Abstract: Aim: was to assess the accuracy of the diagnosis of malformations of the fetus at early stages of pregnancy Materials and methods: 26,404 pregnant women who came to the Republican Center for Screening Mothers and Children on a routine basis in terms of 11 to 20 weeks of pregnancy were examined. Among them, 25,956(98,3%) women were pregnant with a physiological course of pregnancy, 269(1,0%) pregnant women with fetal malformations and 179(0,7%) with pathological pregnancy Prenatal diagnostics included ultrasound, biochemical, invasive and cytogenetic research methods. Initially, a primary ultrasound study of pregnant women was conducted, with the purpose of measuring fetometric, biometric and dopplerometric parameters. In case of deviation of above mentioned parameters from the norm, a second stage-biochemical screening was carried out. When biochemical parameters changed from normative values, the third stage was carried out - invasive and cytogenetic diagnostics. Results: based on results of studies, all women were divided into 3 groups. The first group included women with a physiological course of pregnancy - 25,956(98,3%). In the second group of patients (n=269) with single fetal malformations, there were 230(85,5%), with multiple - 39 (14,5%). In the third group of women (n=179), in most cases, a non-developing pregnancy was registered - 99(55,31%), females with uterine fetal death were 69(38,5%), with bladder drift - 11 (6,2%). Conclusions: every pregnant woman should be examined individually, regardless of age. When carrying out prenatal diagnosis of malformations of the fetus, doctors should use a single algorithm for performing an ultrasound examination. Practitioners should not rely on the age of the pregnant woman; regardless of the age of the pregnant woman, to conduct a more detailed examination for fetal malformations, both 35 years of age and older and younger than 35 years. In order to avoid undeveloped pregnancy, and intrauterine fetal death, as well as early detection of fetal malformations, there is a need for screening in the first trimester of pregnancy Inclusion of the first trimester in the screening program in a timely manner will create risk groups for the birth of children with malformations of the fetus, timely resolve the issue of further introduction of pregnancy, thereby reducing obstetric complications, and also reduce maternal and infant mortality. References 1. Аilamazyan EK, Baranov VS. Prenatal diagnosis of hereditary and congenital diseases. М .: MEDpress-inform. 2006; 74-82 [In Russ]. 2. Prenatal diagnosis of congenital malformations of the fetus. Ed. R. Romero et al. M .: Medicine. 1994; 448 р. [In Russ]. 3. Snyders R.J.M., Nicolaides K.K.H. Ultrasound markers of chromosomal defects of the fetus. M .: Vidar. 1997; 13-21 [In Russ]. 4. Medvedev MV, Yudina EV. Retardation of intrauterine development of the fetus. Moscow: RAVUZDPG. 1998; 204 р. [In Russ]. 5. Teratology of human. Ed. G.I. Lazyuk. M .: Medicine. 1991; 315 р. [In Russ]. 6. Ginter EK. Medical genetics. Textbook. M .: Medicine. 2003; 445 р. [In Russ]. 7. Baranov VS, Kuznetsova TV. Cytogenetics of human embryonic development. S-Pb: N-L. 2007; 640 р. [In Russ]. 8. Prenatal diagnosis of congenital malformations in early pregnancy. Ed. M.V. Medvedev M .: RAVUZDPG. Real time. 2000; 160 р. [In Russ]. 9. Medvedev MV, Altynnik NA. About ultrasound evaluation of fetal anatomy in early pregnancy. Prenat. Diagn. 2002; 1(2): 158-159 [In Russ]. 10. Medvedev MV. Fundamentals of ultrasound in obstetrics. Moscow: Real Time. 2006; 94 р. [In Russ]. 11. Medvedev MV. Ultrasonic fetometry: reference tables and nomograms. Moscow: Real Tim^ 2002; 80 р. [In Russ]. 12. Esetov MA. Ultrasound diagnosis of congenital malformations of the fetus in early pregnancy. Avtoref....doct. med. scie. Moscow, 2007; 26 р. [In Russ]. 13. Medvedev MV. What influences early prenatal diagnosis of skeletal dysplasia? Prenat. Diagn. 2003; 2(3): 237-240 [In Russ]. 14. Nicolaides KH, Sebire NJ, Snijders RJM. The 1113+6 weeks scan. London: Fetal Medicine Foundation. 2004; 192 р. 15. Kamalidinova Sh M. Development of regional standards for ultrasonic fetometry in the 16-40 weeks of pregnancy in the Republic of Uzbekistan. Doctor-Postgraduate student. 2009; 9(36): 728-734 [In Russ]. 16. Carvalho MHB, Brizot ML., Lopes LM, Chiba CH, Miyadahira S, Zugaib M. Detection of fetal structural abnormalities at the 11-14 week ultrasound scan. Prenat. Diagn. 2002; 22(1): 1-4. 17. Den Hollander NS, Wessels MW, Niermeijer MF, Los FJ, Wladimiroff JW Early fetal anomaly scanning in a population at. increased risk of abnormalities. Ultrasound Obstet. Gynecol. 2002; 19(4): 570-574.
Abstract: Aim: was to evaluate possibilities and advantages of endovascular treatment of intracranial aneurysms (IA) and arteriovenous malformations (AVM) using three-dimensional navigation (3D-roadmapping). Materials and methods: during 2010-2013 years 103 embolizations of IA and AVM ir 88 patients were performed in our angiography department. Embolizations of IA were managed by metallic detachable coils, embolizations of AVM - by Histoacryl : Lipiodol glue composition. 3D-roadmapping technique was applied for guidance of endovascular tools in cerebral arteries anc catheterization the IA cavity and AVM-feeding arteries during the procedure. 3D-roadmapping technique is based on creation of composite images that consist of two-dimensional fluoroscopic views superimposed on virtual three-dimensional model of the vessel. Results: endovascular interventions with 3D-roadmapping were performed in 65(63%) cases. In 49 (75%) cases we used 3DRA data to create three-dimensional model of cerebral vessels and in 16 (25%) cases - CT-angiography data. Complex algorithm of diagnosis and endovascular treatment of IA and AVM using 3D-roadmapping was introduced. Conclusion: our experience of the endovascular embolization of IA and AVM with 3D-roadmapping convincingly showed that usage of this technique is possible and effective. In comparison with two-dimensional navigation there was a tendency in reduction of the effective exposure dose, also there was a statistically significant decrease of amount of contrast material , and of time for superselective catheterization of AVM-feeding arteries and IA cavity. References 1. Becske T., Jallo G.I. Chief Editor: Lutsep H.L. Subarachnoid Hemorrhage. Updated: Oct 20, 2011 Available at: http://www.emedicine.medscape.com. 2. Krylov V.V., Prirodov A.V., Petrikov S.S. Netravmaticheskoe subarahnoidal'noe krovoizlijanie: diagnostika i lechenie [Nontraumatic subarachnoid hemorrhage: diagnosis and treatment.]. Consilium Medicum. Bolezni serdca i sosudou 2008; 1: 14-18 [In Russ]. 3. Методические Указания 2.6.1.2944-11 «Контроль эффективных доз облучения пациентов при проведении медицинских рентгенологических исследований». Metodicheskie Ukazanija 2.6.1.2944-11 «Kontrol jeffektivnyh doz obluchenija pacientov pri provedenii medicinskih rentgenologicheskih issledovanij»[«Control of effective patient dose in medical X-ray examinations»] [In Russ]. 4. 5. Debrun G.M., Aletich V.A., Kehrli P., et al: Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: The preliminary 6. Debrun G.M., Aletich V.A., Kehrli P., Misra M., Ausman J.I., Charbel F. Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: the preliminary 7. Fernandez Zubillaga A., Guglielmi G., Vinuela F.. Duckwiler G.R. Endovascular occlusion of intracranial aneurysms with electrically detachable coils: correlation of aneurysm neck size and treatment results. AJNR Am. J. Neuroradiol. 1994;15: 815-820. 8. Svistov D.V., Pavlov O.A., Kandyba D.V., Nikitin A.I., Savello A.V., Landik S.A., Arshinov B.V.. Znachenie vnutrisosudistogo metoda v lechenii pacientov s anevrizmaticheskoj bolezn'ju golovnogo mozga [Meaning of intravascular method in patients with aneurysmal disease brain.]. Nejrohirurgija. 2011; 1: 21-28 [In Russ]. 9. Gallas S., Januel A.C., Pasco A., Drouineau J., Gabrillargeus J., Gaston A., Cognard C., Herbreteau D. Long-term follow-up of 1036 cerebral aneurysms treated by bare coils: a multicentric cohort treated between 1988 and 2003. J. Amer. J. Neuroradiol. 2009; 30(10): 1986-1992.
