Энциклопедия УЗД в Акушерстве и Гинекологии (Тт.1-7)

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1. Warkany J. Congenital malformations: notes
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. . 1995. 3. . 5153.
7. .., ..

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8. Goldstein R., Filly R., Callen P. Sonography of
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9. Kennedy K., Flick K., Thrumond A. First
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J. Obstst. Gynecol. 1990. V. 162. P. 461463.
10. Jones K. Smiths recognizable patterns of human
malformations. 5th ed. Philadelphia: Saunders,
1997. P. 559563.
11. Schinzel A. Caralogue of unbalanced chromo
some aberrations in man. Berlin: de Gruyter,
1984.
12. Zacharias J., Jenkins J., Marion J. The incidence
of neural tube defects in the fetal and neonate
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Amer. J. Obstet. Gynecol. 1984. V. 150. P. 797
798.
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V. 322. P. 669.
19. MRC Vitamin Study Research Group.
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21. Ashwal S., Schneider S., Tomasi G et al. Neu
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12

in twelve liveborn anencephalic infants // Ann.
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23. Reagan J. Ethies consultation: anencephaly and
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V 23. P. 398400.
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14. .., ..

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. 2021.
15. MRC Vitamin Study Research Group.
Prevention of neural tube defects: results of the
Medical Research Council Vitamin Study //
Lancet. 1991. V. 338. P. 131137.
16. Volpe J. Neural tube formation and prosencephalic
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19

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3. ..

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1997. 2. . 8586.
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5. .., ..
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und Obstet. Gynecol. 1991. V. 1. P. 336344.
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22

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1. Myrianthopoulos N., Chung C. Congenital
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6. ..
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24

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mations. Version 4.5. Melbourne. Australia:
8. Jones K. Smiths recognizable patterns of hu
man malformations. 5th ed. Philadelphia:
Saunders, 1997.
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[24].
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26

,
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.

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[15].

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.
,

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,

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.

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S. Bondurant ., 1984 [2]
26
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29
M. Kim, M. Elyaderani, 1982 [6]
K. Fogarty ., 1989 [8]
28
R. Achiron ., 1993 [9]
26
27
29
28
O. Sibony ., 1993 [10]

M. Anderson, J. McGahan, 1994 [11]
21
V. Catanzarite ., 1995 [12]
28
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23
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38
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,
[18].
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,

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34

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, ,
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SPINA BIFIDA
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,
,

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.

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(. 1.35).

(.
1.36) [24].

,

(.
1.37).
. 1.35.
.
.

,
,
.

. ,
. 1.36.
.
.
. 1.37.
()
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46

,
(,
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.

[2, 3].

.
,
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10
..
1998 15
,
. 1983
F.Daffos . [1]
53
.

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1990 1998 .
1219 ,
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, [8].
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[9].

[10, 11].
80
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( 24 )
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10% [12],
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232

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1982 J.Bang . [15]

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Rh.

. 1983

F.Daffos, .CapellaPavlovsky F.Forestier

:
53 [1].

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C.Weiner [2]
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.

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243

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12,9%
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100%
1 .
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4,8
(89,6%)
1 5 [7].
B.Petrikovsky [76]:
(50 )

24,6 , 16,2
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10.5.

, %

, %

, %
.Ludomirsky ., 1987 [78]
100
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63,5
9,4
27,1
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72,2
3,5
24,3
. ., 1993 [51]
42,0
1,4
56,6
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62
32
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62
38
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27,1
42,3
., 1999 [7]
244

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1,5 13,2% (. 10.6).

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100 /,
1 .

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80], ,

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[81],
.

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[60, 79].
M.Ulm . [82],

, ,
,
,
10.6.
, %
F.Daffos ., 1983 [1]
53
13,2
F.Daffos ., 1985 [16]
606
9,0
C.Weiner, 1987 [2]
96
3,1
B.Benacerraf ., 1987 [83]
42
2,4
C.Weiner, 1988 [84]
200
5,0
B.Pielet ., 1988 [85]
58
8,6
A.Ludomirski ., 1988 [86]
100
10,0
E.Jauniaux ., 1989 [87]
50
10,0
C.Donner ., 1989 [88]
144
12,2
F.Daffos, 1989 [89]
2093
7,0
P.Boulot ., 1990 [60]
322
7,5
C.Weiner, 1991 [90]
594
6,6
P.Maxwell ., 1991 [91]
268
1,5
K.Perry ., 1991 [92]
100
5,0
D.Hickok ., 1992 [93]
302
5,8
. ., 1993 [51]
212
5,2
F.Duchatel ., 1993 [94]
341
9,4
A.Ludomirsky, 1993 [95]
7462
8,0
C.Donner ., 1994 [96]
891
7,0
M.Ulm ., 1997 [82]
339
3,8
Y.Chitrit, 1997 [62]
103
5,8
., 1998 [7]
522
8,9
245

10
Rh
.
,

.

26,4 ,
29,1 .

.
[82]
,
,

(61,5%
3,1% ).
,
(18,3%)

100 /,
(8,9%)
[7].
, M.Ulm
. [82],
(
) .

.

.
., 24 ,
31
,
28 .

.

20
.

.
: 46, XY.
.

.
,
2962% [2,
6062, 86],
31,3%.
( 1
),
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19,7% .
. . [51],
1,9%.

(54,1%)

(48,7%) [61].
, ,

.
,
(66,6% 32,3%
) [51].

:
2030
()

KleihauerBetke [97]
10 000 .

0,25 ,
15 .
Rh

Rh
D.
(7886%)
.

.
[2, 60, 86]
,

. Y.Chitrit
. [61] ,
3
56,9% ,
3
22,9% .
,
246

1 19,7%
[7].

:
66,7% ,
30% [61].

[96, 98, 99].

.

,
[61].

.
.
,

. , .Antsaklis .
[62] 7 1981
, 0,4%.
B.Petrikovsky [76]
(50 )
2% ,

.

(0,39%)
,
.

,

.

,

, ,

.
.
,
,
.
,
0,62,91% [66, 68, 51],

,
post factum 2840%
,
.
[60, 62, 86]

.

23,1%
,

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[7].
, ,
,
, ,

.
.

.
,

,
.
,
,
, 1014
,

.

,

.
.Ludomirsky .Weiner [47],
247

10

7% .

:

,
( 2
);
,
( 2
);
;

.
,
34

: ,

, 2% 2,5%;
, 2 1,5%;

22,5%;
32%. 60%

.
,

2%

(. 10.7),
0 8,8% [2, 91].
,
(1,1%)
A.Ludomirsky [95],
10

7000 .

, ,

.
,

.
, 1981

, 1998
A.Antsaklis . [62].
5 :
10.7.

2
, %

> 2
, %
F.Daffos ., 1985 [98]
606
0,8
1,1
C.Weiner, 1987 [2]
96
C.Weiner, 1988 [84]
1400
0,15
C.Donner ., 1989 [88]
144
0,8
1,9
M.Wittle, 1989 [100]
0,5
P.Boulot ., 1990 [60]
322
1,24
1,86
F.Orlandi ., 1990 [63]
500
4,3
D.Maxwell ., 1991 [91]
268
8,8
A.Ludomirsky, 1993 [86]
7462
1,1
. ., 1993 [51]
212
2,91
0,97
R.Snijders, K.Nicolaides, 1994 [101]
1169
1,0
1,0
C.Weiner ., 1996 [75]
0,9
.Antsaklis ., 1998 [62]
1981
2,5
0,6
., 1998 [7]
522
2,5
1,3
248

1)
;
2) ;
3)
,

,

;
4)
,
,
, ;
5)
.

4,8%, 2
2,5%,

( <0,001).

(13,1%)
(8,9%), ,

.

2
1%
1,6% .

,
,
.

,
.
.
,

.

D.Maxwell . [91],
,
,
8,8%.

,

(25%)
(6,6%), (1,3%)
,
.
Kings College
Hospital (), 8 10
1
6 ,

1%,

150 [59].
P.Boulot . [60],

40%
, 40%

.
,

2
2 2,5%
.
23%

, 15%

, 30%
, 32%

.
1,5%,

2,5%. 85%

249

10

, (

),

.

.
8.
9.
,

,
,

.

,

.
10.
11.
12.
13.
1.
2.
3.
4.
5.
6.
7.

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. 1999. 1. . 6366.
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2. Gilbert E.F., Optiz J.M. Malformations and
genetic disorders of the respiratory tract //
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V. 2. Washington, DC: Hemisphere, 1989.
P. 152.
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. 153163.
5. Hernanz Schulman M., Stein S.M., Neblett
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63

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1. Fyler D.C. Single ventricle // Nadas pediatric
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!
.
,

.

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.
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[26].

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72

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.
.

.
, ,
.

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.
,
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.

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[25].

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.
,

,
.
.
57% [1].

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.

82

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83

.
,
.

.

.

: ,
, ,

.
2
(.
3.25) [2].
,

.
.
68% [1].

.
.
40 ,

,
[3].

(15%),
18
[4, 5].

,
( ) [6, 7].
,
, ,
, , , ,
, [5, 711].
.

.

:
,
,
,
(. 3.24).
.

.

, ,

.
. 3.24. . ,
. 1 , 2 .
84

0 24%,
12%.

024%.
. 3.25. .

(RVOT). LA , PV
, MPA
, DUCTUS ,
DESC. AORTA .

.
,

22q11.

2% [12].

4% [13].

,
,
.
%
.

.

.

.
.

.

,

.

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1968. V. 279. P. 8089.

V. 57. P. 205213.
Amer. J. Cardiol. 1987. V. 59. P. 459463.

.

.
.

20%.
.

,
(. 3.26).

.

.

,
.

,
(. 3.27).

.

(. 3.28).

.

.

[1].
.

, 60

[2]. D. Paladini
. [3],

33% . ,
,
, , ,
, , [49].

.

. 3.26.
. RA , LV
, AO .
86

. 3.27. ()
() .
().

1% [10].

4% [11].

.
%
.

.
.
,

(5060
. .),
,
.
,
,
.

( ,
,

).
.
%
.

.
,
,
[12].
. 3.28.
.
.

[13]
.
60% [14].
87

1. .., ..

. .: , 1997. . 128.
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.

.

.
.
3 6% [1].
.

(. 3.29).
,

,

.

.
.

[24].
13, 18
(30%) [4].

1% [5];

[6, 7].

(
88

%
.
, ,

.

,

Norwood (.
).

.
. 3.29.
. RA
, LA , LV
, RV .
) [3].

,
7q11.23 [8]. ,
,
,
FISH
95% [9].

.

,
.

.
3% [10];

13% [11].

;
50% [3].

.
%
. ,

,
. 8
4050%

[12].
.
, ,
.

.

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.

.

.

,
.
,

, [1].
.

0,46 20% (. 3.1).

.
.
Petrikovsky . [17] 3

,
15706 .

.

,
, .
,

,
1 .

. , R. Achiron . [11]
2214

1316 163 (7,4%)

,
2022 59,5%

.

3,0%.

,

(334 ),
13 493
2,5% [18].
.

.
,
(.
90

3.30).
,

,
.

.
1 6 .

. B. Petrikovsky
. [19] 9 65
,
. 3
79 , 4
,
,
.
.
, B.
Petrikovsky . [7], , 36%

. 3.30. .
.
, 12% 51%

.

,
95%
[9]
4072% [4, 5, 8].
3.1.

, %
, %
L. Allan, 1986 [1]

A. Schechter ., 1987 [2]
D. Levy, M. Mintz, 1988 [3]
. , 1994 [4]
H. How ., 1994 [5]
B. Benacerraf, 1995 [6]
B. Petrikovsky ., 1995 [7]
G. Dildy ., 1996 [8]
R. Merati ., 1996 [9]
J. Simpson ., 1996 [10]
R. Achiron ., 1997 [11]
D. Bettelheim ., 1997 [12]
. Kahler ., 1997 [13]
M. Odeh ., 1997 [14]
B. Bromley ., 1998 [15]
2
3,5
20,3
2,4
0,46
4,9
3,6
4,9
3,2
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100
100
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96
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60
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2,7
100
3:1
: ; .
91

3.2.

L. Allan, 1986 [1]

A. Schechter ., 1987 [2]
. , 1994 [4]
B. Benacerraf, 1995 [6]
B. Bromley ., 1995 [21]
B. Petrikovsky ., 1995 [7]
M. Bronshtein ., 1996 [22]
J. Simpson ., 1996 [10]
R. Achiron ., 1997 [11]
D. Bettelheim ., 1997 [12]
I. Chatzipapas ., 1997 [23]
. Kahler ., 1997 [13]
A. Mejides ., 1997 [24]
M. Odeh ., 1997 [14]
B. Bromley ., 1998 [15]
, %
0
3,8
5,6
18
6,1
0
11,1
0,9
0
0
20
1,7
1,9
0
4,8
.

,

21 26
[2].

D. Roberts D. Genest
[20].
,

( 21 16%,
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(2%). 3.2

.
, 3.2,

.

. C. Lehman . [25]

13 ( 10 33 , 30%).

7 36 (19%)
[26].
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. ,
,
35

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35
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[15]. 1 14

41
.
35

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33,6% 0%.

(5
13 )
(7 13).
21 (11 14).

18 [4,
26], 5q [28],
[15], [15, 28]
[10].
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.

,

,
/
92

,
.

.
,
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4,2%.
,
5
, .
J. Wax . Philput [27] 9

.
10 217

, 1 18
3 11

. ,

. 71%

. ,

.
8 217

, 2 18
1 11

. 45%

.

.

,

[7, 12, 11, 14].
R. Achiron . [11]
489
,

, 6 (1,2%)
21.
,
21

0,002%.
,

.
.

.

/

.

.

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28. .., .., ..
.

//
. . . . . 1999. . 7.
2. . 159161.
94

.
(
)
.
,
.
.
0,94 10 000 [1].
20
7 10 000
. 70

[2, 3].
.
.
:
79%
.

.
1030%

.

,
prune belly, ,
[4, 5].
.

(. 4.1).

(. 4.2).

70 95%
, ,
,

[6, 7].

,

95
. 4.1. .
.
. 4.2. .
.
.
,

.
.

,
.
.

() [8].

[10].
.

12,4 [9].

,
(1013 )
.

.

3,5% [18].

[19].
.

:
90% .

.

96

.

,

2350%

[11].

, :
1)

;
2)

;
3)
;
4) ,

,
[12].
:
17

, ,
,

[13, 14].

,

,

[15, 16]. ,

[17].

.

, ,
. C

[11].
,
40% [20].
.

.

,
.

.
,

.

,
,

.

.

20 /.
.
24
.
,
.
,
, .

23

.
97

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.

.
.

.

,
.
.
1 3 0006 000
[1, 2].

,
7
4116 [6].
. 4.3. 1415 .
. 1 ; 2
.
.
.

( 50% ). 70%

,

[25].
.

,

(. 4.3).

(. 4.4, 4.5).
.

.

,
, ,
,
. 4.4. .
.
. 4.5. .
.
99

[7, 8].

[2],
.
.

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.

, 1013

(. 4.6) [11].
. 4.6. 1011 .
.
.

13 18
[14]. ,
,
,
,
.
30
,
[15].

,
,
, ,

[16, 17].
.

,
.
,

.

,

.

,
,

.

[12, 13].

.

. ,

,
,

.
.

.
100

.

10%
0,25%
120 /
,
.

.
.
2448
.

.

, ,
.

.
5 (
)
9095%.
,
8 ,
6580%.
10
1520% [18].

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103

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5. .., ..,
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.
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10%
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.: , 1996. . 181204.

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1987. V. 149. P. 395400.
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.
112

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. . . 1995. 2. . 111117.
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..
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.
,

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1,4% [1].
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114

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// . .
. . . 1995. 1. . 1321.
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116

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: , ,
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. 4.27.
.
.
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119

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.

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143

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.
(. 5.27, 5.28) [14].
.
.
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146

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3 1000 [1]. 2
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,
.
.

[2
4].
.

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.
,

020% [24,
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,
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8%.
,

.

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.

.
.

.
.

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.

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.

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151

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,

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,
, , VATER
, .
.
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.

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.

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.

152

4

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, . ,
,

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,

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.

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,
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1 30 000
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.
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154

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.
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.
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.

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,
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,

.
IV .

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.

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.

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. , ,
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2650%
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,

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)

.
,

.
,

(73%), ,
(15,4%)
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.

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. 75%

[4].
.
.
150
,
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.
.

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, . . [8],

.

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,

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, .

,
161

2
1
2
. 7.3. () () . 1 ; 2 ;
3 .
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.
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.
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162

.
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.

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. ,

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28,6% [2].

(. 7.6).
. 7.6. 23 .
.

.
.

, .

, ,

.

,
7.1.

,
H. Grundy
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; ,
I. Meizner
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, 3,5
D. Lasser
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25
10

, 3 2 1,6
,
3
c
,
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D. Bulas
., 1992 [16]
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30
19
163

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,

,
.

.

20%.

80%.

.

1015%.
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,
.

,

,
.

.

,

.

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. .: , 1997. . 3943.
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0,5 5 .

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(. 7.8).
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,

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.

,
,
. ,

II
, ,
.

,

4
1
2
3
. 7.8. 19 . .
; . 1 ; 2
; 3 ; 4 .
165

68%:
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.

166

. 7.9. ().
; .

,
[219],
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[30, 31], [32, 33]
[34].

,

,

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,
.

,

.

[11].

.
,
,
,
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.

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().

.

,

[27].

,
,
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,
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.

, ,

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,

.

,
(. 7.11).
. 7.11. .

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,

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,

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.
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,
,
, ,

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73%

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,

, ,
c ,

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.

,

,

.

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,
, ,
.

,
.
168

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.

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[1, 2].

[3],

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. ,

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,

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G. Janetschek
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35

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., 1986 [10]
34
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., 1986 [11]
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., 1986 [12]
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9
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., 1989 [13]
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., 1990 [14]
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., 1990 [15]
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175

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. Chen
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37

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.

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,
. ,
,
.
,

.

.

.

1. .., ..,
.. .

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.
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178

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36
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V. Valenti ., 1975
T. Lee, S.Blake, 1977
41
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40
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36
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33
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30
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3239
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3541
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3336
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27
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3234
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36
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37
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3240
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11
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2835
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27
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15
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29
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2740
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. MullerLeisse ., 1992
44
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39
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28
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179

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.
,
,
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.

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,
.

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,
.
.
,
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(34 ).

Picornaviridae.

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.
.

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.
.
,
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.

,
, .

,

. ,

.

.

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()
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.

.
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,
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.

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.

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189

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1. Centers for Disease Control and Prevention.
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192

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,

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6

.

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,
.

1. Reid D., Reid T., Brown T. et al. Human parvovi
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ty of Perinatal Obstetricians. Miami. Fl. 1998.
.

,
[1].
.

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.

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.
,

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.
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)

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.

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.

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.

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,

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,
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.

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,

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.

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,

.

.

.

,

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[17, 18].

8595% [1].

,

.
,
,
,
,

.

,
,
.
1.

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198

15. HoTerry L., Terry G., Londesborough P. et al.
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Recomendation of the Immunization Practices
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VARICELLAZOSTER
. VaricellaZoster
,
,
.

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&
.
17 10 000
[1]. 95%
.
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,

.
1 21 .
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.

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.

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24 .

,

,
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,

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[2].
.

.
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24 .

.

.
,
,

,
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,
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,
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:
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, ,
[8].
.

5 10
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.
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,
.

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,
,
.

, .
.

.

. 10
30%

.
, 24

.
, ,
800
5 per os.
,

[9].

.
1995 ,
, 13
[10].

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200

7. Schraf A., Scherr O., Enders G. et al. Virus de
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P. 409412.
.

Listeria monocytogenes.

,
.

.
.

.
.
2
1000 7,5
1000 .
.
, Listeria monocytogenes
,
.

.

,

20 [6].

.
, ,
, .

.

4050% [6].

. ,

,
[1].

.
.

,

[2, 3].

,

[4, 5].
.
,

,
.
,

.

,
.

201

.

.
.
7 ,

.

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, ,
, ,
; .
,
, .

,

15%.

,
.
,

7 ,
90%
.

.
,
, .

.

,

.

, .
.
Listeria monocytogenes
.

.

, ,
,
.

, .

.

,

.
.

46
[7].

.

per os ( 23 ).

14 .

.

,
.
.

.

,
.

.

.
,
202

,
.

1. Liner R. Intrauterine Listeria infection: prena
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// N. Engl. J. Med. 1988. V 319. P. 823828.
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4.
5.
6.
7.
break of listeriosis // N. Engl. J. Med. 1985.

V 312. P. 404407.
Schuchat A., Deaver K., Wenger J. et al. Role
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.

,
( )

(Ixodes) [1].
,
5075%.

,
,
.
.

[1, 2].
,
.
,
.
,
, ,
[14].
Borrelia burgdorferi

, 4 8
[5].
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Ixodes pacificus [6].

,

[7].

.
[2].

,
.

,
.

,
.
.

[1, 2].

.
,
14 .

,
203

.
,
.

,
.

.

,
.

, ,
, ,
, .

: , ,
, . 20%
,
,
[2].

50% [8].

,
2 .

,

: , ,
, . 20%
, 10%

.
.
Burgdorferi
.
Schlesinger . 1985 [9],
,

.
.

, ,

,
,
, [1, 2].

,
, :
( ,
),
,
(, ,
),
,
(, ,
), ,
(, ).

,
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, [2].

.
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.
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. 4%
24

,

[3].

.

, ,
,
, ,

[10].
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[9].
204

.

68% [1, 2].

,
.

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610

: (
),
. 2/3

, 20%
.

.

(ELISA, LPA, IFA,
) [11].
Western blot :

5392%,
100%. 100% ,

38 90% [1, 11].
.

[12].

75%, 25%.

:

80
47%, 80 23%,
50 0%.
,
100%
.
,

[13].
(
)
( 2 4
), G (4 4
), (2 4
) 14 .

(500 )
(500 ) 30 .

(50 4 )
(100 4 )
14 30 .

(40
) 1030 [13].
. ,

,
(500
) 1021 [13, 14],
(500 )
(500 4 )
10 .
21
,
,
[14].
.

: ,
,

.

( )
,
[15].
205

,

(N).
.
, ,
,
.

.
(4
8%),

,

0%.

[16].

,
,
,
, ,
[17, 18].

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206

.
, Treponema
pallidum.

. 80
,

[1].

: 45%

, 19%
[2].

,
.

,
, ,
, , ,
,

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,
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.
1981
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3000
1990 ,
1995
.
. C
,
.

,

.
,

.
,

.

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.

24 .

T. Pallidum
,

[5].

,

.

,

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( 14
),
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, 74% ,
,
[5].

, ,
,
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. ,
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,
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207

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,
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.
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.
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,
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40%, 20%,
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,

[7].

:
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. ,
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.

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,
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, , ).

,
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. 33%

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[4, 8].
,

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).

.
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.

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.

T. Pallidum ,
,
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[9]:
,
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.

: (VDRL
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) (
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,
,

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.

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,

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,
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.

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.

T. Pallidum.

,

,

. FTAABS
18%
5%
.
MHATP
, 35%
,
,
.

98%, 99%,

82% [11].

VDRL (70%) MHATP
(75%).
IgG IgM
,

T. Pallidum [12, 13].

[14]. ,
,
T. Pallidum [5].

: ,

[5]. ,
24
209

, IgM
.

,
.
1989

,
.

, T. Pallidum
,
,

.

,

,
,

,
, FTAABS.
.

.
.

7
3
[15]. , ,
,
1
G (2,4 ) [16].

, 1
,
G 2,4
1 3 .
G 2
4 4 4 ,
G (2,4 ),
(500 ) 1014 .
100%
,

,

.

, 10%
,

.

(
),
, , , ,
, ,

36 [17].

.

,
.
,
.
,
.

.

. 36

4 8 612
.

. 72%
36
RPR
[18],
56%.

,
2 .
,

.
210

.

.

.
28
.
,

.

.

. ,

,
,
,
.

Congenital Syphilis. New York City. 1986
1988 // MMWR. 1989. V. 38. P. 825829.
2. Rolfs R., Nakashima A. Epidemiology of pri
mary and secondary syphilis in the United
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3. Rolfs R., Goldberg M., Scharrar R. Risk fac
tors for syphilis: cocaine use and prostituti
on // Amer. J. Public Health. 1990. V. 80.
P. 853857.
4. Ingall D., Sanchez P., Musher D. Syphilis //
Infectious diseases of the fetus and newborn in
fant / Eds. Remington J., Klrin J. 4th ed. Phila
delphia: Saunders. 1994. P. 529564.
5. Wendel G., Sanchez P., Peters M. et al. Identi
fication of Treponema pallidum in amniotic flu
id and fetal blood from pregnancies complicat
ed by congenital syphilis // Obstet. Gynecol.

1991. V. 78. P. 890895.
6. Nathan L., Bohman V., Sanchez P. et al. In ute
ro infection with Treponema pallidum in early
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meeting of the Society of Perinatal Obstetri
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7. Berry M., Dijiani A. Resurgence of congenital
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V. 6. P. 1929.
8. Zenker P., Berman S. Congenital syphilis:
trends and recommendations for evaluation and
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P. 516522.
9. Quresh F., Jacques S., Reyes M. Placental his
topathology in syphilis // Hum. Pathol. 1993.
V. 24. P. 779784.
10. Fojaco R., Hensley G., Moskowitz L. Congen
ital syphilis and necrotizing funisitis // JAMA.
1989. V. 261. P. 17881790.
11.Young H., Moyes A., McMillan A., Patterson
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sitive detection of Treponema pallidum by us
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13. Wicher K., Noordhoek G., Abbruscato F. et al.
Detection of Treponema pallidum in early syph
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1992. V. 30. P. 497500.
14. Zelop C., Benacerraf B. The causes and natural
history of fetal ascites // Prenat. Diagn. 1994.
V. 10. P. 941946.
15. Musher D. How much penicillin cures early
syphilis? // Ann. Inter. Med. 1988. V. 109.
P. 849851.
1993 sexually transmitted diseases treatment
guidelines // MMWR. 1993. V. 42. P. 1102.
17. Young E., Weingarten N., Baughn R. et al. Stud
ies on the pathogenesis of the JarischHerxhe
imer reaction. Development of animal model and
evidence against a role for classical endotoxin //
J. Infect. Dis. 1982. V. 146. P. 606615.
18. Fiumara N. Treatment of primary and second
ary syphilis. Serologic response // JAMA. 1980.
V. 243. P. 25002502.
211

.
Toxoplasma gondii

,
.
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[1].
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1. Remington J., McLeod R., Desmonts G. Toxo
plasmosis // Infectious diseases of the fetus and
the newborn infant / Eds. Remington J., Klein J.
4th ed. Philadelphia: Saunders, 1995. P. 140267.
2. Guerina N. Management strategies for infec
tious diseases in pregnancy // Semin. Perinat.
1994. V. 18. P. 305320.
3. Guerina N., Hsu H., Meissner H. et al. Neona
tal serologic screening and early treatment for
congenital Toxoplasmosa gondii infection // N.
Engl. J. Med. 1994. V. 330. P. 18581863.
4. Couvreur J., Thulliez P., Daffos F. Toxoplas
mosis // Obstetrics and perinatal infections / Ed.
Charles D. St. Luis: Mosby Year Book, 1992.
P 158180.
5. Hohlfeld P., Daffos F., Costa J. et al. Prenatal
diagnosis of congenital toxoplasmosis with a
polymerasechainreaction test on amniotic flu
id // N. Engl. J. Med. 1994. V. 331. P. 695699.
6. Daffos F., Forestier F., CapellaPavlovsky M.
et al. Prenatal management of 746 pregnancies
at risk for congenital toxoplasmosis // N. Engl.
J. Med. 1988. V. 318. P. 271275.
7. Hohlfeld P., Daffos F., Thulliez P. et al. Fetal
toxoplasmosis: outcome of pregnancy and in
fant followup after in utero treatment // J.
Pediatr. 1989. V. 115. P. 765769.
8. Hohlfeld P., MacAleese J., CapellaPavlovsky
M. et al. Fetal toxoplasmosis: ultrasonograph
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V. 1. P. 241245.
9. Couvreur J., Thulliez P., Daffos F. et al. In ute
ro treatment of toxoplasmic fetopathy with the
combination pyrimethaminesulfadiazine //
Fetal Diagn. Ther. 1993. V. 8. P. 4550.
10. Wong S., Remindton J. Toxoplasmosis in
pregnancy // Clin. Infect. Dis. 1994. V. 18.
P. 853861.
214

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International CVS4000 (TA)
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(T)
, %
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1159 (TA)
3,5
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940 ()
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Canadian Collaborative CVS Group, 1989
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2248 (T)
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1000 (T)
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1000 (TA)
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,

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[37].

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.

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.

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1. .., ..
. .: , 1999.
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34

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.

(. 10.3).

,
, ,

( ,
),
[14].

.
134

. 10.1. .

.
. 10.2. .
.
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.
. 10.4. .

10 .
2
1
. 10.5. .
.
. 10.6. .

.
135

10
,
11,7%

34,8%
[15, 16].

,
2,9 0,6 /c.
(65,2%)
10

(. 10.4).

(. 10.5).

9,9 3,8 /c, 9,7 3,9 /c.

.

(. 10.6).

(
) (. 10.7),
(. 10.8),
,
,
.

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.

.

.

,

[1719].

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,

.

,

.

.

,

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1
.
2

,

.

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,

[20].
, ,

.

[3],
136

. 10.7. . 10.8. . 10.9.

. . .
.
.

.
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. ; .

.
.
1831 . R. Goosch [21]

.

,

.

.

[22].

.

[23].

,

.
.

[20, 24].
,

[25],

, [26, 27],
,

56% [28].

137

10
. 10.12. .

.
. 10.13. .

.

(. 10.12, 10.13),
,

.

.

,
[27].

[4, 29].

15
/c (. 10.15)
,

.

, .

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,

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(. 10.18).

.

.

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,

.

.

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,
,
,

138

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;
.
.
.

.

[3033].

1% [34].

(. 10.19).

,

[35].

,

.

.
.
,
,
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,
,
,
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.
,
, .

.

,
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. . ;
.
.
139

10
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.
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.
. 10.20. .
.
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.
, .
,

.

,
:

.

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,
[36].

.

.
, ,

.
,
,

.

.

140

, ..
,
.

,

[37].

.

,

,

.

:

(. 10.22).

,

,

. ,

. 10.22. .

.
.

.
,
,

[27].

(
) (
)

,

. ,

(
)

. 10.23. . . ;
; .
141

10
. 10.24. . ()
() .
. 10.25. .
.
. 10.26.
.

,
.

[38].

(. 10.24).
,
,
.

(. 10.25).

,

.

.

(. 10.23).

. ,
,

,
142

. 10.27. . .
; .

(. 10.26).

,
.
,

(. 10.27).

,

,
, ,

,
, ,
,

.
1.
2.
3.
4.

..

: . ., 1912.
..
//

. ., 1960. . 1. . 1734.
.. .
.: , 1979.
.., ..,
.. . .:
, 1975.
5. ..
// . . 1977.
3. . 7496.
6. ..

: . . . . .
., 1978.
7. ..

// .
. . 1975. 10. . 15311538.
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10
infertility // Hum. Reprod. 1988. 3. P. 955

958.
13. .. . .
4. ..: , 1940. . 262.
14. Redmer D.A., Reynolds L.P. Angiogenesis in the
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//
,
10
. . ., 1999. . 126127.
16. .., ..

// . 2000. . 1. 1. .
115122.
17. Kamina P., Chansigaud J.P. Functional
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18. .. . .: ,
1974.
19. ..

//

. ., 1971. . 40.
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27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
.. . . .:
, 1984. . 168.
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..

: . . . . ., 1981.
.., ..
,
//
. . 1987. 12. . 6267.
.., ..

,
, // .
. 1989. 11. . 36.
.., ..,
.. .

// . .
1990. 9. . 7678.
Perguin D.A., Warmerdam P.E., Yedema C.A.
at al. Ovarian vein thrombosis // Ned. Tijdschr.
Geneeskd. 1997. V. 141. P. 23502353.
..

// . . 1990.
12. . 1416.
Johnson S.C., Esclapes M. Sonography of
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Clin. Ultrasound. 1998. V. 26. 3. P. 143.
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Diagnosis of pelvic varicosities in women with
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946949.
.., ..
. .: , 1999. . 100.
Akerlund M. Uterine contraction in non
pregnant women. How are they handled? what
is their significance? // Lakartidningen. 1998.
V. 95. 4. P. 284287.
144

11
.. , ..

.
,
,

,
.
,
1214
1000 1 100
200 . ,

.

9%

I [1].

1993 .
7,4% [2].
95%

,
, ,

[3, 4].

,

.

50% [5],

.

,
,

,
,

.

,
.

[6].

. , J. Wojak
. [7],
145
11
. 11.1. .
.

.
. 11.2. .
.

.
267
,

,

,

.

,
.

,
100%
.

(. 11.1).

(512,5%
),

.

, :
,
,
,
,
.

.

.

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,
.

,

.

,

.
146

.

,
.
M. Budowick . [8] ,

.
,
. ,
,
.

.

,
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(. 11.4).

0,400,45.

.

.

7196%,
9399% [6].

,

. ,
R. Achiron . [9],

95%,
48%.
. 11.3.

5 .

.
. 11.4.
,

7 4 .
0,21,
58,2 /.
147

11
,

2
[5].

, 1

0,400,45.
,

0,55.

(<
21 /),

84%.
D. Jurkovic . [10]

,

.
,

,

.

,
.
I. Zalud A. Kurjak [11]

.

82,8%

, 80,8%
69,3%

.

(0,42 0,12)
, (0,53
0,09 )
.

0,48 0,07.

.

1

.
2

,

,
.

,
.

[12].
,
92%,

1

2

.

1. Nederlof K.P., Lawson H.W., Saftlas A.F.,
Atrask H.K., Finch E.L. Ectopic pregnancy
surveillance // United States. Mortal. Morbid.
Weekly ReP. 1990. Vol. 39. P. 915.
2. .., ..,
.. .
(
). .: , 1995.
3. Hickey J., Goldberg F. Ultrasound Review of
Obstetrics and Gynecology. Philadelphia, NY:
LippicottRaven Publ., 1996.
5. Dillon E.H., Feyock A.L., Taylor K.J.W.
Pseudogestational sacs: Doppler US
differentiation from normal or abnormal
intrauterine pregnancies // Radiology. 1990. V.
176. P. 359364.
6. .., ..
//
148

/ . ..,
.. III . .: , 1997. .
175200.
7. Wojak J.C., Clayton M.J., Nolan T.E. Outcomes
of ultrasound diagnosis of ectopic pregnancy.
Dependence on observer experience // Invest.
Radiol. 1995. V. 30. 2. P. 115117.
8. Budowick M., Johnson T.R.B., Genadry R.
The histopathology of the developing tubal
ectopic pregnancy // Fertil. Steril. 1980. V. 34.
P. 169173.
9. Achiron R., Goldenberg M., Lipitz S.
Transvaginal Doppler sonography for detecting
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J. Med. Sci. 1994. V. 30. 11. P. 820825.
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Transvaginal color Doppler study of blood flow
in ectopic pregnancies // Fertil. Steril. 1992. V.
57. P. 6873.
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blood flow in pregnant and nonpregnant
women by transvaginal color Doppler // J.
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management of ectopic pregnancy //
1. P. 205.

113545, , , 125,. 18 ./: 7812647
065207 5. 06. 1997 .
..
..
.., ..
..

125008, , , 5, ./: (095) 4505020
17.12.99. 6090/8. . 19,0
. .
, 107005, , . . 46.

.
, ..
149

2

.. , ..

.

,

.

.

.

,
.
.

.
a. uterina,

,
, .

.
a. vaginalis
,

.

,
,

.
,

,

,
(. 2.1).
, ,

.
,

,

.

,
,
rete mirabile ( )
,
,
, .

()
()
, stratum vasculosum.

35

5
6
1
. 2.1. . 1
; 2 ; 3
; 4 ; 5
; 6 ; 7 .

,
. ()

, .

( 0,0050,01 )
[1].
,
.
.
,

(. 2.2).

. ,

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media .
.

,

.

.

,
.

(. 2.3).

:

2
. ,
,
. 2.2.
. 1 ; 2
; 3 .
. 2.3. .
36

. 2.4. . 2.5. . 2.6.

.
.
.
.
. 2.7. . 2.8. . 2.9.

.
.
.
,
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(stratum
vasculosum).

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.

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.

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,
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,

[2, 3].

,

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) .
,
.

[3, 4].

.

.
37

100%
[5].
2
,

,1
, .
5 6 .

.

,

(. 2.4).

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.

.

(. 2.5).

3D (. 2.6).

(
) (
,

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40 /
50 /
.

0,9
0,7
(. 2.7, 2.8).

.

1
.
:
0,9 1,0
(. 2.9).
2

(. 2.10).

(. 2.11).
,

.

.

2,3 ( 1 6)

1
.
2

3,3 ( 1
9) .

[68].

,

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,
.

3
12 (. 2.132.15).

.
38

.
,

,
[8, 9].

(, ,
),

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.

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.

.

( )

.

,

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.

.
,
,

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,

[10, 11].

,

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.

. ,

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.

2 .
,
.

39

. 2.10. .

.
. 2.11. .
.
. 2.12.
.
. 2.13. .
.
. 2.14. .
.
. 2.15. .
.
40

0,9
60
50
0,8
0,7
V
max
40
30
0,6
20
0,5
10
0
0,4
14
21
14
21
. 2.16.
()

.
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(Vmax)

.
. 2.18. .
.
. 2.19. .
.
. 2.20. .
() ().
41

,

.

,
(.
2.18).

5,87 3,41 /.

73,6%
5

[11, 12]. ,
22,3%
10

,

.
.

, ,
[13].

3 5

(.
2.19).
,

6,2 2,1 /.

(
) (
)

.

.

( 1 5 ,
3 ) .

.

,
.

.

,

(. 2.20).

8,5 3,3 6 2,5 /c
.

.
4 7 ,
5,1 0,99 .

. ,

10,3 3,7 9,9 3,9 /
(. 2.21).

,

.

10 12 .
42

. 2.21. .
.
. 2.22. .

.

(. 2.22).

,
.

.
20,3
7,2 / ( 35 /,
15 /), 18,8 8,3 /,
( 40 12 /).

.

.

12 /.

.
,

(. 2.23, 2.24).

(. 2.25),
. 2.23. .
.
. 2.24. .
.
43

. 2.25.
.

.

1. Berek J.S., Adashi E.Y., Hillard P.A. Novaks
gynecology. Williams & Willkins, 1996.
2. .. . .
4. ..: , 1940. . 264280.
3. .
.
(2 )// . ..
..: , 1938. .II. . 2830, 6467,
102105.
4. Kamina P., Chansigaud J.P. Functional anato
my of pelvic veins in women // Phlebologie. V.
42. 3. P. 363379.
5. .., ..,
.. .

// . . 1989. . 2831.
6. Akerlund M. Uterine contraction in non
pregnant women. How are they handled? what
is their significance? // Lakartidningen. 1998.
V. 95. 4. P. 284287.
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Contractions of the inner third myometrium //
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8. Abramowicz J.S., Archer D.F.: Uterine en
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9. Lyons E.A., Taylor P.J., Zheng X.H. et al. Char
acterization of subendometrial myometrical
contractions throughout the menstrual cycle in
normal fertile women // Fertil. Steril. 1991. V.
55. P. 771774.
10. .., ..
. .: , 1999. . 27
116.
11. .., ..

// . 2000. .1. N.1. .
115122.
12. ..

/
,
10
.. ., 1999. . 126127.
14. Goldstein S.R., TimorTritsch I.E. Ultrasound
in Gynecology. Churchill Livingstone Inc.,
1995. P. 6061.
44

3

.. , ..

.

[1].
,

.

,

().

.

,

.

,
35 .
,
, 40 [24].

[5],
.

.

.

.
,
, ,
.

,
.

.
: ,
, (.
3.1, . 3.1).
,
,

513% .
8% [6].
2
3
. 3.1.
. 1 ; 2
; 3 .
45

3.1.
D. Kulenkampff ., 1995 [7]

.. .. , 1997 [8]
W. Sawicki ., 1997 [9]
H. Tsuda ., 1998 [10]
.. , 1999 [11]
35%
38%
28%
26%
33%
50%
56%
60%
61%
61%
5%
6%
12%
13%
6%

.

.

10 .

10
,

(
, )
[8].

,
.

.

. ,

.

,

.

.
,

,
.

.

(. 3.2).

.

.
25% [9].
C

.

(
, ,

),
.

,
,

.

46

.

(
)

[8].

()
.

,
.

: 1)

; 2)
; 3)
[8].
C

, ,

.

:
,

.

.

,

,
.

.

.
1013
[10].
,

,
R. Nannini . [12]
1981 .
90 ,

90 .
,
,

,

.

,

(. 3.3).
5
30 .
515 [13].

,
.

,
, ,

.
,
5% [13].

.
100%
.

. 3.2.

. ,
P. Shwrzler . [24],
104
,
,
47

. 3.2.

. .

87%, 91%.

67 89%
. R. Rudigoz
. [25] 27,5%

.

39 M.
Harada . [26]
.

. 3.3. .
, 6
.
G. Ayida . [18]

( 87,5%,
100%)
( 81%,
95%).

,

,
.
.. [23]

80,0
93,9%,
100
100% (. 3.4, 3.5).
I. Shalev . [27] , 6
16

.

,
c,

. ,
P. Gaucherand . [15],
(
94%, 98%)
,
(
67%, 94%).
M. Keltz . [21] 17 34

. 12

,
. 27 34

,
90%, 20%.

45,5% .
48

. 3.4. .
.
. 3.5. .
.
,

.

,

.

,

,

3.2. &
( [13])
,
,

E. Cicinelli ., 1995 [14]
. ,
( )
100%
100%

P. Gaucherand ., 1995 [15]
94%
98%

U. Perlitz ., 1996 [16]
80%
85%

J. Shwayder, 1996 [17]
100%
92,8%
,
G. Ayida ., 1997 [18]
87,5%
100%
J. Bernard ., 1997 [19]
,
( )
89,6%
95,0%

L. Bronz ., 1997 [20]
92%
86%

M. Keltz ., 1997 [21]
100%
100%

P. Schwarzler ., 1997 [22]
87%
91%

.. , 1998 [23]
100%
96,9%

( )
100%
100%
.
L. Bronz . [20]

139
, 50%

.
.. . [28]

97%
.

.
49

.

,

, ,
, .
,

.

,

.

,
.

,
(. 3.6). ,

,
(. 3.7),
,
, (. 3.8).

.
,

[11].

(.
3.9)
,
.
,

,
,

54 100% (. 3.3).
,

,
(

). ,

,
, 33,3 84,3%
. ,

48% ,
, .

.

,
. , .. . [37]

,

3.3. &
( &
[8])
W. Matta ., 1988 [29]

100
A. Kurjak I. Zalud, 1991 [30]
54
A. Kurjak ., 1992 [31]
70
A. Szantho ., 1994 [32]
100
M. Hirai ., 1995 [33]
91
R. Ximenes ., 1996 [34]
90,6
.. ., 1996 [35]
66,7
.. .. , 1997 [8] 87
I. Szabo ., 1997 [36]
91
H. Tsuda ., 1998 [10]
51,5
.. , 1999 [11]
84
.. ., 1999 [37]
53,3
50

. ..
[11]

: 36%,
48%.
H. Tsuda . [10]
84,6%
, 41,9%
57,7% .
,
46,2%
,

,
6,1% .

.
,

85,9%,
82,1%, 84,3%.

(. 3.10) [38],

.

.

, ,
,
. .
3.4 ,

.
.. [11],
0,73
0,08 (. 3.11),

0,82 0,06.
[29, 42],

,

, .

.

,
.

.

.
( < 0,01)

.
,
6 .
,
.. . [37],

3.4.

( [8])
W. Matta ., 1988 [29]

S. Creighton ., 1994 [39]
J. Carter ., 1994 [40]
F. Aleem M. Predanic, 1995 [41]
.. ., 1995 [42]
A. Jurisic ., 1996 [43]
.. .. ,
1997 [8]
I. Szabo ., 1997 [36]
.. , 1999 [11]
0,52
0,80
0,78
0,54
0,718
1,5
2,2
1,48
0,72
0,77
0,73
: ; &
.
51

. 3.6. .
, (), ().

. ,
0,78 0,06,
0,67 0,09.

: 0,75 0,07,
0,71 0,09,
0,69 0,05.

,
(. 3.5).

, ,

[8,
45].
.
( )

.

,

.

(
),
[35, 43].
. 3.7. .
,
, .
. 3.8. .
,
, .
52

. 3.9. . ,
(, ).

,

, .
F. Aleem M. Predanic [41],

.

(0,43); ,
,

.

.

:
0,59 0,50 .

.

[8]. ,
,

[11, 37]. ,
. 3.10.
.

,
.
. 3.11.

.
0,73.
53

. 3.12.
.
0,62.
. 3.13.
.
0,70,
17,7 /.

,

(. 3.12) [8].

.

[35, 43].

,

.
.. [11], ..
. [37]

:

,
.
,

0,61 0,05 (.
3.13),
0,45 0,04 (. 3.14).

.

,
(. 3.15).

.

().
,
.

8
W. Matta
. [29]. 4

.

.
0,52,
0,48,
0,92
0,91. ,
54

3.5. (
[8])
W. Matta ., 1988 [29]

K. Hata ., 1991 [44]
A. Kurjak ., 1992 [31]
A. Szantho ., 1994 [32]
S. Creighton ., 1994 [39]
J. Carter ., 1994 [40]
F. Aleem M. Predanic, 1995 [41]
M. Hirai ., 1995 [33]
P. Sladkevicius ., 1995 [45]
0,48
0,68
0,54
0,62 (0,371,0)
0,6
0,55
0,57 (0,480,68)
0,89
0,9
1,2
0,96
0,80 (0,521,14)
0,67 (0,371,08)
A. Jurisic ., 1996 [43]

R. Ximenes ., 1996 [34]
.. ., 1996 [35]
.. , .. ,
1997 [8]
0,34 0,01
0,64 (0,411,0)
0,490,68
0,320,52
1,21 (0,592,74)

0,61 0,06
0,53 0,08
H. Tsuda ., 1998 [10]
1,384 0,643
1,612 0,719
.. , 1999 [11]
0,61 0,05
0,45 0,04
0,35 0,02
.. ., 1999 [37]
0,59 0,06
0,42 0,06
: ; .

.
S. Creighton . [39],
,

( 1,5 1,8),
( 0,9 1,6). F. Aleem M. Predanic
[41]

1 ,

55

. 3.14.

. 0,5.
. 3.15. .
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.
,
. ,
,
.
,

,
.

, .

. .: , 1994. . 8690.
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.. .

,
,
// . .
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58

4

.. , ..

.
,
26%
1%

.
,

,
3%,

.

. ,
1980 1989
. 186
19 ,

11 .
,

, ,

.

:
40%, 40%,
15%,
( ,
, .) 5%.

FIGO ,

,

.
,
,

[1].
(

,
)
:
.
,

, ,
59

,
(
, , ,
).
,

. ,

,

.
.

: ,
, ,
.

,
2/3
, 1/4 1/10
.
3,5 , .
,
,
.

,
.

,

1/3 .

,
.

;
,

.

, ,
50%
.

.

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.

, ,

,

.

[26]. , ..
.. [3],
9
,

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,
,

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,
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.. . [8]

60

.

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.

.

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(. 4.1, 4.2).

(. 4.3),

.

.

,
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.
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).
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61

,

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; ; ( ;
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; ; (
; , 63).
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,
100%
[9] (. 4.8).

[10].

, ,

,

(. 4.9, . 4.1).

.
,
0,7.
A. Kurjak S. Kupesic [2],
10 ,
. 4.8.
() ().
64

. 4.9. .
.
0,38;
56 /.
. 4.10.
.
. ,
.
. 4.11.
.
. ,
.

:
0,73 0,08, 0,69 0,05.

,
(0,82 0,06).

, ,
(. 4.10, 4.11).

.
,

.
K. Taylor . [11],

,

.

0,62,
0,74 ( 0,88).
(
3,
5,
4)
I. Szabo . [19].

0,84 0,06,
0,77 0,08,
0,74 0,05.
65

4.1.
( [9])
A. Szantho ., 1994 [13]

R. Tepper ., 1994 [14]
0,5 (0,350,79)
0,56, 0,57
0,55, 0,73
0,9 (0,41,7) *
0,286 0,01**
0,523 0,014***
0,40 0,07
0,37 0,03
0,380,41
0,332 0,007
0,63 0,18
0,39 0,07
0,65 0,10***
0,35 0,02
M. Hirai, 1997 [15]

A. Kurjak S. Kupesic, 1995 [2]
C. Chen ., 1995 [16]
A. Jurisic ., 1996 [17]
K. Hata ., 1997 [18]
I. Szabo ., 1997 [19]
.. , 1999 [20]
0,62 0,07
0,583 0,040
0,74 0,05
0,69 0,05
. * ;
.
** .
*** .
. ,

.

.
K. Hata . [12]

. ,

24
14 44 ,
97 (82140)
.

66,4 / (58,3124,0)
21,6 / (6,348,6) [12].
..
[20]: 67,4 /,
16,5 /,
29,6 /.

A. Kurjak
S. Kupesic [21]

,
0,40. ,

90,91%,
99,82%,

71,43%, 99,96%.
K. Hata . [12]

, 41 /.

80%,
97,6%,

80%, 97,6%.
.. [20]

.

66

0,40,
45 /
. ,

100%, 89,6%.
,

.
.

.
1.
2.
3.
4.
5.
6.
7.
8.

..
//

/ . .., ..
III . .: , 1997. . 201226.
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tumors // Ultrasound and the Uterus / Ed.
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Publisching Group, 1995. P. 105113.
.., ..
. .:
, 1990. . 100102.
.., ..,
.., ..
// . .
1991. 3. . 5658.
An Atlas of Transvaginal Color Doppler / Ed.
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1993.
Hiskey J., Goldberg F. Ultrasound review of
obstetrics and gynecology. Philadelphia, NY:
LippincottRaven Publ., 1996.
..
// . .
. . . 1993. 1. . 5559.
.., ..,
..
// . .
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
1997. 1. . 2634.
.., ..
//

/ . ..,
.. III . .: , 1997. . 76119.
.., ..,
.., ..

. .: , 1997.
Taylor K., Ramos I., Carter D. et al.
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Szantho A., Szabo I., Nemet J. et al.
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19. Szabo I., Szcintho A., Csabay L., Papp Z.

Transvaginal color Doppler for assessment of
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Washington, October 2630, 1997. A121.
20. ..

: . . . . ., 1999.
21. Kurjak A., Kupesic S. Textbook on color
Doppler in gynecology, infertility and
obstetrics. 1999.
68

5

.. , .. , ..

[1].
34 38 .
[2, 3].
A. Fleischer [4], 1997 .
50 . .

6% [5].

,
5665 [1, 68],
16%

[1], 5%
40 [9]. R. Rudelstorfer
. [10],
90%
. 94%

50 [11].

FIGO
(1989 .):
I
;
Ib 1/2
;
Ic 1/2
;
IIa
;
IIb
;
IIIa
/
/
(
);
IIIb ;
IIIc
/
;
IVa
/
;
IVb
/
.

,
.
100 000 9
10, 78 [12].
A. Fleischer [4],
3000 .

.
,
I 95%,
II 60% [13].

.

69

1014%
[9, 10, 1416]. ..
[17]

7,8%
.

37 1000
[1821].

,

,

.
.. .
[6],

,

.

. . Coleman
. [22] ,

27% ,
100%.

, ,
, ,
,

,
.
.

.

[23] (. 5.1).
1.

.
2.

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3.

.
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.
. 5.1,
,

20 (. 5.2). 90%

10 [50]. ,

,

(. 5.2).
,

8 [16, 28, 42, 5254]. D. Dordoni
. [16], F. leem . [43],
70

5.1.

( [24])
R. Auslender ., 1991 [25]

17,8
T. Bourne ., 1991 [26]
20,0
S. Granberg ., 1991 [27]
18,2
M. Wikland ., 1991 [28]
18,0
D. Botsis ., 1992 [29]
16,6
T. Bourne ., 1992 [30]
20,2
B. Karlsson ., 1992 [31]
20,3
R. Mancini ., 1992 [32]
16,2
18,1
A. Dorum ., 1993 [34]
20
A. Kurjak ., 1993 [35]
20
P. Sladkevicius, L. Valentin, 1993 [36]
24
O. Bakos ., 1994 [37]
13,9
J. Carter ., 1994 [38]
14
C. Exacoustos ., 1994 [19]
19,5
K. Gruboeck ., 1994 [18]
24,9
B. Karlsson ., 1994 [39]
21,1
A.H. , .. ,1994 [40] 20,1
T. Van de Bosch ., 1994 [41]
1335
B.B. ., 1995 [42]
2024
.. , .. , 1995 [24]
19,3
F. Aleem ., 1995 [43]
22,6
G. Weber ., 1995 [44]
17,1
K. Gruboeck ., 1996 [45]
29,5
B. Gull ., 1996 [46]
19
L. Bronz ., 1997 [47]
1021
I. Fistonic ., 1997 [48]
14,1
J. Alcazar ., 1998 [49]
14,7*
20,2**
: *
50%; **
50%.
C. Exacoustos . [54]
8

.

8 . ,

159
,
62 ,
5
. 5.2.
.
23 .
1 (3%) , 610 10
(31%), 1115 14 (43%) 15
37 (67%) [55].
,
18
930

,
107 .
4
0,6%, 58 5,4%, 911
12,5%, 11 33,5% [56].

,

5.2.

T. Bourne ., 1991 [26]

S. Granberg ., 1991 [27]
D. Botsis ., 1992 [29]
A. Dorum ., 1993 [34]
O. Bakos ., 1994 [37]
B. Karlsson ., 1994 [39]
.. ., 1999 [51]
,
4,0 2,0
3,4 1,2
3,2 1,1
2,6 1,4
4,0
4,6
3,9 2,5
4
71

4 5 [24].

78,2
100%, 60100%,
8296,2%. ,
,

,

56 . A. Kurjak
S. Kupesic [50],
10%
510 .

. , ..
[57],
6 ,

,

:

48,3%,
56,8%.

96,5% (!),
90,9%, 92,3%.

,

, .

R. Osmers . [53].

8 , 2,2%

. ,
5

,

. ,

5,4%
12 ,

2,2
4,6.
,

(. 5.3, 5.4). ,
R. Auslender . [25],

14,3 ,
. 5.3.
.
() 22 .
. 5.4.
.
()
16 .
72

15,8 ,
17,8 . I. Fistonic
. [48]

12,4 ,
13,4 ,
14,1 .
G. Conoscenti
. [58],

.

,
.
.

. .. ..
[59],
: 1)
; 2)
; 3)
; 4)

; 5)
; 6)

. 5.5.
.
,
.
; 7)

; 8)

.
E. Andolf . [60]

, 85%
, , 9%
6%
.
( 45%)

,

,
10%
[35]. .. [61]

57% .

.

: 25%
, 25%
(. 5.5).

[35].
. 5.6. .
.
73

,

.

. ,

0,6 0,3 ,
,
, ,
(. 5.6).
16,9%

(. 5.7).

(. 5.3).
,
1,5
,
2
,
,
.
3
,
(. 5.8). ,

.

(. 5.9).

,

, ,
(. 5.10).
. 5.7.
.
,
.
. 5.8.
. .
.

.

,

. .. [62],

, ,
1/3 .

68 97% [31,
6368] (. 5.4).
I. Szabo . [63],

74

5.3.
,
1,0
(n=15)
1,5
(n=13)
2,5
(n=25)
3,0
(n=8)
4,0
(n=13)
15
(17,4%)
13
(15,2%)
19
(22,1%)
2
(2,3%)
2
(2,3%)
6
(6,9%)
4
(4,7%)
7
(8,1%)
2
(2,3%)
4
(4,7%)

86%,
90%,

92%, 83%.

,
50% 50% (. 5.11).
4,0
(n=12)
12
(14%)
,
. Karlsson . [31],
,

79%, 100%.
M. Coute . [66],

5.4.
, %
. Karlsson ., 1992 [31]

G. Weber ., 1995 [44]
I. Szabo ., 1997 [63]
J. Alcazar ., 1998 [49]
S. Gabrielli ., 1998 [64]
S. Kupesic, A. Kurjak, 1998 [65]
79
85
86
100
79
100
, %
100
89
90
91,7
94,4

30
15
. 5.9.

.
. 5.10. .

, .
75

. 5.11. . 50%;
50%.
,

.

S. Kupesic A. Kurjak [65]:
100%, 94,4%,

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(0,520,94)
0,80 0,05
(0,541,05)
1114
18,6 0,5
(16,320,9)
9,6 0,5
(8,610,6)
0,49 0,02
(0,450,52)
0,51 0,02
(0,420,57)
0,68 0,03
(0,640,71)
0,68 0,03
(0,550,79)
1517
23,2 0,7
(16,826,1)
8,9 0,6
(6,614,5)
0,43 0,02
(0,410,49)
0,51 0,03
(0,460,62)
0,59 0,04
(0,530,71)
0,82 0,04
(0,711,02)
1822
29,8 2,1
(21,646,5)
11,7 1,1
(4,917,2)
0,41 0,02
(0,340,48)
0,52 0,03
(0,410,56)
0,57 0,03
(0,440,72)
0,64 0,03
(0,520,85)
2326
18,46 0,8
(15,422,4)
10,8 0,9
(5,117,4)
0,46 0,01
(0,450,48)
0,50 0,01
(0,450,56)
0,62 0,03
(0,520,75)
0,73 0,02
(0,620,84)
: 1 ; 2 .
95

. 7.3. .
(); .
. 7.4.
.
(1) (2).

.

20 28
14 .

28,9 ( 23 34 ),
13,5 ( 12 16
),
4,5 ( 3
6 ). 13 (65%)
.

: 1)
(57 ); 2)
(810 ); 3)
(1114 ); 4)
(1517 ); 5) (18
22 ); 6) (2326
). M,
, . ,

K. Hata . [10],
,

, .
,
(. 7.5),

,
(1822 )
29,8 2,1 /.
(2326
) 18,46 0,8
/.

, 8,7 0,8
11,7 1,1 /.
(. 7.6)

(0,49
0,01),
(0,41 0,02)
(1822
),
96

/
0,60
30
25
20
15
10
5
57
810
1114 1517 1822 2326

0,50
0,40
57
810
1114 1517 1822
2326
. 7.5.
.
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.
. 7.7.
.
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.
().
0,46 0,01.

,
,
0,54 0,01
0,5 0,03.
.
,

,

,

.

.

(.
7.7), I. Zalud
. [11], ,

10 35% .
[8,
9],

0,6 0,670,7,
1,20 1,31.
[12, 13],

0,4.

( 6 /)
(,
) (. 7.8).
97

,

,

.

1. Berek J.S., Adashi E.Y., Hillard P.A. Novaks
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2. Niswender J., Moore R., Akbar A. et al. Flow
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P. 381388.
3. Jaffe R., Warsof S.L. Color Doppler imaging in
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4. .., .., ..,
..

// . . 1989. 7. . 2831.
5. Kurjak A. An atlas of transvaginal color Dop
pler. The current state of the art. NY, L.: The
Parthenon Publ. Gr., 1994.
6. Sen C., Cepni I., Erel T. et al. Doppler assess
ment of ovulation period // Ultrasound Obstet.
Gynecol. 1996. V. 8. Suppl. 1. P. 105.
7. Schurz B., Schon H.J., Wenzl R. et al. Endo
vaginal Doppler flow measurements of the ova
rian artery in patients with a normal menstrual
cycle and with polycystic ovary syndrome dur

ing in vitro fertilization // J. Clin. Ultrasound.
1993. V. 21. 1. P. 1924.
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corpus luteum // Ultrasound Obstet. Gynecol.
1996. V. 8. Suppl. 1. P. 252.
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the periovalatory period: relationship to the time
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7. P. 135140.
10. Hata K., Collins W. Color Doppler imaging and
ovarian tumor angiogenesis: the Janus approach
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11. Zalud I., Maulik D., Conway C. Pelvic blood
flow in postmenopausal women: color, power
V. 8. Suppl. 1. P. 8.
12. Platt L.D., Karlan B.Y., Raffel L.J. et al. Fa
milian ovarian cancer screening: results from the
Gilda Radner ovarian cancer detection program
// Ultrasound Obstet. Gynecol. 1995. V. 6. Sup
pl. 2. P. 34.
13. .., ..

? // . . 1997.
2. . 9.
98

.. , ..
.

()

.

0,6 11% [15],

.

13 3
(
) 10
23 910 .

,
[3, 6, 7],

()
,
0,520,56.
C. Battaglia . [8]

:

()
1,42 0,09,
0,74 0,18. ,

(3,08 0,53 3,58 0,36 ).

(3,75 0,52)
(3,67 0,41)

.
J. Zaidi . [9],

()

(16,89 2,36 /)
(8,74 0,68 /).
,

.
,
26 ,
, 57
,

(. 8.1, 8.2).

(. 8.1, . 8.3, 8.4).

. , . Battaglia . [8, 10,
11]
99

8.1.

68#
11,7 0,8
(8,615,3)
12,7 0,8
(7,718,3)
0,63 0,01
(0,510,57)
0,59 0,01
(0,510,61)
1415#
11,9 0,5
(9,613,9)
10,9 0,5
(8,614,6)
0,56 0,02
(0,510,55)
0,6 0,02
(0,500,57)
2426#
10,8 1,1
(6,917,2)
12,4 1,1
(8,917,2)
0,59 0,02
(0,530,56)
0,64 0,03
(0,520,58)
,

.

.
J. Zaidi . [9]

1
1
. 8.1.
. (1)
(2).
. 8.2.
. (1)
(2).
. 8.3. ()
()
.
. 8.4. ()

.
100

.
. Battaglia .
[8, 10, 11],
(3,68 0,26)
, (3,31
0,26). [10]
( > 0,05)

(0,52 0,06 0,54
0,07 ).

.
()

,
.
.

15 30% [12].
,
,

[12].

.

,
.
. 8.5.
. .
. 8.6.
.
. 8.7.
.
. 8.8. (
) .
101

,

.

,
,

.

(. 8.5).

.

().

, , .
325%
[12]. ,

,

,
.

(. 8.6). ,

,
,
(. 8.7). D.
Kalogirou . [14],

( <
0,03). S. Kupesic . [15]

,
.

12,7 /
0,55 (. 8.8).
.

.

.

[16].
C. Anandakumar . [17] 7
9 (!)
,
,
.
,

(. 8.9),
(. 8.2)

.

. , S.
Kupesic . [7]
0,52 0,06.
. Jurisic
.[18]
0,64 (0,510,78).
M. Pascual . [19]

84,6
99,2%. ,
C. Anandakumar . [17],
8.2. #

12
12,4 9,8
(4,218,1)
0,5 0,02
(0,490,58)
102

,

610 .
.
,

,

.

,

,
, ,
.

(. 8.10).
S. Kupesic A. Kurjak [20]

0,46 0,08. ,

(. 8.3).
.
[27]

8.3.

19
24,2 7,4
(11,342,4)
0,43 0,1
(0,320,46)
750%
. ,
, ,
,

. ,
.

8.4. #

(/)
37
11,4 5,2
(8,922,4)
0,54 0,03
(0,490,59)
70%
[21]. S. Kupesic . [22],

(36%)
(12%), 0,40 0,59.
,

(. 8.11)

,
.
,

, (. 8.12),
,
(. 8.13),

.
,

(. 8.4).
11,4 5,2
/.

,

1022 /.
0,54 0,03 ( ) 0,59 0,02 [22].

, ,

,
. ,
J. Alcazar . [23],

88,9 91%,
76,2
88,9%.
. ,
103

. 8.9. .
.
. 8.10. .
.
1
2
. 8.11. .
.
. 8.12. ,
. 1 ; 2
.
,

.
100% ,

75,7%, 54,5%.

.

26,1
11,5 /, 0,47 0,02.
,

0,44 [7] 0,53 0,09 [24].

.
. Papadimitriou . [25]
.

,

/
(. 8.14, 8.15).

.
, S. Kupesic . [24]

104

. 8.13. .
, .
. 8.15. .

47,1
52,4% .

. Alatas . [26],

,
.
,

.

(0,71 0,07) [26].
. 8.14. .

1. HamiltonFairby D., Pearce D. Polycystic
ovary syndrome // Annual. Progr. Reprod. Med.
1993. P. 7180.
2. .., ..
. .: , 1990.
3. .., ..,
..
//
/ .
.., .. . 3. .: , 1997.
. 132174.
4. .., ..
// . . 1994. 1.
. 1114.
5. Adams J., Polson D.W., Franks S. Prevalence
of polycystic ovaries in women with anovulation
and idiopathic hirsutism // Br. Med. J. 1986. V.
293. P. 355359.
6. Kupesic S., Kurjak A., Stilinovic K. The
assessment of female infertility // n Atlas of
transvaginal color Doppler. The current state of
the art / Ed. Kurjak A. L.: The Parthenon Publ.
Gr., 1994.
7. Kupesic S., Marton U., Kurjak A. Polycystic
ovary syndrome Doppler parametres // Lijec.
Vjesn. 1996. V. 118. Suppl. 1. P. 4244.
8. Battaglia C., Artini P., Salvatori M. et.al.
Ultrasonographic patterns of polycystic ovaries:
color Doppler and hormonal correlations //
P. 332337.
105

9. Zaidi J., Campbell S., Pittrof R. et. al. Ovarian

stromal blood flow in women with polycystic
ovariesa possible new marker for diagnosis? //
Hum. Reprod. 1995. V. 10. P. 19921996.
10. Battaglia C., Artini P.G., DAmbrogio G. et. al.
The role of color Doppler imaging in the
diagnosis of polycystic ovary syndrome // Am.
11. Battaglia C., Artini P.G., Genazzani A.D. et al.
Color Doppler analysis in lean and obese women
with polycystic ovary syndrome // Ultrasound
12. .., ..
. M.: , 1998.
13. Zaidi J., Jurkovic D., Campbell S. et al.
Luteinized unruptured follicle: morphology,
endocrine function and blood flow changes
during the menstrual cycle // Hum. Reprod.
1995. V. 10. P. 4449.
14. Kalogirou D., Antoniou G., Botsis D. et. al.
Transvaginal Doppler ultrasound with color
flow imaging in the diagnosis of luteal phase
defect (LPD) // Clin. Exp. Obstet. Gynecol.
1997. V. 24. P. 9597.
15. Kupesic S., Kurjak A., Vujisic S., Petrovic Z.
Luteal phase defect., comparison between
Doppler velocimetry, histological and hormonal
markers // Ultrasound Obstet. Gynecol. 1997.
V. 9. P. 105112.
16. Cacciatore B., TommolaRossi., Wahlstrom T.
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adnexal tumors // Ultrasound Obstet. Gynecol.
1996. V. 8. Suppl. 1. P. 203.
17. Anandakumar C., Chew S., Wong Y.C. et al.
Role of transvaginal ultrasound color flow
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ovarian tumors // Ultrasound Obstet. Gynecol.
1996. V. 7. 4. P. 280284.
18. Jurisic A., Djukic M., Rakic S. et al. The value
of color Doppler ultrasound in detection of
ovarian malignancies in women under 30 years
of age // Ultrasound Obstet. Gynecol. 1995. V.

6. Suppl. 2. P. 103.
19. Pascual M.A., Hereter L., Carreras O. et al.
Transvaginal ultrasound diagnosis of ovarian
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20. Kupesic S., Kurjak A. Development of an early
human being from conception to implatation
transvaginal color Doppler study // An Atlas of
transvaginal color Doppler. The current state of
the art / Ed. Kurjak A. L.: The Parthenon Publ.
Gr., 1994.
21. Aleem F., Pennisi J., Zeitoun K., Predanic M.
The role of color Doppler in diagnosis of
endometriomas // Ultrasound Obstet. Gynecol.
1995. V. 5. 1. P. 5154.
22. Kupesic S., Kopjar M., Kurjak A. Scoring
system for endometriosis // Ultrasound Obstet.
Gynecol. 1995. V. 6. Suppl. 2. P. 112.
23. Alcazar J., Laparte C., Jurado M. et. al. The role
of transvaginal ultrasonography combined with
color velocity imaging and pulsed Doppler in the
diagnosis of endometrioma // Fertil. Steril.
1997. V. 67. P. 487491.
24. Kupesic S., Kurjak A., Pasalic L. et. al. The
value of transvaginal color Doppler in the
assessment of pelvic inflammatory disease //
Ultrasound Med. Biol. 1995. V. 21. P. 733738.
25. Papadimitriou A., Kalogirou D., Antoniou G.
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V. 23. 4. P. 229232.
26. Alatas C., Aksoy E., Akarsu C. et. al.
Hemodynamic assessment in pelvic infla
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ultrasonography // Eur. J. Obstet. Gynecol.
Reprod. Biol. 1996. V. 70. 1. P. 7578.
27. .., ..,
.. .
. .:
, 1995.
106

9

.. , ..

J.
Folkman [1], ,

. ,

,
, .

,
[2]

, , ,

[3].
,

[4].

.

,
:
,

.

,

[5, 6]
[7].

()

1989 .

A. Kurjak [8], T. Bourne
. [9], T. Hata . [10].

.
,

. .
Bourne . [9], . Kurjak . [11,
12]
:
() 0,4,
() 1,0.

[13, 14].

.

[15].

.
107

. Kurjak . [8, 11, 12,

1636], H. Schulman . [37],
A. Fleischer . [3846], A. Pascual
. [47], Z. Weiner . [48, 49],
I. TimorTritch . [50, 51], M. Kawai
. [52, 53], T. Bourne . [5456],
C. Jeng . [57], A. Caruso . [58],
M. Ilyas . [59], .. [60]
,

B.
, A. Fleischer . [39]

70% (III
) .
A. Tekay P. Jouppila .
[61, 62], B. Bromley . [63], B. Leeners
. [64, 65], M. Rehn . [66, 67]

, (L. Valentin [68, 69], L. Platt
[7072])

.
V. Schneider
. [73], D. Brown . [74], K. Hata
. [7577], K. Jain . [78],
J. Carter . [79, 80], H. Prompeler
. [8185] . [8689]
,

.

,

,
(
)
(
,
)
.
9.1. ( %)

J. Antonic S. Rakar [90]

F. Dambrosio . [91]
A. Kurjak . [29, 32]
C. Jeng . [57]
H. Shulman . [92]
B. Salle . [93]
M. Emoto . [6]
A. Desroches . [94]
K. Hata . [76]
A. ekay P. Jouppila [95]
C. Chou . [96]
Z. Maly . [97]
A. Kurjak . [31]
M. Pascual . [98]
J. Alkazar . [99]
D. Brown . [74]
I. TimorTritsch . [50]
H. Prompeler . [83]
A. Lissoni . [100]
..
.. [101]
[102]
14
22
52,2
35
30
54,8
54
40,3
89
59
60
61
62
64,8
67
70,4
89
85
100
100
99
93
100
84,2
100
100
100
98
97
96
95,7
75
100
89
98
78
69,2
95
100

. ,

(. 9.1),
75100%
14
98,9%

.

[102]

(15 15 )

(13 15 86,7%).

69,2%
,
73,3 53,8%
.
,

108

9.2. ( %)
.
,

A. Tailor . [106]
76
100
.
S. Guerriero . [107]
94
100
, ,
A. Valcamonico . [108]
96
96

Cacciatore . [29]
98
100

[109]
87
98,4

( ).
, Y. Zalel . [103], A. Kurjak
M. Predanic [30] , ,
.
2425% .

,

,

() [104, 105].
. , S.
, Stein . [110], ,
, ,
98,4100%
7698% 77, 69, 49 89%
(. 9.2).
, . Anandakumar
. [157] 77, 68, 40 91%.
A. Tailor .
,
[106], .
2
2
2
1
1
2
1
. 9.1.
. 1 ; 2
.
. 9.2.
. 1
; 2 .
109

I. TimorTritsch .
[50], . Pascual . [98] ,

.

. . Kurjak . [31]
,

, ,
,
.
H. Prompeler . [83]

3,
9 (p < 0,0001). ,
(19)
,
.
P. Albertis . [111]

6
. J. Alcazar . [99]

7,5 5,5,
1,4 1,4 (p < 0,05).
,
(
PRF 1 )

2,4 0,8 ( 1
6), (. 9.1) 6,4 1,8
( 1 14) (p < 0,05).
,

,
,

(. 9.2).

. A. Fleisher . [38]
1991 .

.
.
,
,

,
.
A. Fleischer . [42]
,

.

,

.
A. Kurjak . [31] ,

,

, ,
,
, .
J. Alcazar . [112]

(90%) ,
(88,6%).

[97, 113].

(. 9.3)

(. 9.4).

(. 9.5),

(. 9.6).

110

. H. Pairleitner .
[114, 115] ,

,

(. 9.7).
(. 9.3).
. Kurjak . [35] 1992 .
:

0,28
0,4,
0,4.

. , I. Takac
. [113], F. Dambrosio . [91], H.

Schulman . [37], I. TimorTritsch
. [51], H. Prompeler . [83], S.
Guerriero . [107],
0,40,47.
[102]
0,35
0,03, 0,60 0,03.

.
, M. Emoto . [6],
M. Shieber C. Sohn [116], G. Zanetta
. [117], K. Hata . [76, 118], U.
Hamper . [119], ..
.. [120], T. Udo .
[121], K. Jain [78]
0, 50,55.
9.3.
A. Kurjak . [12]
H. VaccaroCerva, [122]
A. Kurjak I. Zalud [35]
H. Schulman . [37]
A. Tecay P. Jouppila [61]
P. Gausherand . [123]
A. Tecay P. Jouppila [61]
C. Spreafico . [124]
M. Kawai . [53]
C. Spreafico . [124]
G. Zanetta . [117]
V. Shneider . [73]
D. Brown . [74]
H. Prompeler . [82]
J. Carter . [79]
S. Stein . [110]
A. Desroches . [94]
Z. Maly . [97]
K. Hata . [76]
J. Carter . [79]
I. Takac . [113]
B. Leeners . [64]
J. Alkazar . [99]
B. Leeners . [64]

1991
1991
1992
1992
1992
1992
1992
1993
1993
1993
1993
1993
1994
1994
1995
1995
1995
1995
1995
1995
1996
1996
1996
1996
1998
1999
56/624
4/17
38/136
29/54
11/61
12/40
11/61
23/37
16/39
41/42
47/186
47/186
33/159
64/81
< 0,4
< 0,7
0,4
0,4
< 0,5
< 0,5
< 0,6
< 0,4
< 0,4
0,5
< 0,56
< 0,8
0,4
0,5
0,4
< 0,4
< 0,5
< 0,6
0,72
0,8
< 0,4
< 0,4
0,45
< 0,5
0,4
0,44
96
100
97,3
96
46
82
87,5
75
88
87
93,8
50
85
13
24
94
100
93
94
82
75
96
50
58
83
99,8
94
100
95
89
72
88,8
79
89
94
56
96
77
97
90
83
57
73
59
97,4
58
91
79
87
95
98
80
96
42
100
35
75
47
84
50
71
94
80
48
93
99,7
100
95
90
89
96
96
73
97
92
98
91
88
:
; ; ;
.
111

. 9.3.
.

.
. 9.4.
.

().
. 9.5.
.

().
. 9.6.

.

().

,
0,6 0,7.
. 9.7.
.
.

(0,45) I. Timor
Tritsch . [51].
1,15.
I. Takac . [113], P.
Albertis . [111], U. Hamper .
[119], Z. Weiner . [48], G. Zanetta
. [117], A. Fleisher . [44], M.
Kawai . [52, 53], ..
112

.. [120],

0,56 0,93,
0,83 1,93.
[102]
0,47
0,05, 1,04 0,09.
. 9.4

.

.
I. TimorTritsch . [50] ,

94%,
99%. A. Kurjak
. [29]
(< 0,4) (< 0,65)

,
100, 98
90% .

. , 85
A. Pascual . [47]

.
= 0,4 ,

100, 96,
73 100%. = 1,0
100, 98, 89 100%.
K. Vairojanavong .
[127],
< 0,4 66,6% ,
< 1,0 85,7%. ,

.
I. Takac . [113]

82,1 97,4%,
59,0 87,2%.
A. Tekay P. Jouppila [95] ,

9.4.
T. Bourne [13]
A. Fleisher . [44]
Z. Weiner . [49]
M. Kawai . [52]
Z. Weiner . [48]
M. . [125]
G. Zanetta . [126]
H. Prompeler . [85]
P. Albertis . [111]
D. Brown . [74]
Z. Maly . [97]
S. Stein . [110]
B. Leeners . [64]
I. Takac . [113]
B. Leeners . [64]

1989
1991
1992
1992
1993
1993
1993
1994
1994
1994
1995
1995
1996
1996
1996
1998
1998
1999
8/9
11/32
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23/37
41/42
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33/159
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.

.

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(157 /)
10 .
T. DuBose
13

1.3. 1014
( [18])
,
10
M. Cullen ., 1990 [19]

S. Rottem ., 1990 [20]
R. Achiron, O. Tadmor, 1991 [21]
L. Dolkart, F. Reimers, 1991 [22]
I. TimorTritsch, S. Rottem, 1991 [17]
P. Johnson ., 1992 [24]
U. Gembruch ., 1993 [25]
.. ., 1994 [18]
U. Marton, A. Kurjak, 1994 [26]
J. Smrcek ., 1999 [27]
A. Suy ., 2000 [28]
0%
11
12
13
14
30%
90%
100%
100%
100%
100%
16%
58%
80%
45%
36%
71%
93%
63%
100%
100%
100%
100%
100%
100%
72%
100%
100%
> 25%
27%
90%
74%
100%
95%
96%
44%
100%
54%
. [14], H. Robinson J. ShawDunn [15],

(175 177 /
) 9 .

100 / 9

.

(83,4%)
(97,9%)
[13]. J. Hickey F. Goldberg
[16]

85 /
58 . ,

90%

I .

11
,
[17].
,

1213
(. 1.3). P.
Johnson . [24]

13 74% 14
72% .
10 .

1.4.

1114

( [29])
,
,
,

11
12
13
14
,

L. Dolkart, F. Reimers, 1991 [22]
< 70%

U. Gembruch ., 1993 [25]
67%
80% 100%
100%
.
.. ., 1994 [18]
> 90%

R. Achiron ., 1994 [30]
90%
U. Marton A. Kurjak, 1994 [26]
96%

J. Smrcek, ., 1999 [27]
100%

14

. 1.16. 12 6 .
.
. 1.17. 14 .
.
11 45%
, 12 63%, 13 95%,
14 100% (. 1.16, 1.17) [18].

,

13 (. 1.4).
U. Gembruch . [25],

100% ,
, 13
. 11
67%
, 12 80% .
R. Achiron
. [30],

90%
1315 .
L. Dolkart F. Reimers [22],

13
30% . ,
U. Gembruch . [25],
,

.

90

90%
13
[18]. 90

12 .
,

/ 913 , ,

.
R. Achiron O. Tadmor [31]
, 911

/ 70% ,

50%, 1213
95 65% .
,

34 ,

[32].

15

1.5. ( )
1317 [29]
,
13
14
15
16
17
1,9
0,83,0
2,0
0,93,1
1,4
0,91,9
1,6
1,12,1
2,4
1,13,7
2,5
1,23,8
1,6
1,22,0
1,9
1,42,4
3,0
1,54,5
3,1
1,64,6
2,0
1,52,5
2,2
1,72,7
3,6
2,05,2
3,7
2,25,3
2,2
1,72,7
2,4
1,83,0
4,3
2,66,0
4,4
2,76,1
2,4
1,92,9
2,7
2,13,3
,

(57,5 ). II

.
R. DAmelio . [33], I. Shapiro
. [34], 18

, 18

.

18 .

1317
,

(. 1.5).

.

I. Shapiro . [34],
M. Bronshtein . [35],

17 .

.

[36, 37],

I. Shapiro . [34],
R. Achiron .
[36], . . .

,

.

1112 .

.
M. Leiva . [37], 7

10%
,
3%. 12

90% . G. Rizzo
16

. 1.18. 12 3 .
.

( ) .
. 1.20. 12 3 .
.

.
. [38]

1113 76,2%
,
66,6 61,9% .

1214

94,4% (. 1.18, 1.19),
91,2
89,6% (. 1.20).
. 1.19. 12 3 .

.
.

,
.

10
.
()

, ()

.

. ..
. [39],
/ I II
0,5,
0,80,9.

.

/
.

G. Rizzo . [38]
17

, 1113 20
. 12
,
[39].

. A. Sharkey .
[40],

13 ,
30,2 5,4 /.

89
,

c 10 .

,

(. 1.21, 1.22).

,

12
[28, 41, 42],
31%
9 , 76% 10
11
(. 1.23) [11].
,
S. Rottem [42], 1011

75%
, 1112
.
A. Suy . [28], 1213

97% .

8,5
, ,

.
,

.

,
. 1.21. 12 1 () 13 3 ().
.
18

. 1.22. 12 6 . () () .
.
1
1
2
1
. 1.23. 11 (
53 ).
. 1 ; 2 [11].

. G. Tsukerman . [43]

12
.

.

10 6 [7].

,

.

.

.
,
9
1,2 (0,52,1 ), 10 1,5
(0,82,6 ), 11 1,9 (1,03,1 ),
12 2,4 (1,43,7 ) [11].

.
,

. ,
I. TimorTritsch . [44] ,

8 . ,

,

1,5 .
19

. 1.24. 8 (
21 ).
.
. 1.25. 9 (
27 ).

[11].
1
2
2
1
. 1.26. 10 . 1
; 2
[11].
. 1.27. 10 3 . 1
; 2 .
D. Cyr . [45] 10
7 10

.
6,3
(510 ). W. Schmidt
. [46]
(69 ) 8
56 9 .

,

78 [11].

.

(. 1.24, 1.25),
10
(. 1.26, 1.27) (. 1.6).

11 5 [47, 48]. 12

(. 1.28, 1.29).
20

. 1.28. 13 2 .
,
.
. 1.29. 12 6 .
,
.
1.6.
[11]
,
7
8
9
10
11
12
1,9 (0,23,6)
2,4 (0,74,1)
3,3 (1,65,0)
4,0 (2,35,7)
3,9 (2,25,6)
0
1,8 (1,02,7)
2,1 (1,33,0)
2,4 (1,63,3)
2,7 (1,93,6)
3,0 (2,23,9)
3,3 (2,54,2)

,

1213
(. 1.7).
1011

.

(. 1.30).

, 1112

.

1116
.
P. Rosati L. Guariglia [49],
4,45
11 12,7 16 ,
3,57 9,8 ,
3,5 10 ,
14,45 35,55 (. 1.8).

10 ,
1112 (. 1.9).

(. 1.31,
1.32). J. Braithwaite . [41],
,

1213
98% .

21

1.7.

S. Rottem, 1992 [42]

J. Braithwaite ., 1996 [41]
P. Rosati, L. Guariglia, 1996 [49]
A. Suy ., 2000 [28]

11
12
75%
100%
13
14
15
16
92%
93%
97%
100%
97%
99%
100%
100%
100%
99%
79%
86%
75%
78%
94%
1.8. ( ) 1116 [49]
,
11
4,45
3,165,80
3,57
3,005,25
3,50
2,455,45
14,45
11,6218,60
12
13
14
15
16
6,32
5,258,41
4,90
3,816,27
5,00
3,416,19
19,15
15,5722,16
8,45
6,6310,55
6,20
4,907,80
6,15
5,107,35
23,15
19,5827,09
9,90
7,9512,48
7,45
5,809,10
7,40
5,909,10
26,60
22,6530,71
11,62
9,6013,87
8,52
7,209,67
8,37
6,839,81
30,72
26,9434,70
12,70
10,0714,29
9,80
8,3711,09
10,00
7,8411,95
35,55
30,4340,28
. 1.30. 14 .
. .

12 .
,
N. Sebire . [50],
,
67 .

,
.
N. Sebire . [50]
300 1014
,

6 .

,

.
,
1014

8 .
22

. 1.31. 12 6 .
.
. 1.32. 13 .
.
1.9.

,
11
S. Rottem, 1992 [42]

P. Rosati, L. Guariglia, 1996 [49]
A. Suy ., 2000 [28]

12
75%
13
14
15
16
100%
100%
91%
92%
96%
100%
98%
100%
100%
100%
98%
77%
87%
83%
74%
92%

8 [51].

:
9 ,
10 ,
11 [5254].
A. Zorzoli . [55],
296 9
16 ,
90,9%
, 73,6%,
59,5%,
60,5%,
51,7% .
, A. Suy
. [28],
1214
94
96% (. 1.33, 1.34).
11
(. 1.35, 1.36),

,
. 1114

,

II
. ,
,
,

II [56].

23

. 1.33. 10 3 .
.
. 1.35. 12 6 .
.
. 1.34. 12 () 13 () . .

. ,
A. Zorzoli . [55]

5,1% (3,17,0%)
4,4% (3,45,5%) .
,
,
4,9% (1,28,4%).

1114
6 11 , 8 12 , 10
13 13 14 [55].
. 1.36. 13 .
.
24

. 6

,

.

,
(. 1.37).
45 .

(.
1.38). I

.
, ,

. 12
,
, [51].

(. 1.10).
H.G. Blaas [7]

29
7 13
7
( 142 )
, 10
.
10 11

.

.
,

I .

:

; ,
.

, 16% [60]
(. 1.39).

,
.

.
. 1.37. 11 5 .
.
. 1.38. 89 .
.
25

1.10. ( ) (
[7])
A. Rempen,
1991 [57]
D. Lindsay
.,
1992 [58]

5
6,57,5

7
8
9
10
11
12
5,0
5,5
5,7
5,8
5,7
5,3
2,9
3,1
3,4
3,8

I
.

[61]. ,
2 5,6 5
10

.
. 1.39. .
.
C. Stampone
.,
1996 [59]
.
.,
1997 [60]
H.G. Blaas,
1999 [7]
6,5
7,5

4,1
4,5
4,8
4,9
4,9
4,7
4,0
4,0
5,0
5,2
5,0
E. Lyons [62] 6 15

. 9

8

21 24 . J.
Green J. Hobbins [63]

,
8 12
2 .

.

.

,
,
. . 1.11

.

.

26

4,2
4,3
4,8
5,3
5,3
4,3

1.11.
46
,
< 2 812
> 6 10
1.12.

,
6
7
8
9
10
. Kurjak ., 1994 [64]
P. Joupilla, 1998 [65]
33,3
85,7
85,7
78,3
61,1
3,42
3,14
3,10
3,12
3,45
75
50
0,96
0,83

.
,

.

[64] [65]

(. 1.12).
. Kurjak . [64]

6 10
,

5,8 1,7 /c.
,

,
:
,
.
, .
Kurjak . [64], ,
P. Joupilla [65],

.

.

(0,91,1
/) . Kurjak . [64].
, P. Joupilla [65]

,
5
43,7% , 7 25%,
8 37,5%.

0,5 1,1 /.

. 10

.
27

P. Joupilla [65]

,

,
.
,

.

,
. ,
,
. ,
I

.

,
. ,
I

. ,
,
.

.

(. 1.40).

1015 ,

.

,
(
) ()
. .. ..
[66]

(6,5 ) ,

, ..
(. 1.41).
.. . [67]
1%
. .. [68]

(),

. .. ..
[66] ,

100% .
, ,

,
, , 6,5
,
.
,
,
,

[69, 70]. ,
,
[70, 71].

[72].
. 1.40.
1011 .
.
28

. 1.41.
[66].
. 1.42. 9 .
.
.. .. [66]

:

,
,
.
Trophacan
:
,

. ,

.

,

hyperante retroflexio.
,

[73],
,

. ,
,

,
.

100% (.
1.42).

, ,

.

.

1. .., ..

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//
V C

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.

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. [30],
9 (.
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.

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16

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14

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14
F. GonzalesGomes ., 1992 [19]
10
.
L. Nelson, M. King, 1992 [20]
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13

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(. 2.7).
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13 3

R. van ZalenSprock ., 1995 [24]
12 1
O. Parant ., 1997 [25]
14

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11

C. Turner ., 1999 [27]
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H. Wong ., 1999 [29]
13

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26
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[51].

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[54]
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bifida 1214 .

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bifida H. Blaas . [55].
3
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7,5 (. 2.18, 2.19).
45

2228 .
L. Hernadi M. Torocsik [32]

3991 1114 1820
6
spina bifida,
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[13, 34].

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46

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[58].
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2.21). M. Bronshtein . [57]

3000 1416

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48

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510 1000
.

20
.

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,
14
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11 4 .

( 62 1 )

12 [69].

M. Bronshtein
. [72].
1991 . I

.

4000 1216
21
13 .

,
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1116
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. , M. Bronshtein E.
Zimmer [83],
16
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Cullen . [100]
622

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1016
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.
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. (

();

;
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51

2.3. 1017
( [68])
.. ., 1989 [69]
U. Gembruch ., 1990 [70]
12
1112
T. Bennett ., 1991 [71]

12
1216
U. Gembruch ., 1993 [73]
1114
W. Sepulveda ., 1994 [74]

M. Cullen ., 1995 [75]
G. DOttavio ., 1995 [33]
M. Rustico ., 1995 [76]
12
13
14
14
14
14
M. Rustico ., 1995 [77]
14
E. Tegnander ., 1995 [78]
16
16
17
15
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R. van ZalenSprock .,1995 [79]

L. Allan ., 1996 [80]
U. Gembruch ., 1996 [81]
15
L. Hornberger ., 1996 [82]

M. Bronshtein, E. Zimmer,1997 [83]
R. Chaoui ., 1997 [84]
J. Hyett ., 1997 [85]
R. Liang ., 1997 [86]

J. Areias ., 1998 [87]
M. Bronshtein, E. Zimmer, 1998 [88]
W. Henrich ., 1998 [89]
Y. Lam ., 1998 [90]
A. Matias ., 1998 [91]
16
16
1416
17
15
16
16
10
12
13
1416
14
12
12
52

1016
2.3
V. Bognoni ., 1999 [92]
1112
.. , 1999 [93]
1213
M. Guschmann ., 1999 [94]

Y. Lam, M. Tang, 1999 [95]
.. , 2000 [96]
J. Martinez ., 2000 [97]
13
13
14
13
14
12
1316
B. Puerto ., 2000 [98]

A. Yamasaki ., 2000 [99]
14
15

,
, +,
, +, +,
+
+
+
. ;
; ; ;
; ; ;
; ; ;
; ; .
R. Achiron O. Tadmor
[101]

913 .
13

, 12

.

20
. G.
DOttavio . [33]
14

(6 15),

2022 .
,

,
53,857%
[72, 81],
II III
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.
,

1314 .

.
53

()

.

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,

.
1 2400 [103].

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22 ,
.

M. Bocian .
[104]. 14
,
. Y. Lam . [90]

(
) 12
(. 2.30).

,
. , E. Jauniaux
. [105] ,
. 2.30. 12 .
. 1
; 2 [90].
. 2.31. 12 3 .
;
.
(*); [105].
54

1016
12

5

10 9 9 (. 2.31).

,
.

20

.
.
.
5 .

1
30006000 [106, 107].

.

.

,

, 7 4116
[108]. 70%

,
.

,

(. 2.32,
2.33).

.
.

I
[69, 109, 110],
II
.
,
1012
[111].

13
W. Schmidt F. Kubli [112] 1982
.
. 2.32. 1415 .
. 1 ; 2
.
. 2.33. 1415 .
. .
55

. 2.34. 1213 . 1 ;
2 .
. 2.35. 12 .
[117].
18. M.
Pagliano . [109]
,
, 10 .

1213 (. 2.34) [69].
R. van ZalenSprock . [111]
14

1114 .
,

100%
,
18,

.
R. Snijders . [113]
15 726
1014
18 ,
11
18 13.
12
14 (1632 ) 1014 (1473
) 4 ( 2
)
[13, 34].
)
.
,
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0,94
10 000 [114].
20
7 10 000 .

.
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12,4
[115].
II
, (1012 )

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,
.
1
14 000 [116].
56

1016

106 727
1014
14
[117].

,
(. 2.35).

.

1 4500 [118].

,
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1618 (. 2.36).

.
12
13 .

.

,
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.

. ,

6973% [119, 120].

,

.

,

[121123].

.
,

1317
. , M. Bronshtein . [124]

14
5 .

14
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,
1617 . M.
Valenzano . [125]

16 ,
,

,
.
57

()

.
,

12 . 1,35,9
1000 [126].

,
.

,

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II
,

.

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,
II III
.
15 4
. 2.37. 14 .
.
,
[129].

[127].
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,

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.. [129]
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,

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: 21 19 20 ,
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.

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.

58

1016
. 2.39. 15 .
; .
. 2.38.
12 () 16 ()
[132].

. , L. Hernadi
M. Torocsik [32]
3991 11
14 1820 3
,

:
1820 ,
31 .

.
M. Bronshtein . [130]
12
.
. 2.40. 11 6 .
[147].

1632
1214 [13].
Prune&belly

0,06%
.
59

2.4. Prunebelly
M. Bulic .,
1987 [135]
A. Drugan .,
1989 [136]
R. Stiller,
1989 [137]
. Ragno .,
1991 [138]
J. Odita,
1992 [139]
T. Shimizu .,
1992 [140]
S. Freid .,
1995 [141]
.. .,
1995 [142]
R. MacMahon .,
1995 [143]
14
12,5
35 ,
13

,
,

15
14
34 ,
11
15
13
15
15
14
14
M. Yoshida .,
1995 [144]
E. Cazorla .,
1997 [145]
T. Hoshino .,
1998 [146]
.. ,
.. ,
1999 [147]
.. ,
2000 [148]
14
13
13
12

8 [131].

(
, ),
.
, N. Sebire . [131],
7 15 ,
1014 ,

. 5

37 ,
31 ,

34 ,
36 ,
38 ,

3 , 2

. 3

.
.. . [132]
,
12

.
4

.
60

1016

(. 2.38).
Prunebelly
:
,

. prune
belly 1
35 00050 000 [133].

Prunebelly

,

.
.

.
Prunebelly
II
[134].

,
(.
2.39).
16
Prunebelly
16 (. 2.4).
,
. 2.4, 5 16
,

.
.. ..
[147]

Prunebelly.
11 6

18 ( 2.40).

1011

,
I
II

.

,

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,
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.

. BenAmi .
[157].
14

5,8 ,
5
,
.

22

5
,
(
).

61

. 2.41. 14 . . ;
. [166].
. 2.42. 16 . . ;
().

.

. , T. Tongsong
S. Pongsatha [166]
14
10 ,
9 , 8
,
,
(. 2.41).
.

,
, .
62

1016
2.5.

,
N. Fisk .,
1991 [149]
M. Bronshtein,
Z. Weiner, 1992 [150]
11
II
14
II
13
13
10
12
II

II
12
14
16
14

II

12
12
13

5 ,
,
,
12
G. DOttavio
., 1997 [161]
B. Petrikovsky
., 1997 [162]
L. Hill, J. Leary,
1998 [163]
1315
11
13
N. Den Hollander
., 1998 [164]
S. Gabrielli
., 1999 [165]
17
13

IV

13
15
M. Valenzano
., 1999 [125]
16
T. Tongsong,
S. Pongsatha,
2000 [166]
T. Tongsong
., 2000 [167]
14
16
M. Dimaio .,
1993 [151]
L. Otano .,
1993 [152]
. Soothill .,
1993 [153]
R. Ajayi .,
1995 [154]
K. Leung .,
1995 [155]
..
., 1996 [156]
. BenAmi
., 1997 [157]
S. Eliyahu .,
1997 [158]
J. Hyett .,
1997 [159]
L. Hernadi,
., 1997 [32]
N. den Hollander
., 1997 [160]
,

,

,
,
,

,
,
,
,
,
,

,

,

,

,
,

,
. ; c
.
63

. 2.43. 17 .
. ,
.

,

.
,
.

16 17 .
16

: 12
13 , 10 ,
9 , 8 9
, 6 7 , 6 7
(. 2.42). ,
,

.

. 20

.

II .
17

:
,
(. 2.43),

.
,
.

. ,
()
1317 6
, 3
, 9
, 2 , 2
1
.
1.
2.
3.
4.
5.
6.
7.
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18. 11. P. 11981201.
164.Den Hollander N.S., van der Harten H.J.,
Laudy J.A. et al. Early transvaginal
ultrasonographic diagnosis of BeemerLanger
dysplasia: a report of two cases // Ultrasound
165.Gabrielli S., Falco P., Pilu G. et al. Can
transvaginal fetal biometry be considered a
useful tool for early detection of skeletal
dysplasias in highrisk patients? // Ultrasound
166.Tongsong T., Pongsatha S. Early prenatal
sonographic diagnosis of congenital
hypophosphatasia // Ultrasound Obstet.
Gynecol. 2000. V. 15. 3. P. 252255.
167.Tongsong T., Sirichotiyakul S., Chanprapaph
P. Prenatal diagnosis of thrombocytopenia
absentradius syndrome // Ultrasound Obstet.
Gynecol. 2000. V. 15. 3. P. 256258.
72

.. , .. , ..
90

, I
.

,

.
nuchal
oedema ( ), nuchal fluid
( ), nuchal fluid
accumulation (
), nuchal fold (
), simple hygroma ( ),
nuchal thickening ( ) .
.

,
1994 . ,
.

K. Nicolaides
nuchal translucency
( , ),

.
1995 .
,
[1],

, ,
,
[2].
,

. 43

1014
[3].

() ,

73
. 3.1. 10 3 . 2,2 .

,
(. 3.1). ,
,
,
,
:
1) 1014

45
84 .
2)
.

.
,
95100% (.
3.1).
,
.
B. Whitlow D. Economides [20]
,
10 13
,

100, 98, 98 98% .
14
90%.
(58 66%),
L. Kornman . [9] S.
Bewley . [6], ,

10 .
1014
94%
[19]. (6%),
,
,
1011 .
3.1.

P. Pandya ., 1995 [4]

J. Szabo ., 1995 [5]
S. Bewley ., 1995 [6]
S. Bower ., 1995 [7]
L. Kornman ., 1996 [9]
R. Zimmerman ., 1996 [10]
R. Kadir, D. Economides, 1997 [11]
P. Taipale ., 1997 [12]
E. Hafner ., 1998 [14]
E. Pajkrt ., 1998 [15]
P. Theodoropoulos ., 1998 [16]
R. Maymon ., 1999 [17]
M. Muller ., 2000 [18]
.. , M.. , 2001 [19]
1014
912
813
814
1013
813
1013
1013
1016
1014
1014
1014
1014
1014
1014
1014

, %
100
100
66
100
100
58
100
100
99
91
100
96
100
100
96
94
74

,

?
1.
.

2/3
(.
3.2). A. Herman . [21],

(p < 0,02).
2. .

,
(. 3.3). I.
Chatzipapas . [22] ,

0,62 (
0,530,70 )

, 0,40
(0,340,47 ).
,

. I. De Graaf .
[23], 85 10
14 ,
1,91 ,
1,93 (
).
. 3.2. 11 1 .

;
. 1,4 .
. 3.3.
.
; ;
.
75

. 3.4. () ()
.
3. .

,

(. 3.4). A.
Herman . [24],

0,95
0,14 ,
,
23 .
4.
.
,
,

.

.

.

.
M. Schaefer . [25]
8,23%
(26 316 ),
0,8 .
,

.

,
,

, ,

. ,

,
.

,

. , 1
,
23 ,

,

(. 3.2).
P. Pandya . [26]

1014 .
4
, 1200
.
,
,
,
0,27 , ,

, 0,31 . ,

76

3.2.

P. Pandya ., 1995 [26]

L. Kornman ., 1996 [9]
A. Herman ., 1998 [21]
A. Herman ., 2000 [24]
E. Pajkrt ., 2000 [27]
0,27
0,31
0,40, 0,24
0,40
0,28 0,34
0,36

0,58
0,95
0,90, 0,94
0,35
0,44
. ; .
,
0,22 . 95%

0,54
, 0,62 .
, ,
,

,
.
,
,

,

[8].
,

1013
94%
,
93%,
100% .

0,40
0,24
.
, ,

, (80
100
)

.
, ,

,

100
.

,

.
,
A. Herman . [24],
,
.

.
P. Pandya . [26],

.

,

.

77

. E. Pajkrt .
[28],
, ,

50 86%
(!). ,
.

,

.

.

,
,
0,41 6,4% (. 3.3).
,
,
1,95
6,4% [37, 38].

,
,
.
, ,

.
3.3.

K. Nicolaides ., 1992 [29]

M. SchutleValentin, 1992 [30]
B. Brambati ., 1994 [31]
. Comas ., 1994 [32]
L. Ovari ., 1994 [33]
E. Pajkrt ., 1994 [34]
J. Duyos, 1994 [35]
S. Bewley ., 1995 [6]
S. Bower ., 1995 [7]
P. Pandya ., 1995 [4]
J. Szabo ., 1995 [5]
P. Taipale ., 1997 [12]
A. Josefsson ., 1998 [36]
E. Hafner ., 1998 [14]
.. ., 2000 [37]
.. ., 2000 [38]
R. Maymon ., 2000 [39]
M. Muller ., 2000 [18]
E. Pajkrt ., 2000 [40]
1014
1014
1012
913
1014
1015
1013
813
814
1014
912
1013
1016
1014
1014
1013
1014
1014
1014
1014
, %
>2,5
>3,0
>3,0
>3,0
>3,0
>3,0
>3,0
>3,0
>3,0
>2,5
>3,0
>3,0
>3,0
>4,0
>2,5
>2,5
>3,0
>95
>95
>95
78

6,0
1,4
3,8
1,5
0,5
2,2
1,1
6
2,0
3,6
2,4
2,1
0,8
0,41
1,7
1,95
6,4
4,6
1,4
6,1

.
,

E. Pajkrt [34] M. Muller [18].
(>3,0
)

(2,2 1,4%).
E. Pajkrt
. [40]
3 (6,1%).
90

3 ,
. ,
Fetal Medicine Foundation
First Trimester Screening Group
,

I
100
000 ,

. ,

.

.

95
[3].

S. Yagel . [41]

: 95
>3,0 .
,

(85,7%),

87,9 94,6% .
,

.

1014
1,2 1,9 [42].

,

,

[19].
3.4. (5, 50 95 )

[19]
10 0 10 6
11 0 11 6
12 0 12 6
13 0 13 6
,
5
50
95
0,8
0,8
0,7
0,7
1,5
1,6
1,6
1,7
2,2
2,4
2,5
2,7
79

3,5
3,0
95
2,5
2,0
50
1,5
1,0
0,5
0,5
0,5
0,5
0,5
0,5
0,5
0,5
0,5
0,5
,
. 3.5. . Fetal Medicine Foundation First Trimester Screening
Group [3]; .. , .. [19].
2000 .

, ,
,
(. 3.4) [19].
,
Fetal
Medicine Foundation First Trimester Screening
Group (
) (. 3.5).

,
B. Thilaganathan . [43].

(1944 ),

.

.
,
,
,

.

(11 ) (12
)
1993 . (. 3.6).

80

.

.
,
,
21.

,

.
,

:

.
,

,
.
1995

369
.

:

[1]. ,
2000 .
1983
,
29,6%
(. 3.5).

(50,5%).
23,9%
,
9,9% 4,9%.

10,8% .
90

:

.
. 3.6. 12 . 11 (
) .
P. Pandya . [57], 3

7% , 4 27%, 5
53%, 6 49%, 7 83%,
8 70 %, 9 78%.

: 3 4

18%, 4 5 19%, 5 6 29%,
6 7 82%, 7 8 100%,
8 9 67%, 9 100% [60].
2000 .

,
.
7
,
4
,

:

, (.. , ..
, .. , ..
, .. );

, (.. ,
.. , .. , ..
, .. , ..
);

27,

,
81

3.5.

J. Szabo, J. Gellen,
1990 [44]
M. SchutleVallentin,
H. Schindler,
1992 [45]
L. Shulman
., 1992 [46]
Y. Ville .,
1992 [47]
R. Wilson .,
1992 [48]
R. van ZalenSprock
.,1999 [49]
M. Johnson
., 1993 [50]
B. Hewitt, 1993 [51]
A. Nadel .,
1993 [52]
G. Savoldelli
., 1993 [53]
K. Nicolaides
., 1992 [29]
P. Trauffer
., 1994 [54]
C. Comas
., 1995 [55]
E. Hafner
., 1995 [56]
P. Pandya
., 1995 [57]
J. Szabo
., 1995 [5]
G. DOttavio
., 1997 [58]
J. Martinez
., 1998 [59]
A. Graneras
., 2000 [60]
, 2000
21
18 13 45,
>3,0
7 (88%)
>4,0
7 (88%)
>2,5
32
15 (47%)
>3,0
29
8 (28%)
>3,0
14
3 (21%)
>4,0
18
6 (28%)
>2,0
68
41 (60%)
16
>2,0
>4,0
29
63
12 (41%)
43 (68%)
5
15
3
15
1
1
2
10
1
2
>4,0
24
19 (79%)
15
>3,0
88
33 (38%)
21
>3,0
43
21 (49%)
>3,0
51
9 (18%)
>2,5
26
8 (30%)
>3,0
>3,0
1015
96
194 (19%)
43 (45%)
101
28
51
10
13
14
2
15
3
>4,0
34
13 (38%)
>3,0
142
35 (24%)
17
>3,0
115
44 (38%)
23
14
>3,0
80
26 (32,5%)
12
140
29
58
64
1983
587 (29,6%) 296
. 21 21; 18 18; 13 13; 45, .
82

3.6.

S. Bewley ., 1995 [6]

S. Bower ., 1995 [7]
C. Comas ., 1995 [55]
P. Pandya ., 1995 [4]
J. Szabo ., 1995 [5]
L. Kornman ., 1996 [9]
G. DOttavio ., 1997 [58]
F. Orlandi ., 1997 [62]
P. Taipale ., 1997 [12]
D. Economides ., 1998 [63]
E. Hafner ., 1998 [14]
E. Pajkrt ., 1998 [15]
813
814
913
1014
912
813
1013
1315
914
1016
1014
1114
1014
1014
(.. , .. , ..
);
,
(.. , .. , ..
, .. ).

80
( 3 10 ).

23,842,9%
32,5%,

(29,6%).

:
34,6%,
7,7%, 11,5%.
(
)

. 46,2%
(
,
, .).
>3,0
>3,0
>4,0
>2,5
>3,0
>3,0
>3,0
>4,0
>95
>3,0
>3,0
>95
>2,5
>3,0

1/3 (33%)
4/8 (50%)
4/7 (57%)
3/4 (75%)
28/31 (90%)
2/4 (50%)
2/3 (57%)
7/10 (70%)
4/7 (57%)
7/13 (54%)
5/7 (71%)
6/8 (75%)
4/7 (57%)
6/9 (67%)
83/121 (68,6%)

,

,
,

.

.

,
II

[61]. ,

, ,
21
.

83

3.7. 21
5%
D. Krantz ., 1996 [65]

N. Wald ., 1996 [66]
E. Berry ., 1997 [67]
F. Orlandi ., 1997 [62]
J. Haddow ., 1998 [68]
D. Wheeler, M. Sinosich, 1998 [69]
I. De Graaf ., 1999 [70]
K. Spencer ., 1999 [71]
G. Tsukerman ., 1999 [72]
J. Macri, 2000 [64]
X. Navarro ., 2000 [73]
1013
814
914
914
915
912
1014
1014
813
1014
1014
,

.
,
,

68,6%
21 (. 3.6).

, .

Fetal Medicine Foundation First
Trimester Screening Group,
306
22 .

100 311
1014 [42].

>95 .

1:300.

268 (82,2%) 326
, 234
(71,8%)
.
4444
(4,4%) ,
21
, %
22
77
47
11
48
17
37
210
31
50
15
63
62
55
61
60
67
55
67
69
74
66
7907 (8,3%)
.

13,3%.

,
17
, , ,
,

81,8% [64].

21,
.
35

.

,
,
. ,
35 , ,
,

. , E. Pajkrt
. [15],

24% ,

.
79%.
84

3.8. 21 ,

M. Brizot ., 1995 [75]

F. Orlandi ., 1997 [62]
P. De Biasio ., 1999 [76]
I. De Graaf ., 1999 [70]
K. Spencer ., 1999 [71]
C. Bach ., 2000 [77]
E. Casals ., 2000 [78]
J. Macri, 2000 [64]
1014
914
1014
1014
1014
1114
1014
1014
1473

67%
2,2%.

1:100
78%
8,1%.
1:300
21
100%,
19,8%.

,
,
.
, 22,2%

,
77,8%
,
, .

I

.
I

.

21
, %
80
11
13
37
210
6
15
33
89
87
85
85
89
90
86
91

4550% [3], ,
.

21 65% (. 3.7).

I
.
H. Cuckle J. Van Lith [74],

,
9 72%, 10 66%, 11 58%,
12 51% 13 46%.
,

,
90% 21
I (. 3.8).

I
.

,

.

. ,
,

85

I
,

(

)

,
. ,
,

.
. .
[79], I
109 21,
, 6

, 103
.
5 6

.
II
,

,
,

. 21
. 6
1

.
, J. Hyett
. [80], ,
21

. , 3

5,3%, > 7
23,5%. ,
,

70%.

,

,

3 4 .

,
21
.
,

.

.
.
,

.
,
I

.

.

18
( )

(0,16/1000). 13 (
)
0,083/1000 [79].

1014
18 13
,
. ,
Fetal Medicine
Foundation First Trimester Screening
Group, 95
74,8%
71,7%
[3]. , C. Comas [55],

>3 , 66,7%
, F. Orlandi
. [62] 82%.
86

N. Tul . [81] K. Spencer . [82],

18 13.
K. Spencer . [82], 42
13
(>95 )
62% . N. Tul . [81]
50
18 95
78% .

,
, 7 ,
21 (5,9 ) [60].
, 18 13

. . Pandya
. [57] 3 1014
64

15,6% , 4 12,5%, 5
15,6%, 5 56,3%.

18 13
,

.
,

. K.
Nicolaides . [3], 18

.
5,9
(.
3.7). ,
(18,8%)
.
200
100
190
90
180
, /
80
,
70
60
50
40
30
20
70
75
80
85
90
95
100
,
. 3.7.
18 [3].
170
160
150
140
130
120
110
38
48
58
68
78
,
. 3.8.
13 [3].
87

. 3.9. 1213 . 7,5 () 7,7 ()

.

13
, .

, K.
Nicolaides . [3], ,
18 3,1

.
:
68,8% (. 3.8).

18 13
.

.
3 .

1213 (7,5
7,7 )

(. 3.9) [83].
(
18) .

.
N. Tul . [81],

18 89%, F. Orlandi
. [62] 100%. 13

90% [82].

1014
,
, CATCH 22
10.

,

.
2%.

,

[79]. Fetal Medicine
Foundation First Trimester Screening Group,
(59,4%)
1014
95
[3].

, ,
,

(
88

200
100
190
90
180
, /
80
,
70
60
50
40
30
20
70
75
80
85
90
95
100
170
160
150
140
130
120
110
38
48
58
68
78
,
. 3.10.
[3].
. 3.11.
[3].
) [3].

8,5

(. 3.10).

(35,7%).
. Spencer . [84],

( , )
90%

.

I

.

I. De Graaf . [85].
36
9 6 .

. 12

.
2,2 .
. 13 2

5 (50 ),
5 .

.

(69,)
.
.. . [86]

7
89

1 11 4 .
(3 )

10 6 . 5
6 ,

.

,
.
II

[8789].

, Fetal Medicine Foundation First
Trimester Screening Group, 87%
[3].

.
N. Sebire . [90]

87,9%.

,

.

1,8 [3]. I

53,1% (. 3.11).

3 .

(. 3.12).

(47, XXY) 47,
, 47 XYY,
0,17% [91].

N. Sebire . [90].
40%

95 .

,
, CATCH 22
10 [92, 93]. CATCH 22

[ (),
(),
(), ()],
(H) 22.
M. Lazanakis . [92]

.
12
.
CATCH 22

. 3.12. 12 . (6 )
();
.
90

.
P. Schwarzler . [93]
10
I .
(5 ) 12 ,

,

,

.
,

.

.
,

.

.

I
,

.

,

,

.

,

,
.

1. .., ..

// . .
. . . 1995. 1. . 1321.
2.
. . 2 / .
.., .. .: , 1996.
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5. Szabo J., Gellen J., Szemere G. Firsttrimester
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6. Bewley S., Roberts L.J., Mackinson M., Rodeck
C. First trimester fetal nuchal translucency:
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// Br. J. Obstet. Gynaecol. 1995. V. 102. P. 386
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7. Bower S., Chitty L., Bewley S. et al. First
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// 27 th British Congress of Obstetrics and
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8. Braithwaite J.M., Kadir R.A., Pepera T.A. et al.
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ultrasound setting // Prenat. Diagn. 1996. V. 16.
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10. Zimmerman R., Hucha A., Salvoldelli G. et al.
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11. Kadir R.A., Economides D.L. The effect of
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19. .., ..

//
. . . . . 2001. .
9. 1. . 3537.
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21. Herman A., Maymon R., Dreazen E. et al.
Image magnification does not contribute to the
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22. Chatzipapas I., Spathopoulos Y., Whitlow B.,
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23. De Graaf I.M., Muller M.A., Van Zuylen A.A.
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1. P. 6770.
96

.. , ..

,

,
.

.

1014

, ,

,
.

,
303 (5,9%) 5168

(. 4.1).
,

.
A. Souka . [20]

3,4
2,4% , 3,5 4,4

7,1%, 4,5 5,4 12,3%, 5,5
6,4 16,7%, 6,5
35,6% .

.

.

, 35,5%
14 ,
50,9%
13,6%

[24]. , 2/3

.
,

,
97
4.1.
1014
Y. Ville .,
1992 [1]
> 3,0
61
10
R. van ZalenSprock
., 1992 [2]
B. Hewitt, 1993 [3]
M. Johnson .,
1993[4]
A.Nadel .,
1993[5]
> 3,0
13
> 3,0
> 2,0
10
32
1
5
> 4,0
16
P. Pandya .,
1994 [6]
L. Shulman .,
1994[7]
D. Salvesen, O. Goble,
1995 [8]
B. Hewitt .,
1996 [9]
M. Moselhi,
B.Thilaganathan,
1996 [10]
F. ShaBan .,
1996 [11]
L. Hernadi,
M. Torocsik, 1997 [12]
G. DOttavio .,
1997 [13]
C. Reynders .,
1997 [14]
B. Thilaganathan
., 1997 [15]
> 4,0
177
22
> 2,5
32
(1)
> 3,0
(1), (1)
> 3,0
44
> 4,0
(1), (1),
(1)
(2), spina bifida (1)
> 3,0
28
> 3,0
17
> 4,0
21
> 3,0
35
> 4,0
30
10
C. Bilardo .,
1998 [16]
> 3,0
47
11
Y. Fukada .,
1998 [17]
E. Hafner .,
1998 [18]
> 5,0
> 2,5
72
> 3,0
21
E. Pajkrt .,
1998 [19]

(1),
(3), (1), (1),
(2),
(2)
(1), (1),
(1)
(1)
(1), (1),
(1), (2)
(1),
(1), (1),
(1),
(1)
(1), (1)
(1), (1),
Joubert (1)
(1), spina bifida (1),
(2), (1), (1),
(1), (1),
(2)
(1), (1),
(2),
(1),
(1), (1),
(1), GM1 (1),
(1), (1)
(1), (1)
(1),
(2), (1),
(1), (1), TorielloCarey (1)
(1)
98

A. Souka .,
1998 [20]
> 3,0
4116
J. Van Vugt .,
1998 [21]
> 3,0
63
46
270
25
R. Maymon .,
> 95
2000 [22]
> 3,0
E. Pajkrt .,
2000 [23]
161
.
[20]
( 306 ,

1014 , 22
),

47,8%
, 6,2%
,
7,5%
, 38,5% .

,

I
(. 4.2).

(5), (4),
(6), (1),
(1), (1),
(2), (1),
(1), (1),
(43), (8),
(7), (1),
(2), (1),
(5), (4),
(2), (8), spina bifida (4),
(1), (10),
(1), (15),
(6), (2),
Joubert (1), NanceSweency (1),
(1), (3),
(1),
(1), (1),
VACTERL (2), (6)
(1),
(1), (2),
(1),
(1), (1),
(1)
(4),
(1)

,

58,3
92% ( 87,6%) .

,

.
. Bilardo . [16],

32%,

7,5%,
. C E. Pajkrt
. [23] 40 4,0% .
,

99

4.2.
[24]
M. Johnson ., 1993 [4]

P. Trauffer ., 1994 [25]
P. Pandya ., 1995 [26]
J. Szabo ., 1995 [27]
N. Sebire ., 1996 [28]
L. Hernadi, M. Torocsik, 1997 [12]
C. Reynders ., 1997 [14]
. Bilardo ., 1998 [16]
J. Van Vugt ., 1998 [21]
3 (11,5%)
6 (31,6%)
44 (8%)
5 (41,7%)
1 (25%)
5 (35,7%)
7 (20,6%)
15 (31,9%)
11 (17,5%)
97 (12,4%)
23 (88,5%)
13 (68,4%)
520 (92%)
7 (58,3%)
3 (75%)
9 (64,3%)
27 (79,4%)
32 (68,1%)
52 (82,5%)
686 (87,6%)
.

,

,

.

,

, . 4.4.

(. 4.3).

,
,

,

, 80%
4.3.
( [24])
P. Pandya ., 1995 [26]

J. Hyett ., 1996 [29]
A. Souka ., 1998 [20]
46
>7
3,3%
5,3%
3,7%
20,7%
8,8%
11,5%
64,3%
23,5%
55,6%
4.4. ,

( I)

100

1995 .
[3033].

112
,

1014 .
,
21
,
18
/
,
13
,
,
,

.

56%
.
10%
3
75% 4 .

.
, ,
,

.

.

J. Hyett . [34],
1389

1014 (. 4.5).
,

17,3 1000 ,
2
. ,

.

. ,
, U. Gembruch
. [35] R. Achiron . [36], 16
(80%) 20

.

[37].

4.5.
104

[34]
(> 95 )

1000
(
,

2,53,4
1102
5,4
)
3,54,4
188
26,6
.
4,55,4
56
53,6
>5,5
43
232,6

1389
17,3

101

4.6.
[40]

> 95

, ,

9 (18%)
3 (6%)
8 (16%)
10 (20%)
8 (16%)
12 (24%)
50 (100%)

1014

. P. Schwarzler
. [38] 4523
, 9

2,5 .
,

1618 .

:
,
[39]. ,

,

.

,

,
(. 4.6).
J. Hyett . [40],

(> 95 )

> 99
2 (22%)
2 (67%)
4 (50%)
10 (100%)
4 (50%)
6 (50%)
28 (56%)

56,0%, 93,8%

1,5%, 99,9%.
,

. ,

30%
,

2024

1014

.

1 2400
.

:
A. Souka . [20],
8 4116 .

.

[41].

102

2 (22%)
1 (33%)
3 (38%)
8 (80%)
1 (13%)
5 (42%)
20 (40%)

,
, 37% [41].
37%
1014
,

[42]. , 83%
,

,
.
D. Bulas . [43]
Fryn

12
.
, 1
15 000
,

,
. 16

,
.
. 20

,
,
,
. 24
. 34
,
.

Fryn :
, ,
, ,
.

1 4000

,

. ,
.

I

,

.
A. Souka . [20]

7 4116 ,
R. van ZalenSprock . [44]
14
1114 . 8 14

3,5 10 .
,
,
18 13.

( , ,
,
,
),
I ,

[18, 44, 45].
1014

8 [46].
E. Zimmer M. Bronshtein [47]

(16 ),

12
. N. Sebire . [46]

6 (40%) 15
,
.
6 2

.
103

I
II

.

,

(. 4.7).

. BenAmi
. [51].
14

5,8 ,
5
,
.
22

5 ,

( ).
,

.

,

. 4626

12 ,

[9, 12, 20].

,
.

71,4% . ,

.

,
.
,
,
, ,
,
. P.
Ammala R. Salonen [57]

12
.
,

,

.

()

.
,
, 50%

[58].
R. Ibba . [59]
18 . 11

4 .

. 12

. 15

, 18

.

.
,

104

4.7. ,
1014
N. Fisk .,
1991 [48]
11
II
. Soothill .,
1993 [49]
12
II
K. Leung .,
1995 [50]
14
. BenAmi
., 1997 [51]
14
S. Eliyahu .,
1997 [52]
12
C
J. Hyett .,
1997 [53]
12
L. Hernadi,
M. Torocsik,
1997 [12]
N. den Hollander
., 1997 [54]
13
12
G. DOttavio
., 1997 [13]
1315
B. Petrikovsky
., 1997 [55]
11
C. Bilardo .,
1998 [16]
12
E. Hafner .,
1998 [18]
L. Hill, J. Leary,
1998 [56]
12

I
A. Souka .,
1998 [20]
13
11

5 ,

,
,

,
,
,

105

. ,
7
.

1 10 000 .

,

. J. Van Vugt . [21]

,
[60] 5

.

1 2000
. :
, ,
(,
),
,
, (
).

4116

,
[20].
,
510

,
5 [2, 4, 1416].

: 1 20 000
.

,

, ,
, ,

.
J. Hyett . [61]
11

5 .

.
20
,

.
,
.

,

. J. Hobbins .
[62]
,
11

4
, , A.
Souka . [20],

6 .
&

1014

(5,4%),

(13,7%) [63]. N. Sebire . [64]

.
143
.
,
106

12%

, 4

.

[16, 65]. 4
.
( I)

.
( I)

1
10 00025 000

.
,
,
.

.
12
.

6
,

(. 4.8).

1 25 000

.

(
, ),
, ,
, ,

[67].

.
2
,
.

,

(. 4.9).
4.8. ,

,
,

A. Rijhsinghani
.,
1997 [65]
C. Bilardo
., 1998 [16]
A. Souka .,
1998 [20]
J. Van Vugt
., 1998 [21]
R. Stiller .,
1999 [66]
5,6
>3
3,5
9,6
7,5
107

4.9. ,

C. Bilardo
., 1998 [16]
I. de Graaf
., 1999 [68]
G. Christiaens
., 2000 [69]
>3

5,5
5,8
5,3
> 95
4,4

1. Ville Y., Lalondrelle C., Doumerc S. et al. First
trimester diagnosis of nuchal anomalies:
significance and fetal outcome // Ultrasound
Geijn H.P. Firsttrimester diagnosis of cystic
hygroma course and outcome // Amer. J.
3. Hewitt B. Nuchal translucency in the first
trimester // Aust. NZ J. Obstet. Gynecol. 1993.
V. 33. P. 389391.
4. Johnson M.P., Johnson A., Holzgreve W. et al.
Firsttrimester simple hygroma: cause and
outcome // Amer. J. Obstet. Gyncol. 1993. V. 168.
P. 156161.
5. Nadel A., Bromley B., Benacerraf B.R. Nuchal
thickening or cystic hygromas in first and early
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111

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1. ..
//
/ .
.., ., .. .:
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. 1984

S. SmithJensen
N. Hahnemann,

.

1,2 ,
0,7
.

910
84,5% [17].

.
80 XX

,

I
. 1983
,
, 1991

I
100 000 [18].

.

,
,

125

.
80

I [19, 20].
, 90

,
,

.

.

, ,

.

,

.

:
1. :
, .
2. :
, .
3.
:
,
.
4.
: , ,
.
5. :
(
),

.

.
, , ,

.
,

.

.

( )
,
.

.

. , ,

.

, ,
.

.
,
.

.

.
126

.
Portex,
.

.

.

, ,
.
,
, ,

.

,
20 57
,
,
, ,
, .

.

.

. ,

,
10 .

,
.

.

.
, . Brambati,
1991 .
90% 30,6
( 10 5,0%) [21]. 7 ,

91%
31,2 .
( 10 )
13,2% [22]. M. Ahoda .
93,2%
[23].
(),

(1998 ),

94,9% [24]. 7

()
27 ()
,

,

86,1%.
,

. ,

,

.

,

.

7080

,
127

.

I
[25],

.
,
,
1,9
25 ,
. Rodeck . [25] 1983 .

. ,
,
,
98%.
.
,
,
, 1,6%,

[26].

,
,
,
.

,

, ,
,
.

( )

80
.

,

.

.

.

.
,

.
,

,

.

2,0 0,5%
.

,
. ,

,

.

,
, ,
.

,

.
.

S. SmidtJensen N. Hahnemann
[17].

, (
)
,
128

.
,
.

,
,
.
:

.

.

,
.

,
.

.
,

20 18 G

.

20 ,

.

, .

,

( ).

.

,

.

. ,

, ,

.
, S. Smidt
Jensen N. Hahnemann
1988
100%
28 [27]. ,
3 ,

. L. Bovicelli .
[28],
,
99,7% ,
97%, 2,8%,
0,2% .
1015 .
( 5 )
9,4% .
(1159
),
B. Brambati 1988 ,
0,3%
,
24 [29].
K. Nicolaides . [30],
99,3%.
[24],

99% .
, 99,4%.

.
,

.
,
23 .

80
() ,
129

,
.
,

.

, II
. ,
,
.
.

.

, II
,
.
( 6.1).
90
12
15 1
, 2025%

710 [40]. 1970 . Emery
,

,
, 12
15
9899% [41].

,
90

810 ,
11% 12
3 .

,

. ,
. Cederholm . Axelsson

85,7% [42].

.
.

23 ,
7 17
96,5%
, 2
[30, 31, 3537, 4245].

, ,
.
, ,

13,6% [46].

6.1.
n
,
%
,
%
541
222
407
106
300
1805
879
731
349
314
412
25
217
1215
1215
1520
1215
1215
1215
1215
1215
7
0
0
1,7
0
1,7
0,5
2,5
0,6
1,0
2,2
3,6
1,4
2,3
1,8
2,2
4,0
2,9
5,3
1,8
2,2
3,8
F. Hanson ., 1987 [31]

J. Nevin ., 1990 [19]
C. Penso ., 1990 [32]
G. Hackett ., 1991 [33]
B. Assell ., 1992 [34]
G. Henry, W. Miller, 1992 [35]
F. Hanson ., 1992 [36]
K. Nicolaides ., 1994 [30]
J. Johnson ., 1996 [37]
C. Brumfield ., 1996 [38]
S. Tharmaratnam ., 1998 [39]
130

9798%
99,5% [35].

1112% [42].

[43],
.

.

12
.
c
1954
J. Westin [47]. ,
,

.

.

,

,
.

.

.

,

. , 1995
. Dommergues . [48]

.

.

1011
. 1987
Y.Ville . [49]
,
, , ,
8
13 . D. Subrek . [50]

,
. ,
I
,
.

.

,
.

.

.
,
2 3,5 ,
1,7 .
.
131

.

[50].

2 ,
0,70,8 .

,
.

,
;

.
9
12 ,
,
.

,

. , D. Subrek
. [50] 3 14
,
I
.
25 27 G.
,

.

,

,
. ,

,
,

. 1012%

.
1997 Y. Ville . [49]

,

. 270
I
.

5 13 .

: 75 100%.

412% ,

, ,
.
,
,
,
. 1992 Y. Dumez . [51]

,

(
),
.

,
. 6
42

. 12,8%
13 23 .
31
.

I

. , Y. Ville . [49]
35%
.

. ,

.
,

132

,
,
.

[52],
, [49],

.
,
,

,

, .

, .

.

. ,
,
,

FISH.

.

6 12 .

,
,
.

. J. Ross .
[53],
25%,
5%.
,

I
.

II
.
,
,
,
.

I
. , F. Orlani
. [54], 1214
4,8%,

. ,

,

.

I
II
.

,

,
:
35 ;
133

(

, );
,

,
,

(
);
,

.

I
.

.

,

.

,
.

.
80

()
()
. ,
()

911 [55].
,

(1522 )
: 0,75 ( 15
22 0,72 ), 0,73
(0,72 ), 1,90
(2,01 ), 2,69
(2,22 ),
1,28 (1,31 ) [56].

.
(
,
pregnancy associated plasma protein A),

, 90
, , I

.
,

I
6065% .
9 13

1,48 4,71 ,
, I
.
( 2,15 ),
0,43 .

: 68
0,35 , 911 0,40 , 1214
0,62 .
0,43 ,
2,06
. ,
D. Wheeler . [57] 66,6%
5%
72,7%

,
1,2%
.
68,8%.
,
I

,

.

N. Wald . Macintosh
134

1998 ,
I
60% 5%
[58, 59].

. Spencer . [60]
. Cuckle J. Lith [61],
1999 .

.
, .
Cuckle J. Lith [61],
44
(. 6.2, 6.3, 6.4).

9 11 ( 6.5).

,

. ,

.
,

I .

,
,

.
,

,

,

.
, 1998
(29%)

, 12%

6.2. 5% [61]
"
"

+ "
+ "
+
+ " + "
+ + "
++ "
+ + " + "
33%
38%
64%
46%
48%
73%
67%
81%
82%
89%
6.3. [61]
90%
85%
80%
75%
70%
" + "
+
"
+
"
+
" +
"
23%
16%
11%
8%
6%
12%
7%
5%
3%
2,2%
12%
7%
4%
2,7%
1,5%
6%
3,5%
2,1%
1,5%
1%
. 6.4 6.5 .
135

+
.

77,7%
81,2%
,
86,4%

87,2%
,
87,9%
,
88,3%

.

, ,
(
). ,
, ,

[21].

(,
, ),

,
,

.
6.4. [61]
"
"
" + "
" + " +
" + " +
4

41,8%
52,2%
64,6%
66,6%
68,6%
70,1%
72,7%
, 9%
(
)

[24]. 10
I

(34%),
(15,5%).

. ,

31% [24], ,
, 42% .
6.5. 5% "
[61]

9
10
11
12
13
"+
"
"+
"
71,6
65,6
58,2
50,9
46,4
73,1
67,5
60,4
53,7
49,3
74,6
69,3
63,0
57,3
53,9
75,8
70,8
64,9
59,4
56,1
89,1
86,8
84,0
81,2
79,5
89,7
87,6
84,9
82,4
80,8
90,2
88,2
85,7
83,5
82,2
90,5
88,6
86,4
84,2
83,0

I

. ,

:

.

?

,
136

. 3
34

.
.

(),
.

.

[62].
3
5

.

, ,
. ,

(3
).

,

, ,
.

,

, 5

(, )
. ,
10%
, 90%
[63, 64].

,

.

.
,

I
9 11 .
137

(11 )

.
(9 )

,
.
B. Brambati . [22],
10 000 I
, 911 58%
, 9 33%, 12
9%. , 93,7%
I
914
6,3% [24].

?
,

9 ,
, .
, 9 (7
)

.

chorion
frondosum ( ) chorion
laeve ( ). Chorion frondosum
,

. 910
chorion frondosum
36
,

. Chorion laeve
,
.
, 910

.

.
, 910

,

.
,

,
,
.
1991 H. Firth .

, .
,
1,8 1000
,
1 1000 [65, 66].
,

,

I .

,

9 [67]. ,
,

,
,
.

.

,
,

[68].
138

1999
,

[69].

216 380
,
, ,
8
6.6.

() [69]

"
(. 6.6).
,
10 000
,

8
3 415
4
11,7
9
18 442
9
4,9

10
39 028
15
3,8
11
32 528
11
3,4
I
12
13 170
3
2,3

106383
42*
1/2533

1/1642
911 .
: * 42 71,3% "
, 11,3% , 17,4% .

,

.

.

, ,

RW ,

.

,
,
.

,
,

.
(
),
,

, .
,

, ,
(
).

,
,
, ,
,
.
1520 ,
,
2,04,0
( )
.
139

.

,
.

.

.

,
23 ,

.

,

,
,

.
,

,
.

,

. 6.7
,

I .

, ,
. ,

,
,
.

. ,

, ,

: 1, 2, 3
,
20 28
.

(total losses),
. ,

. ,
,

,
.
,
2
,
, 30
,

,
46%,
18%, 4% [24].
,

(12
) ,
,
.

B. Brambati . [21]:
140

S.Smidt"Jensen
. [27]
L. Bovicelli
. [28]
B.Brambati
. [29]
M. Ahoda
. [23]
B.Brambati
. [21]
S. Smith"Jensen
. [70]
Canadian
Collaborative
Study [71]
B. Brambati
. [22]
M. Cederholm
. [42]
K. Niolaides
. [30]
A. Daniel
. [45]
H. Nagel
. [43]
S. Tharmaratnam
. [39]
..
. [44]
, [24]
[25]

2,4
3,1
0,4
6,1
10,4
6,5
5,4
6,5
3,8
4,6
2,7
3,2
1,5
6,8
6,8
2,4
1,7
4,8
4,0
3,9
1,2
0,4
2,6
3,3
7,0
5,6
5,6
"
, %
2,7
3,2
, %
1,3
2,3
0,2
1,9
0,8
2,6
13,2
31,2
2,5
6,0
4,0
2,6
5,4
, %
6,8
14,8
9,0
5,7
1,6
3,0
19,0
37,6
0,3
, %
5,2
5,2
0,2
0,04
0,3
0,3
13,8%,
1,0%, + 6,1%
5,1%

4,7%, 5,3%
2,6"4,7%
+ 3,5%
+ 3,8%
+ 6,4%
6,2%
10,1%
6,2%
8,7%
, %
6.7. ,
141
6.8.
,
[21]

17
814
1530
30
6,9%
13,8%
27,6%
51,7%
2,9%
0%
28,8%
68,6%
20,7%

;
2,9% (. 6.8).

,

. W. Holzgreve
P. Miny ,
(12%)

6%

[72].

.
B. Brambati . [22],
10 000 ,

0,14% .

.
,

4,5% (8 176
), 1,3%
(4 302 ) [24].
,

,
, ,

.

,

.

.

,

.
,
,
,

, (. 6.9).

,
,
.
[21, 22],

3,0 3,5%.

,
.
[22],

8 9,2%,
9 12
4,7%. ,
,

,
.
,
.
B.Brambati . [22],

30 1,22%, 30
34 2,27%, 35 2,7%.
M. Ahoda . [23]
35
3,1%, 35 6,1%.

4,14,5%.
142

6.9.
B.Brambati
. [29]
. Ahoda
. [23]
.Brambati
. [21]
S.Smith"Jensen
. [70]
. Brambati
. [22]
S. Tharmaratnam
. [39]
" "

"
"
" "
, % , %
,
%
6,1
0,8
"
,
%
0,4
"
,
%
"
"
"
"
,%
"
, %
0,4
5,2
4,6
5,1
0,8
0,5
4,7
4,0
1,9
1,6
5,2
5,3
0,6
2,6
0,8 ()

,

, , 10

.
,

, ,

.
S. SmithJensen
. [70] 1991 . (. 6.10).
,

,
.
,

I .

(14%)
10
, ,
,
.
4,8
8,1
7,1
0,4
0,35
0,3 ()
0,34
0,3 ()

.

.
[70] ,

(. 6.11).

.
, ,
,
,

.
,
6.10.
[70]
,
0"10
11"20
21"30
31"40
40
3,8%
4,2%
4,1%
4,0%
14,0%
6,3%
6,6%
7,4%
8,6%
143

6.11. "
I "
[70]
(kU/I)
< 20
21"40
41"60
60
2,6
2,2
3
16,1*
7,2
5,5
20
13,3*
. * "
.
,
( 100
) 7,2 10,9%,
(
5,0%) [30, 71, 7376].
,

,

.

.
. Cederholm . [42],

20,7%,
3,4%.
,

,
.
,
,
.

I ,
,
,
. 90
,

[76, 77].

.
,
0,53,2%
, 1,1%.

(1%),
(06,1%) [19, 3139, 78]. . Daniel
. [45] ,

(1011 0,121,4%,
1213 1,3%, 14 2,1%),

(1011 1/33, 12
1/74, 13 1/78, 14 0).

.
,

.

.

,
.

1983 G. Simoni . [11]

144

,
.

.
24
40 ,

0,050,08. ,
,

,

.

80
. Niazi . [9].

,

,

0,62,7% [31, 43].

,
,

. . Borrell
. [79] 0,3%,
D. Ledbetter . [80] 0,5%.

.
4 ,

.

,

.
,

0,61,7%
[43, 70, 8183].

.

.

. ,

, , 0,55,2%
[30, 43, 70].
,
4,6% ,
,
[24].
,

.
,
, .
,
5,1%
1%
[24]; 13,9%
1,6% .
,
(
5 )
.
,

, , ,
.

,
145

, ,
33%
, 25%
, 42%
,
.
60%

40%
[24].

,
, 1,2
2,9% ,
1,6 5,2%,
3,4% [24, 26, 70].

.

( )

.

.

,
,
, ,
.

,

,

.

.
,

(, ).

,

.
,
,

(, , ,
, , ,
,
),
(, ,
, ),

( ).

.
,
II ,
I ,
,
,

.
,
,

. R. Thompson .
[84],
23
, 50%

[85].

I
. , 40%
,
12 ,
146

,
[86].

,

23%,
12%, [85].

.
,
,
,

I
.

. ,
,
28

2,5 7,4% [87]. ,

, ,
2% 100
66
, ,

1,5% [70].
,
.

.

(,

)

.

35 38 [18].

I
,

,

.

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ahnemann
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151

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31 , .
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. ,
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1354),
19891991 .
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,
, [47].
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24 726 1/190,
9960 , 35
, . ,
,
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,
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25

35
,
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. ,
1 ,
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58%.

[48]. ,
10

(. 2.3).
,
90
,
21

.
90

. J. Haddow . [49]

()

,

.
,

,

,
[50].
1993 . J. Fitzerald . [51]

,

. G. Palomaki . [52]
,

,

1/140.
,

.

,

.

, .

,
,

(pregnancy associated plasma
protein ,
)
,
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5 .

, , ,

. II

[5355].
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,
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.
7
[58].
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[59].
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SP1 ,
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. , II

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.

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.
90 ,

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,

21 [6062].
I
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[63]. ,

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,
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21
22.222.3,
[67].
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. .
Abraha . [68]
, S100

.
125
90
, 125

[69].
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10 125,
,

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21.

80

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8 0,35 , 911 0,40 ,
1214 0,62 . ,

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,

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).
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Spencer . [74] ,

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.
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14
,
.

.
[85] ,
I
,
,

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.
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29

30
%

44

E. Casals
.,
1999 [75]
N. Wald
.,
1999 [76]
N. Wald
.,
1998 [77]
M. Macintosh
.,
1993 [78]
D. Wheeler
.,
1998 [79]
H. uckle,
J. Lith,
1999 [80]
. Spencer
.,
2000 [74]
. Spencer
.,
1999 [73]
12
I %
12
1520
+
+
0,72
+
+
+
+
+
2,06
+
+
+
2,22
2,69
+
1,73
1,9
+
+
1,31
0,73
2,01
0,72
+
+
+
+
+
+
+
+
0,4
+
+
0,36
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%,
2,53
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1,79
0,86 ***
0,75
+
0,82*
+
+
+
+
+
%,
1014
14
+
+
+
+
+
+
0,27 **
59
1014
1014
%
,
2.4.
68,8
41,8
77,7
52,2
81,2
64,6
86,4
66,6
87,2
66,6
60
16
44
89
33
38
46
48
67
20
15
31
31
40
5
5
5
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+
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%,
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29
25
63
60
68,6
87,9
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9
10
11
12
13
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65,6
58,2
50,9
46,4
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67,5
60,4
53,7
49,3
74,6
69,3
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57,3
53,9
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70,8
64,9
59,4
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87,6
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88,6
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5% [74]
%
%
, % , %
. * ; ** ; *** .
. Hallahan
.,
1998 [82]
J. Haddow
.,
1998 [81]
%
%
I
2.4
31
,
.
,
,
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.

I .
,

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:
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)
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1999 [89]
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,
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1014
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%
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.,
1998 [90]
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77
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%,
,
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.

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,

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(core )
1994 . . Cuckle . [92].

.
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.
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, ,
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, L. Cole
. [103] ,

.

,

.

,

. ,
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,
[94, 99]

.

2.8. % %

H. Cuckle ., 1994 [93]

J. Canick ., 1995 [94]
H. Cuckle ., 1995 [95]
. Hayashi, . Kozo, 1995 [96]
. Spencer ., 1996 [97]
L. Cole ., 1997 [98]
T. Isozaki ., 1997 [99]
L. Kellner ., 1997 [100]
Y. Lam ., 1997 [101]
T. Hallahan ., 1998 [102]
L. Cole ., 1999 [103]
, %
7
14
24
5
29
12
13
32
29
13
23
6,1
5,3
6,0
2,8
2,4
4,5
4,1
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5,4
71
93
88
20
41
58
62
66
35
31
65
34

.
(, )
.

,

,

.

1996 .
, .
Hayashi . Spencer [96, 97].
,

,

.

.
2,47 4,01 [97, 104].
,

.
[97, 98, 105, 106],

47
58% 5%
.

,
3%
.

.

,

.
, L. Cole .
[104], 7,8 . ,
,
,

I (1114 ),
II (1522 ) .
I ,
,
, 80%, II 78%
5%
. +
+
92%
5%
.

97%
. ,
,

.

,

. M.
Weinans . [107],
1011
,

, 38% 5%
.

,
.
, L. Cole .
[108] 75%

0,5%.

81% 5%
[109].

,

.

35

.
,

.

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40

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S. Levi ., 1991 () [19]
G. MacquartMoulin .,
1989 () [20]
D. Baronciani .,
1995 () [21]
R. Ashe ., 1996 () [22]
S. EikNes .,
1992 () [23]
B. Ewigman ., 1993 () [24]
.. , 1990 () [12]
S. Chambers .,
1995 () [25]
C. Luck, 1992 () [26]
Z. Papp ., 1995 () [27]
R. Achiron, O. Tadmor,
1991 () [28]
L. Chitty .,
1991 () [29]
I. Shirley ., 1992
() [30]
. Stoll ., 1995 () [31]
E. Zimmer ., 1997 () [32]
G. Bernaschek .,
1994 () [33]
S. Levi ., 1995 () [34]
Eurofetus (
), 1999 [35]
K. Lee ., 1998 () [36]
A. QueisserLuft .,
1998 () [37]
T. Gillerot, 1995 () [38]
P. Boyd .,
1998 () [39]
G. DOttavio .,
1997 () [40]
N. Anderson .,
1995 ( ) [41]
E. Zimmer ., 1997 () [32]
O. Behrens .,
1999 () [42]
K. Eurenius .,
1999 () [43]
T. Stefos ., 1999 () [44]
19801988
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.

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. 2000. . 8. 1. . 1822.
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//
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, , 2000. . 722.
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..

// . . 2002. . 1.
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10 ! // . .
2002. . 1. 3. . 167168.
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//

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.. .: ,
, 2000. . 152160.
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//
. . . . . 2001. .
9. 1. . 3840.
62. .., ..,
..
//

/ .
.. .: , ,
2000. . 7396.
63. :
/ .
.. .: , ,
2002.
64. .., ..

// .
. 2002. . 1. 2. . 158159.
65. I
//
. . . . . 1999. .
7. 2. . 9597.
66. ..

: . ... . . . .,
2002.
67. / .
.. .: , ,
2000.
68. IV
// .
. 2002. . 1. 2. . 8687.
69. .., ..,
..

// . . 2002. . 1.
2. . 103105.
70. .. :

// . . 2002. . 1.
1. . 2934.
71. .., .., ..

:
// . 2001. . 2.
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//
162 23.05.97.
75. ..
. VII.
/
/ . . . . .
2001. . 9. 4. . 274283.
88

4

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281)
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105

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K. Nicolaides [53]
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[17]
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44%
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50,0%
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4.6. :

S. Rotmensch
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[54]
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B. romley
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[55]
M. Respondek
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[56]
M. Wessels
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[57]
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[33]
17,4%
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50,0%
56,0%
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108

4.7. :

()
()

()

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/

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/
L. Feuchtbaum
. [59]
.
[60]
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. [61]
45%
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80%
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92,3%
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28,6%
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3,6%
3,6%
32,1%
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10,7%
29,6%
32,1%
10,7%
10,7%
3,6%
25,0%
3,6%
10,7%
7,1%
3,6%
25,0%
25,0%
17,9%
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7,1%
40%
23,1%
70%
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80%
82,1%
64,3%
35,7%
20%
20%
5,1%
12,8%
7,1%
25,0%
17,9%
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17,6%
7,1%
3,6%
3,6%
42,9%
7,1%
35,7%
10,7%
50,0%
35,7%
7,1%
7,1%
75,0%
21,4%
14,3%
10,7%
42,9%
32,1%
10,7%
15%
30%
[62]
80%
20%
7,7%
12,8%
2,6%
46,2%
38,5%
10,3%
2,6%
69,2%
25,6%
2,6%
59,0%
53,8%
5,1%
109

4.8. [53]

21
18
13
45,
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15%
(
16%
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8%
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1%
7%
54%
29%
1%
14%
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26%
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9%
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18%
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8%
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urotsuki . [50],
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50
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40
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20
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10
6,7%
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1
3

++
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. 4.4. [17, 22, 23].
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31,6%

.
2000 . 11 22

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. [5] (40%)
,
I
.
114

25
16,8%
17,6%
12,8%
14,4%
20
12,3%
15
9,2%
10
3,7%
5
3,0% 6,3%
0
7,6%
3,8%
0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

. 4.5. .
%
80
70
60
50
40
30
20
10
0
199091 199293
1994
1995
1996
1997
1998
1999
2000
2001
35
. 4.6. .

,
,

,
. ,
,
,
,
.

115

4.10.

,
,

.
,

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II , 2000
23,0%
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1,7%
15,9%
31,6%
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0,8%

.

:
(.
4.8).

,
,
,
,
, .
%
400
1998 . 5,1%
2000 . 5,7%
350
50
44,4%
45
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40
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300
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35
4,2%
250
30
25
200
100
20
17,6%
150
5,5%
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0
7,5%
18,4%
50
15
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80,6%
0
10
5
0
/
/ /
(%)
. 4.7. II .
116

35

. 4.8. (
.
2124
()
;
;

3234

. 4.9. .
117

:

;

;

.

.

.

.

(. 4.9). ,
,

.

.

1. Prenatal Diagnosis in Europe // Eur. J. Hum.
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:
. . . . . ., 1979.
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.
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//
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:
/ .
.., .., .. .:
, , 1999. .
231253.
15. ..
//
: /
. ..,
.., .. .: ,
, 1999. . 215230.
16. ..
//
118

/ . .. .:,
, 1999. . 123151.
17. ..

: . . . . ., 1997.
. 60.
18. .., ..,
.., ..
//
. . 1997. 4. . 610.
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.. .
:

// . . 2002. . 1. 1. . 11
16.
23. .., .., ..
.
:
/
/ . . 2002. . 1. 2. . 9196.
24. ..

//
/ .
.., .. .:
, 1999. . 29.
25. .., ..,
.., ..
. .: , 1996.
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//
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// . . 2002. . 1. 1. . 5
11.
29. Lioquet Ph., Feitsma A., Hauspy J. et al. The
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// . . 1998.
1. . 4250.
31. .., ..,
.., ..
//
/
. .., .. .:
, 1999. . 3751.
32. .., ..,
.. .
// II
., 2000.
. 71.
33. .. :

// . . . .
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// .
/ . .. .:
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119

37. .., ..,

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//
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. .: ,
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//
15 . ., 1998.
47. .., .., ..
. //
. . . . . 1999.
. 7. 4. . 279284.
48. ..

// . . . .
. 1999. 4. . 284.
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.. .
:
// . . . . . 1997.
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50. Murotsuki J., Tanigawara S., Uebara S. et al.
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.. .
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120

21 //
. . . . . 1993.
3. . 110114.
59. Feuchtbaum L., Currier R., Lorey F., Cunningham
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//
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62. .. 18: 28
// .
. 2002. . 1. 1. . 3542.
121

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. ., 1996. . 1318.
2. .., ..,
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// . . . . . 1997.
3. . 9499.
3. .., ..

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. .:
, 2001. . 4860.
4. .., .., ..,
..
.
. ., 1995. . 121.
5. .., ..,
.. . //

() / . .. .
: , 1999. . 2. . 550578.
6. Knutsen T., Bixenman H.A., Lawce H., Martin
P.K. Chromosome analysis guidelines
preliminary report // Cytogen. Cell Genet.
1990. V. 44. . 14.
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1. Larsen T., Nguyen T., Munck M. et al.
Ultrasound screening in the second trimester.
The pregnant women experience, expectations
and acceptance // Ultrasound Obstet. Gynecol.
1998. V. 12. Suppl. 1. P. 58.
2. Crang!Svalenius E., Dykes A., Jorgensen C.
Factors influencing informed choice of prenatal
diagnosis. Womens feeling and attitudes //
3.
4.
5.
6.

1. P. 61.
Celerholm M., Axelsson O., Sjoden P. Womens
concerns and psychological reactions before
undergoing an invasive procedure for prenatal
karyotyping // Ultrasound Obstet. Gynecol.
1998. V. 12. Suppl. 1. P. 58.
Loquet Ph., Feitsma A., Hauspy J., Groof K.
et al. The psychological advantags of advancing
the gestational age for amniocentesis //
Suppl. 1. P. 59.
Antolin E., Comas C., Torrents M. et al. The
role ductus venosus blood flow assessment in
screening for chromosomal abnormalities at 10!
16 weeks of gestation // Ultrasound. Obstet.
Gynecol. 2001. V. 17. 4. P. 295300.
.. : !
// . . 2002. . 1. 3.
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1. .., .., ..
//
/ .
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4. Kurjak A., Kupesic S., IvancicKosuta M. Three
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5. Chung B.L., Kim H.J., Lee K.H. The application
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6. Paul C., Krampl E., Skentou C. et al. Measurement
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.. .: , 2005. . 185190.
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. I.
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13. Sacchini ., ElSheikhah A., Cicero S. et al. Ear
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14. Aase J.M., Wilson A.C., Smith D.W. Brief
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15. Farkas L.G., Katic M.J., Forrest C.R., Litsas
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39

19. Ginath S., Debby A., Malinger G. Demonstration

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// .
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1114 //
. . 2003. . 2. 1. . 2326.
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. . 2005. . 4. 2. . 157160.
35. ..

//
. . 2004. . 3. 4. . 253256.
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.. . I
// . .
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// . .
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40

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.

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,

// .
. 2006. . 5. 2. . 157160.
92

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1
2
. 3. .
. .
. (1). . 2
; 3 .
.

II
, ,
9097% [17].

8085% .
, F. Vials
. [8],
STIC

94,2% .
A. Muller
Brochut . [18], STIC

95%
.

,
,
96

D. Maulik .
[19] 94,4%.

STIC
,

[20].
,
93,3% .
K.
Francini . [21]

STIC
. ,
1824

,

100% ,
,
95, 91 59% .
25 36
STIC

100%

,
1824 , 79%.

STIC
.
1.

STIC

.

.
. ,

, , ,
.

(,
)

STIC.
2.

,
,

. ,
,
,

.
,

5 7 .

,
11 1 .

. ,

.
3.

( Y). ,

, . ,
, ,
,
,

.
,
,

.
4.

Z.
II
25
97

. 4. ,
STIC.
,
() . 1
. 2
. (1). 3
. 2 . 4
. 3 . 5 ,

5. , :
,
.

,
.

III ,

3540.
5.

7,5
15 .
,
.
,
,

.

.

,
.

.

Y,

(. 4, 5).
F. Vials
. [22],
STIC

98

100% .

TUI (Tomographic
Ultrasound Imaging),

STIC. TUI

9

.
,

,

(. 6).

.
,

,

.

1215

1,14
(0,71,4 ), 1619
1,78 (1,42,6 ), 20
24 2,82 (2,23,4 ),
2
3
. 5.
.
,
() . 1
. 2 . 3
.
(1), .
(2), ,
. 4 . 3 . 5
,
5.
().
99

. 6. TUI .
.
. . . ,
.
2529 3,63 (2,24,6 ) 30

34 4,37 (3,45,3 ) [15].
,
J. Espinoza
. [23], TUI

99%
,
96,9%,
98,5%,
88,2%,
93,3%
87,2% .
TUI
,
,

(. 710).
3D XI (3D eXtended
Imaging) Medison
Multi Slice View

1 24
(. 11).

.

0,3 5 .
,

100

. 7. TUI .
(). .
(), ().
.

,

.

(. 12).

Volume CT,
,
,
(. 13).
Oblique
View, ,
,

.

. . 14,

,
Multi Slice View.
(S,
start) (E, end)
,

. . 14,

,

.

101

,

,

.

Oblique View,

.

[24],
Multi Slice View Oblique
View

. 8. TUI 2036
. 87,5%
( ,
). . ()

().
70,8%,
79,2%
75%.

43,8%
,

39,6% .
,

.

. 9. TUI

.

. . () ()
.
,

. 15.

102

. 10. TUI
.
.
.

,

.

STIC
DiagnoSTIC,

. 11. Multi Slice

12 .
103

. 12.
, Multi Slice View.
. .
. . .
. .

().

DiagnoSTIC
,

STIC.
104

. 13.
, Volume CT. .
. . .
. 14.
Oblique
View. .
(SE)
().
().
. 15.
Oblique
View.
(). (SE)
().
.
105

1
1
2
2
. 16. ,
DiagnoSTIC. . 1 ; 2 .
.
. . .

(. 16) [25].

.

,
TUI

,
.
,

,
.

, .

,

.
,
DiagnoSTIC

.
,

,
.

. ,

/ ,
106

,

.

, ,
,

.

,
.

,

DiagnoSTIC,

.
,
DiagnoSTIC,

(. 17, 18).

,

,
.

,

. DiagnoSTIC

,

12,

.

.

(. 19). ,

,

,

[17].

,

.

(. 20) [17].

.

.

.
,

.

,

DiagnoSTIC (. 21, 22).

DiagnoSTIC

,
107

. 17. TUI
.
. , .
. .
. 18. .
TUI DiagnoSTIC. .
() () . .
().
108

. 19. .
.
TUI DiagnoSTIC.

( ),
( ).
. 20. .
.
TUI DiagnoSTIC.

( ),
( ).
. 21. . TUI DiagnoSTIC.

. LV ; RV ; LA ; RA
. (AO).
. .
(TP). DA ; SVC [11].

.

.

. ,
109

. 22. .
TUI
DiagnoSTIC.
().
. 24.
()
(),
DiagnoSTIC
. 1 ; 2 ; 3

; 4 .
. 23.
(). .
; .
,

,

DiagnoSTIC (. 23).

(. 24).

.

I
110

. 25. 12 4 . .
5,2 ().
(). , ,
DiagnoSTIC .
(), ( )
( ).
II (. 25).

(glass body),
3D
(. 26, 27).

,
.

. . 28

. ,

. ,

,
111

. 26.
DiagnoSTIC (, ) .
, ,
. , .
. 27. (, )
() 22 DiagnoSTIC.
. 28.
DiagnoSTIC (, ) (),
. . .
112

. 29. 23 . .
.
.
. 30. . .
. ().

,
,
(. 2936).

,
STIC.

STIC

() [17, 2527].

.

.

113

. 31. 23 . . .
().
. 32. .
.
()
.
. 33. .
.

().
. 34.
(Ao),
(IVS),

. LV
; RV [16].
. 35. .
(RV) (PA).

(PVA), PA
(LPA). IVS
; LV [16].
114

. 36.
. .

.

,
3D
(. 37, 38).
, ,

,
STIC

(. 39).

HDFlow,
.

.
HDFlow

, (. 40,
41). 1 ,
HDFlow

.
HDFlow

.

Bflow.

,
(. 42).
115

. 37.

.
. 38.
() (PA)
.
. 39. 22 . .
, .
, (1). 2 .
P. Volpe . [28]

STIC Bflow

,
116

. 40. TUI HDFlow.

()
.
2
3
. 41.
HDFlow
.
. 42. (1)
Bflow. 2 , 3
.
,

.

.
117

. 43. . . .
, . B
flow. ( )
( ) [28].
. 44. inversion (, ).

,

67 75%
.
STIC Bflow
100%
. ,
26

,

,
.
STIC B
flow

118

2
3
. 45. inversion
.
().
. 46. 13 1 . inversion.
1 ; 2 ; 3
.

(. 43).
L. Gon
calves . [29]
STIC B
flow
.

III ,

15 .

Bflow: dynamic range 12,
sensitivity 45, persistence 2.
10
15 , 20
30.

,
.
,
STIC Bflow

60,9% .

50% , 40,6%.

19 .
, ,

3/4D
inversion.

T. Nelson . [30] 1996 .,

.

inverse (,
, ),

.
,
,
inversion
, ,
,
(. 44) [3033]. inversion

(. 4548) [33, 34].

inversion
119

. 47. . . inversion.
, .
. 48. . .
(). . .
.
. . inversion

. . 49

,

.

,
.
120

. 49. ,
. STIC.
.
, .
(). () ,
. ().
(), , .
. inversion. .
STIC.
. 49,
.

.
,

. ,

.
,

,

.

.
121

1
1
1
5
3
2
3
4
5
. 50. .
(1) (2) () (3)
(). 4 ; 5 ; 6 ; 7
. .
. 1 ; 2 . .
(). inversion. (1)
(2), (3). 4 ; 5 .

,
(. 49, ).
.

,
122

,
,
(. 49, ).

,
,

, .
,
,

.

. . 49,

,
,
inversion,

.

,
inversion,

[25].
()
6,6% [35]
70% ,
[36].

,

,

(. 50, ).

50%
22 30
III ,

[37].
,

,
II 12 ,
30 24 .

.

[25].

[17] 8:

() ()
? . 50,

,
,
,
.

(. 50, ),

inversion 3/4D.
. 50,
,
.

inversion

,

,

[33].

.

.
;
;
(. 51, ).
75%
123

. 51. . . ,
.
. .
(), .
inversion. .
.

.

,
,
,
. 1420%
22q11,

, DiGeorge
.

,
.

.

,
1%
,
.

,
.

,
,

. . 51,
,
,
STIC
.

.
124

,

. . 51, ,
(
)
.

inversion

(. 51, ).

,

STIC

,

.

.

4DView ,
,
.
.

[13].
4300
.

.

TELESTIC
STIC
,

.
, TELESTIC

.
C
1. .., ..

//
. 2003. 1. . 1519.
2. .., .., ..,
.. ( )
// . 2003.
1. . 714.
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Group. Evaluation of prenatal diagnosis of congenital
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2001. V. 17. 5. P. 386391.
4. .., ..,
.. .
?

// . . . .
. 2000. 2. . 8488.
5. .., ..

// . . 2004.
. 3. 3. . 239.
6. .., ..

// . . . . .
2001. 4. . 284295.
7. ..

: . . .
. ., 2005.
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fetal ventricular septal defect with 4D color Doppler
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.: , , 2000.
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25. ..

// . . 2005. . 4. 3.
. 169178.
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33. .. :
? // .
. 2006. . 5. 1. . 1417.
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Baltimore, 1995.
126

.

,

.
30
30%.

.

47 120,
5
[1]. 1%

,
50%.

,
.

6
.

/,

(. 1) [2].
I
, ,

,

. ,
I

(),

.
B. Bromley . [3]

. 1.
9 .
,
.
127
. 2. 11 . VOCAL.
,

()
() 5 . 94%

.

8%. R. Dickey
. [4]
1,9%
3765
.
80% ,
5 , 26,5%
57,9 10,6% 8
.
,
()

, .
VOCAL (Virtual Organ Compu

teraided AnaLysis)

(. 2).

VOCAL
. .
Falcon . [5]

11 14
.
,
,
0,37 , ,
, 2,17 .

,
69 11 144 13
6 .
128

. 3. . .
.
. 4. . .
.
. 5. . , .
.
. 6. . . .
129

. 7. (, ).
.
. 8. TUI ().
TUI.

.

/
. ,

,

,
.

,

(. 35).

130

. 9. , 4D. .
. 10. ()
() ( B. Benoit, ).

(. 6, 7). ,

,
40. ,

. , ,
, ,

.

,
.

,
TUI (Tomographic
Ultrasound Imaging),

9

. ,

(. 8).

.

131

. 11. 11 . .
. . .
2
3
. 12. 1213 . .
, TUI. 1 ; 2
; 3 . .
.
,
(. 9, 10).

, 2
,
. ,
,
.
()

.
1 50 000 1 100 000
[6, 7].
,
,

.
,

.

13 ,
.

,

pagus,
,
.
28%, 18%,
10%,
10%, 6%.

132

. 13. 14 . . .
.
. .
. 14. . .
(www.SonoPortal.net).
.
I
.

,
[2].

,
,

.
,
,
11

(. 11) [8].
,

,
..
(. 12).
,

(. 13).
133

. 15. 24 . . .
(www.SonoPortal.net).

().

,
3D
.

,

(. 14).

,

(. 15).
,

,
(), ,
1%
1 35 000
.

, .
1983 . M. Van Allen . [9]

().

.

.

,

,
[10].

, .
()

,
.

, ,

.

.
,
, ,
(,
, ),
,
134

. 16. . .
, . ().
. .
. .
. . .
, ,
, ,
, ,
, , ,
,
, ,
135

. 17. . .
. . ,
. .
, .
.
,
.

[11].

:
1. Acardius anceps
:

, ,

.
2. Acardius acephalus
,
, ;

, ,
.
3. Acardius acormus
; ,

.
4. Acardius amorphus
,
.

.
,
.

,

(. 16).

136

. 18. . . , ,
. , .
(www.TheFetus.net).

,

.
II

137

. 19. 2728 . . , ,
. . ,
. .

(. 17,
).
,
,
(.
17, ).

,

.

,

(. 17, , ).

,

(. 18, ).

,
1 500 000
.

.
,
(
).

.
,
138

3 .

(
),
( )
,
.
,
,
.

,

(. 18, , ).
,
,
.

.

,
(
, ),
,
,
.
,

, ,

[12].

2000 .,

[12],
91%
,
82,5%,
55,8%,
45%,
40%.

,

.

,

,
, ,
, ,
, ,
.

,

(. 18, ).

2728
(.19) [13].

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2. .., ..
// /
. .. .:
, 2005. . 7196.
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139

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1. P. 1521.
8. .., ..,
.., .., ..

// . .
2005. . 4. 2. . 155156.
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13. .. :
// .
. 2004. . 3. 4. . 294298.
140

,
,

,
.

[1].

,
[2].

.

,

.
,

,

,

. ,

, , ,

[3].

VOCAL (Virtual Organ Computeraided
AnaLysis),

(. 1).
1114
VOCAL

[4, 5]. P. Wegrzyn .
[5]
500 1114
.
,
,
0,6 ( 6,1 7,4 ), ,
, 0,7
( 10,5 9,2 ).

[6].

10,82 40,86 .
P. Wegrzyn . [5],

141
. 1. 12 . VOCAL.
51
(5 31,2 , 95
82,4 ) 11 91 (5
55,7 , 95
147,2 ) 13 6 . 1517

111,1114 [7].
M. Metzenbauer . [4]

17
(),
9 . ,
,

.
M. Metzenbauer . [4]
,

.
P. Wegrzyn .
[5]
83 .
,
,

21
.
13 18

(. 1).
39%

5
. ,
,
,
13 18. ,

,
142

1. [5].
21
18
13

45
17
6
10
0,035 ( 0,059 0,130)

0,469 ( 0,600 0,339)
0,467 ( 0,638 0,297)
0,197 ( 0,343 0,051)
0,2034
<0,0001
0,0027
0,6661

1/3 1114
[8, 9].

13
18
. ,
, ,

,
90% . ,

[10]. , , 13
18

.

P. Wegrzyn
. [11]
.
290 37
11 14

VOCAL.
,

83%
,
76%.
83,6 (5
56,0 , 95
124,9 ) 11 149,3 (5
100,0 , 95 223,1 )
13 6 .
114,9
(5 77,6 , 95
170,1 ) 11 217,9 (5
147,2 , 95
322,5 ) 13 6 .

.

, ,

.
M. Chen . [6]

912
VOCAL .
105 : 43
62
,
. 11
(10,5%)
,
.

() 912
1,37
0,65, 1,13 0,39.

( > 0,05).

.
143

E. Hafner . [12]

382
1623
VOCAL

().
,

II
52,5
82,5% .
,

,

.

,

2024
25,08% [13].

.
R. Ruano
. [14]
VOCAL
12

21 35 (
28 ) .
11 (91,7%) 12 .

,
168,39 242,07
.
,

.
R. Ruano . [15],

() ,

.

(),
()
().

, 3,94
14,88; 1,49 6,39 .
,

, ,

.

,

.

.

. placenta
accreta ,
,
, .
placenta increta
.
placenta percreta

(. 2).

1 10 000 .
,
1 24 506
[16]. 56

[17].

,
[18].

144

. 2.
. placenta accreta;
placenta increta; placenta percreta.
80 [19, 20].

90

.

G. Guy
. [21].

.

,

,
.
,

,

,

,
[22].
,
,
,

.

() ,

,
(. 3) [3].

,

. ,

,

,
[23].

, ,

.
0
,

.
,
,

145

. 3. . ; ;
[3].
. 4.
.
. 5.
HDFlow.

,
.

, ,

,

(. 46)

.
. Hull . [24] M. Chou
. [25]

.
M. Chou . [26]
,
,
placenta percreta (. 7).

.
,
.. [27],

9 .

,

.

(
)
,

146

. 6. HDFlow. .
.
. 7. placenta previa percreta.

. ,
,
. ,
. ,
, .
. . ,
. ; L ; P [26].
.

.
.

,

(. 8).
147

1
2
. 9.
() .
. 10.
.
. 8. 9 . .
. 1 ; 2
.
.
,
. (
.. ).

(. 9).
. 11.
.
148

. 12. . , .
. .
.
. 13. 12 3 .
2,3 . (2,5 ). (2,2 ).
(. 10, 11).

,
.

. ,

.

(. 12).

, , ,
.

. F. Ghezzi . [28]
1014
645 .
149

2. [29].
21
18
13

XXY
97
42
6
18
6
4
0,156 ( 0,99 0,81)

0,131 ( 0,91 1,23)
0,183 ( 0,57 0,5)
0,142 ( 0,8 0,66)
0,298 ( 0,47 1,01)
0,055 ( 0,08 0,18)
<0,0001
0,065
0,171
0,099
0,055
0,663
14
.
95
4 (28,6%) 14 ,
2,
1, 1.

35 (5,5%) 631
. ,

.

,
G. Rembouskos . [29].
11 14
1150
173 ,
97 .

.

2,9 45
4,4 84 .
21
,
,

(. 2).

.

, 10%

(. 13).

1420% .

,

.

60%,

,

.

8090% (. 14, 15).

,
,
(. 16, 17).

().

.

0,5%,
5% [30].

(6090%)

150

. 14. .
. .
. 15. .
. , .
. 16. (, ). .
. 17. (, ). .
,
.

, ,
,

, .
151

. 19. 1213 . .

().
. 18. . . .

.
.
, ,
7,2 14%.

A. Geipel . [31] ,
13 14,3
20% , 18 20,8
26,9%,
.
, .. [32],
,

.

.
13,9%,
33,3%.

(
46,4%), (35,7%).

.

,

,
, ,
.

,

. ,

3065% [33].

152

. 20. . , . .
. 21. 33 . .
[37].

94% [34].

,
,
(. 18, ).

(. 18, ).

,

(. 18, ),

100%
(. 19).

,

[35, 36].

,

(. 2022).

D. Sherer . [37],

33 ,
153

. 22. . .
. (www.TheFetus.net).
. 23. . .
. (www.TheFetus.net).

. ,

(. 23) [38].
,
0,041,25% [39].

,
. ,
,
,
.

154

. 24. . . ()
. .
. ,
. () ,
(1) (2).
[40],

.

.
, 1 20 .

,
.

[3].

,

.
.

(
)
,
(, ,
). ,

[41].

,
,

.

(. 24, ).
,
:
,
.

155

. 25. . .
,
.
. 1 ; 2 . .
.
,

(. 24, ).

,

.

(. 24, , ).

(vasa previa)

,
[42].

,

[29, 43]. Vasa previa

,

,
.

,

.
,

.
vasa
previa
.
vasa previa

.
,
vasa
previa

. ,

, vasa previa
. ,
S. Heinonen . [44], 80

. (82
, 3
),
[43].
, ,
,

/ .

91% [45].
156

. 26. . .
. . ,
. .
Foetus ; wall ; cervix (www.TheFetus.net).

100%.

vasa previa.
W. Lee . [46],
vasa previa

,

,

(. 25).

vasa previa
.

,

(. 26).
,
vasa previa

,
.
157

1. .., ..
. .:
, 1986.
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,
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