Fetal growth restriction remains a leading cause of preterm birth and neurological disorders in children and is associated with high neonatal and perinatal morbidity and mortality. Fetal growth restriction is strongly associated with preeclampsia, placental insufficiency, and does not tend to decrease in frequency. The terms small for gestational age and fetal growth restriction are similar in terms of fetometry, however, in modern literature, these concepts differ based on blood flow disorders in the mother-placenta-fetus system and perinatal complications. A deep understanding of the multifactorial pathogenesis of early and late fetal growth restriction will allow for developing targeted therapy of placental insufficiency. Determining the role of new placental growth biomarkers plays a significant role in understanding the pathogenesis of placental dysfunction and developing measures to predict placenta-associated pregnancy complications. This review article highlights new approaches to effective fetal growth restriction screening. Recent advances in ultrasound diagnosis of fetal growth restriction provide the basis for multivariate testing that can provide cost-effective screening for placental-associated pregnancy complications, including fetal growth restriction.

Thrombotic microangiopathy (TMA) is a clinical and morphological syndrome, which is based on damage of the endothelium. Clinically, TMA is characterized by a triad of symptoms: thrombocytopenia, microangiopathic hemolytic anemia, and target organ damage. In obstetric practice, TMA most often occurs with preeclampsia or HELLP syndrome, atypical HUS, TTP. The review presents the basic differential criteria for the diagnosis of TMA during pregnancy and after childbirth, as well as the management of patients.

BACKGROUND: Fetal growth restriction (FGR) is one of the current problems in modern obstetrics and perinatology, which is associated with a large number of adverse perinatal outcomes. AIM: This study aimed to assess the diagnostic significance of the combination of autoantibodies (AAB) in the early and late FGR manifestation. MATERIALS AND METHODS: The study involved 117 pregnant women, classified into Group 1 (90 women with FGR) and Group 2 (27 women with a physiological course of pregnancy). Pregnant women with FGR were divided into two subgroups depending on the time of manifestation, i.e. FGR subgroups with early and late manifestation (45 patients each), respectively. Upon hospital admission, all patients of the study groups had blood sampling to determine autoimmune AABs using the ELI-P-test. RESULTS: An isolated increase in AABs to human chorionic gonadotropin (hCG) antigen, TrM (AAB markers of changes in vascular and hemostasis system), S100 protein, antineutrophil cytoplasm antibodies (ANCA), and KiMS (AABs to the cytoplasmic antigen of glomerular kidney cells) were observed in the early FGR manifestation when comparing the abnormal AAB spectrum in the early and late FGR manifestation, while a statistically significant isolated increase in the level of AABs to DNA and insulin was found in the late FGR manifestation. CONCLUSIONS: The study revealed the diagnostic significance of AAB combinations, as well as the combinations of increased AAB levels to hCG, S100, ANCA, and KiMS and an increase in AABs to DNA, collagen, and S100 protein in the early and late FGR manifestation, respectively.