No abstract

This article presents the data on the prevalence of congenital fetal anomalies in our hospital population obtained for the past five years (2013–2017). We analyzed the changes in their structure and the timing of diagnoses for the anomalies. In addition, the comparison of our results with international data was performed and extremely rare anomalies were described.

BACKGROUND:Early screening for preeclampsia has shown high efficiency for low-risk groups, however, the presence of systemic vascular disease in patients with diabetes mellitus complicates their use and requires the development of additional approaches to predicting preeclampsia in this group of patients. AIM:The aim of this study was to evaluate the effectiveness of early prediction of preeclampsia with extended combined screening in patients with pregestational types of diabetes mellitus. MATERIALS AND METHODS:This study included 75 pregnant women: 40 patients with type 1 diabetes mellitus, and 35 patients with type 2 diabetes mellitus. To determine the risk of further preeclampsia development, we evaluated biochemical, biophysical and anamnestic factors, along with the serum levels of placental growth factor, soluble fms-like tyrosine kinase 1, and soluble endoglin at 11+0to 13+6gestational weeks. The main outcome assessed was the development of preeclampsia. RESULTS:In patients with further development of preeclampsia (35% in type 1 and 40 % in type 2 diabetic women), we observed higher soluble fms-like tyrosine kinase 1 / placental growth factor ratios, as well as elevated serum soluble endoglin (type 1 diabetes mellitus) and soluble fms-like tyrosine kinase 1 (type 2 diabetes mellitus) levels. Isolated determination of placental growth factor showed no significant differences in the levels of this angiogenic factor in preeclampsia. A multivariate predictive model for preeclampsia demonstrated high prognostic parameters: for patients with type 1 diabetes mellitus, area under the curve was 0.96 (95% confidence interval 0.931.00), with positive predictive value 76.7% and negative predictive value 90.1%; for patients with type 2 diabetes mellitus, area under the curve was 0.94 (95% confidence interval 0.861.00), with positive predictive value 88.5% and negative predictive value 97.1%. CONCLUSIONS:Specific biochemical and biophysical markers of preeclampsia combined with maternal risk factors and assessment of carbohydrate metabolism can increase the predictive value of early screening studies for preeclampsia in women with pregestational diabetes mellitus.

The case of umbilical cord entanglement in мonochorionic monoamniotic twins pregnancy is presented in this article. The role of systematically ultrasound and color Doppler examinations in the diagnosis of the umbilical cord entanglement and modern approaches in management of мonochorionic monoamniotic twins pregnancies is discussed.

This article presents an annotation and discussion of our own clinical observation of a high-risk multiple pregnancy after in vitro fertilization in a patient with tuboperitoneal infertility. We report a case of early prenatal diagnosis of a rare malformation of a single fetus in dichorionic twin pregnancy (pentalogy of Cantrell). The feasibility of cumulative assessment of the risks of assisted reproductive technology complications to determine the tactics of management and intensive observation during pregnancy, as well as the use of invasive intrauterine interventions for multiple pregnancy to reduce perinatal risks is discussed.