The article discussesthe currentstate of the care level for fetuses, newborns and children with congenital abnormalities of the cardiovascular system. There are considered the features of prenatal diagnostics of heart defects and aspects of the management of pregnancy and childbirth of women with the specified pathology in the fetus. The authors made the analysis of the existing problems in the diagnosis and treatment of congenital heart defects and heart rhythm disorders in children. The article substantiates the introduction of the perinatal cardiology concept and formulates the main issues to be solved at this stage of development.

The respiratory syncytial viral (RSV) infection is the leading cause of lower respiratory infections (bronchiolitis, pneumonia) in young children. Premature children and children with an inherent heart defect experience a heavy course of the infection, they require treatment in the resuscitation department, oxygen therapy and ALV. This article summarizes the first experience in Russia of executing a regional program on immunoprophylaxis of the RSV infection using monoclonal RDV-antibodies prepared with palivizumab among the following categories of children: premature children, children with a bronchopulmonary dysplasia and an inherent heart defect. The inclusion of palivizumab into the rehabilitation program of these categories of patients allowed to decrease the frequency of lower respiratory infections and corresponding hospitalizations by 4.6 and 4.8 times respectively. Not a single patient out of the 5 hospitalized with a lower respiratory infection, immunized with palivizumab, had his treatment connected with RSV. A high level of the drug's safety was also determined-none of the children experienced any sort of unwanted effects.

Aim. To compare the data of pre- and postnatal expert echocardiographic diagnostics of obstructive left heart defects (LHD) to identify a possible predictors and reasons for hypo- and overdiagnosis of this.Material and methods. A retrospective analysis of data from expert echocardiography of 194 fetuses and newborns with suspected obstructive LHD (coarctation of the aorta (CA), interruption of the aortic arch, aortic stenosis (AS), CA or interruption of the aortic arch with AS, hypoplastic left heart syndrome (HLHS)) was performed.Results. After birth, critical obstructive LHD was confirmed in 59,3% of newborns (115 out of 194): in cases of prenatally diagnosed CA — in 41% of children (42 out of 103); AS — in 67% (4 out of 6); CA with AS — in 65,9% (27 out of 41); HLHS — in 93,9% (39 out of 44); or interruption of the aortic arch with and without AS — in 100% (11 out of 11). After birth, the discrepancy in diagnoses of critical congenital heart defects was detected in 2 cases — obstructive LHD were not confirmed, but total anomalous pulmonary venous drainage (APVD) was detected. In children with a confirmed diagnosis of HLHS after birth, there was a hypodiagnosis of obstructive forms of APVD in three newborns.Conclusion. The probability of confirming a critical obstructive LHD after birth is higher, the more LHD were hypoplasized during intrauterine imaging. APVD may be “hemodynamically masked” as HLHS when prenatal echocardiography is performed. The combination of HLHS and obstructive forms of APVD can lead to HLHS “hemodynamic aggravation” due to an additional decrease in blood flow of left heart.

The article discusses the current state of the medical care for fetuses, newborns and children with cardiac rhythm and conduction disturbances. The authors discuss the features of prenatal diagnostics of arrhythmias and management of pregnancy and childbirth of women with this pathology of the fetus. They analyze the diagnostics and treatment issues of arrhythmias in children. The article substantiates the introduction of the perinatal cardiology concept and formulates the main issues of this stage of development.