Immune thrombocytopenia (ITP) is an autoimmune disease which is characterized by antibody-mediated destruction of platelets by the reticuloendothelial system. The rate of ITP is 3.3 per 100,000 adults per year with a prevalence of 9.5 per 100,000 adults. Pregnancy does not increase the frequency or severity of ITP, but ITP can significantly affect pregnancy and cause bleeding in women.Pregnancy requires regular control of the number of platelets: monthly in the I and II trimesters, every 2 weeks – in the III trimester, and weekly control near the delivery date. Indications for treatment are determined by the pregnant woman condition, not the fetus, since it has not been proven that the treatment reduces the risks of thrombocytopenia in newborns with the development of cerebral hemorrhage.The drug of the first line of treatment of such pathology is prednisolone at a dose of 1 mg/kg orally once a day. An increase in the number of platelets is usually observed within 3-7 days, the maximum response is determined after 2-3 weeks. If necessary, the dose can be increased. When the required level of platelets is reached, the dose can be gradually reduced by 10-20 % to the minimum dose necessary to maintain the number of platelets at an acceptable level.Thrombocytopathy can be the cause of primary hemostasis disorders, even if the number of platelets in the blood is normal. For diagnosis, tests are carried out to detect the aggregation ability of platelets. In addition, flow cytometry can be used, which makes it possible to detect the defects of surface membrane receptors, as well as defects of the end point of secretion.ITP is a common cause of thrombocytopenia after viral infections. The onset of this pathology is more often detected in the second and third weeks after the onset of COVID-19. The treatment aim is to prevent the significant bleeding in patients with COVID-19.The article presents a clinical case of a pregnant woman with ITP and thrombocytopathy, whose pregnancy was complicated by COVID-19. The patient complained on bleeding gums, the appearance of hematomas on the skin. Medical treatment of the main disease included prednisolone, eltrombopag, intravenous human immunoglobulin, transfusion of platelet concentrate. At 34–35 weeks of pregnancy alive boy was born with a body weight of 2800 g, length of 49 cm, 7–8 points on the Apgar scale.

The aim. To highlight such a rare pathology as myelodysplastic syndrome in pregnant women, provide recommendations for treatment, management, and delivery in such patients according to modern literature, and share own experience of successful pregnancy and delivery management in two women with this pathology. Conclusions. Myelodysplastic syndrome is extremely rare in pregnant women, and the disease is associated with an increased risk of complications for both mother and fetus. The issue of planning and management of pregnancy in patients with this disease should be decided jointly by hematologists and obstetrician-gynecologist after a thorough comprehensive examination clarifying the state of bone marrow hematopoiesis. Pregnancy and delivery should be managed in a highly qualified institution with a multidisciplinary approach and the ability to monitor hemogram, dynamic monitoring of the fetus, adequate and timely supply of blood components.

The article is devoted to the analysis of scientific publications about the etiology, pathogenetic mechanisms, and management of the patients with epithelioid hemangioendotheliomas.Epithelioid hemangioendothelioma is the vascular tumor that affects liver, spleen, lungs, and various other organs and tissues. The tumor is malignant with high metastatic potential and variable course. The frequency of it is less than 0.1 per 100,000 population. The etiology is unknown. The role of the molecular and genetic mechanisms is studied, and today an association of the WWTR1-CAMTA1 protein in the development of epithelioid hemangioendothelioma was determined.Visual examination, computed tomography and magnetic resonance imaging, which are characterized by typical signs: «white target sign», «lollipop sign» are used for the diagnosis. There are no treatment standards for epithelioid hemangioendothelioma. Chemotherapy, radiofrequency ablation, surgery, and liver transplantation are usedOnly 8 cases of epithelioid hemangioendothelioma during pregnancy have been described in the medical literature, three cases of which are connected with one woman. Among them: progressive liver tumor with negative outcomes – the perinatal and maternal mortality; epithelioid hemangioendothelioma of the liver with the birth of a live, full-term baby; multifocal malignant hemangioendothelioma of the liver with premature birth by cesarean section and the development of sepsis in the mother; palate tumor involving the oropharynx and the birth of a child in physiological terms; presacral tumor, the diagnosis of which was confirmed after pregnancy; recurrent course of intracranial epithelioid hemangioendothelioma with liver and heart damage and three obstetric cases.The article describes a clinical case of epithelioid hemangioendothelioma of the liver in a pregnant woman with a history of resection of the left lobe of the liver. The management of this case with timely diagnosis, delivery at 35 weeks by cesarean section of the child in a satisfactory state is presented. The woman delivered a male infant weighing 2500 g, height 48 cm in satisfactory condition. Thromboprophylaxis was performed for 10 days, lactation was excluded.

The article is devoted to the most common liver disease which is associated with pregnancy – obstetric cholestasis. The frequency of this pathology among all liver disorders in pregnant women is almost 27%, second only to viral hepatitis. On average, it is diagnosed in 2–4 cases per 1000 pregnancies. A characteristic feature of obstetric cholestasis is the tendency to the recurrent course in future pregnancies, which is observed in 60–70% of next pregnancies. This disorder usually manifests itself in the II or III trimester of pregnancy. The links of pathogenesis and differential diagnosis of obstetric cholestasis are briefly described in the article, the main attention is paid to laboratory diagnostic markers of the disease, among which the concentration of bile acids in the blood of a pregnant woman is the most important. An increase concentration of bile acids ≥10 μmol/L is currently a main diagnostic criterion for obstetric cholestasis and can stimulate the release of prostaglandins, increase the sensitivity of the myometrium to oxytocin and its contractility, which in 12–44% of cases causes premature birth. Modern recommendations on pregnancy management and childbirth tactics for women with obstetric cholestasis and the main methods of treatment are also presented in the article. Today, for the treatment of cholestatic hepatosis in pregnant women, medicines are used that specifically reduce the phenomena of intrahepatic cholestasis – ursodeoxycholic acid and 5-adenosylmethionine, as well as symptomatic treatment – cholestyramine (or other sequestrants of bile acids), H1-histamine receptors blockers, phenobarbital. Today, the most convincing evidence of effectiveness and safety is the data on ursodeoxycholic acid. This article describes a clinical case of pregnancy in a woman with obstetric cholestasis. The woman used combined oral contraceptives for 10 years to prevent an unwanted pregnancy, which obviously caused the future development of this disease during pregnancy. The patient had timely diagnosis and appropriate treatment. At the 37th week of pregnancy, a vaginal delivery took place. A live female child was born, body weight 3000 g, length 48 cm in satisfactory condition.