[Morphological diagnosis of obstetric pulmonary embolism]. / Morfologicheskaya diagnostika akusherskoi tromboembolii legochnoi arterii.

Pulmonary embolism (PE) is one of the most common fatal complications in a wide variety of pathologies along the most common death causes of the population - diseases of the circulatory system and oncology. The development of PE in the postoperative and postpartum periods can also be fatal. The diagnosis of PE is very difficult and in 50-80% of cases it is not diagnosed at all. During autopsies it is important not only to diagnose PE but also to establish the source of its origin. An example of PE in a 34-year-old pregnant woman is given; the PE source was thrombosis of the right deep femoral vein facilitated by varicose veins of the lower extremities and severe preeclampsia. The presence of severe preeclampsia in a pregnant woman caused the development of venous sinus thrombosis accompanied by bilateral exophthalmos, necrosis of a pituitary gland part and progressive cerebral edema.

CHOLESTASIS OF PREGNANCY.

The article presents data concerning the prevalence, clinical manifestations, methods of diagnostics, treatment and prevention of cholestasis of pregnancy, as well as the case management depending on the gestation and the cholestasis severity. A clinical case of a typical course of cholesrasis of pregnancy is presented.

PANCREATITIS IN PREGNANCY: CASE MANAGMENT.

The purpose of the review is to summarise the current data on chronic and acute pancreatitis with the goal to improve the diagnostics and treatment of women during pregnancy, which complicates differential diagnosis of hepatopancreatobiliary system pathology. The features of the incidence, etiology, parhogenesis and evaluation of the severity of the clinical manifestations of acute pancreatitis in pregnant women are given, It is emphasis that the most frequent its reason is the gallstones following by the biliary pancreatitis. The experience of use in pregnant patients imaging methods - endoscopic ultrasound, magnetic resonance cholangiopancrearography and endoscopic retrograde cholangiopancreatography, as well as treatments that include endoscopic sphincterotomy, stone extraction from the common bile duct and laparoscopic cholecystectomy. The recommendations are based on expert opinions and are not supported by randomized controlled trials. Nevertheless more active clinical management allows to diagnose and treat effectively pancreatitis, including biliary etiology, which contributes to a sharp decline in maternal and perinatal mortality.