Safonovа I. Antenatal ultrasonographic monitorings and determine the degree of perinatal risk to optimize the antenatal care and postnatal tactics.

The work is dedicated to the development and scientific substantiation of a differentiated system of perinatal risk graduations according to antenatal ultrasonographic (US) monitorings results to improve antenatal care, optimize prenatal counseling, perinatal prognosis and the need for post-natal follow-up at pregnancy at a low risk and at a high risk.In the antenatal period US studies were performed in 6228 pregnant women to obtain further perinatal and postnatal follow-up data. 4580 women with singleton pregnancies at a low risk were examined in a prospective observational population-based study, 1458 pregnant women at a high risk due to different factors, were examined in the framework of prospective cohort studies and case series analysis.The study investigated and proved the value of routine US scan in the III trimester of low-risk pregnancy.The operative characteristics of antenatal US monitoring in the diagnosis of diabetic fetopathy, fetal hemolytic disease, the specific anomalies of multiple pregnancy were studied, as well as predictions of perinatal complications in post-term pregnancy in determining of perinatal risk degree.Based on the results of the study echographic perinatal risk gradations were proposed as extremely high or high risk which require monitoring in perinatal center, or uncertain risk which requires postnatal follow-up. The development of advanced tools for calculating the degree of perinatal risk as echographic scale can improve the understanding of different professionals working in the general perinatal space: obstetricians, radiologists and neonatologists.