[Preventability of perinatal losses by the example of the large industrial cities Chelyabinsk and Novosibirsk]. / Predotvratimost' perinatal'nykh poter' v Cheliabinske i Novosibirske.

Perinatal mortality rate is an indicator that characterizes the quality of medical care, as well as the social and economic situation in the region. OBJECTIVE: to audit perinatal losses in large regional centers of the Russian Federation with a population of over 1 million inhabitants, such as Chelyabinsk and Novosibirsk. MATERIAL AND METHODS: A comprehensive postmortem examination of 309 cases of perinatal losses in 2016 was made, which was supplemented with an assessment of preventability according to the Scandinavian-Baltic classification. RESULTS: The rate of preventable deaths in Chelyabinsk and Novosibirsk amounted to 91 and 81.5% of cases, respectively; the deaths were due to stillbirths at more than 28 weeks' gestation and to dead newborns in almost half of cases. The proportion of intranatal deaths was shown to increase in Chelyabinsk; the number of neonatal deaths at more than 33 weeks' gestation rose in Novosibirsk. CONCLUSION: Supplementing the traditional clinical and postmortem analysis with an assessment of the preventability of perinatal loss makes it possible to ensure a unified approach to evaluating these conditions and the comparability of autopsy results in different subjects of the Russian Federation and to determine regional reserves for reducing perinatal mortality rates.

[Liver disease and maternal mortality]. / Patologiia pecheni i materinskaia smertnost'.

Liver diseases associated (acute fatty liver of pregnancy) and unassociated (liver hemangioma) with pregnancy and complications due to liver failure are serious conditions and can lead to maternal death. The paper describes two maternal deaths related to liver pathology.

[Features of Expression of the PsSst] and PsIgn1 Genes in Nodules of Pea (Pisum sativum L.) Symbiotic Mutants].

The sequences of the PsSst1 and PsIgn1 genes of pea (Pisum sativum L.) homologous to the symbiotic LjSST1 and LjIGN1 genes of Lotusjaponicus (Regel.) K. Larsen are determined. The expression level of PsSst1 and PsIgn1 genes is determined by real-time PCR in nodules of several symbiotic mutants and original lines of pea. Lines with increased (Sprint-2Fix⁻ (Pssym31)) and decreased (P61 (Pssym25)) expression level of both genes are revealed along with the lines characterized by changes in the expression level of only one of these genes. The revealed features of the PsSst1 and PsIgn1 expression allow us to expand the phenotypic characterization of pea symbiotic mutants. In addition, PsSst1 and PsIgn1 cDNA is sequenced in selected mutant lines, characterized by a decreased expression level of these genes in nodules, but no mutations are found.

[Amniotic fluid embolism as a cause of maternal death].

This article reports the case of death of a puerperal woman resulting from amniotic fluid embolism. The diagnosis was established based on the results of the pathohistological study that revealed the presence of mucoproteides and epithelial scales in pulmonary blood vessels and capillaries.

[Placental morphology in inherited thrombophilia].

OBJECTIVE: To study placental morphological changes in inherited thrombophilia. SUBJECT AND METHODS: A morphometric method was used to examine placentas from 37 patients divided into 3 groups: 1) 13 pregnant women with verified inherited thrombophilia; 2) 14 pregnant women with inherited thrombophilia and signs of placental inflammatory manifestations (basal deciduitis, intervillositis, placentitis); 3) 10 women with normal pregnancy (a control group). RESULTS: In inherited thrombophilia, the placentas exhibited morphological manifestations of chronic placental insufficiency as pathological immaturity with a predominance of intermediate differentiated villi and as dissociated maturity of cotyledones, with a substantial reduction in the specialized terminal villi, excessive intervillous fibrinoid formation and villous immuring, evolving pseudoinfarctions, fewer capillaries in the terminal villi, and their increased stromal proportion. At the same time, no significant differences were found in the morphological pattern in inherited thrombophilia concurrent with placental inflammatory changes. CONCLUSION: In inherited thrombophilia, there is chronic placental insufficiency caused by delayed development of the shaggy chorion.

[A case of congenital Coxsackie B virus infection].

The paper describes a clinical case of congenital Coxsackie B virus infection in a girl aged 1 month and 15 days of life who has undergone a detailed postmortem examination.

[The nosological structure of mortality of low-weight fetuses in Novosibirsk].

The nosological structure of mortality was studied among low-weight fetuses, by analyzing 667 autopsy protocols over 2006-2008. There were 255 cases of spontaneous miscarriage and 412 cases of medically indicated abortion. Spontaneous and artificial abortions most frequently occur in repeated pregnant women at 26-27 weeks gestational age. In the nosological structure of fetal mortality, intrauterine fetal asphyxia was most commonly in spontaneous miscarriage; intrauterine pneumonias and generalized infection ranked second; in artificial abortion, the number of congenital malformations doubled and that of intrauterine fetal asphyxia reduced. In spontaneous and artificial abortions, the incidence of decompensated chronic placental insufficiency increased by twice.

[The nosological structure of congenital fetal malformations in Novosibirsk].

The authors comparatively studied the nosological structure of congenital malformations (CM) in 395 fetuses at 22-27 weeks post-conception age and the efficiency of prenatal diagnosis in Novosibirsk. They analyzed 227 and 168 autopsy protocols of fetuses with CM over the periods from 2000 to 2002 and from 2006 to 2008, respectively. In the nosological structure of mortality among low-weight fetuses, CM ranked third in 2000-2002 and second in 2006-2008. During all the observation periods, the structure of CM showed 4 major systemic CMs: multiple anomalies of development, the central nervous and urogenital systems, heart, and vessels; multiple CMs occupying a prominent place. There was a preponderance of hydrocephalus and spinal hernias among central nervous system CMs, that of hydronephrosis with megaureter among urogenital CMs, and that of ventricular septal defect among CMs of the heart and vessels. The efficiency of prenatal diagnosis in the above observation periods was 46-75%.

[A case of neonatal galactosemia].

The paper describes a rare case of hereditary thesaurismosis, galactosemia, in a full-term neonate girl aged 12 days with morphologically verified fetal giant-cell cholestatic hepatitis with the development of ascitis and jaundice.

[A case of malignant germ-cell tumor with choriocarcinoma].

The authors describe a case of the malignant retroperitoneal germ-cell tumor in a 20-year-old male, which appears as several types of tissues that are derivatives of three germinal layers with the presence in its composition of choriocarcinoma, metastases of which to the vital organs were a cause of death.