Objectives: to evaluate the clinical effectiveness of the Metida for the prevention of perinatal pathology in pregnant women with gestational endotheliopathy and with the risk of preeclampsia.Materials and methods. 68 pregnant women with verified gestational endotheliopathy and with risk of preeclampsia > 1:150 participated in a prospective clinical comparative study. The patients were divided into subgroups: the first subgroup included 30 women who from 11–13 weeks of pregnancy received acetylsalicylic acid 100 mg/day and vitamin D 2000 IU/day; the II subgroup included 38 pregnant women who from 11–13 weeks of gestation received acetylsalicylic acid 100 mg/day, vitamin D 2000 IU/day and Metida (300 mg of elemental magnesium, 30 mg of vitamin B6). 28 practically healthy pregnant women of the control group received vitamin D 1000 IU/day. The clinical effectiveness of therapy was evaluated by comparing the number of cases of perinatal pathology; cases of intrauterine suffering of the fetus; the dynamics of indicators of laboratory-instrumental research methods (markers of the risk of perinatal pathology) and the pregnancy outcomes.Results. Metida as an additional preventive therapy made it possible to significantly reduce the number of cases of placental dysfunction (р = 0.01) and intrauterine suffering of the fetus (р = 0.02) compared to standard preventive therapy. There was also a 6-fold reduction in the incidence of preeclampsia and premature birth due to magnesium supplementation, compared to pregnant women who received only acetylsalicylic acid and vitamin D. There was a significant decrease in serum indicators of markers of endothelial dysfunction in women with gestational endotheliopathy as a result of taking magnesium: vascular endothelial growth factor (p < 0.00001), endoglin (p < 0.00001) compared to patients who did not receive magnesium, and there was also normalization of the of 25(OH)D level in blood serum compared to the control group (p = 0.33).Conclusions. Additional Mg supplementation during pregnancy may reduce the likelihood of perinatal pathology in high-risk patients and help normalize serum markers of endothelial dysfunction in women with high risk of preeclampsia.

The study of the features of the upper respiratory tract and the relationship of their parameters with other anatomical formations and structures of the human body is one of the promising areas of modern science. Since numerous anatomical components are involved in the functioning of the respiratory tract, their detailed study should be carried out separately. One of these components that is of direct interest to science and practice is the soft palate. The purpose of the study is to establish the peculiarities of the teleroentgenometric parameters of the soft palate in Ukrainian young men and young women without pathology of the upper respiratory tract with an orthognathic bite without and taking into account the type of face. Determination of teleroentgenometric parameters of the soft palate was carried out in 72 young women and 46 young men with no pathology of the upper respiratory tract with an orthognathic bite (primary lateral teleroentgenograms were taken from the database of the research center and the Department of Pediatric Dentistry of the National Pirogov Memorial Medical University, Vinnytsya). For all young men and young women face type was determined using Garson's morphological index. The analysis of the obtained results was carried out in the statistical package “Statistica 6.0” using non-parametric estimation methods. As a result of the conducted research, pronounced gender differences were found (significantly greater, or a tendency to greater values in young men): the value of the PM-U distance in representatives without taking into account the type of face by 7.1 %, with very wide – by 9.2 %, with wide – by 8.4 % and with narrow – by 7.4 % face types; values of the SPT distance in representatives without taking into account the face type by 10.3 %, with very wide – by 16.4 % and with narrow – by 23.1 % face types; the values of the NL/PM-U angle in representatives without taking into account the face type by 7.6 % and by 11.5 % with wide face types; the size of the SPA area in representatives without taking into account the type of face by 17.2 %, with very wide – by 24.4 %, with wide – by 13.4 % and with narrow – by 32.2 % of face types. When analyzing the value of teleradiographic parameters of the soft palate in young men between different types of faces, it was established that significantly higher values or trends towards higher values in representatives with a narrow face of the SPT distance and SPA area than in young men with a very wide (respectively by 8.9 % and 13.0 %) and average (by 13.9 % and 22.2 %), respectively, face types, and in young men, regardless of face type, there is a tendency for greater values of the PM-U distance than in representatives with an average face (by 4.2 %). In young women with a narrow face, only a tendency to greater values of the NL/PM-U angle was established than in young women with a wide face (by 6.2 %). The results of the study are an integral element of determining the normative values of various parameters of the upper respiratory tract, which enables practicing doctors to more correctly distinguish the norm from pathology.

Annotation. A review of the scientific literature on the problem of diagnosis and modern methods of treatment of cervical pregnancy is presented. Ectopic pregnancy (ectopic pregnancy) is a condition in which the implantation and development of a fertilized egg takes place outside the uterine cavity and is one of the threatening conditions for life and reproductive health of women. Cases of cervical pregnancy occur with a frequency between 1:8 600 and 1:12 400 cases of the total number of all pregnancies and less than 1% of the number of ectopic pregnancies. Suspicion of a diagnosis of “cervical pregnancy” is an indication for immediate hospitalization of the woman in a gynecological hospital, a thorough examination and selection of treatment, because this pathology can provoke massive bleeding in the first trimester of pregnancy. In the practice of obstetrician-gynecologist for a long time there was one method of treatment of this pathology – extirpation of the uterus. To date, there are conservative and surgical treatments, that we will cover in this article. We conducted a systematic review and analysis of relevant literature sources, which have been published in the vast majority over the past 10 years (2012-2022), on modern methods of diagnosis and treatment of cervical pregnancy. The search was conducted in search databases PubMed, Google Scholar, Cochrane Library, Web of Science. The following search terms were used in the work: “cervical pregnancy”, “ectopic pregnancy”. It was found that the problem of treatment of cervical pregnancy remains relevant today, because there is no clear opinion on the best method of treatment. The decision to use one or another method is left to the attending physician, who must adequately assess the patient's condition, obstetric situation and possible options for prescribing appropriate treatment, the available methods were justified.

Objectives: to evaluate the effectiveness of multidose supplementation of vitamin D on the dynamics of serum levels of markers of lipid metabolism in pregnant women with obesity. Materials and methods. The study included 75 pregnant women with the І degree of obesity and low vitamin D status, who were divided into subgroups depending on the vitamin D dose of and the baseline 25(OH)D level in blood serum: I subgroup – 24 women with 25(OH)D less than 22.0 ng/ml who received Decristol 4000 IU/day; II subgroup – 26 pregnant women with 25(OH)D = 22.1–28.0 ng/ml who received Decristol 2000 IU/day; III subgroup – 25 patients with 25(OH)D over 28.1 ng/ml, who received 1000 IU of vitamin D per day. Pregnant women of all these subgroups also took acetylsalicylic acid at a dose of 100 mg/day. The control group included 26 practically healthy women who received 600 IU of vitamin D per day. Serum adipokinins levels were studied at 11–13, 22–24 and 31–33 weeks of gestation.Results. Significant differences were found in the increase of leptin (p < 0.0001) and resistin (p < 0.0001) and the decrease of adiponectin (p = 0.006) in pregnant women with impaired vitamin D metabolism against the background of moderate obesity in the І trimester compared to the control group. A more positive effect was found for Decristol 4000 IU (patients with vitamin D deficiency), against the treatment of Decristol 2000 IU (patients with vitamin D deficiency). At 31–33 weeks of gestation, there was a statistically significant decrease in serum level of resistin (p = 0.006) and a similar increase in adiponectin (p = 0.025) in patients receiving vitamin D 4000 IU, compared with the same indicators in clinical subgroups. Resistin and adiponectin may be markers of perinatal pathology in obese pregnant women in the first trimester of gestation, in terms of specificity (91.5 and 78.7%, respectively), sensitivity (100.0 and 91.3%, respectively); positive probability (11.75 and 4.29%, respectively), negative prognostic value (100.0 and 94.9%, respectively) and test accuracy (94.3 and 82.9%, respectively).Conclusions. The use of markers of lipid metabolism as diagnostic criteria during pregnancy in women with the І degree of obesity and low vitamin D status has predictor and prognostic value for the risk of perinatal pathology and helps to assess the effectiveness of comprehensive prophylactic therapy.