The parameters of the enzyme involved in biologically important reactions occurring in an open thermodynamic system — the body of a pregnant woman during the gestational period — were studied. The role of an unfavorable premorbid back ground has been established: infectious diseases, repeated exacerbations of chronic inflammatory processes during prolongation of pregnancy, risk factors for perinatal complications, which causes certain morphofunctional changes in the placenta, form ing placental insufficiency. Pregnant women associated with diseases of the genitouri nary system are more often susceptible to infection. Ultrasound examinations made as part of screening the physiology of the system: mother — placenta — fetus, revealed changes in the structure of the placenta, which indicated a disruption in the relationship between the nascent embryo and the mother’s body, and ultimately manifested itself as violations of compensatory and adaptive mechanisms in the placenta, more pronounced in the sample, burdened by the presence of chronic foci of infection. The dependence of disturbances in the functional ability of the placenta on the level of the enzyme — thermostable alkaline phosphatase specific for it — was revealed. At the same time, a change in the activity of this enzyme was observed, which determined the compensatory capabilities of the provisional organ. In patients with an increased infectious index and placental dysfunction, unstable values of a specific placental enzyme are observed, as evidenced by an unfavorable course of pregnancy, accompanied by the threat of miscar riage and premature birth. These disorders occurred during prolongation of pregnancy and during the process of delivery. A significant decrease in the activity of placental alkaline phosphatase and a decrease in its relationship to alkaline phosphatase were es tablished. The worst indicators reflecting the intrauterine development of the fetus were observed in the sample with placental dysfunction and the risk of infectious complica tions, which was associated with delayed fetal development, and the birth of children with a combination of signs of intrauterine suf fering and hypoxia.