prognostic marker of the degree of risk of pregnancy complications; it was proved for the first time that the choice of effective therapy for restoring hemodynamics in the mother-placenta-fetus system, in women who underwent COVID-19 at different stages of pregnancy, leads to a decrease in the number of thrombophilic complications.
Implementation of the research results. The results of the scientific research were introduced into the practical activities of the Samarkand Regional Perinatal Center by Order No. 128/1 of 01.09.2022 and the Samarkand City Maternity Complex No. 1 by order No. 58/1 of 03.10.2022. In pregnant women who underwent COVID-19 at different periods of pregnancy, changes in the mother-placenta-fetus system were determined using simple and effective research methods, such as ultrasound and Dopplerography, and this saved 53,000 soums; obstetricians and gynecologists, as well as neonatologists and therapists, are needed to diagnose signs of complications in the echocartin, that is, it has been proven that there is no need for other highly qualified specialists for this, due to the lack of need to train new personnel, state budget funds have been saved. With early detection of disorders in the hemostasis system in pregnant women with COVID-19: the period of stay of patients in the hospital was reduced from 10.5 days to 7.5 days and the number of hospital bed days was reduced; due to the reduction of the period of stay in the hospital for several days, the number of necessary drugs was reduced (on average, drugs are used for 1 day in the amount of 130,000 soums). Examination of pregnant women infected with viral diseases using simple and effective research methods such as ultrasound and Dopplerography served to save 85,000 soums: in the early stages up to 16 (10-11 weeks. - fetometry), 19-21, 32-34, 38-40 weeks of pregnancy; due to the absence of the need to use other research methods, it was possible to reduce costs by 23.5%; early detection of changes in the hemostasis system and endothelial dysfunction using fast, budgetary and effective research methods, contributed to the prevention of possible pregnancy complications, as well as the absence of the need to use long-term and expensive research methods, and this saved 106 000 soums: the coagulogram was checked in 105 (100%) patients, time was saved and efficiency was increased; endothelin-1 was also determined in 105 (100%) patients, efficiency was increased by 78.6%.
Improving the functionality of blood circulation in the uteroplacental and fetal-placental systems, a comprehensive analysis of possible complications during pregnancy and childbirth in women who have had viral infections, improving diagnostic, preventive and prognostic measures for managing pregnancy and childbirth contributed to the birth of live, full-term and healthy newborns in women who experienced COVID-19 during pregnancy, as well as a decrease in maternal mortality and perinatal mortality, 43% of women underwent rehabilitation in the postpartum period, 23.8% of women who underwent severe COVID-19 improved their quality of life.
To introduce scientific novelty on the topic “The impact of COVID-19 on the state of hemodynamics in the mother-placenta-fetus system in pregnant women”, a letter was sent to the Ministry of Health from Samarkand State Medical University on November 9, 2022 under No. 4295 (Conclusion of the Ministry of Health No. 8 n-z / 679 of December 15, 2022).
The structure and volume of the dissertation. The content of the dissertation consists of an introduction, five chapters, conclusion, list of used references. The volume of the dissertation consists of 113 pages.
The administrative structure and socio-economic history of the Bukhara emirate, which arose in the second half of the 18th century, has attracted the attention of foreign travelers and specialists on Central Asia since the last century. At the problem study, the majority of researchers relied on diaries and official information from European ambassadors and administrators of the Russian Empire. The effect of this approach is also evident in studies conducted at this time. Of course, there are a lot of thoughts and reflections based on local narrative and historical sources. In general, in the research carried out, the basic concepts and conclusions about the administrative-territorial structure of the Bukhara emirate were formed. For example, when summarizing the findings of the research, from the administrative units of the emirate in the provincial (wilayat) and district (tuman) status, problems such as the administrative units in rural areas – amlak and the system of governance of eldership – are well illustrated. Speaking about the district (tuman) of the Bukhara Emirate, first of all, the name of the territories that have the status of a district (tuman) depending on their obligations and units of measure, is one of the most relevant aspects of the task. The administrative-territorial divisions of “koriya”, “tuman”, “hazor” and “obhur” are one of the important aspects that will be focused on in the article. However, only general opinions were expressed, and specific analytical studies were not conducted on the same micro district. The article presents an attempt to disclose the administrative-territorial structure of the emirate, its management and socio-economic problems on the example of the Wobkent district. And of course, this is not an accident. Firstly, this administrative unit, called Wobkent or Komot, was one of nine regions of the country with an important economic territory with developed agriculture, including ancient settlements in this region. Secondly, the analysis of the problem on the example of a single territory allows you to see specific aspects related to the basics of socio-economic development, problems in the subsystems and the territorial characteristics of the administrative and territorial administration of the emirates. And also, a lot of documents are mentioned, which reflect the district’s (tuman) waqf facilities. The territories of the district (tuman) with a developed irrigation sector were advanced in agriculture and occupied a special place in the life of the emirate.
This study is an analysis of the educationalcurriculum of teaching English language in medical high schools. In the beginning of 21st century, English has become as integral partof educational curriculum in the medical high schools in the Republic of Uzbekistan. Generally speaking, the process of teaching and learning English as a foreign language in the Republic of Uzbekistan has get high levels. But there are still some problems and different local specificities that involved in this process. The researcher in the aim makes a contrastive view of the possibly existing problems of teaching English in the medical
institutes to elicit possible factors and to suggests that learning problems provided to students are influenced by a teacher’s short-term pedagogical experience, his or her evolving more theoretical than practical approach, routinized behaviors.
The article analyzes the present state of the Institutionof advocacy in the Republic of Uzbekistan. It provides an investigation of existing problems, without which it is impossible to further reform the advocacy. The article presents the author's classification of development stages of the advocacy as well as the development prospects and directions. Moreover,the article focuses on the thorough study of the results of a sociological survey conducted among lawyers and students, contributing to identify problems in the field of advocacy and form ground proposals for their elimination