This work is devoted to the studying of usefulness of 1st trimester combine screening test, when ultrasound and biochemical markers of chromosomal anomalies are estimated for prediction of late obstetrical complications, like intrauterine fetal growth retardation, gestational hypertension, preeclampsia, preterm delivery. These diseases are placenta related and occur due to the insufficient throphoblast invasion and uterine spiral arteries remodeling at the end of the 1st and in the 2nd trimesters of pregnancy. The objects of investigation were all pregnant women without exception at term 11+0-13+6 who visited our clinic for 1st trimester combined test with calculations of personal risks for chromosomal anomalies. Of these women, 565 patients with known pregnancy outcomes and those who had singleton pregnancy. The 1st trimester combine screening test was provided according to standards of the Fetal Medicine Foundation.It was determined, that combination of early diastolic notches on both uterine arteries Doppler spectrum, RI >0,8, PI>2,0, small volumes of fetus, placenta and their correlations with CRL (placenta 3D Volume/CRL?1,0 and fetal 3D Volume/CRL<0,35) low levels of РАРР-А and ?-hCG (less than 0,35 MoM), increased quantity of NK cells in peripheral blood and their cytotoxic activity in vitro are the most important symptoms in the prediction of such complications, as intrauterine fetal growth retardation, hypertension, preeclampsia with early manifestation, preterm deliveries are associated with the worst parameters of newborns. The calendar of screening examinations is offered which in all categories of patients allows timely, with high efficiency, without additional unnecessary investigations and charges to reveal overwhelming majority of possible chromosomal anomalies and malformations; as far as the signs of possible future obstetrical complications: 11+0-13+6, 20-21 g.w. (actual recommended calendar in Ukraine is: 9?11 and 16?19 g.w.); for all pregnant women with the signs of the probable futureobstetrical complications - more detailed echography at 20-21 g.w. with obligatory uterine arteries Doppler, more thorough follow-up of fetal condition, and, if necessary, additional ultrasound examinations. Such calendar of screening examinations allows to introduce the approach "Fetus as a patient", to attract neonatologists and family's members for cooperation with obstetricians-gynecologists in order to optimize perinatal care
