Shauosh B. Priority choice of delivery way in risk group pregnant women with perinatal pathology.

Object of the study: Pregnant (37-39 weeks of gestation) with a small pelvis, large fetus and obesity. Purpose of the study: To reduce maternal and perinatal compli-cations in women with a high risk of perinatal pathology (obesity, small pelvis, large fetus) by means of choice of optimum method of delivery using MRI data. Methods of the study: MR cephalopelvimetry, USS, clinical ex-amination, anthropometry, clinical and statistical methods. Practical significance: consists in reduction of the number of un-necessary operations of cesarean section using choice of delivery tactics on the basis of the findings of determining correspondence of the inner size of the pelvis and thickness of the soft tissue and to the size of the fetal head. Objective possibility to increase the per-centage of planned operations and prevention of urgent ones was determined. A protocol of MR fetopelvimetry was worked out and introduced into practice. Morgan's index was modified with the account of the fat layer thickness. Thecapabilities and high efficacy of MR fetomelvimetry during the choice of optimum method of delivery in prevention of maternal and newborn trauma, perinatal pathology were shown. Novelty of the obtained results: For the first time, comparative study of traditional anthropometry and MR fetopelvimetry was done. Discrepancy of external and internal sizes of the pelvis in women with obesity was proven. The findings of MR study of the maternal pelvis, fetal head, thickness of presacral and postsacral fat layer are new. The accuracy of prognosis of the newborn weight and correspondence of the sizes of the pelvis and fetal head was de-termined. The findings of the research allowed to test a new objective approach to determining the method of delivery in high risk pregnant with perinatal pathology (obesity, small pelvis, large fetus), MR cephalopelvimetry. The necessity of this study in the above group of patients was substantiated. Introduction: The findings of the research were introduced to the practical work of fourmaternity hospital of Zaporozhie, Regional Clinical Hospital, are used in pre-attestation and training for obstetricians and gynecologists and radiologists in Zaporozhie Medical Academy for Post-graduate Training. Sphere of application: Medicine, obstetrics and gynecology.