Ukrainian Journal of Perinatology and Pediatrics

Nuchal translucency as a potential marker of Emanuel syndrome: a case report

2025-09-20T23:06:21+00:00

Aim: to study a clinical case of Emanuel Syndrome (ES) in a newborn child, which arose as a result of a balanced chromosomal translocation in the mother, for early detection of the syndrome.

Clinical case. A 32-year-old woman with an uncomplicated family history presented with a fetus showing increased nuchal translucency (NT) of 3.2 mm at 12 weeks of gestation. The pregnant woman refused the proposed invasive testing. Second-trimester ultrasound identified placenta previa, moderate oligohydramnios, and a hyperechoic focus in the left ventricle, with no major structural anomalies. Biochemical markers in both trimesters were unremarkable. Postnatally, the infant displayed mild dysmorphic features, severe hypotonia, and profound developmental delay. Cytogenetic and Fluorescent In Situ Hybridization analyses confirmed Emanuel syndrome due to a supernumerary chromosome der(22)t(11;22) inherited from the maternal balanced translocation t(11;22).

Conclusion. Increased NT may serve as a useful early marker for ES in prenatal screening, even in the absence of structural malformations or family history. Further research is warranted to validate NT's role in improving early detection of the syndrome.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The copyright agreement from the child's parents was obtained for the study.

The authors declare no conflict of interest.

Familial dyslipidemia: a case from practice

2025-09-20T23:22:20+00:00

According to the leading world publications, near 450,000 children worldwide are born with familial hypercholesterolemia. However, there is still the problem of untimely confirmation of this pathological condition in the pediatric cohort of patients, as well as questions about the effectiveness of diagnosis and treatment.

Aim - to study the prevalence and course features of familial hyperlipidemia in young children, according to leading scientific sources and own practical experience, for physicians to get acquainted.

More than 28,000 papers were found in the research databases on the subject of the study. A generalization of literary data was carried out.

A clinical case of familial dyslipidemia in patient M. aged 1 month and 17 days was described. Disease manifested with the appearance of multiple xanthomas on the skin of the trunk, 0.3-0.5 cm in diameter, at the background of intoxication. Signs of anemic syndrome, increased levels of certain liver enzymes (aspartate aminotransferase, lactate dehydrogenase), as well as hypertriglyceridemia and hypercholesterolemia took place. Decreased level of fecal Elastase-I was noticed to confirm early signs of pancreatic insufficiency. The diagnosis of familial hyperlipoproteinemia type V according to Friedreichson was confirmed at the Center for Orphan Diseases and Gene Therapy of the National Children's Specialized Hospital.

Conclusions. According to various data, familial dyslipidemia, confirmed genetically, occurs in 89.9% of cases that are included in the registry of Familial Hypercholesterolaemia Studies Collaboration (FHSC). The clinical case presented for consideration confirms the genetic component and early manifestation of symptoms in an infant whose sibs also have similar symptoms to those of past acute hyperlipidemic pancreatitis.

The research was carried out in accordance with the principles of the Declaration of Helsinki. Copyright agreement from the child's parents was obtained for the study.

The authors declare no conflict of interest.

Obstetric aspects of metabolically associated steatotic liver disease

2025-09-20T21:57:35+00:00

Аim - to review the current literature on the frequency, etiopathogenetic factors, diagnosis and treatment of metabolically associated steatotic liver disease (MASLD) in pregnant women to develop criteria for predicting complications of pregnancy and childbirth.

The relevance of the problem of MASLD worldwide in the general population and in pregnant women is shown. Etiopathogenetic factors and risk factors that determine the occurrence of the disease are considered. The effectiveness of methods for diagnosing and treating pregnant women with MASLD is analyzed. Attention is focused on complications caused by MASLD during pregnancy for both the mother and the fetus. The impact of MASLD on the course of pregnancy and childbirth is considered, in particular, the risk of miscarriage, gestosis, premature birth, placental complications, fetal hypoxia, postpartum hemorrhage, and other obstetric problems.

Conclusions. Metabolically associated steatotic liver disease in the modern world has a tendency to increase in the general population, therefore it is a high socio-economic burden and is a global health problem that needs to be addressed by both medical communities and politicians, especially in obstetric practice, because pregnancy against the background of MASLD is characterized by a high risk of complications of both pregnancy and childbirth, leading to impaired condition of mothers, newborns and subsequent development of children, which indicates the need to develop criteria for routine screening of this nosology before conception and during pregnancy to identify a high risk group for the development of MASLD, criteria for timely prediction of complications of pregnancy, childbirth and optimize the tactics of pregnancy, childbirth and the postpartum period, which will lead to a decrease in obstetric and perinatal complications.

The authors declare no conflict of interest.

Chronic abdominal pain syndrome in pediatric practice

2025-09-20T22:14:56+00:00

The publication collects and systematizes the main factors and concepts of chronic abdominal pain syndrome, which relate to various etiological directions of the development of this phenomenon and their changes in the course of a number of pathological conditions. The work presents modern syndromal terminology and a list of regulatory documents regarding this pathological condition in pediatric practice. Despite the fact that during the last decade, numerous studies have been published regarding methods of diagnosis and treatment of chronic abdominal pain syndrome, inadequate relief of chronic pain remains a pressing problem in children.

Аim - a review of modern views on the etiopathogenesis of chronic abdominal pain syndrome and their analysis for an adequate perception of the existing problem in solving the issues of its diagnosis and treatment, prevention of negative consequences and prevention of possible complications.

Analysis of literary sources and own experience convincingly attests to the fact that chronic abdominal pain syndrome in children is a purely individual phenomenon that depends only on the leading pathological process in the abdominal cavity, which can be aggravated by the presence of concomitant pathology. Understanding this fact and a full-fledged laboratory-instrumental examination will make it possible to carry out a balanced differential diagnosis with the determination of the leading factor of chronic abdominal pain syndrome in each specific clinical situation.

Conclusions. Despite the multifaceted symptoms of chronic abdominal pain syndrome, in order to successfully and timely determine the leading diagnosis and choose the optimal treatment tactics, we consider the further development of their algorithms and standards of pathology taking into account its age aspects, at various stages of providing timely medical care in order to reduce the number of complications and negative consequences in this category of patients.

The authors declare no conflict of interest.

Psychological features of the development of children with autism spectrum disorders

2025-09-20T22:27:49+00:00

A set of disorders characterized by a deficit in communication and social interaction are autism spectrum disorders. Today, autism is not considered a disease. These are disorders that affect almost all aspects of a child's life. The psychological characteristics of the development of children with autism spectrum disorders depend on differences, disorders and deviations. Common to all autism spectrum disorders is impaired social integration and the reluctance of children with autism to come into contact with the environment.

Аim - to conduct a systematic analysis of scientific sources on the psychological characteristics of the development of children with autism spectrum disorders.

The identified signs of autism, such as impaired social interaction and communication skills, limited interest in things and activities, the need for stability, difficulties with the perception and understanding of emotions, require the study of the psychological characteristics of the development of children with autism spectrum disorders. The problem of studying the psychological characteristics of the development of children with autism spectrum disorders requires a controlled process of social development, social formation of the personality of a child with autism. There is a need to help the child in mastering moral relationships in the family and society, knowledge of legal, economic, civil and everyday relationships taking into account personal and social problems and needs of the environment. Scientists insist on the development of sociality (social values, social traits, social behavior) as a system of social interactions of an autistic child. The social formation of the personality of a child with autism spectrum disorders is a necessary component of the psychological characteristics of the development of children with autism spectrum disorders.

The authors declare the absence of a conflict of interest.

Preservation of the social health of adolescents under martial law

2025-09-20T22:48:46+00:00

A systematic analysis of scientific sources on the preservation of social health of Ukrainian adolescents allowed us to assert that the social health of adolescents is an important component of social development. The article states that the social side of health reflects the physical condition of adolescents and their focus on their social responsibilities. Scientists consider emotional, social, communicative, and intellectual competence to be components of the social health of adolescents. Preservation of social health is a component of the social well-being of adolescents. The physical development of adolescents, adherence to a healthy lifestyle, regimen, and balanced diet are associated with the formation of social health and socialization.

Doctors and psychologists distinguish adolescence as an important stage in the development of a child. Martial law conditions are difficult life circumstances that prevent adolescents from accepting and fulfilling social roles, social norms and values, and behavioral patterns.

The aim - to conduct a systematic analysis of scientific sources on the preservation of the social health of adolescents under martial law.

Under martial law, there is a change in the values of social health of the entire population and adolescents in particular. The article emphasizes the importance of social health, the formation of a healthy lifestyle for adolescents, and the rejection of harmful habits (drug use, alcohol, and smoking). The social health of adolescents is a relevant direction in ensuring social support for adolescents. Preservation of social health requires a systematic approach and cooperation between the government, citizens, and public organizations to create favorable conditions for the comprehensive development of adolescents. Martial law conditions negatively affect the quality of life and satisfaction of the needs of adolescents. Preservation of the social health of adolescents has a positive impact on socialization, social well-being, and the degree of integration into Ukrainian society.

The authors declare no conflict of interest.

Improving the quality of life in pregnant women with gastroesophageal reflux disease as a marker of the effectiveness of the treatment

2025-09-19T20:11:28+00:00

Aim - to investigate the effectiveness of the drug "Hialera" by determining the quality of life indicator in pregnant women with gastroesophageal reflux disease (GERD).

Materials and methods. The study included 30 pregnant women with GERD manifestations. Among them, 7 (23.3%) women had a confirmed diagnosis on fibrogastroscopy (FGDS) during this pregnancy, 6 (20.0%) women had a diagnosis of GERD confirmed before pregnancy during FGDS pregravidally. The remaining 17 (56.6%) pregnant women had heartburn and regurgitation, (and at night), during the period of 6-10 weeks during early toxicosis and after 30 weeks. Women answered of the GERD Health-Related Quality of Life (GERD-HRQL) questionnaire before and after treatment with Hyalera (1 stick 3-4 times a day as a plan or as needed when heartburn symptoms occurred). The survey results determined the impact of heartburn and regurgitation on a person's daily life and the effectiveness of treatment.

Results. Among the 30 pregnant women examined with clinical manifestations of GERD before the start of treatment, 25 (83.3%) patients noted heartburn/regurgitation daily; in 26 (86.6%) women the above symptoms affected daily activities. After 10 days of treatment, only 2 (6.6%) women had symptoms that persisted daily and 3 (10.0%) had symptoms that affected their daily activities. After treatment, 3 (10.0%) women reported feeling unwell compared to 26 (86.6%) pregnant women before treatment. After starting treatment, no women reported sleep disturbances related to heartburn.

Conclusions. A significant improvement in the quality of life was noted in pregnant women with heartburn after the start of treatment with the Hyalera remedy. It is important that the manifestations of heartburn and regurgitation decreased already during the first day after the start of treatment. It is also essential to restore a full night's sleep in pregnant women. The Hyalera remedy, due to its composition, helps eliminate heartburn and heaviness in the stomach, prevents the occurrence of repeated episodes of heartburn, reduces inflammation of the mucous membrane of the esophagus and stomach, normalizes the permeability of the mucous barrier of the esophagus and stomach

The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Committee on bioethics and deontology of these institutions. The informed consent of the children's parents was obtained for the research.

No conflict of interests was declared by the authors.

Current structure of risk factors for abnormal invasion (PAS) and placenta previa in Ukraine

2025-09-19T20:24:32+00:00

Abnormal placental invasion (PAS) and placenta previa (PP) continue to be one of the key issues of modern obstetrics due to the severity of peripartum and intrapartum complications for pregnant women and mothers in labor. Despite significant advances in the diagnosis of PP and PAS and modern delivery technologies that allow for the prevention of massive intranatal blood loss, optimal strategies for managing pathologies of this spectrum have not yet been found, probably due to the focus on the management of clinical cases that already occur.

Aim - to conduct an analysis of obstetric and gynecological history, the course of pregnancy and childbirth in pregnant women with PP, PAS based on medical documentation of childbirth in Kyiv for the period 2011-2021, in order to identify significant risk factors.

Materials and methods. A retrospective case-control study of cases of PP, PAS, recorded in medical institutions of Kyiv in the period 2011-2021 among 195147 births was conducted. All pregnant women were assessed for age, pregravid extragenital pathology, menstrual cycle characteristics, patency, gravity, number of caesarean sections (СS), manual separation and removal and remnants of the placenta in the postpartum period, use of assisted reproductive technologies (ART), gestational age, method of delivery, blood loss, duration of hospitalization, and basic parameters of newborns. Statistical analysis was performed using the statistical software package.

Results. The analysis revealed that the main risk factors for PP are СS, and the risk significantly depends on the number of СS in the anamnesis, ART, parity, instrumental abortions and to a lesser extent age. Factors such as obesity, smoking, multiple pregnancy and fetal sex have a less close relationship with PAS disorders.

Conclusions. Based on the results obtained, it can be concluded that the main risk factor for PAS spectrum disorders is PP, which is diagnosed in more than half of patients, and the vast majority of them have a history of СS. Another option is the presence of PAS in the absence of a history of uterine scars, and it is in them that the greatest risk of not establishing a diagnosis of PAS before childbirth. In addition to СS, the most significant risk factors are ART and surgical interventions on the uterus. An accessible method for assessing the degree of risk of developing PAS has been developed, which allows the formation of risk groups for additional examination and preconception preparation.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for all participants.

The authors declare no conflict of interest.

Some histochemical features of proteins of deciduocytes of the basal plate of the placenta in chronic basal deciduitis against the background of iron-deficiency anaemia in pregnant women

2025-09-19T20:43:26+00:00

Free radicals and their impact on the placenta are the subject of active scientific research, as they may have significant implications for the health of pregnant women and fetal development.

Aim: to use histochemical methods to establish the quantitative characteristics of oxidative protein modification and limited proteolysis in deciduocytes of the basal plate of the placenta in cases of chronic basal deciduitis against the background of iron-deficiency anaemia in pregnant women.

Material and methods. A total of 82 placentas were examined using chemiluminescence and histochemical techniques, including methods by A. Yasuma and T. Ichikava, as well as bromophenol blue staining by Mikel Calvo and Bonheg.

Results. In cases of chronic basal deciduitis, the luminescence intensity of nitroperoxides in deciduocytes increased to 170±4.8 arbitrary units (arb. units). The quantitative analysis revealed an R/B (Red/Blue) coefficient, indicating the ratio of amino to carboxyl groups, of 2.34±0.01, and the optical density of histochemical staining for free amino groups of proteins was measured at 0.197±0.002 relative optical density units (rel. OD). These findings were statistically significant (p<0.001) when compared to placentas with inflammation but without anemia.

Conclusions. The activation of free radical processes appears to be the key factor driving the morphological characteristics of chronic basal deciduitis in iron-deficiency anemia of pregnant women. This is marked by an elevated concentration of peroxynitrites, resulting in enhanced oxidative protein modification and increased activity of limited proteolysis.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the respective institution.

The author declares no conflict of interest.

Prognostic factors of successful labor induction in women at risk of post-term pregnancy: the role of anthropometric and clinical indicators

2025-09-19T21:16:27+00:00

Aim - to analyze the factors affecting the success of labor induction in patients at risk of post-term pregnancy, including anthropometric indicators, obstetric history, and clinical examinations.

Materials and methods. This cohort retrospective study involved pregnant women at risk of post-term pregnancy who underwent labor induction protocols at the Kyiv Perinatal Center from January 1, 2023, to December 31, 2024. The sample included medical records of 654 patients, of whom 482 (73.7%) had successful inductions, while 172 (26.3%) required cesarean sections after failed induction attempts. Statistical analysis was performed using logistic regression.

Results. It was found that age, BMI, fetal weight, and Bishop score significantly affect the success of labor induction. Higher BMI, older maternal age, and greater fetal weight decrease the likelihood of success, while a higher Bishop score positively influences the outcome.

Conclusions. Age, BMI, fetal weight, and Bishop score are key factors influencing the success of labor induction in women at risk of post-term pregnancy. The findings can be used to improve prediction models and for personalized management of such patients.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution cited in the manuscript, and written informed consent was obtained from all participants.

The authors declare no conflicts of interest.

Peculiarities of diagnostics of breast diseases and management of patients' observation in Ukraine who plan to implement reproductive plans

2025-09-19T21:29:03+00:00

In Ukraine, breast cancer ranks first in the structure of oncological diseases among the female population. Changes in hormonal status and the formation of post-traumatic syndrome affect the development of infertility and breast diseases among women of reproductive age.

Aim: to analyze the complex of diagnostics and monitoring of breast diseases in patients planning pregnancy using assisted reproductive technologies, in order to improve early diagnosis of breast diseases.

Materials and methods. 162 patients were examined at the Kyiv Mammological Center. The average age of the examined women was 33.7±3.4 years. All patients underwent a general clinical examination, ultrasound examination of the mammary glands, mammography, and morphological verification of formations.

Results. During the general clinical evaluation, 64% of the patients reported no complaints, and 36% of patients had complaints (breast pain, discomfort). Structural sonographic pathology (BI-RADS 1) was found in 23% of patients. The most common fibrocystic changes in the mammary glands are BI-RADS 2, which was found in 31% of observed persons. Simple cysts with typical ultrasound signs were found in 24% of patients. The next examination was offered to women after 6 months, and macrocysts were found in 7% of patients. BI-RADS 3 was found in 26% of the examined patients. The most common ultrasound findings were fibroadenoma (24%) and cysts with inflammatory changes (2%). Among BI-RADS 4, the most common morphologically verified lesions are atypical ductal hyperplasia (8%), complex sclerosing lesions (16%), intraductal lesions (10%). BI-RADS 5 was detected in 4% of patients.

Conclusions. In the comprehensive examination of women planning to undergo assisted reproductive technology procedures, it is necessary to apply general clinical assessment, ultrasound diagnostics, and, when indicated, mammographic imaging and morphological verification of detected lesions.

The authors declare no conflicts of interest.

Predictive factors for successful labor induction in women with premature rupture of membranes: a retrospective analysis

2025-09-19T21:45:51+00:00

Premature rupture of membranes (PROM) is a significant complication that affects perinatal outcomes, particularly in preterm pregnancies. PROM has serious consequences for both maternal and fetal health, as it disrupts the essential physiological role of amniotic fluid in protecting the fetus and supporting its development, while also increasing the risk of infections and other complications. In modern perinatology, this issue is one of the leading causes of preterm birth and perinatal mortality.

Induction of labor in the case of PROM is an important measure to minimize the risk of infections and complications for both the mother and the child. However, the success of this process depends on numerous factors, including the condition of both the mother and the fetus.

Aim - to identify the key factors influencing the effectiveness of labor induction in women with premature rupture of membranes (PROM) and assess their impact on the success of the induction.

Materials and methods. A retrospective analysis was conducted on 79 clinical cases of pregnant women with PROM. Parameters such as age, body mass index (BMI), and fetal weight were considered in the study. Logistic regression analysis was used to assess the predictive factors for successful labor induction.

Results. It was established that a higher BMI, greater fetal weight, and maternal age were associated with a decreased likelihood of successful labor induction. The obtained data were confirmed by logistic regression analysis, indicating a significant impact of these factors on the prediction of induction outcomes.

Conclusions. Age, BMI, and fetal weight are key risk factors for unsuccessful labor induction in women with PROM. The results can be used to provide a personalized approach to managing such patients and optimizing labor management strategies.

This study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committee of the institution. Informed consent was obtained from all patients.

The authors declare no conflict of interest.

Prognostic value of elevated SLPI levels for early detection of sepsis in children with community-acquired pneumonia

2025-09-19T21:58:58+00:00

Sepsis is one of the most serious complications of community-acquired pneumonia in school-aged children, requiring early diagnosis and risk stratification. Although the Phoenix Sepsis Score has been introduced to assess organ dysfunction, its sensitivity during the first hours of hospitalization remains limited. Evaluating the serum level of secretory leukocyte protease inhibitor (SLPI) as an additional sepsis biomarker may enhance early identification of severe infection.

Аim - to determine the prognostic significance of serum SLPI levels for the early detection of sepsis in children with community-acquired pneumonia.

Materials and methods. A total of 135 children aged 5–18 years with bacterial community-acquired pneumonia were examined. Sepsis was assessed using the Phoenix Score (≥2 points indicating sepsis). SLPI levels were measured by ELISA and stratified by quartiles. Statistical analysis included the χ² test, logistic regression, and ROC analysis (AUC, ΔAUC), with adjustment for age, sex, and disease severity.

Results. Sepsis was identified in one-third of patients within the first 24 hours of hospitalization. In the fourth SLPI quartile, the proportion of sepsis reached 50%, compared to only 20.6% in the first quartile. Elevated SLPI levels were associated with increased sepsis risk. Adding SLPI to the baseline model of routine inflammatory markers increased the AUC from 0.65 to 0.69, and sensitivity from 21% to 67%. In the final model, only elevated SLPI and D-dimer levels remained independent prognostic markers.

Conclusions. Elevated SLPI levels in children with community-acquired pneumonia represent an independent risk marker for sepsis and enhance the predictive accuracy of screening models. SLPI determination should be considered for inclusion in standard laboratory monitoring during the first day of hospitalization.

This study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution. Informed consent was obtained from all patients (parents or legal guardians).

The authors declare no conflict of interest.

Systemic inflammation and risk of chorioamnionitis-related preterm birth: a single-center retrospective analysis

2025-09-20T20:34:04+00:00

Aim - to assess the predictive value of systemic inflammatory markers for chorioamnionitis in women with preterm birth.

Materials and methods. This single-center retrospective cohort study included 198 cases of preterm delivery (<37 weeks) at Kyiv City Maternity Hospital No.5 during 2022. Data were extracted from electronic medical records. Multivariate logistic regression was used to analyze associations between histologically confirmed chorioamnionitis and clinical/laboratory indicators.

Results. Elevated maternal leukocyte count emerged as the strongest independent predictor of chorioamnionitis. Increased C-reactive protein levels also demonstrated significant predictive power. Other variables, such as cervical length, procalcitonin, and psycho-emotional state, lost significance after adjustment. The ROC curve showed good model discrimination (AUC=0.747).

Conclusions. Systemic inflammatory markers, especially leukocytosis and C-reactive protein, play a key role in predicting chorioamnionitis and may improve early risk screening for preterm birth.

The authors declare no conflicts of interest.

Prognostic value of platelet indices in children with haemostatic disorders induced by herpetic infection and their relation to the inflammatory process activity

2025-09-20T20:52:18+00:00

Platelets are the smallest but highly reactive morphological components of blood, primarily involved in fibrosis and maintenance of normal haemostasis, but there is also considerable evidence of their multifunctionality, including their involvement in inflammation

Aim - to assess the prognostic significance of changes in platelet indices in children with haemostatic disorders induced by herpes infection.

Materials and methods. We examined 100 children aged 0-18 years with haemostatic disorders induced by herpetic infections. In addition to general clinical examinations, platelet indices, namely mean platelet volume (MPV), thrombocrit (PCT), platelet large coefficient (P-LCR) and platelet distribution width (PDW), all subjects underwent determination of levels of C-reactive protein, interleukin-1 and interleukin-6, endothelin-1, and polymerase chain reaction of herpes viruses of 8 types.

Results. It was determined that at MPV values below 5.79 fl there was a significant risk of severe thrombocytopenia and vasopathy, and at values above 13.62 fl - severe thrombocytosis. At PCT levels within the third to fourth quartile, there was a significant risk of severe haemostatic disorders. A P-LCR above 53.08% was a prognostic marker for the development of severe thrombocytopenia and vasopathy, and less than 3.11% for severe thrombocytosis.

Conclusions. The study found that platelet indices are prognostic markers of the severity of haemostatic disorders induced by herpes infection in children. Thus, a decrease in MPV and PDW is a prognostic marker of severe thrombocytopenia and vasopathy, and an increase in PCT and P-LCR is a prognostic marker of severe haemostatic disorders.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for all participants. Informed consent was obtained from patients (parents of children or their guardians).

The authors declare no conflict of interest.

Features of early morphogenesis of the human venous system in normal and pathological conditions

2025-09-20T21:02:27+00:00

During human ontogenesis, three circulatory systems function sequentially: the vitelline, placental, and pulmonary. The vitelline system is transient and is replaced by the placental circulation, which persists until the end of intrauterine development.

Аim - to clarify the features of early morphogenesis of the human venous system under normal conditions and in pathology, in order to identify critical periods of its formation and detect prerequisites for congenital cardiovascular malformations.

Materials and methods. The study was carried out on 33 series of sagittal, frontal, and horizontal sections of human embryos and prefetuses aged 4-10 weeks of intrauterine development (crown-rump length 6.0-38.0 mm), stained with hematoxylin and eosin. For the analysis of venous structures in 10 fetuses aged 4-8 months, macromicroscopic dissection, microscopy, and modern imaging techniques with three-dimensional (3D) reconstruction and morphometric analysis using ImageJ software (NIH) were applied.

Results. The most rapid development occurs in vessels belonging to the placental circulation and the portal system, which is evolutionarily related to the regressed vitelline circulation. These venous channels appear before the placenta is fully formed. At early stages, venous vessels have thin walls, and their lumen often exceeds the diameter of the aorta. The umbilical vein initially represents the widest vessel with a thick wall, later becomes equal to the aorta, and before obliteration is thinner than it. The complex morphogenesis of the venae cavae determines a predisposition to anomalies.

Conclusions. In embryos with a crown–rump length of 6.0-7.0 mm, the most developed vessels are those of the placental circulation (umbilical arteries and vein). Venous vessels initially lag behind arteries in development but subsequently exceed them in diameter. Disturbances of morphogenesis may result in anomalies such as double vena cava or umbilical vessel defects, increasing the risk of congenital heart malformations.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for all participants.

The authors declare no conflict of interest.

Psychological stress, barriers to medical care, and gender challenges in women with reproductive health disorders during wartime

2025-09-20T21:22:00+00:00

This article examines the impact of military conflicts on women's reproductive health, particularly psychological stress, barriers to accessing medical care, and gender challenges. Reproductive health is one of the most vulnerable areas in crisis conditions and requires attention to multifactorial influences.

Аim - to assess the impact of military conflicts on the physical, psychological, and emotional health and access to medical care for women with reproductive health disorders (RHD).

Materials and methods. The study utilized data from surveys and clinical examinations of 1,000 women with RHD and 100 healthy women in the control group. A multifactorial approach and statistical methods were used to evaluate health status, stress levels, and barriers to accessing medical services.

Results. The primary barriers identified were financial difficulties (42.7%), the absence of healthcare facilities in conflict zones (35.8%), and cultural barriers (19.4%). Military conflicts contributed to the spread of inflammatory diseases of the reproductive organs (60.3%) and menstrual cycle disorders (64.7%). Over 58.8% of women experienced high levels of stress, 82.4% reported symptoms of post-traumatic stress disorder, and 85.2% were diagnosed with depression. Gender discrimination and sexual violence remain significant issues, affecting 27.3% and 12.7% of women, respectively.

Conclusions. The results underscore the need to implement integrated support programs, including mobile healthcare services, psychological assistance, and awareness initiatives on reproductive health. Economic and social support, adaptation of healthcare services to wartime conditions, and consideration of gender aspects are crucial for protecting women in crisis conditions.

The research was carried out in accordance with the principles of the Declaration of Helsinki. Copyright agreement from the patients was obtained for the study.

The authors declare no conflict of interest.

Analysis of laboratory and instrumental markers of endothelial dysfunction in children with SARS-CoV-2 associated pneumonia and its relationship with the JAK2 V617F gene polymorphism

2025-09-20T21:40:56+00:00

SARS-CoV-2 may act as a trigger for the initiation of immunopathological processes such as endothelial dysfunction.

Aim - to determine the levels of endothelial dysfunction in children with SARS-CoV-2-associated pneumonia and to analyze its relationship with the JAK2 V617F gene polymorphism.

Materials and methods. The main study group included 160 children with SARS-CoV-2-associated pneumonia, while the control group comprised 40 healthy children. The main group was stratified by sex, age, severity of disease, levels of pro-inflammatory proteins, structural indices of the vascular wall, and functional measures of endothelial status. The presence of the JAK2 V617F gene polymorphism was assessed using polymerase chain reaction.

Results. The JAK2 V617F gene polymorphism was detected in 138 children (86.25±2.47%) with SARS-CoV-2-associated pneumonia and was significantly more frequent in those with severe disease. Among 132 children (82.5%) with pulmonary and extrapulmonary complications, 94 (95.9%) had a severe course of SARS-CoV-2-associated pneumonia. In children with complicated pneumonia, the JAK2 V617F gene polymorphism was diagnosed significantly more often. Children with SARS-CoV-2-associated pneumonia carrying the JAK2 V617F polymorphism demonstrated higher levels of C-reactive protein (by 42.95%), procalcitonin (by 19.01%), fibrinogen (by 14.89%), and D-dimer (by 34.53%), as well as elevated levels of interleukins 1 and 6, endothelin-1, and vascular endothelial growth factor (by 25.12%, 29.22%, 35.04%, and 36.12%, respectively). The mean value of flow-mediated dilation was significantly higher in children with severe SARS-CoV-2-associated pneumonia. Children with a non-severe course of pneumonia without the JAK2 V617F polymorphism had a 41.67% lower carotid intima-media thickness.

Conclusions. Children with SARS-CoV-2-associated pneumonia had a more severe course of disease, which correlated with the presence of the JAK2 V617F gene polymorphism. Severe pneumonia with pulmonary and extrapulmonary complications was more frequently observed in patients with the identified JAK2 V617F polymorphism.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local institutional ethics committee. Informed consent was obtained from all participants.

The authors declare no conflict of interest.