The multidimensionality of transformations that take place, the diversity of destabilizing factors in the environment reduce reliability, sustainability, efficiency of both logistics processes and the entire production and economic activity, and they need their modern economic reflection. The successful activity in the unstable economic environment is impossible without proper strategic analysis and the formation of the effective management system that requires the search for new techniques, the development of logistics-oriented concepts, management approaches to logistics processes that can ensure the goals achievement under the continuous systemic development and disturbance flow. The goal of the research is to improve the technique and develop a management model for logistics processes, considering the effect of the disturbance flow. In accordance with the goal, it is necessary to solve the following scientific problems: to reveal the patterns of logistics processes for the formation of a signal system on management points within the framework of management structures; to develop components of the management technique for logistics processes, taking into account the disturbance flow; to systematize and supplement the principles of logistics processes for the formation of the rational totality of components in the management technique. Thus, the implementation of the proposed management technique for logistics processes will lead to the formation of optimal management impacts within each element, subsystem and the entire structure of the supply chain, ensuring the sustainable development vector at each time period and achieving the goals set under the influence of the disturbance flow, adaptability, flexibility and efficiency of processes.

Introduction. A significantly increased frequency of multiple pregnancies including more than two fetuses is a consequence of using assisted reproductive technologies and ovulation stimulations. However, such pregnancies remain poorly investigated. Aim: to study the course and perinatal outcomes of quadruplet pregnancies.Materials and Methods. 7 pregnant women with quadruplets were examined. A comprehensive examination, including fetometry, monitoring of the cervical length, Doppler examination, and treatment of all complications were performed for all pregnant women. Results. Quadruplet pregnancy belongs to the peak risk group for the frequency of multiple gestational complications: cervical incompetence (85.7 %), anemia (71.4 %), preeclampsia (57.1 %), fetal growth retardation (71.4 %), premature birth (100.0 %), massive bleeding during delivery (33.3 %), extremely low birth weight newborns (30.8 %), respiratory disorders (100.0 %), intraventricular hemorrhages (38.5 %).Conclusion. Women with quadruplet pregnancies should be monitored and give a birth in level 3 perinatal centers. Delivery should be preferentially performed by caesarean section. The data obtained additionally underline that as few as a single embryo should solely transferred.

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Multiple pregnancy is currently considered an important social and research problem, because it is often associated with a number of complications, such as premature birth and extremely low birth weight. Multiple pregnancies are facilitated by late reproductive age of the mother and in vitro fertilization (IVF) with the transfer of several embryos. In this review, we analyze specific characteristics of multiple pregnancies after IVF. Key words: twins, neonatal outcomes, in vitro fertilization

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