[Placental mesenchymal dysplasia]. / Mezenkhimal'naia displaziia platsenty.

OBJECTIVE: To carry out a clinical and morphological analysis of 6 cases of placental mesenchymal dysplasia (PMD) that is not associated with Beckwith-Wiedemann syndrome. MATERIAL AND METHODS: Medical records, placental macroscopic and microscopic changes, histochemical (MSB staining) and immunohistochemical studies of placental tissue with antibodies against p57, CD34, smooth muscle actin, desmin, and Ki-67 were analyzed. RESULTS: Vascular anomalies in the chorionic plate and stem villi, the increased size and edema of the stem villi during normal formation of the terminal branches of the villous tree, the lack of proliferation of villous trophoblast were the typical signs of PMD and were noted in all cases. Comparison of the results of ultrasonography with the morphological pattern of the disease suggested that there were ultrasound signs that were typical of PMD. The characteristics of the course and outcomes of pregnancy in PMD were given. The features of morphological changes in the presence of PMD concurrent with preeclampsia were found. Significant variability in p57 expression in PMD was shown and variants of changes given. There were no substantial features of the expression of desmin and smooth muscle actin in PMD. CONCLUSION: MDP has typical morphological and ultrasound signs. The significant variability in the levels of chorionic gonadotropin and alpha-fetoprotein and in the expression of p57 does not allow their use in the differential diagnosis of PMD. The high incidence of thrombotic events in the intervillous space and fetal vessels, as well as intrauterine growth restriction, intrauterine hypoxia, and an impaired neonatal adaptation period in PMD should be taken into account when determining the management tactics for female patients and newborns.

[Surgical treatment of pregnant women with benign ovarian tumors].

The article describes the features of surgery in tumors and tumor-like formations of the ovaries in pregnant women. The influence of surgery on the course and outcome of pregnancy and childbirth is presented. It is showed high efficiency of laparoscopic surgery during I and II trimesters of pregnancy.

[Pregnancy in women with heart defects: outlook on the problem].

Modern approach to management of pregnancy and delivery in women with heart defects is presented in this paper. The 3-level system of observation of this contingent of patients is based on stratification of risk of development of cardiological complications which allows to form an algorithm of physicians actions, and to optimize tactics of ambulatory and hospital stages of treatment. Stratification of risk is supplemented with quantitative echocardiographic parameters which reflect hemodynamic overload of the myocardium and facilitate work of a practical physician. Special consideration is given to pregnant women subjected to palliative cardiac surgery. If contractile function is preserved these women have good prognosis relative to prolongation of pregnancy and unassisted delivery.

[Placental morphology in pregnancy complicated with iron-deficiency anemia].

Iron-deficiency anemia in pregnant females negatively affects pregnancy, delivery, neonatal infants. Anemia-caused placental changes found during pregnancy are characterized by imbalance between the processes of adaptation and dysadaptation in response to the developed hypoxia in the pregnant-placenta-fetus system and placental tissue ischemia. When iron-deficiency anemia had developed before pregnancy, placental morphological changes show the signs of chronic placental insufficiency. The developed therapy for anaemia with Ferro-Folgama corrects all the elements of the pregnant-placenta-fetus system.

[Supraventricular paroxysmal tachycardias during pregnancy: the therapeutic tactics and prognosis].

The paper contains recommendations on treatment of supraventricular paroxysmal tachycardias (SVPT) during pregnancy. The recommendations are based on contemporary literature data and authors" own data. SVPT in postural syndrome are shown to be benign and to demand no continuous antiarrhythmic therapy, while tachycardiac attacks are terminated by vagal tests and adenosine application. Relapsing and steady forms of SVPT with a high heart rate are accompanied by subjective symptoms and require preventive antiarrhythmic therapy, which should be conducted considering risk/benefit ratio. According to the authors, sotalol is the most effective and safe pharmaceutical.

[Preoperative preparation for abdominal delivery of pregnant women with fetal distress]. / Podgotovka k abdominal'nomu rodorazresheniiu beremennykh so stradaniem ploda.

A complex of the methods currently available for examining the fetoplacental system was used in 36 patients with severe extragenital and obstetric abnormalities, which allowed the authors to diagnose fetal affections such as hypoxia, hormonal dysfunction of the fetoplacental system before abdominal delivery. The employment of differential drug preparation for cesarean section with due regard to the severity of the fetus' status, maturity and the pattern of an obstetric and extragenital abnormality enhanced the adaptabilities of the fetus and improved perinatal parameters in cesarean section.