[Prenatal cleft palate diagnostics by structural and functional peculiarities of the tongue].

The aim of the study was to assess tongue position and function in cleft lip and palate children in order to use them for ultrasound prenatal diagnostics of this malformation. The study included 258 cleft lip and palate patients, as well as 2078 pregnant women (20-22 gestation weeks). The ultrasound scans of 39 cleft palate fetuses were evaluated retrospectively. All cleft palate patients exhibited tongue configuration disorder, tongue asymmetry, low tip and high dorsum position. These signs may be useful for prenatal cleft palate diagnostics which fact is proved by assessment of ultrasound pictures of cleft palate pictures including that of 8 patients revealed prospectively.

[Doppler-metric and Doppler echocardiographic study of the nature and stage of disorders of fetal hemodynamics in intrauterine fetal growth retardation]. / Dopplerometricheskoe i dopplerékhokardiograficheskoe izuchenie kharaktera i étapnosti narusheniia gemodinamiki ploda pri vnutriutrobnoi zaderzhke ego razvitiia.

Pregnancy course, labor outcome, and doppler-metric findings were analyzed in 174 women, 98 with normal pregnancy (controls) and 76 with small-for-date fetuses when examined on weeks 28-41; the aim of the study was to analyze the pattern of hemodynamic disorders in small-for-date fetuses. A classification of fetal hemodynamic disorders has been developed, that distinguishes three types of disorders differing in severity: first degree--disordered fetoplacental circulation not reaching the critical values and satisfactory fetal hemodynamics; second degree--compensated disorders of fetal hemodynamics; third degree--critical state of fetal hemodynamics. Use of this classification in clinical practice will help define rational strategy of pregnancy follow-up.

[Pathogenesis of deceleration in the prenatal period]. / O patogeneze detseleratsii v antenatal'nom periode.

Comprehensive examination, making use of cardiotocography, dopplerometry, and doppler echocardiography, was carried out to disclose the contribution of fetal hemodynamic disorders to the pathogenesis of antenatal deceleration in 69 pregnant women. Disorders of both intracardiac fetal hemodynamics and of the fetoplacental circulation were revealed in all the cases with deceleration. Therefore, circulatory disorders underlie the pathogenesis of decelerations. The development of decelerations is related to the progressive deterioration of fetoplacental circulation and, specifically, to marked changes in the intracardiac hemodynamics in conditions of augmenting peripheral vascular resistance and hypoxia of the fetus.

[Doppler-echocardiographic study of intracardiac hemodynamics in intrauterine fetal growth retardation]. / Dopplerékhokardiograficheskoe izuchenie vnutriserdechnoi gemodinamiki pri vnutriutrobnoi zaderzhke razvitiia ploda.

Presents the results of Doppler echocardiographic examination of fetal hemodynamics, carried out in 90 women with normal pregnancy and small-for-date fetuses. Analyzes the specific features of fetal intracardiac blood stream in asymmetric and symmetric forms of development retardation. Discloses the regularity in changes of the ventricular diastolic function index in relation to placental resistance growth and of the maximal rate of transvalvular blood stream. Defines the Doppler echocardiographic signs of decompensation of myocardial contractility in conditions of high peripheral vascular resistance. Makes a conclusion on the relationship between changes of cardiac hemodynamics and centralized blood supply in small-for-date fetuses.

[Comparative study of dopplerometry and morphological study of placenta and uterine arteries in the evaluation of hemodynamic disorders in the "mother-placenta-fetus" system]. / Sravnitel'nyi analiz Dopplerometrii i morfologicheskogo issledovania platsenty i spiral'nykh arterii v otsenke gemodinamicheskikh narushenii v sisteme mat'-platsenta-plod.

The paper gives the comparative results of Doppler examination of blood flow in the mother-placenta-fetus system and morphological examination of the vessels of the funis, placenta, and placental bed. The latter examination allowed all the cases of placentomaternal and placentofetal circulatory diseases to be divided into 3 groups. There was a clear-cut correlation between the Doppler metric and morphological findings.

[Pathomorphology of spiral uterine arteries, umbilical vessels and placenta in disorders of maternal-fetal circulation]. / Patomorfologiia spiral'nykh arterii matki, pupochnykh sosudov i platsenty pri narusheniiakh materinsko-plodnogo krovotoka.

The comparison of the spiral uterine arteries structure, umbilical vessels and placenta is performed in 16 women with normal haemodynamics and in 31 women with disturbances of mother-foetus circulation, and the data obtained were compared with results of dopplerometry made before the delivery. Three clinical groups are distinguished according to the predominant localization of the resistance to the blood flow: the first--with the domination of the spiral arteries obliteration (lack of gestational changes, hyperplastic arteriosclerosis) with a characteristic ultrastructural pathology of the syncytiotrophoblast microvilli, rheological disturbances in the intervillous space and large necroses of villi; the second--with a predominance of early immaturity of the stroma and capillaries or sclerosis and compression of foetal villous capillaries, i. e. with a reduction of a capillary bed and increase of the resistance to the blood flow; the third--with a predominance of the umbilical arteries narrowing and supporting villi and signs of a blood stasis in the foetal veins. Morphologic heterogeneity of the mother--foetus circulation disturbances should be taken into consideration when choosing obstetric tactics.

[Doppler echocardiographic evaluation of fetal hemodynamics in the third trimester of uncomplicated pregnancy]. / Dopplerékhokardiograficheskaia otsenka gemodinamiki ploda v III trimestre neoslozhnennoi beremennosti.

This paper discusses the evaluation of intracardiac fetal hemodynamics using Doppler cardiography. Reference values have been obtained for transvalvular blood flow for atrioventricular valves and valves of major fetal cardiac arteries. Hemodynamic fetal patterns and their normal changes in third-trimester uncomplicated pregnancy are demonstrated.

[The diagnostic potentials of dopplerometry in the fetal growth retardation syndrome]. / Diagnosticheskie vozmozhnosti doplerometrii pri sindrome zaderzhki razvitiia ploda.

Findings of conventional sonography and Doppler studies at 34-41 weeks of gestation have been compared in 210 women. Uteroplacental and fetal blood flows were evaluated in intrauterine growth retardation syndrome. Sensitivity, specificity and predictive value of these studies were assessed for fetal vessels, umbilical artery, uterine arteries and fetal measurements. Obstetric and neonatal outcomes were analyzed in relation to hemodynamic abnormalities in the maternal-placental-fetal system.