The aim: To evaluate the peculiarity of clinical manifestations of neonatal respiratory distress syndrome (NRDS) in deeply premature infants from mothers with phenotypic markers of undifferentiated connective tissue dysplasia (UCTD). Materials and methods: The study represent the results of a retrospective clinical and statistical analysis of 268 premature birth report card and newborn report sheet. .The main (1 group) included 50 pregnants with obvious phenotypic markers of UCTD, the comparison group (group 2) consisted of 50 pregnant women without phenotypic markers of UDCTD. Results: According to the study, in 12 (24%) pregnant women of the main group at the time of admission to the clinic had contractions,which required specific therapy. Cervical cerclage was performed in 38 (76%) patients of the main group due to the presence of cervical insufficiency (CI). In these cases, the severity of the CI on the Steinber scale was 7.2 ± 0.4 points in the main group against 4.4 ± 0.2 points in the comparison group (p <0.05). Group I patients were more likely to have complications of labor such as:premature rupture of membranes, uterine contraction abnormalities and fetal distress, which required in most cases cesarean delivery (7% and 2%), respectively (p <0.05). The incidence of neonatal complications requiring respiratory support was 67% in group I and 48% in group II. According to our observations, the clinical manifestations of bronchopulmonary dysplasia were twice as high in infants of the main group (66%) against (44%) of the comparison group (p <0.05). Conclusions:1.Neonatal respiratory distress syndrome in premature infants is more often associated from mothers with UDCTD. 2. The high importance of steroid prophylaxis of NRDS and antioxidant therapy in reducing the frequency of mechanical ventilation and the development of bronchopulmonary pathology, especially in infants from mothers with UDCTD syndrome, has been proven. 3. The possibility of diagnosing disorders of functional maturation of the lungs in the fetal period using a non-invasive method of ultrasonography has been confirmed.

Вступ. Маловоддя у вагітних – акушерська патологія, яка тісно пов’язана з акушерськими ускладненнями та перинатальної патологією. Мета дослідження. Вивчити морфологічні зміни в посліді на органічному, тканинному та клітинному рівнях у жінок при маловодді. Матеріали та методи. Вивчено основні органометричні параметри посліду та проведено морфологічне дослідження плаценти у 50 жінок, які народжували при маловодді, і у 30 з фізіологічною вагітністю. Результати досліджень та їх обговорення. Згідно з даними клініко-морфологічних досліджень, вагітність у жінок з маловоддям тісно пов’язана з морфологічними особливостями посліду. Органометричні параметри плаценти, пуповини і морфологічна картина екстраембріональних структур вказують на порушення морфогенезу в даних структурах, а також на морфофункціональні зміни, що характерні для розвитку плацентарної і параплацентарної недостатності. За результатами досліджень, у 54% в стромі ворсин хоріону виявлено нагромадження плодового фібриноїду, в 44,0% склероз проміжних і термінальних ворсин. В амніотичному епітелій плодових оболонок морфологічні зміни в епітеліоцитах мали характер дистрофії у вигляді вакуолізації і гігантоклітинної дистрофії. Ключові слова: плацента, плодові оболонки, маловоддя.

The aim: The impact of undifferentiated connective tissue dysplasia on the formation of the placenta. Materials and methods: The morphostructure of 50 placentas with the undifferentiated connective tissue syndrome and 50 placentas of women with physiological pregnancy and absence of connective tissue pathology was studied. Results: The results of morphological studies have shown that the main pathogenetic link of placental dysfunction with highly resistant blood flow in the umbilical arteries in pregnant women with undifferentiated connective tissue dysplasia syndrome is a disorder of functional differentiation of the villous tree.In these cases the dominats were large and medium-sized villi with narrowed lumen in arterial, venular and capillary vessels and arterial spasm and venous plethora, as well as with numerous chaotically sclerosed villi, indicating stage I and II of placental. There is a large amount of fibrins in intervillous space which narrows it and leads to violation of microcirculation and placenta tissue hypoxia. Conclusions: The morphological basis of high flow resistance in the umbilical artery with the undifferentiated connective tissue dysplasia syndrome in pregnant women is a pathological immaturity of the placental villous tree. Morphological study of the architecture of the stem and intermediate placental villi revealed a violation of the structure of collagen fibers in the form of lack of crosslinks of bundles of collagen fibers.

The aim: Study of the relationship between cervical insufficiency and dysplastic stigma in miscarriages. Materials and methods: 80 pregnant women were examined at 23-27 weeks of gestation.) Group I included 40 pregnant women with the threat of premature birth, with habitual miscarriage and correction of cervical insufficiency (CI) by using pessary in the anamnesis. Group II consisted of 20 pregnant women with the threat of premature birth and correction of CI by using pessary without the burden of habitual miscarriage, the control group of 20 almost healthy pregnant women. Results: The studies revealed phenotypic signs of dysplastic stigmatization in 39 (97.5 + 2.5%) pregnant women of group I, in 18 (90.0 + 6.9%) group II and in 4 (20.0 + 9.2%) control, which indicates a high prevalence of connective tissue dysplasia in women with CI, which also has a laboratory reflection in the form of increased excretion per day of oxyproline and a decrease in total glycosaminoglycans in both groups at risk of preterm birth. Conclusions: The most common gestational complication in women with connective tissue dysplasia is the risk of premature birth. Improving existing and finding new diagnostic and therapeutic measures for women with UDСTD will reduce the risk of preterm birth.