Nidelchuk O. Optimization of prenatal diagnosis, pregnancy and delivery at birth defects of the lungs and congenital diaphragmatic hernia in the fetus.

The dissertation is devoted to the development and implementation of innovative methods of prenatal diagnosis, management of pregnancy and delivery at congenital malformations (CM) of the lungs and congenital diaphragmatic hernia (CDH) in the fetus, to reduce mortality, morbidity and disability from this pathology. The risk factors, peculiarities of the course of the pregnancy, childbirth and the state of newborns in women with prenatally diagnosed CM of the lungs and CDH in the fetus are determined. Developed and patented prenatal ultrasound methods for assessing the state of fetal lungs: a method for determining the fitting of lung dimensions to the age of gestation based on pulmonary-femoral index (PFI) and a method for determining the degree of fetal pulmonary hypoplasia. First developed and implemented working classifications for the evaluation of the fetal lung hypoplasia based on the analysis of lung biometrics data and the calculation of gestational compliance indices at CM of the lungs and CDH. The gestational normograms of fetal lung size without birth defects for each week of physiological pregnancy from 12 to 37 weeks have been obtained. The new ultrasound criteria for normal and pathological development of lungs, the characteristics of ultrasound imaging in pattern in the dynamics of pregnancy are presented. The efficiency of prenatal multidisciplinary consultation is proved in the presence of congenital anomalies of lung and CDH. A comparative analysis of the results of retrospective and prospective studies has revealed.