FEATURES OF LATE PRETERM INFANTS IN THE CONDITIONS OF THE REGIONAL PERINATAL CENTER

The purpose of the study was to investigate the main factors predisposing to the birth of children at gestational age of 34–36 weeks, the features of the course of the neonatal period, the structure of morbidity and mortality in the conditions of the regional perinatal center. Material and methods. A retrospective analysis of 380 medical records of an inpatient patient of the Regional Perinatal Center of State Novosibirsk Regional Clinical Hospital born on a gestational age of 34–36 weeks for 2017–2018 was performed. Results and discussion. All women with premature late delivery had a burdened somatic and/or obstetric-gynecological history. 70 % of women were delivered by surgery. The anthropometric characteristics of late preterm infants in 85 % of cases corresponded to gestational age, in most of them the neonatal period proceeded with the development of respiratory disorders, hyperbilirubinemia, and low tolerance to enteral nutrition. Children with less gestational age needed respiratory support for a longer time. Due to the difficult condition at birth, about 40 % of the children were transferred from the maternity ward to the intensive care unit of the newborn. A quarter of late premature infants received medical care exclusively in a maternity hospital. The mortality rate was 1 %. Thus, late premature babies are a special category of newborns, when nursing which it is necessary to carry out timely diagnosis of pathological conditions, as well as the prevention of adaptation disorders, especially in the early neonatal period

Возможности лучевых методов в ранней пренатальной диагностике диастематомиелии (клинический случай)

The presented clinical case demonstrates capabilities of ultrasonography and MR imaging in diagnostics of combined developmental defect of spine  (disorganization, wedge-shaped vertebra, scoliosis) and spinal cord (diastematomyelia) in fetus of 21th week of development confirmed by pathomorphological study.Представленный клинический случай демонстрирует возможности УЗИ и МРТ в диагностике сочетанного порока развития позвоночника (дезорганизация, клиновидные позвонки, сколиоз) и спинного мозга (диастематомиелия) у плода на 21-й нед развития, подтвержденные при патоморфологическом исследовании

External cephalic version. Case report and literature review

Breech presentations are at a greater risk of perinatal and neonatal mortality and morbidity than cephalic presentations. Currently more then 80% of breech presentations are dealt with by caesarean section. External cephalic version from 36 weeks reduces the chance of breech presentation at birth and caesarean section. Large observational studies suggest that complications are rare. Success rates for external cephalic version at term in routine clinical practice is of 48% to 78%. The clinical use of ECV at term, with the appropriate precautions, should be offered any woman in whom the value of an improved chance of a cephalic birth outweighs the risk of the procedure. In this article is described the case report of a successful external cephalic version and review the literature on this subject.Самопроизвольные роды в тазовом предлежании связаны со значительно более высоким риском перинатальной заболеваемости и смертности в сравнении с родами в головном предлежании. Этим обусловлена высокая частота кесарева сечения при тазовых предлежаниях. В настоящее время показано, что наружный акушерский поворот после 36 недель является безопасной альтернативой традиционному ведению родов при тазовом предлежании (через естественные родовые пути, либо кесарево сечение). Успешность поворота достигает 48 - 78%. Многими исследованиями показано, что наружный акушерский поворот рационально предлагать всем беременным с тазовым предлежанием с учетом противопоказаний к процедуре. В статье описан клинический случай успешного наружного акушерского поворота и представлен обзор литературы по этому вопросу

Biomarkers of gastric atrophy at stomach cancer

Background. Atrophic gastritis (AG), being the basic premalignant condition for the stomach cancer (SC), is commonly diagnosed and screened for by noninvasive biomarkers (pepsinogens, gastrin-17), however the data on those biomarkers at SC is inconsistent. Aim of investigation. To evaluate the markers of stomach atrophy along with risk factors of SC of different localization, histological type and stage in the «case series» study. Material and methods. Original investigation was designed as «case series», that included 85 patients with SC (48 m and 37 f, mean age 61.2±13,6 years) who were consistently referred to two medical institutions. All patients underwent interviewing the questionnaire concerning smoking and alcohol consumption, presence of gastroenterological symptoms and family history. Blood serum samples were analyzed using ELISA test kits «GastroPanel» («Biohit Plc», Finland). Manufacturer recommended threshold levels were used at diagnostics of AG. Results. The diagnosis of SC of the III to IV stage was established in 67.9% of patients. The most common location of the neoplasm was the stomach body (63,5%). Helicobacter pylori (H. pylori) infection was revealed by serological method in 74.1% of cases, of which in 15.1% the attempt of eradication treatment was carried out. In 90.6% of patients the adenocarcinoma of different differentiation grade was diagnosed, low degree of differentiation was the most common (57.6%). Signet-ring cell carcinoma was diagnosed in 7.1% of patients, undifferentiated tumor - in 2.4%. Pepsinogen-I (PGI) level under 50 mcg/l was found in 43.2% of patients, indicating different degrees of fundic atrophy. Significantly lower PGI scores were detected in SC patients with histologically verified atrophy. No significant differences in biomarker levels according to tumor location, histological type of SC and tumor stage were found. Conclusions. The «case series» study demonstrated high rate of late SC diagnostics with predominance of corpus location and the most malignant types. H. pylori infection was diagnosed in serologically in the most of patients, however attempts for eradication therapy was carried out only in 15% of patients. Fundic atrophy was diagnosed by serological tests in over 40% of patients, however no association with location, stage and morphological type of the tumor was established. Blood serum samples were analyzed using ELISA test kits «GastroPanel» («Biohit Plc», Finland). Manufacturer recommended threshold levels were used at diagnostics of AG