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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">zdor</journal-id><journal-title-group><journal-title xml:lang="ru">Проблемы здоровья и экологии</journal-title><trans-title-group xml:lang="en"><trans-title>Health and Ecology Issues</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2220-0967</issn><issn pub-type="epub">2708-6011</issn><publisher><publisher-name>Gomel State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.51523/2708-6011.2020-17-3-5</article-id><article-id custom-type="elpub" pub-id-type="custom">zdor-261</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКАЯ МЕДИЦИНА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL MEDICINE</subject></subj-group></article-categories><title-group><article-title>Повышение эффективности дородовой диагностики расщелин губы и нёба</article-title><trans-title-group xml:lang="en"><trans-title>Improving the efficiency of prenatal diagnosis of cleft lip and palate</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5563-1788</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чуканов</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Chukanov</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чуканов Алексей Николаевич — к.м.н., доцент, декан факультета общественного здоровья и здравоохранения, доцент кафедры ультразвуковой диагностики ГУО «Белорусская медицинская академия последипломного образования»</p><p>e-mail: a.chukanov@tut.by</p></bio><bio xml:lang="en"><p>Alexei N. Chukanov — Candidate of Medical Sciences, Associate Professor, Dean of the Faculty of Public Health and Healthcare, Associate Professor at the Department of Ultrasound Diagnosis of the SEE «Belarusian Medical Academy for Postgraduate Education»</p><p>e-mail: a.chukanov@tut.by</p></bio><email xlink:type="simple">a.chukanov@tut.by</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГУО «Белорусская медицинская академия последипломного образования»</institution></aff><aff xml:lang="en"><institution>Belarusian Medical Academy for Postgraduate Education</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>28</day><month>09</month><year>2020</year></pub-date><volume>0</volume><issue>3</issue><fpage>36</fpage><lpage>42</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Чуканов А.Н., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Чуканов А.Н.</copyright-holder><copyright-holder xml:lang="en">Chukanov A.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.gsmu.by/jour/article/view/261">https://journal.gsmu.by/jour/article/view/261</self-uri><abstract><p>Цель исследования: определить наиболее эффективный и доступный метод, позволяющий диагностировать различные типы расщелин губы и нёба у плода, применение которого возможно в большинстве специализированных учреждений службы родовспоможения. Материал и методы. В исследование были включены результаты ультразвукового обследования в различных режимах плодов (59 случаев) с расщелинами губы и нёба различных типов в сроках гестации от 16 до 36 недель. Результаты. Определены показатели чувствительности общепринятого метода двухмерного ультразвукового исследования в В-режиме при диагностировании всех типов расщелин, которая составила 81,3 %, и чувствительность при диагностировании расщелин нёба и расщелин губы и нёба, составившая 80,3 %. Определены показатели чувствительности нового разработанного метода диагностики (ультразвуковой эластографии нёба), составившие при диагностировании всех типов расщелин 89,8 %, а при диагностировании расщелин нёба и расщелин губы и нёба - 90,2 % (46/51). Демонстрация будущим родителям изображения лица плода, полученного при проведение трехмерной реконструкции в В-режиме, способствует принятию семьей более взвешенного и правильного решения по дальнейшей тактике в отношении беременности. В случаях расщелины нёба определен новый визуализационный диагностический критерий - раздвоение язычка. МРТ головы плода не является эффективным и доступным методом диагностики расщелин лица, который может широко применяться на практике. Заключение. Целесообразным и необходимым является обязательное исследование кариотипа у плодов с расщелинами, выявленными в ходе визуализирующего исследования в любом сроке гестации. В качестве нового диагностического критерия расщелин нёба, выявляемого при ультразвуковом исследовании в В-режиме, можно использовать раздвоение язычка. Использование метода эластографии нёба в сочетании с разработанными колористическими критериями расщелин губы и нёба и расщелин нёба повышает пренатальную выявляемость их в общей популяции на 9,9 %. При этом выявляемость всех типов расщелин повышается на 8,5 %. Для объективизации пояснений о сущности выявленного дефекта лица и структур ротовой полости необходима демонстрация будущим родителям трёхмерной сонограммы лица плода, полученного при проведение трехмерной реконструкции в В-режиме. МРТ головы плода не может быть рекомендовано в качестве эффективного и доступного метода диагностики расщелин лица в силу невозможности получения в большинстве случаев удовлетворительного изображения.</p></abstract><trans-abstract xml:lang="en"><p>Objective: to identify the most effective and affordable method to diagnose various types of fetal cleft lip and palate, the use of which is possible in the majority of specialized obstetric care facilities. Material and methods. The study included the results of ultrasound examination of fetuses (59 cases) in various modes with cleft lip and palate of various types within gestational periods from 16 to 36 weeks. Results. The sensitivity indices of the generally accepted method of two-dimensional B-mode ultrasound have been determined for diagnosing all types of clefts, which amounted to 81.3 %, and the sensitivity for diagnosing cleft palate and cleft lip and palate amounted to 80.3 %. The sensitivity indices of the newly developed diagnostic method (ultrasound elastography of the palate) have been determined, which amounted to 89.8 % in the diagnosis of all types of clefts, and 90.2 % in the diagnosis of cleft palate and cleft lip and palate (46/51). Demonstration of the image of the fetal face obtained during the three-dimensional B-mode reconstruction to its future parents helps the family to make a more balanced and correct decision on further pregnancy tactics. In cases of cleft palate, a new visualization diagnostic criterion has been defined - tongue bifurcation. MRI of the fetal head is not an effective and affordable method for the diagnosis of facial clefts, which can be widely used in practice. Conclusion: It is advisable and necessary to conduct an obligatory study of the karyotype in fetuses with crevices identified during imaging examination at any gestational age. As a new diagnostic criterion for cleft palate, detected by B-mode ultrasound, tongue bifurcation can be used. The utilization of the EN method in combination with the developed coloristic criteria for RHN and RN increases their prenatal detection in general population by 9.9 %. At the same time, the detectability of all types of crevices increases by 8.5 %. In order to objectify the explanations about the essence of revealed defects of the face and structures of the oral cavity, it is necessary to demonstrate a three-dimensional sonogram of the fetal face obtained during three-dimensional B-mode reconstruction to its future parents. MRI of the fetal head cannot be recommended as an effective and affordable method for diagnosing facial clefts due to the impossibility to obtain a satisfactory image in most cases.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>пренатальная диагностика</kwd><kwd>врожденные пороки лица</kwd><kwd>расщелины губы и неба</kwd></kwd-group><kwd-group xml:lang="en"><kwd>prenatal diagnosis</kwd><kwd>congenital malformations</kwd><kwd>cleft lip and palate</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Mastroiacovo P, Maraschini A, Leoncini E, Mossey P, Bower C, Castilla EE, Feldkamp ML, et al. Prevalence at birth of cleft lip with or without cleft palate: data from the International Perinatal Database of Typical Oral Clefts (IPDTOC). 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