Method for diagnosing the cases of chronic fetal hypoxia

FIELD: medicine.

SUBSTANCE: method involves carrying out cardiotocographic examination taking into account day rhythmostasis and following data analysis. Diagnostically significant cardiotocographic characteristics like basal rhythm, accelerations, acceleration durations, motor fetus activity and integral fetus state characteristic are determined. Non-conjugated estriol/progesterone coefficient is calculated with day rhythmostasis taken into account. Maternal and fetal blood circulation hemodynamic values synchronization coefficient is determined. Diagnostically significant characteristics values typical for fetus hypoxia are determined. When carrying out cardiotocographic examination, basal rhythm (strokes/min) is equal to 156±2.9 at 12 o'clock and 159±3.7 at 20 o'clock; accelerations (strokes/min) 3.0±0.2 at 12 o'clock and 2.2±0.3 at 20 o'clock; acceleration durations (s) 14.2±0.7 at 12 o'clock and 13.6±1.2 at 20 o'clock; motor fetus activity (during 10 min) 2.0±0.4 at 12 o'clock and 1.7±0.3 at 20 o'clock; integral fetus state characteristic 1.25±0.15 at 12 o'clock and 1.37±0.22 at 20 o'clock. When determining noncojugated estriol/progesterone coefficient: 0.57±0.05 at 8 o'clock and 0.67±0.06 at 20 o'clock. When determining maternal and fetal blood circulation hemodynamic values synchronization coefficient: 2.35±0.19 before 37 pregnancy weeks date and 2.78±0.18 after 37 pregnancy weeks date. The values corresponding to the above referenced ones, functional fetus state change and chronic fetal hypoxia are to be diagnosed.

EFFECT: high accuracy of diagnosis.

 

The invention relates to medicine, namely to obstetrics and gynecology, and relates to a method for the diagnosis of chronic intrauterine hypoxia.

The experience of clinical and experimental obstetrics today confirms the value of the dynamic approach in determining the functional state of the life support systems of the fetus, as any physiological parameters have the time dispersion caused by the evolution of living matter and astronomical causes (Mosquitoes FI Chronobiology and the bases of bioenergetics. Moscow, Medicine, 2000). Currently available data indicate that in the diagnosis of fetal hypoxia requires a comprehensive evaluation of the results of different methods of research and analysis in the last trimester of pregnancy should be based on the fetal cycle "sleep-Wake" and characteristics of the biological rhythms of the functional system "mother-placenta-fetus" in norm and pathology (ALEXANDER Khloponin circadian rhythms functional parameters of the system "mother-placenta-fetus" in uncomplicated pregnancy and threatened interruption with regard to morphological and functional asymmetries of the female reproductive system. Rostov-on-don, 2000).

One of the most effective approaches to solving problems of control for intrauterine fetus during pregnancy and childbirth is the tsya the study of spatial-temporal variations of adaptive levels in relation to pregnancy hormones (estriol, progesterone), indicators of reactivity of the cardiovascular system of the fetus (frequency, rhythm, heart rate variability), the speed of blood flows in utero-placental and placental-fruit-channels (blood vessels of the fetus, umbilical cord, uterine arteries), which provides the most complete picture of the course of gestational process (botcheva TL Chronophysiology and stereotactically features of the system "mother-placenta-fetus" during normal and complicated pregnancy. Rostov-on-don, 1999).

Important in obstetric clinic acquires the concept of chronobiological norms, reflecting a combination of morphological and functional indicators of maternal and fetal characterizing the state as a whole and of individual systems on the basis of studying the dynamics of biological rhythms and their integral indicators and definitions sredneperiodicheskii values of these parameters.

There is a method of diagnosing the condition of the fetus by registering his cardiac activity using a machine (Chernukha E.A. Generic unit. Moscow, Medicine, 2002).

In a known method for the diagnosis of hypoxia is determined diagnostically significant features cardiotocogram (basal rhythm, acceleratio) and the deviation from the norm is judged on the existence of a breach of the condition of the fetus.

The disadvantage of this method of having aetsa reduced diagnostic accuracy of a hypoxia of a fetus in the third trimester of pregnancy due to lack of information content when using only estimates of cardiotocogram.

Closest to the claimed is a method of diagnosis of fetal status by registering his heart with respect to biological rhythms functional system "mother-placenta-fetus" (Rykov, S., Lipatov I.S., Tezikov J.V., Gordeeva E.V., Gogel LU Bioritmologicheskikh principles for evaluating the functional status of the fetus. Abstracts and articles XXXVI final scientific-practical conference of teachers of Samara military medical Institute. - Samara, 2003. - S-129).

In this way the diagnosis of hypoxia is determined diagnostically significant features cardiotocogram with regard to their circadian rhythm, namely in 12 hours and 20 hours - time highest and lowest deviations and deviations from the norm judge the existence of a breach of the condition of the fetus.

The disadvantage of this is closest to the proposed method is reduced diagnostic accuracy of a hypoxia of a fetus in the third trimester of pregnancy due to the lack of information content when using only one test.

The problem solved by the invention is the diagnosis of chronic hypoxia.

The technical result is to increase the accuracy of diagnosis. This technical result is achieved in that in the method for the diagnosis of chronic intrauterine hypoxia PL is Yes by rithmomachia diagnostically significant figures of machine additionally produce rithmomachia factor unconjugated estriol/progesterone (ne/N) and the definition of the coefficient of synchronization (Sf) hemodynamic maternal and fruit blood flows and the change in these parameters compared to the norm diagnose disorders of the functional status of the fetus, indicating the presence of chronic hypoxia.

Method for the diagnosis of chronic hypoxia is as follows.

The pregnant woman and the fetus is examined taking into account the identified physiological and complicated by hypoxia pregnancy daily ritmistas levels of placental hormones, performance machine (CTG) and maternal hemodynamics and fruit document (USDG): at 12.00 and 20.00 hours - CTG and USDG; 8.00 hrs and 20.00 hours - blood sampling to determine the level of hormones.

The survey is produced by defining a

- indicators cardiotocogram mother and fetus;

- rithmomachia unconjugated estriol and progesterone to calculate their ratio (ne/N);

- systole-diastolic ratio (Vs/Vd) document in the uterine arteries and vessels of the umbilical cord with the calculation of the coefficient of synchronization of uterine and fruit blood flows (Sf).

When physiological and complicated by hypoxia pregnancy the above parameters have the following values.

Indicators CTG when determining the fully automated computer cardiotocography the APC-1 (firms is "UNICOS") in the norm in the third trimester of pregnancy have the following quantitative characteristics:

- basal rate (beats/min) at 12.00 132±3,2 and 20.00 hours 139±4,1;

- acceleratio (BPM) at 12.00 8,3±0.1 and at 20.00 hours 8,9±0,2;

the duration of acceleratio (s) at 12.00 20,1±0.5 and at 20.00 hours 23,2±0,6;

- motor activity of the fetus (for 10 min) at 12.00 3,8±0.6 and at 20.00 hours 4,2±0,5;

- integrated indicator of fetal status (SRP<1.0 corresponds to a state of "healthy fruit") at 12.00 0,52±0.03 and at 20.00 hours 0,74±0,04.

Chronic hypoxia is characterized by the following indicators CTG:

- basal rate (beats/min) at 12.00 156±, 2.9, and at 20.00 hours 159±3,7;

- acceleratio (BPM) at 12.00 3,0±0.2 and at 20.00 hours 2,2±0,3;

the duration of acceleratio (s) at 12.00 14,2±0.7 and at 20.00 hours 13,6±1,2;

- motor activity of the fetus (for 10 min) at 12.00 2,0±, 0.4, and at 20.00 hours 1,7±0,3;

- integrated indicator of fetal status (1.0<SRP<2.0 corresponds to the "initial violation of the condition of the fetus"; 2.0<SRP<3.0 - "expressed by the human status of the fetus"; SRP>3.0 - "sharply expressed human status of the fetus") at 12.00 1,25±0.15 and at 20.00 hours 1,37±0,22.

The level of steroid hormones in serum (unconjugated estriol, progesterone) was determined by radioimmunoassay method. Unification and standardization research is achieved by using special the data sets (Kit), in which all the preparatory stages of the technological process of the research is done the factory by (Artamoshkina L.V. Hormonal immunologicheski relationships in the system "mother-placenta-fetus during late pregnancy. Kyiv, 1998). When comparing data rithmomachia factor unconjugated estriol/progesterone biggest difference metric for physiological gestation and complicated by hypoxia pregnancy marked at 8.00 hrs and 20.00 hours while maintaining circadian rhythm. The normal ratio (ne/N) corresponds to the following values:

at 8.00 am - ne/N of 1.52±0,2;

at 20.00 hours - ne/P 1,5±0,1.

When hypoxia: 8 : 00am - ne/P 0,57±0,05;

at 20.00 hours - ne/P 0,67±0,06.

The synchronization coefficient of hemodynamics (Vs/Vd) maternal and fruit blood flows were calculated by the formula Sf=1/V, where V is the coefficient of variability of the relationship of the modulating frequencies (T1/T2, where T is the length of the longest period in the spectrum (Halberg castle P., Katinas G.S., Chronobiologic glossary of the international society for the study of biological rhythms. Ind. J ChronobioL, 1993, No. 1).

When evaluating cross-functional relationships there are 3 types of synchronization (Ugulava LI Bioritmologicheskikh the formation of compensatory-adaptive reactions in the clinical model of stress. Tomsk, 1999): hypersynchronous (HS) - factor synchronization Sf>,5; synchronous (AU) - Sf corresponds to 3.0-3.5; asynchronous (AC) - Sf<3,0.

The factor of synchronization during physiological gestation before 37 weeks of pregnancy is equal 3,24±0,16, in this period in all the examined pregnant marked synchronous type of communication of the parent document and fruit. After 37 weeks Sf corresponds 4,08±0,24, there hypersynchronous type cross-functional relationships.

In chronic hypoxia of the fetus in the third trimester of pregnancy regardless of gestation is an asynchronous type of communication of the parent document and fruit. The coefficient synchronization before 37 weeks of pregnancy corresponds to 2.35±0,19, after 37 weeks of pregnancy - 2,78±0,18.

EXAMPLE 1. Pregnant M., 26, has been registered by place of residence in the antenatal clinic city clinic with a diagnosis of Pregnancy 1, 9-10 weeks. Of illness notes colds, mumps and varicella in childhood. Extragenital diseases - chronic pyelonephritis, recent exacerbation 3 years ago. Menstrual function without features. Gynecological diseases, uterine cervix. Her husband is healthy. In terms of obstetric-therapy-pediatric complex was observed regularly. At 22 weeks of clinical and instrumental signs of threatened abortion, about which within 15 days n is accounted for hospital treatment in the Department of pathology of pregnancy clinical hospital №2 of them. N. A. Semashko. Therapy included tocolytic, antiplatelet agents, antagonists of calcium, antioxidants, electrophoresis with magnesium sulfate in the region of the uterus. Survey data (us fetometry, ultrasonic dopplerography), α-fetoprotein, tetrapolar rheovasography, conjunctival biomicroscopy, the height of the symphysis of the uterus in the dynamics, the General analysis of blood, urine, biochemical blood) before discharge corresponded to "normal pregnancy". Discharged in a satisfactory condition for further treatment and observation in the antenatal clinic. At 29 weeks. pregnancy a comprehensive survey in terms of screening inpatient hospital №2 of them. N. A. Semashko: UZ - fetometry, USDG uterine and fruit document, CTG mother and fetus, conjunctival biomicroscopy, regional and integral rheovasography, determination of unconjugated estriol, progesterone, General analysis and biochemical analysis of blood, urine.

Results: total weight gain during pregnancy - 4 kg; photometric data are consistent with 28-29 weeks. pregnancy; violations circulation in the vessels of the conjunctiva 1 degree; violations of regional and Central hemodynamics were not detected akineticheskie type hemodynamics; the study of blood and urine - without features; CTG - 12.00 and 20.00 hours is - basal rhythm 130 and 134 beats/min, respectively, acceleratio - 8 and 7.7 BPM, duration of accelerati 18 and 20, the motor activity of the fetus - 3 stirring for 10 min, the SRP is 0.65 and 0.71; rithmomachia factor unconjugated estriol/progesterone (8.00 hrs and 20.00 hours) - to 1.32 and 1.41, respectively; the coefficient synchronization maternal hemodynamics and fruit-document - 3,06, timing type : synchronous.

Clinical diagnosis:

Pregnancy 1, 29 weeks. Head previa fruit.

Chronic pyelonephritis in remission. The uterine cervix of the uterus.

Recommended vitamin-mineral complex for pregnant women "Obscene".

At 34 weeks at a reception at a local obstetrician-gynecologist pregnant complains of dragging pain in the abdomen, waist.

Objective: the uterus when palpable comes to tone, the height of the fundus of the uterus, abdominal circumference correspond 33-34 weeks. the pregnancy. With a diagnosis of Pregnancy 1, 34 weeks. Head presentation of the fetus. The threat of premature birth. Chronic pyelonephritis in remission. The uterine cervix is sent to hospital treatment in the Department of pathology of pregnancy clinical hospital №2 of them. N. A. Semashko, where we conduct a comprehensive examination and treatment of the threat of premature birth. The results of the survey at 34-35 weeks. pregnancy: ULTRASOUND - fetometry the fruit on the photometer the ical data corresponds 34-35 weeks of gestation; USDG - disruption of blood flow 1A degree (in the uterine arteries); conjunctival biomicroscopy - the circulation of the 1st degree; General analysis of blood and urine - without pathology; urine on Nechiporenko - norm; biochemical blood - norm; CTG at 12.00 and 20.00 respectively - basal rhythm 154 and 158 BPM, acceleratio to 3.2 and 2.5 beats/min, duration of accelerati of 14.8 and 13.9, motor activity of the fetus - 2.5 perturbations and 2 stir for 10 min, the SRP of 1.28 and 1.41; the ratio of unconjugated estriol/progesterone 8.00 hours and 20.00 hours, respectively of 0.62 and 0.71; Sf maternal and fruit document is 2.55, asynchronous synchronization type. In addition to the diagnosis: chronic Feto-placental insufficiency (hfpn), chronic hypoxia. During the week there is therapy aimed at correcting hfpn, chronic hypoxia - siglin, Actovegin, trental, antioxidants, antihypoxants, unithiol, ginipral, oxygen therapy. Control tests at 35-36 weeks. - indicators USDG, CTG, rithmomachia factor unconjugated estriol/progesterone, Sf - stable. Continued conservative treatment hfpn with daily control of CTG. The survey results 37 weeks - there is positive dynamics (basal rhythm, acceleratio, test fetal movement, SRP (0,85) - within normal limits; ne/N at 8.00 am - 1,23; Sf-2,9). Solved provest is induced birth with the use of hormonal and energy background amniotomy. Delivery at 37 weeks were uneventful. Born live, full-term boy weighing 3000 g, length 50 cm, with rating on a scale of Apgar at 1 min - 6 points, 5 min - 7 points (asphyxia mild), without signs of morphofunctional immaturity. In the early period of adaptation and stay in the Department of newborn baby was in satisfactory condition. The post-partum period the mother was uneventful, postpartum women and newborn was discharged home on day 7 after birth in a satisfactory condition. Results histological examination of the placenta: subcompensated placental insufficiency.

EXAMPLE 2. Pregnant N., 34 years, was registered in female consultations of the Regional perinatal center with a diagnosis of:

Pregnancy 3, 11-12 weeks.

Perforada older.

Burdened obstetric history (2 of medical abortion in terms of 7-8 weeks., 9-10 weeks. without complications).

From the anamnesis: every 2-3 years ARI, baby infection does not remember appendectomy at the age of 14. Extragenital disease - varicose disease of the lower extremities. Gynecological diseases - chronic salpingo-oophoritis. Her husband is healthy. In the first half of pregnancy took place early toxicosis mild (outpatient treatment). At 28-29 weeks. the threat of premature birth, about which within 3 weeks were treated in the Department of miscarriage Regional perinatal center. At 34 weeks, she developed swelling, blood pressure 140/90 and of 145/90 mm Hg, urine protein of 0.066 g/l, the total weight gain of 14 kg With a diagnosis of Pregnancy 3, 34 weeks. Combined preeclampsia on the background of varicose disease of the lower extremities. Perforada older. Burdened obstetric history, hospitalized in the Department of pathology of pregnancy clinical hospital №2 of them. N. A. Semashko. Treatment, including anti-hypertensive therapy, herbal therapy, antiplatelet agents, antioxidants, metabolites, electrophoresis with reopoliglyukine on the region of the fundus of the uterus. At 36 weeks during clinical and laboratory and instrumental examination revealed: HELL 120/80 and 125/85 mm Hg, pastos legs, daily diuresis positive; us-geometria - without features; UZ-planetography - ultrasound signs of preeclampsia; USDG violation document 1A degree (in the uterine vessels); conjunctival biomicroscopy - disturbance of microcirculation 1 degree; the fundus of the eye - without a pathology; integral rheovasography - hypokinetic type hemodynamics; General analysis and biochemical study of blood - without pronounced changes (total protein 62 g/l without dysproteinemia); urine - norm; CTG at 12.00 and 20.00 hours, respectively - basal rhythm 155 and 158 BPM, acceleratio to 3.0 and 2.5 beats/min, duration of accelerati of 13.6 12.8, test fetal movement - 2 stirrings and 1.5 sevelen the I for 10 minutes, SRP - 1,39 and 1.57; ratio ne at 8.00 hrs and 20.00 hours, respectively of 0.53 and 0.61; Sf-2,39, asynchronous type. Diagnosis: Pregnancy 3, 36 weeks. Combined preeclampsia is mild on the background of varicose disease of the lower extremities. Hfpn. Chronic hypoxia. Perforada older. The TAA.

Taking into account the signs of chronic intrauterine hypoxia ( according to rithmomachia CTG, ne/N, Sf), decided to strengthen therapy hfpn and 24-48 hours to repeat the examination. 48 hours after therapy, including intravenous drip aktovegin, Riboxin, pentoxifylline, shetina, pyracetam, performed control testing: performance rithmomachia CTG, ne/N, Sf - deteriorated (basal rhythm 156-159 BPM, acceleratio - 2,8-2,0 beats/min, the duration of acceleratio - 13,5-12,4 with the test fetal movement - 1.7 and 1.4 stirring for 10 minutes, the SRP - of 1.45 and 1.59; ne/P - 0,5-0,6; Sf-2,2, asynchronous type). Given the lack of effect from treatment hfpn, the progression of chronic hypoxia solved urgently, adorability pregnant by caesarean section, the consent of the woman on the operation received. The operation went without features, operating invited neonatologist-resuscitator. Born alive prematurely girl weight 2450 g, length 45 cm, asphyxia moderate severity (score on scale Apgar 1 through m is the gram - 5 points in 5 minutes - 5 points), with evidence of morphofunctional immaturity. In the early period of adaptation and during the observation of infants in the neonatal condition was from moderate to satisfactory. Post-partum mother was uneventful. 10 the day the child is in a satisfactory condition transferred to the division of premature babies children's city clinical hospital №1 for further follow-up and further evaluation. Histological examination of the placenta: decompensated chronic placental insufficiency. After 1 year, the child development corresponded to the age norm.

Thus, rithmomachia the functional parameters of the life of the fetus (cardiac activity, adaptive in relation to pregnancy hormones, synchronization of maternal hemodynamics and fruit document) as opposed to the single studies without consideration of biorhythms in the system "mother-placenta-fetus" can effectively monitor the fetus in utero and to timely diagnose chronic hypoxia.

Change indicators proposed to describe the state of fetoplacental complex, shows the breakdown of adaptive capabilities of the fetus and the need for their intensive correction until early delivery.

<> The outcomes for the fetus from the standpoint of evidence-based medicine have determined the sensitivity, specificity, accuracy, predictive value of positive and negative results of this method for the diagnosis of chronic hypoxia during pregnancy, which are respectively equal to 95,3%, 98,8%, 98,3%, 91% and 98%, which indicates a high information content and reliability of the proposed diagnostic method.

The positive effect of the proposed diagnostic method is fundamentally new possibilities timely diagnosis of fetal hypoxia due to the assessment of previously unused parameters. The method is non-invasive, safe for the health of the pregnant woman and the fetus, is widely available for modern obstetrics institutions.

On the date of filing the application the applicant has not found a way to diagnose with the stated set of features, resulting in making the conclusion on the conformity of the proposed technical solution the criteria of the invention of "novelty."

According to the results of the comparative analysis of the totality of the features of the proposed diagnostic method provides him with new properties in the form of increased accuracy of diagnosis, that is, in the opinion of the applicant, ensures compliance with the proposed method the criterion of "inventive step".

The criteria of the invention "industrial applicability is confirmed by the fact, that the inventive diagnostic method can be successfully applied in mass preventive examinations of pregnant women and their fetuses as a screening to identify accurate and early signs of fetal hypoxia.

Method for the diagnosis of chronic hypoxia, including machine with the circadian ritmistas with analysis of data, wherein the determined diagnostically significant performance machine: basal rhythm, acceleratio, duration of accelerate, motor activity of the fetus, integrated indicator of fetal status; calculate the ratio of unconjugated estriol/progesterone (ne/N) with the circadian ritmistas and determine the coefficient synchronization hemodynamic maternal and fruit of the document and when the value diagnostically significant figures of machine:

basal rate (beats/min) at 12.00 156±, 2.9, and at 20.00 hours 159±3,7;

acceleratio (BPM) at 12.00 3,0±0.2 and at 20.00 hours 2,2±0,3;

the duration of acceleratio (C) at 12.00 14,2±0.7 and at 20.00 hours 13,6±1,2;

motor activity of the fetus (for 10 min) at 12.00 2,0±, 0.4, and at 20.00 hours 1,7±0,3;

the integral indicator of fetal status at 12.00 1,25±0.15 and at 20.00 hours 1,37±0,22;

unwise is iente ne/N:

8 : 00am - ne/P 0,57±0,05;

20.00 - ne/P 0,67±0,06

and the factor of synchronization hemodynamic maternal and fruit document: before 37 weeks of pregnancy from 2,35±0,19, after 37 weeks of pregnancy 2,78±0,18; detect a change in the functional status of the fetus and diagnose chronic hypoxia.



 

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2 cl, 8 dwg

FIELD: medicine.

SUBSTANCE: method involves examining retina light sensitivity degree using computer-aided perimetry approach within 60° bandwidth from fixation point. Direct orbital muscle thickness and retrobulbar space volume is additionally determined by applying ultrasonic b-scanning method. Linear blood circulation speed and resistance index are also determined in the central retinal artery and posterior short ciliary arteries. Macular or general light sensitivity reduction 25% and more relative to age-specific norm being observed together with 50% growth and more in direct orbital muscle thickness, retrobulbar space volume growth by more than 35% in combination with linear blood circulation speed reduction in the central retinal artery and posterior short ciliary arteries by 40% and more and increasing resistance index by 20% and more relative to physiologic norm, optic nerve abnormality is diagnosed at early disease stages.

EFFECT: high reliability of diagnosis.

2 tbl

FIELD: medicine.

SUBSTANCE: method involves diagnosing gestosis severity degree with clinical signs and blood circulation being studied. Ultrasonic examination with Doppler color mapping is carried out in female patients manifesting fuzzy clinical symptoms. Intrarenal artery resistance index is determined. The value being within 0.62-0.65%, mild gestosis is to be diagnosed. The value being within 0.66-0.69%, moderate severity degree gestosis is to be diagnosed. The intrarenal artery resistance index being equal to or greater than 0.7%, severe gestosis cases are to be diagnosed.

EFFECT: high accuracy of diagnosis; noninvasive diagnosis method.

FIELD: medicine.

SUBSTANCE: method involves making lumbar puncture and measuring liquor pressure, taking pleocytosis into account, making ultrasonic transcranial Doppler flowmetric examination of brain, determining linear blood circulation speed on interior carotid artery and posterior cerebral artery, detecting intracranial venous discharge disorders through orbital and vertebral veins. Regression coefficient is calculated from a formula

where X1 is patient age (in years); X2 is the pleocytosis in the first lumbar sample (in cells number per 1 mcl of liquor); X3 is the meningitis symptoms duration (in days); X4 is the focal symptoms availability (1- yes, 0- no); X5 is the general cerebral symptoms duration (in days); X6 is the liquor pressure when taking the first lumbar puncture (in mm of mercury column); X7 is the linear blood circulation speed in interior carotid artery (in Hz/s); X8 is the linear blood circulation speed in posterior cerebral artery (in Hz/s); X9 is the intracranial venous discharge disorders based on ultrasonic transcranial Doppler flowmetric examination data; retrograde discharge through orbital veins, increased one through vertebral veins and others (1- yes, 0- no). Value of y≤0.5, unfavorable outcome is to be predicted with cerebroasthenic, asthenoneurotic and hypertension syndromes being formed. If y>0.5, favorable infectious process outcome is to be predicted.

EFFECT: high accuracy of diagnosis.

4 tbl

FIELD: medicine, ophthalmology.

SUBSTANCE: the present innovation deals with methods for diagnostics of vascular pathology of optic nerve (ischemic opticopathies) and, also, predicting vascular pathology of optic nerve lesion and counterlateral eyeball. One should perform dopplerographic registration of circulatory parameters: peak systolic velocity PSV cm/sec and end diastolic velocity EDV cm/sec on the 2nd, 3d min both before and at the background of functional loading: dealing with lifting legs up to 90° in area of internal carotid artery, central retinal artery and ciliary artery. Moreover, calculation of resistant index RI c. u. should be performed by the following formula (PSV cm/sec - EDV cm/sec)/PSV cm/sec and reactivity index RY c.u. by the following formula PSV cm/sec after loading/PSV cm/sec before loading. At RI value being above 0.7 and RY value being below 1.0 one should detect deterioration of visual functions and the absence of circulatory reserves in tested eye and counterlateral one. At RI value being below 0.7 and RY value being above 1.0 it is possible to detect the maintenance of visual functions and circulatory reserves in tested and counterlateral eyes. The innovation enables to accelerate and simplify the trial and carry out it with available physical loading for a patient without applying any additional appliances and medicinal preparations.

EFFECT: higher efficiency and accuracy of diagnostics and prediction.

6 dwg, 3 ex, 2 tbl

FIELD: medicine, cardio-vascular surgery.

SUBSTANCE: one should perform ultrasound scanning of the 1st volar metacarpal artery both before and at the background of radial artery compression, moreover, at decreased peak systolic rate of circulation in the 1st volar metacarpal artery at the background of compression by 40% or less against peak systolic rate of circulation before compression one should diagnose ulnar type of wrist's circulation and at decreased peak systolic rate of circulation at the background of compression by more than 40% against peak systolic rate of circulation before compression or at appearance of retrograde circulation one should diagnose radial type of wrist's circulation.

EFFECT: higher efficiency and accuracy of diagnostics.

6 dwg, 2 ex

FIELD: medicine, otorhinolaryngology.

SUBSTANCE: one should detect amplitude-frequency circulatory characteristics in mucosal microcirculation system of inferior concha at the side of lesion due to laser Doppler flowmetry: AmaxCF/σ - circulatory fluctuations synchronized with cardiorhythm; IFM - index of flux motions, the ratio between active and passive mechanisms of circulatory regulation in microcirculation system. In 3-4 d all measurements should be repeated. If AmaxCF/σ value is increased at simultaneous decrease of IFM value one should consider the treatment to be efficient. The present innovation enables to obtain objective parameters of maxillary sinus state.

EFFECT: higher accuracy of detection.

3 ex

The invention relates to medicine, obstetrics
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