Підвищення ефективності пренатальної діагностики хромосомної патології: Автореф. дис… канд. біол. наук / Л.А. Хлівна, Укр. наук. гігієн. центр. — К.

OE?A?INUeEEE IAOEIAEE A?A??I?*IEE OeAIO?

OE?AIA

Ethaeieea Aiaoie??aia

OAeE 618.3: 616-053.1/-076.5

I?AeAEUAIIss AOAEOEAIINO? I?AIAOAEUeII? Ae?AAIINOEEE O?IIINIIII?
IAOIEIA??

03.00.15 — aaiaoeea

Aaoi?aoa?ao aeena?oaoe??

ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa a?ieia?/ieo iaoe

EE?A — 1998

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Aeiiaoeueeiio i?aeiaeaniiio iaaeeei-aaiaoe/iiio
oeaio?? IIC Oe?a?ie.

Iaoeia? ea??aieee: aeieoi? iaaee/ieo iaoe

A?aociaa Na?oeaia Ai?en?aia,

Aeiiaoeueeee i?aeiaeaniee

iaaeeei-aaiaoe/iee oeaio?,

caa?aeoth/a,

aeieoi? iaaee/ieo iaoe, i?ioani?

Aa?eeye ?ai? ?iiaiiae/,

Oe?a?inueeee iaoeiaee

a?a??i?/iee oeaio?, aee?aeoi?.

Io?oe?ei? iiiiaioe: aeieoi? iaaee/ieo iaoe, no. i. n.

I?e?inueea Ia??y Aiae???aia,

?inoeooo aenia?eiaioaeueii?

?aae?ieia?? iaoeiaiai oeaio?o

AII Oe?a?ie,

caa?aeoth/a a?aeae?eii oeeoiaaiaoeee,

eaiaeeaeao a?ieia?/ieo iaoe, no. i. n.

Noaoaiiae/

Aaiia Aieiaeeie??aia

Oe?a?inueeee iaoeiaee oeaio?

iaaee/ii? aaiaoeee, caa?aeoth/a

a?aeae?eii ?aiiueiai ?icaeoeo

ethaeeie.

I?ia?aeia onoaiiaa: Iaoe?iiaeueiee Oi?aa?neoao ?i. Oa?ana Oaa/aiea,
I?i?noa?noai Ina?oe Oe?a?ie, eaoaae?a caaaeueii? oa iieaeoey?ii?
aaiaoeee, i. Ee?a.

Caoeno a?aeaoaeaoueny 28 n?/iy 1999 ?. i 10 aiaeei? ia can?aeaii?
niaoe?ae?ciaaii? a/aii? ?aaee Ae26.604.01 Oe?a?inueeiai iaoeiaiai
a?a??i?/iiai oeaio?o, 253660, i. Ee?a-94, aoe. Iiioae?aiea, 50.

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Oe?a?inueeiai
iaoeiaiai a?a??i?/iiai oeaio?o,

Ee?a-94, aoe. Iiioae?aiea, 50.

Aaoi?aoa?ao ?ic?neaiee 25 a?oaeiy 1998 ?.

A/aiee nae?aoa? niaoe?ae?ciaaii? a/aii? ?aaee ______________ Naeaciueia
A.TH.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeueiinoue oaie. Iaeiith c aaaeeeaeo caaea/ iaaee/ii? aaiaoeee
? i?ioieaeoeea o?iiiniiieo caoai?thaaiue, yei iathoue cia/io ieoiio aaao
a no?oeoo?i i?e/ei aeeoy/i? nia?oiinoi oa iiaaeiaeiinoi.

Aeooaeueiinoue i?iaeaie iineeth?oueny aenieith iiioeyoeieiith
/anoioith o?iiiniiieo neiae?iiia, yei aeyaeythoueny o 7 c 1000
aeeaiia?iaeaeaieo aeioae (Aa?eeye I.?., Aiaoaeei I.C., 1991(. *anoioa
iaeaieueo iioe?aii? iaoieiai? — neiae?iio Aeaoia (NAe) — neeaaea? a
na?aaeiueiio 1 ia 800-1100 iiaiia?iaeaeaieo (Eacthe A.E., 1979; Aa?eeye
?.?. ? ni?aaao., 1984; Eiceiaa N.E., 1987; A?aociaa N.A., 1996(.

Aoaeoeaiinoue i?aiaoaeueii? aeiaaiinoeee (IAe) o?iiiniiieo
caoai?thaaiue caeaaeeoue, aieiaiei /eiii, aiae ?ioaiiy aeaio ieoaiue —
oi?ioaaiiy a?oi ?eceeo, a yeeo i?iaiaeyoueny iiaaceaii aeineiaeaeaiiy,
oa aeai?o iaoiaeia, ui aeei?enoiaothoue aeey oeeoiaaiaoe/ii? IAe.
A?aoiaoth/e oa, ui ia?aaaaeia aieueoinoue o?iiiniiieo neiae?iiia
aiaeiinyoueny aei iooaoeie «de novo», oieueee ?ic?iaea /ioeeo e?eoa?i?a
oa ?aoaeueiee aiaeai? aaaioieo i?e i?ecia/aiii iiaaceaii? IAe iiaea
iiaeaeueoe nooiiiue aeyaeaiiy o?iiiniiii? iaoieiai? aiaeii/an ic
cieaeaiiyi ianyao aeeiioaaieo aeiaaiinoe/ieo iaiiioeyoeie.

Oi?ioaaiiy a?oi ?eceeo iiaeiii cae?enithaaoeny c o?aooaaiiyi
iniaeeainoae iiioeyoei?. Aeei?enoaiiy o?aaeeoeieiiai iieacaiiy aeey
i?iaaaeaiiy iiaaceaieo aeineiaeaeaiue — aie aeiiee aieueoa 35 ?ieia — ia
iiaea nooo?ai aieeiooe ia iiioeyoeieio /anoioo o?iiiniiieo caoai?thaaiue
a Oe?a?ii, oiio ui eieueeinoue eioiio aaaioieo ia ia?aaeuo? 9% (Arbuzova
S.B., 1997(.

I?e aeai?i iaoiaeia iiaaceaii? IAe iaiaoiaeiith oa iaia(yceiaith
oiiaith ? aacia/iinoue ? aeniea iioi?iaoeaiinoue aeineiaeaeaiiy. Oaeei
aeiiaai ia?o ca ana aiaeiiaiaea? o?ainaaaeiiiiaeueiee aiiiioeaioac (AOe)
(Tabor A., 1988; Mennuti M., 1989; Wolstenholme J., 1994(.

I?ioa, aiaeic aiiiioe/ii? ?iaeeie (A?) ia iaea?aeaa iioe?aiiai
aeei?enoaiiy a Oe?a?ii /a?ac o?oaeiiinoe?noue aeineiaeaeaiiy oa o?eaaeee
oa?i?i eoeueoeaoaaiiy, ui iiynith?oueny iaaeineiiaeinoth o?aaeeoeieii
aeei?enoiao?ieo eoeueoo?aeueieo iaoiaeee (Cieioooeia O.A.,1980; Nadler
H., 1969; Gregson N., 1970; Nelson M., 1973(.

O ca(yceo c aeuacacia/aiei, iaoith aeineiaeaeaiiy ? oaeineiiaeaiiy
iaoiaeieiai/ieo oa iaoiaee/ieo iiaeoiaeia aei aeiiieiaiai? aeiaaiinoeee
o?iiiniiii? iaoieiai?.

Caaaeaiiy aeineiaeaeaiiy.

1. Aecia/eoe iiaeeeainoi noeioeyoei? ?inoo aiiiioeeoia iaeii/anii
c? cieaeaiiyi aeo?ao oa /ano, iaiao?aeieo aeey eoeueoeaoaaiiy
aiiiioe/ii? ?iaeeie.

2.?ic?iaeoe iioeiaeueii oiiae io?eiaiiy o?iiiniiieo i?aia?aoia
aeniei? yeinoi c eoeueoo?e eeioei aiiiioe/ii? ?iaeeie.

3.Iaa?oiooaaoe aeiaaiinoe/io cia/ouinoue ia?aaaaeiiai aeei?enoaiiy
o?ainaaaeiiiiaeueiiai aiiiioeaioaco aeey IAe o?iiiniiii? iaoieiai?.

4.I?iaiaeicoaaoe aoaeoeaiinoue aeyaeaiiy o?iiiniiii? iaoieiai? a
?iciiiaiioieo a?oiao aaiaoe/iiai ?eceeo.

5.Anoaiiaeoe iaeaieueo iioi?iaoeaii e?eoa?i? oi?ioaaiiy iioieia ia
iiaaceaio i?aiaoaeueio aeiaaiinoeeo.

Iao/ia iiaecia aeineiaeaeaiue.

1. Anoaiiaeaii oaeoi?e, ye? aieeaathoue ia o?eaae?noue no?ie?a
eoeueoeaoaaiiy aii?ioeeo?a.

2. Cai?iiiiiaaii niinia io?eiaiiy aenieiyeinieo o?iiiniiieo
i?aia?aoia c 25-30 iaoaoacaie ia neei.

3. Aia?oa aeeiiaii ?iaioo c ii?iaiyeueii?e oa?aeoa?enoeee yeinoi
eoeueoo?e c ee?oei A? oa aioiaeo o?iiiniiieo i?aia?aoia, a caeaaeiinoi
aiae neeaaeo eoeueoo?aeueieo na?aaeiaeu.

4. Cai?iiiiiaaii iiaee aeeoa?aioeieiaaiee iiaeoiae aei oi?ioaaiiy
a?oi aenieiai aaiaoe/iiai ?eceeo c o?aooaaiiyi aieo aaaioieo,
aeooa?nueeiai aiaiiaco, aeaieo aiioiii/iiai oa OC-ne?eiiiaia.

Oai?aoe/ia oa i?aeoe/ia cia/ouinoue aeineiaeaeaiiy.

1. Cai?iiiiiaaii iiaeeoieiaaio iaoiaeeeo eoeueoeaoaaiiy oa
oienaoei? aiiiioeeoia, yea aeicaiey? a iaeei?iooee oa?i?i i?iaanoe
oeeoiaaiaoe/iee aiaeic.

2. I?iaaaeaii iiaeai? eoeueoo?aeueieo noiio?a c iioeiaeueiei
neeaaeii, yeee aeicaiey? cieceoe aeo?aoe ?iai/iai /ano oa ?aaeoeaia, ui
aeei?enoiaothoueny i?e eoeueoeaoaaiii oa oienaoeii aiiiioeeoia.

3. Cai?iiiiiaaii iiai i?eioeeie aei oi?ioaaiiy iioieia ia
oeeoiaaiaoe/io aeiiieiaiao aeiaaiinoeeo c ?ic?aooieii iiaeeaiaeoaeueiiai
?eceeo, yei aeicaieythoue iiaeaeueoe aoaeoeaiinoue aeyaeaiiy o?iiiniiii?
iaoieiai? iaeii/anii c? cieaeaiiyi eieueeinoi i?iaaaeaieo iiaaceaieo
aeineiaeaeaiue.

4. Oaeineiiaeaii o?aaeeoeieiee iiaeoiae aei i?ecia/aiiy iiaaceaieo
aeineiaeaeaiue aaaioiei aieii iiiaae 35 ?ieia.

Ai?iaaaeaeaiiy a i?aeoeeo.

Io?eiaii aeaii iieeaaeaii a iniiao i?ecia/aiiy oa i?iaaaeaiiy
iiaaceaieo aeineiaeaeaiue a Aeiiaoeueeiio IIAOe. Iiaeeoieiaaia iaoiaeeea
eoeueoeaoaaiiy oa oienaoei? aiiiioeeoia aeei?enoiao?oueny a ?yae?
aaiaoe/ieo eiinoeueoaoeie oa oeaio??a Oe?a?ie.

Iiai i?eioeeie oi?ioaaiiy a?oi aenieiai aaiaoe/iiai ?eceeo
a?aoiaothoue i?e ?iaioi c aaaioieie a aeiii/eo eiinoeueoaoeiyo oa
iieiaiaeiiiiiaeieo caeeaaeao.

Ia iiaenoaai ?acoeueoaoia ?iaioe aoee cai?iaaaeaeaii
?aoeiiiaeicaoi?nueei i?iiiceoei?: «Niinia iieo/aiey o?iiiniiiuo
i?aia?aoia ec eoeueoo?u eeioioeeoia ia?eoa?e/aneie e?iae»; «Niinia
iieo/aiey o?iiiniiiuo i?aia?aoia ec eoeueoo?u aiieioe/aneie aeeaeeinoe»
(?? 3416, 3417, 1996 a.).

Iniiai? iieiaeaiiy aeena?oaoe?? aoee ?ic?iaeai? a ?aieao
Iaoe?iiaeueii? I?ia?aie «Ae?oe Oe?a?ie», caoaa?aeaeaiith Oeacii
I?aceaeaioa Oe?a?ie ?63/96 a?ae 18.01.96.

Iniaenoee aianie caeiaoaa/a a i?iaaaeaiiy aeine?aeaeaiue.

Aeena?oaio iniaenoi ?ic?iaea ? cai?iaaaeea a i?aeoeeo Aeiiaoeueeiai
iiaeiaeaniiai iaaeeei-aaiaoe/iiai oeaio?o iiaeeoieiaaio iaoiaeeeo
eoeueoeaoaaiiy oa oienaoei? aiiiioeeoia. Aeena?oaioii iniaenoi
aiooaaeeny aeeaeeueii na?aaeiaeua, yei aeei?enoiaoaaeeny aeey
eoeueoo?aeueieo aeineiaeaeaiue, aeeiioaaany oeeoiaaiaoe/iee aiaeic
eeioei aiiiioe/ii? ?iaeeie, aiiioaoo ieaoeaioe oa ioiiaeiii? e?iai,
i?iaiaeeany aiaeic io?eiaieo aeaieo. Aaoi?ii naiinoieii ii?aoeueiaaii
?acoeueoaoe ?iaioe oa iiaeaioiaeaiee oaeno aeena?oaoei?.

Ai?iaaoeiy ?acoeueoaoia ?iaioe.

Iniiaii iieiaeaiiy aeena?oaoeieii? ?iaioe aeiiiaiaeaeeny ia: 2-io
c(?caei iaaee/ieo aaiaoeeia Oe?a?ie (aeiaoaiue 1995, Euea?a);
eiioa?aioeiyo ii i?aiaoaeueiie aeiaaiinoeoei a Oeaio?aeueieo oa
Noiaeii?a?iiaenueeeo e?a?iao (aa?anaiue 1996, I?aaa; /a?aaiue 1997,
Aoaeaiaoo); 1-io Eiia?ani Oe?a?inueei? Anioeiaoei? niaoeiaeinoia
oeueo?acaoeiai? aeiaaiinoeee a ia?eiaoieiai?, aaiaoeoei oa aiiaeieiai?
(o?aaaiue 1997, Oa?eia); iaeanieo, iinueeeo oa iiae?aeiiieo naiiia?ao c
iaaee/ii? aaiaoeee (1993-1998 ??.).

Ioaeieaoei?.

C oaie aeena?oaoei? iioaeieiaaii 11 ?iaio, a oiio /ene? 6
aeo?iaeueieo noaoae.

Ia(?i oa no?oeoo?a ?iaioe.

Aeena?oaoeieia ?iaioa aeeeaaeaia ia 137 noi?iieao iaoeiiieniiai
oaenoo o aeaeyae? 5 ?icae?e?a ? neeaaea?oueny c anooio, iaeyaeo
eioa?aoo?e, iieno ia’?eoo oa iaoiaeee aeine?aeaeaiiy, ?icae?e?a aeanieo
aeine?aeaeaiue, iaaiai?thaaiiy ?acoeueoao?a, aeniiaeia oa nieneo
eioa?aoo?e. Oaeno aeena?oaoei? iethno?iaaiee 15 oaaeeoeyie oa 20
iaethieaie. Nienie eioa?aoo?e iinoeoue 196 iaca.

CIINO ?IAIOE

Iaoa?iaee oa iaoiaee aeineiaeaeaiiy.

Eiiieaenia i?aiaoaeueia aeiaaiinoeea caeienithaaeany a
Aeiiaoeueeiio IIAOe. Oi?ioaaiiy iioieia ia iiaaceaii aeineiaeaeaiiy
aeeiioaaeiny ia iiaenoaai aeaieo aiaiiaco, ?acoeueoaoia oeeoiaaioe/ieo
aeineiaeaeaiue, oeueo?acaoeiaiai oa aiioiii/iiai ne?eiiiaia.

Oeueo?acaoeiaee ne?eiiia i?iaiaeeany ca noaiith, cai?iiiiiaaiith
A?a/aiiiith I.ss. (1992).

I?e aiaeici ia?ea?ia iaoa?einueei? ne?iaaoee (IN) aeei?enoiaoaaeeny
?ic?iaeaii aaciai oa a?aie/ii cia/aiiy aeueoa-oaoii?ioaiio (AOI) oa
oi?iiii/iiai aiiaaeio?iiiio (OA) aeey eiaeiiai oeaeiy aaaioiinoi oa ?o
ciiio i?e o?iiiniiieo ii?ooaiiyo o ieiaea (Ieeieaiei I.E., 1997(.
Eiiaiiiaaiee ?ecee ?ic?aoiaoaaee caiaeii i?eioeeio Wald i Cuckle (1988).

Aeey iiaaceaii? IAe ia?aaaaeii aeei?enoiaoaaany
o?ainaaaeiiiiaeueiee aiiiioeaioac. Iniiaith aeey i?iaaaeaiiy
aeineiaeaeaiue noaei oaeineiiaeaiiy o?aaeeoeieiiai niiniao io?eiaiiy
o?iiiniiieo i?aia?aoia c eoeueoo?e A?. Iiaeeoieiaaia iaoiaeeea aoea
ii?aoeueiaaia ia 150 eoeueoo?ao ia?aeaeueii c eoeueoeaoaaiiyi i
oienaoei?th A? ca eeane/iith iaoiaeeeith (Nadler, 1969; Gregson, 1970;
Nelson, 1973(.

Onueiai i?iaaaeaii 1603 aiiiioeaioaca, 104 ieaoeaioioeaioaca i 11
ei?aeioeaioacia. Anii?aoeiy iaoa?iaeo aeey iiaaceaieo aeineiaeaeaiue
i?iaiaeeeanue o oa?iiii aaaioiinoi 14-25 oeaeiia iiae eiio?ieai
oeueo?acaoeiaiai neaia?o Aloka — SSD 630.

Aeey ioeiiee o?iiiniiiiai iaai?o a eeioeiao ieaoeaioe aiaeicoaaee
i?aia?aoe, aeaioiaeaii «iaiiai?yiei» iaoiaeii (Eoeaoia I.I., 1989(.

Eoeueoeaoaaiiy ioiiaeiii? e?iai ieiaea oa ia?eoa?e/ii? e?iai
aaoueeia i?iaiaeeee ca caaaeueiiaeciaiith iaoiaeeeith (Hungerford D.,
1965(, aeei?enoiaoth/e cai?iiiiiaaiee iaie niinia neio?iiicaoei? iioicia
a eoeueoo?i — aei ii/aoeo oienaoei? eoeueoo?o eiioioeeoia aeo?eioaaee
2-2,5 aiaeeie o oa?iinoaoi c oaiia?aoo?ith 36 (N.

Aeey io?eiaiiy aeeoa?aioeieiiai caaa?aeaiiy o?iiinii, ioeiiee
?icii?ia aaoa?io?iiaoeiiaeo oa yaea?oeaooai?thth/eo ?aeiiia
aeei?enoiaoaaee G-, C- i Ag- iaoiaee (Naeaciaa TH.A., 1972; Sumner,
1971; Bloom, 1976(.

Iaoaiaoe/ia ia?iaea ?acoeueoaoia aeeiioaaeanue ia eiii(thoa?i IBM
PC/AT 486 c aeei?enoaiiyi i?ia?aie STATGRAPHICS aa?ni? 3.0; Excel 5.0;
SAS aa?ni? 6.04.

?acoeueoaoe aeineiaeaeaiue oa ?o iaaiai?aiiy

Iiaeeoieaoeiy aoaiia eoeueoeaoaaiiy aiiiioe/ii? ?iaeeie.

Aoee anoaiiaeaii /eiieee, yei aieeaathoue ia o?eaaeinoue
eoeueoeaoaaiiy aiiiioeeoia oa yeinoue o?iiiniiieo i?aia?aoia.

I?aeoe/ii a onio inioth/eo ia nueiaiaeii iaoiaeeeao ianooiiei ca
anii?aoei?th A? i?iaiaeyoue aoai oeaio?eooaoaaiiy io?eiaii? ?iaeeie c
iaoith aiaeie?aieaiiy aia?iiiaeueieo eeioei aiae iioi? noiioi. Iiae /an
oeaio?eooaoaaiiy eeioeie iiaeooue iioeiaeaeoaaoeny; e?ii oiai, i?e
aiaeie?aieaiii iaaeinaaeiai? ?iaeeie aiaeaoaa?oueny ?o /anoeiaa ao?aoa.
Oaeei /eiii, a oeie i?iai A? ia?ainii cieaeaia i?ie?oa?aoeaia
aeoeaiinoue aiiiioeeoia.

I?e onoiaiii aoaio oeaio?eooaoaaiiy A?, yeee aenooia? ia?aae
noaaeaiiyi eoeueoo?e, /a?ac 72 aiaeeie iiney ii/aoeo eoeueoeaoaaiiy ia
aeii oeaeiio aoei aiaeii/aii cia/io eieueeinoue i?ee?iieaieo aei
noano?aoo eeioei. E??i oiai, aei oeueiai /ano o 75% eoeueoo? aoee
noi?iiaaii eieiii? aeiaiao?ii 2-3 ii. A ia?aeaeueiie eoeueoo?i, aea A?
iiaeeyaaea oeaio?eooaoaaiith, ca aiaeiai/iee i?iiiaeie /ano eieueeinoue
i?ee?iieaieo aei eoeueoo?aeueii? iiaa?oii eeioei aoea cia/ii iaioith.

Aaaeeeaei /eiieeii, yeee ni?ey? nei?i/aiith /ano eoeueoeaoaaiiy, ?
aeei?enoaiiy aenia?eiaioaeueii aeia?aieo eiiieaenieo aeeaieueieo
noiioia, aei yeeo aoiaeyoue neioaoe/ii na?aaeiaeua Ham’s F-10, Ham’s
F-12, RPMI — 1640, a oaeiae aia?iiiaeueia oaey/a ne?iaaoea (AON) (80 oa
20%, aiaeiiaiaeii). I?e eoeueoeaoaaiii A? ia caaaeueiiaeciaiiio
na?aaeiaeui Chang’s, niaoeiaeueii i?ecia/aiiio aeey noeioeyoei?
a’yei?inoo/eo eeioei oa eiiie (Chang H., 1991(, i eiiieaeniie
aeeaeeueiie noiioi, /aniaeo aiaeiii ia aiaecia/aii. E?ii oeueiai,
aa?oinoue na?aaeiaeua Chang’s iaeaea a 10 ?acia ia?aaeuo? aa?oinoue
eiiieaeniiai na?aaeiaeua.

Aaaeeeaith ia?aaaaith cai?iiiiiaaii? iaoiaeeee ? oa, ui aiia ia
iio?aao? aeei?enoaiiy NI(- iieoaaoi?a aeey eoeueoeaoaaiiy eeioei A?, oae
ye iiaeia?aiee neeaae noiioia, aei yeeo aoiaeeoue HEPES, aeicaiey?
iiaeo?eioaaoe iioeiaeueiee ?iaaiue eeneioiinoi (7.2-7.4). Aiaenooiinoue
NI(-iieoaaoi?a /anoi aenooia? ia?aoeiaeith aeei?enoaiith aiiiioeeoia
aeey oeeoiaaiaoe/ii? IAe, oiio ui ani o?aaeeoeieii iaoiaeeee aaeaioiaaii
naia aei oei?? oiiai eoeueoeaoaaiiy ee?oei A?.

Ua iaeiei eoeueoo?aeueiei caoiaeii, yeee aieeaa? ia oa?i?i
eoeueoeaoaaiiy, yeinoue o?iiiniiieo i?aia?aoia oa aa?oinoue ianoaaeaiue,
? ciiia aeeaeeueii? noiioi ia ?ai?oa 5-6 aeiae. Iaoi aeineiaeaeaiiy
aeiaaee, ui, ia aiaeiiio aiae eeane/ieo iaoiaeee, iaia? iio?aae eiaeii
3-4 aeii i?iaiaeeoe ciiio aeeaeeueii? noiioi, oiio ui na?aaeiaeua
neeaaeaii c aaeeeei caianii iiaeeaieo ?a/iaei, ? ia i?ioyc? cacia/aiiai
ia?iiaeo /ano ae/a?iaiiy ?o ia aiaeaoaa?oueny. Ia?oo ciiio aeeaeeueiiai
noano?aoo i?iaiaeeee ca 16-18 aiaeei aei ii/aoeo oienaoei?,
neio?iiicoth/e iioioe/iee ?iciiaeie eeioei a eoeueoo?i. Caaaeyee
oeueiio, aaeaeiny caieueoeoe iioioe/iee iiaeaen o 2-2,5 ?ace ii?iaiyii c
aiaeiai/iith i?iaith A?, caoieniaaiith o?aaeeoeieiei niiniaii.
Aeaie?aoio ci?io aeeaeeueiiai na?aaeiaeua — ia 5 aeiao oa ca 16-18
aiaeei aei ii/aoeo o?enaoe?? — i?iaiaeeee eeoa a eoeueoo?? c iecueeith
i?ie?oa?aoeaiith aeoeai?noth.

Oaeei /eiii, aianeiaeie i?iaaaeaii? ?iaioe, aoea cai?iiiiiaaia
oaeineiiaeaia iaoiaeeea eoeueoeaoaaiiy oa oienaoei? aiiiioeeoia, ui
aeicaiey? i?ioyaii 7-9 aeia, ia aiaeiiio aiae eeane/ii?, yea iio?aao?
15-18 aeia, io?eiaoe o?iiiniiii i?aia?aoe aeniei? yeinoi c 25-30
iaoaoacaie ia neei (oaae. 1, iae.1).

Oaaeeoey 1

sse?nii-/aniaa oa?aeoa?enoeea o?aaeeoe?eii? oi iiaeeo?eiaaii? iaoiaeee

Iaoiaeeea, yea aeei?enoiao?oueny Ia??iae aaeaac??, aeiae Ia??iae
a?aeiia-eaiiy i?oioe/ii? aeoeaiino?, aeiae Ia??iae oi?io-aaiiy
aeeoa?ai-oe?eiaaiiai iiii-neith, aeiae E?euee?noue iaoaoac ia iaeiiio
nee?

O?aaeeoe?eia 5 5-8 15-18 10-15

Iiaeeo?eiaaia 3 3-5 7-9 25-30

Iae. 1. E?euee?noue iaoaoac, io?eiaia o?aaeeoe?eiei (a) iaoiaeii oa
iiaeeo?eiaaiei (a) c aeei?enoaiiyi neio?ii?caoe?? i?oic?a.

Cai?iiiiiaaia iaoiaeeea aoea ai?iaiaaia ia ia?aeaeueieo eoeueoo?ao
A?, yeo anii?oaaee a ?icieo oa?iiiao aaaioiinoi. *aniaeo aiaei?i i?e
eoeueoeaoaaiii A?, io?eiaii? c 16 ii 25 oeaeii, ia iiii/aii. A i?ioeani
?iaioe c A?, yea aoea anii?iaaia aei 16 oeaeiy, anoaiiaeaii, ui /an
eoeueoeaoaaiiy neeaaean a na?aaeiueiio 14 ae?a. Oiio, aeeiioth/e ?aiii
aiiiioeaioace, aeey nei?i/aiiy ia?iiaeo eoeueoeaoaaiiy A? i?iiiio?oueny
caaaaoeoe aeeaieueio noiio na?aaeiaeuai IMDM.

Iaa?oiooaaiiy ia?aaaaeiiai aeei?enoaiiy o?ainaaaeiiiiaeueiiai AOe
aeey oeeoiaaiaoe/ii? IAe.

Aieiaiith ia?aaaaith o?ainaaaeiiiiaeueiiai aiiiioeaioaco ? eiai
aacia/iinoue, ui i?iaeaiiino?iaaii oniia aeineiaeieeaie oa aoei iieacaii
o iaoie ?iaioi. ?ecee ia?a?eaaiiy aaaioiinoi iiney i?iaaaeaiiy oei??
iiaaceaii? iaiiioeyoei?, caiaeii c eioa?aoo?ieie aeaieie, ia ia?aaeuo?
0,5-0,7% (Ai/eia I.I., 1982; Tabor A., 1988; Mennuti M.,1989(. C 1603
aeiaaiinoe/ieo AOe, i?iaaaeaieo a IIAOe i. Aeiiaoeueea, ia?a?eaaiiyi
aaaioiinoi caeii/eeeny 4 iiaaceaii iaiiioeyoei?, ui neeaei 0,2% aiae
caaaeueii? eieueeinoi ianoaaeaieo. A iaeiiio c oeeo aeiaaeeia aoea
aeyaeaia o?iiiniiia iaoieiaiy ieiaea — o?eniiiy 21.

Canoiniaoth/e iiaeeoieiaaio iaoiaeeeo, yea aeicaiey? io?eiaoe
aenieiyeinii o?iiiniiii i?aia?aoe i?e cieaeaiii no?ieia eoeueoeaoaaiiy
A?, aeiaaiinoe/iee aiiiioeaioac aeeiioaaany ye aieiaiee iaoiae
iiaaceaii? ae?aaiinoeee o?iiiniiieo caoai?thaaiue.

sse aeiaeaoeiai iaoiaee ie aeei?enoiaoaaee ieaoeaioi- oa
ei?aeioeaioac. Aei iaoiaeo ei?aeioeaioaco caa?oaeeny a e?aei?o
aeiaaeeao, ui iiynith?oueny neeaaeiinoth aeeiiaiiy oa aenieei ?eceeii
oneeaaeiaiue iiney aeaii? iiaaceaii? iaiiioeyoei? (Eoeeaa A.I.,1990;
Nicolaides K., 1986(. A iaoeo aeineiaeaeaiiyo ei?aeioeaioac aeeiioaaany
c iaoith aa?eoieaoei? aeiaaiico, a oaeiae i?e cia/iiio iaeiaiaeaei —
eiee ani??aoe?y iaaeieiieiaeii? ?iaeeie aoea iaiiaeeeaa.

Ieaoeaioioeaioac i?iaiaeeee o aeiaaeeao iiciueiai caa?oaiiy aeiiee
aei IAOe (o oa?iiii aaaioiinoi 23-25 oeaeiia), a oiio /enei, i?e
aeyaeaiii a oeeo no?ieao OC-iciae o?iiiniiii? iaoieiai? ieiaea.
I?aeoe/ii ?aeeiith ia?aaaaith ieioeaioioeaioaco aoee iaei oa?i?ie
noaiieoaoaaiiy (2,5-3 aiaeeie) io?eiaiiai aiiioaoo. I?iaanoe yeiniee
o?iiiniiiee aiaeic o eeioeiao aiiioaoo ieaoeaioe aaeaeiny o 71%
aeiaaeeia. Iaaaea/i i?e aiaeici ea?iioeio a ?aooi aeiaaeeao aoee
coiiaeaii iayaiinoth aaeeei? eieueeinoi aiiiiei?aeieo ieanoeiie
aianeiaeie ao?aoe o?iiinii iiae /an iaoea?aoei? oeaieie ioeoiaith
eeneioith (10,6%), iecueeith yeinoth o?iiiniiieo ieanoeiie (10,7%),
aiaenooiinoth iaoaoac ia aioiaeo i?aia?aoao (4,8%) oa iaeei ia(?iii
anii?iaaii? oeaieie (2,9%). C aiaeiai/ieie i?iaeaiaie cono??/athoueny e
iioi aeineiaeieee, aiaeii/ath/e oaeiae i aieueo aenieee ?ecee
oneeaaeiaiue iiney aeaii? iaiiioeyoei? o ii?iaiyiii c
o?ainaaaeiiiiaeueiei aiiiioeaioacii (Eoeaoia I.I., Aa?oeaaa I.A., 1989;
Wapner R., Jackson L., 1988(.

Ia?aeaeueii c ieaoeaioioeaioacii aeeiioaaee aiiiioeaioace. Eeioeiio
iano, iio?iaio aeey oienaoei?, io?eioaaee /a?ac 7-9 aeia. C onio i?ia A?
aoee aeaioiaeaii aenieiyeinii o?iiiniiii i?aia?aoe.

Nooo?aith aaaeith ieaoeaioioeaioaco ? aeniea /anoioa oeaieiiiai
iica?oeecio, yeee ?a?no?othoue, aiaeicoth/e i?aia?aoe c aiiioaoo
ieaoeaioe. A iaoeo aeineiaeaeaiiyo aiia neeaaeaea 5,4%, oi/a a
eioa?aoo?i aeacothoue i aieueo cia/ia /enei aiaenioe?a. Oae, i?e
oeeoiaaiaoe/iiio aiaeici eeioei ieaoeaioe o 4 aeiaaeeao aoee aiaecia/aii
o?iiiniiii ii?ooaiiy: o?eniiiy ii o?iiiniiao 21 (2 aeiaaeee) oa
ia?ea?ieo o?iiiniiao (mar = G oa mar < E). Oeaieiiee iica?oeeci a A? i?aeoe/ii ia cono?i/a?oueny (Bui T. et al., 1984; Worton R., 1984(. Aiaeicoth/e o?iiiniiii i?aia?aoe, aeaioiaeaii c eoeueoo?e aiiiioeeoia, ie cioeioeeny eeoa c yaeuai iiieeeiaiai (eoeueoo?aeueiiai) iica?oeecio, /anoioa yeiai neeaea 2,9%, ui ocaiaeaeo?oueny c eioa?aoo?ieie aeaieie (Masis A., 1986; Krawczun M., 1989; Jha A., 1992(. Ii?iaiyiiy aeiaaiinoe/ii? cia/ouinoi iienaieo iaoiaeia aeaiiino?o? ia?aaaao o?ainaaaeiiiiaeueiiai AOe, aacia?a/ieie i aieiaieie yeinoyie yeiai ? iiiiiaeueiee ?ecee oneeaaeiaiue, aeniea iioi?iaoeaiinoue, a oaeiae iaeiaioa /enei aiaenioe?a iica?oeecio. Aeyaeaiiy o?iiiniiii? iaoieiai? ieiaea a ?icieo a?oiao aaiaoe/iiai ?eceeo. A oiaei eiiieaenii? IAe ?iciiiaiioiee niaeo? o?iiiniiieo oa aaiiiieo ii?ooaiue a ea?iioeii ieiaea aoa aeyaeaiee o 8% ianoaaeaieo. A no?oeoo?i aaiiiieo iaoieia?e cia/ia ieoiia aaaa iaea-aeaea neiae?iio Aeaoia - 41,5%, neiae?iio Aaeaa?aena - 15,1% oa neiae?iio Oa?ia?a - 15,1% (iae. 2). Oaaeeoey 2 Nooi?iue aeyaeaiiy o?iiiniiieo ii?ooaiue a ea??ioei? ieiaea a ??cieo a?oiao aaiaoe/iiai ?eceeo A?oia ?eceeo E?euee?noue aii?ioeaioac?a aaniethoia / % E?euee?noue ieiae?a c o?iiiniiieie ii?ooaiiyie aaniethoia / % A?e iaoa?? a?eueoa 35 ?ie?a 324/20,2 6/1,85 Aenieee eiia?iiaaiee ?ecee /a-?ac a?e iaoa?? (a?eueoa 35 ?ie?a) oa IAA 141/8,8 6/4,26 Aenieee eiia?iiaaiee ?ecee /a- ?ac a?e iaoa?? (a?eueoa 35 ?ie?a) oa ??aaiue ia?ea??a IN 242/15,1 33/13,60 Aeeoeia c neiae?iiii Aeaoia a aiaiiac? 128/8,0 1/0,78 Aeeoeia c IA? a aiaiiac? 55/3,4 - Ci?iaiee ??aaiue ia?ea??a IN (a?e iaoa?? iaioa 35 ?ie?a) 579/36,1 55/9,50 Iayai?noue o?iiiniiii? ia?aaoaei-ae a ea??ioei? aaouee?a 30/1,9 15/50,0 Aeyaeai? OC-ia?ea?e o?iiinii-ii? iaoieia?? 86/5,4 6/7,0 Caoai?thaaiiy, c/aieai? c? noaooth 18/1,1 - Nooiiiue aeyaeaiiy o?iiiniiieo aaa?aoeie ieiaea aa?ithaaea a ?icieo a?oiao ?eceeo i caeaaeaea aiae i?eioeeiia ?o oi?ioaaiiy. Aiaeic aoaeoeaiinoi aeyaeaiiy o?iiiniiieo iaoieiaie a o?ueio a?oiao aaaioieo aieii iiiaae 35 ?ieia iieacaa, ui c 324 aeiiie, yeei aeiaaiinoe/iee AOe aoa i?ecia/aiee oieueee c i?e/ei aieo, o?iiiniiii ii?ooaiiy a ea?iioeii ieiaea aoee aeyaeaii eeoa o 6 ianoaaeaieo, ui neeaei 1,85%. A ae?oao a?oio eioiio aaaioieo aiaeianaii aeiiee c iaoyaeaiei aeooa?nueeei aiaiiacii (IAA), oiaoi iayai?noth niiioaiieo aeeeaeiia, o?eaaeiai aacieiaeaey, ii?ooaiue iaino?oaeueiiai oeeeeo. A aeaiie a?oii, noi?iiaaiie ia iiaenoaai a?aooaaiiy aeaeieueeio iieacieeia, o?iiiniiii aaa?aoei? ieiaea aoee aeyaeaii o 6 c 141 ianoaaeaii? (4,26%). O?aoth a?oio aaaioieo, iai?aaeaieo ia iiaaceaio IAe, neeaee aeiiee, aieii 35 ?ieia i aieueoa, c? ciiiaiei ?iaiai AOI i OA. Caaaeueia eieueeinoue eioiio aeiiie, ianoaaeaieo ia ia?ea?e IN neeaaeaea 1970. Ia iiaenoaai ?acoeueoaoia a?io?i?/iiai ne?eiiiao a a?oio ?eceeo aoee aiaeianaii eeoa 242 aaaioii. O?iiiniiii ii?ooaiiy o ieiaea aeyaeaii o 33 ianoaaeaieo, ui neeaei 13,6%. Aiaeic eaoaiianoe/ieo aeaieo iieacaa, ui na?aae aeiiie aieii iiiaae 35 ?ieia, yeei AOe ia aoa i?ecia/aiee, ia ca?a?no?iaaii aeiaaeeia ia?iaeaeaiiy aeeoeie c o?iiiniiieie caoai?thaaiiyie. Oaeei /eiii, caaaeyee aeei?enoaiith ne?eiiiao ia?ea?ia IN oa aeeoa?aioeieiaaiiio iiaeoiaeo aei oi?ioaaiiy a?oi ?eceeo, aaeaeiny cia/ii iiaeaeueoe nooiiiue aeyaeaiiy o?iiiniiii? iaoieiai? iaeii/anii c ?iceei cieaeaiiyi eieueeinoi iiaaceaieo ianoaaeaiue na?aae aeiiie noa?oiai aieo. O?aaeeoeieiei iieacieeii aei i?ecia/aiiy aeiaaiinoe/iiai AOe, e?ii aieo iaoa?i, ? iayaiinoue aeeoeie c NAe a aiaiiaci. Iaeiae, ca aeaieie eioa?aoo?e, ?ecee iiaoi?iiai ia?iaeaeaiiy aeeoeie c o?iiiniiiith iaoieiai?th, cie?aia c o?eniiinth 21, ia ia?aaeuo? 1% (Milunsky A., 1979; Stene J. et al., 1984(, ui aoei iiaeoaa?aeaeaii a oiaei iaoiai aeineiaeaeaiiy. Oae, a ?acoeueoaoi i?iaaaeaiiy oeeoiaaiaoe/ii? aeiiieiaiai? aeiaaiinoeee 128 aeiieai oei?? a?oie, o?iiiniiia iaoieiaiy aoea aeyaeaia eeoa o iaeiiai ieiaea - 46, del(X) / 45, X0 - iica?/ia oi?ia neiae?iio Oa?ia?a. E?ii oiai, a 3-o aeiaaeeao aoee aeiaaiinoiaaii aeaoaeoe iaa?aeueii? o?oaee ieiaea. Oiaoi, oi/a oei aeiiee i aiaeiinyoueny aei a?oie aenieiai ?eceeo, aii ia caaaeaee iia’ycaiee c iiiai?iinoth ia?iaeaeaiiy aeeoeie c o?iiiniiiith iaoieiai?th. Aei oe??? a?oie aaaioieo oae naii, ye i aei a?oie aeiiie, ui iathoue a aiaiiaci aeeoeio c i?e?iaeaeaieie aaaeaie ?icaeoeo (IA?), o?aaa aeei?enoiaoaaoe aeeoa?aioeieiaaiee iiaeoiae, a?aoiaoth/e aeaii oeueo?acaoeiaiai oa aiioiii/iiai ne?eiiiaia i?e i?ecia/aiii iiaaceaieo aeineiaeaeaiue. Iniaeeai aeooaeueiei ? ?ic?aooiie iiaeeaiaeoaeueiiai ?eceeo c aeei?enoaiiyi ?iaiy ia?ea?ia IN o aeiiie aieii aei 35 ?ieia. Caaaeyee ianiaiio ne?eiiiao aaaioieo ia ia?ea?e IN, ieoiia aaaa aeiiie oei?? a?oie a no?oeoo?i iai?aaeyiue ia AOe neeaea 36,1%. O?iiiniiii ii?ooaiiy a ea?iioeii ieiaea aoee aeyaeaii o 9,5% aeiaaeeia. Iieacaiiyie aei i?iaaaeaiiy aeiaaiinoe/iiai AOe, yei ia iio?aaothoue aeiaeaoeiaiai ?ic?aooieo iiaeeaiaeoaeueiiai ?eceeo, ? iayaiinoue a ea?iioeii aaoueeia aaiiiieo aiaoiei?ae?e aai o?iiiniiieo ia?aaoaeia. A aeaiie a?oii o?iiiniiii ii?ooaiiy o ieiaea aoee aeyaeaii a 50% aeiaaeeao, i?aaenoaaeaii a 36,7% naaeainiaaieie o?aineieaoeiyie, oniaaeeiaaieie aiae aaoueeia i a 13,3% - ianaaeainiaaieie. Aeiaaiinoe/iee AOe i?iaiaeeee i oei aeiieai, o eio?eo i?e oeueo?acaoeiaiio aeineiaeaeaiii (OCAe) ieiaea a 2-io o?eiano?i aoee aeyaeaii niaoeeoi/ii aeey o?iiiniiii? iaoieiai? ia?ea?e: oeeia oeenoiaia?iia, caieueoaiiy ?icii?ia oeeii? neeaaeee, ii?eiaeoaciy, aano?iiaaaeiy, nei?i/aiiy aeiaaeeie noaaia, ii?ooaiiy ia(?io iaaeieiieiaeii? ?iaeeie. O?iiiniiii caoai?thaaiiy a oeie a?oii aeiaaiinoiaaii o 3-o ieiaeia c oeeiith oeenoiaia?iiith, ea?iioei - 45,X0. I?iaaaeaii aeineiaeaeaiiy ocaiaeaeothoueny c eioa?aoo?ieie aeaieie, caiaeii yeeo iioi?iaoeaiinoue OC- ia?ea?ia a 2-io o?eiano?i ia oaea cia/ia, uia aieeiooe ia iiioeyoeieio /anoioo o?iiiniiii? iaoieiai? (Brombati B., 1995; Orlandi F., 1997(. Caiaeii inoaiiio aeaieo, iaeaieueo iioi?iaoeaiei OC-ia?ea?ii aeciaii eiii?oeaaee i?inoi? ieiaea (nuchal transluency) a 1-io o?eiano?i aaaioiinoi. Ca?eueoaiiy eiai ?icii?o iiiaae 2,5 ii a 85% aeiaaeeia niieo/o?oueny c o?eniii?th 21 (Nicola1des K.,1992; Brizot M., 1995(. Oae? ci?ie niinoa?iaaeeny iaie a 3-o aeiaaeeao, a iaeiiio c yeeo aeiaaiinoiaaiee NAe. ?acoeueoaoe i?iaaaeaiiai ii?iaiyeueiiai aiaeico nooiaiy aeyaeaiiy o?iiiniiieo ii?ooaiue aeacothoue ia iaiaoiaeiinoue aeei?enoaiiy aeeoa?aioeieiaaiiai iiaeoiaeo aei ioeiiee iiaeeaiaeoaeueiiai ?eceeo i?e i?ecia/aiii iiaaceaii? IAe. Io?eiaii aeaii eyaee a iniiao cai?iiiiiaaii? noaie oi?ioaaiiy a?oi ?eceeo aeey i?iaaaeaiiy iiaaceaieo aeineiaeaeaiue, a yeie aca?iica(ycie oa niaaeei?iiinoue iaoiaeia eiiieaenii? IAe aeicaieythoue iiaeaeueoe aoaeoeaiinoue aeyaeaiiy o?iiiniiieo iaoieiaie ieiaea (iae. 3). Iae. 3. Oi?ioaaiiy a?oi ?eceeo aeey i?iaaaeaiiy ae?aaiinoe/iiai AOe c o?aooaaiiyi eiiieaenii? IAe. Oaeei /eiii, iiaenoieii i?iaaaeaii? ?iaioe ? ?ic?iaea iiaeeoieiaaii? iaoiaeeee io?eiaiiy o?iiiniiieo i?aia?aoia aeniei? yeinoi c eoeueoo?e ee?oei aiiiioe/ii? ?iaeeie, yea aeicaiey? oe?iei aeei?enoiaoaaoe aeiaaiinoe/iee aiiiioeaioac aeey i?aiaoaeueii? aeiaaiinoeee o?iiiniiieo caoai?thaaiue, oa oaeineiiaeaiiy iiaeoiae?a aei oi?ioaaiiy a?oi aenieiai aaiaoe/iiai ?eceeo. AENIIAEE 1. Io?eiaiiy o?iiiniiieo i?aia?aoia aeniei? yeinoi c eoeueoo?e ee?oei aiiiioe/ii? ?iaeeie i?e cieaeaiii aeo?ao oa /ano, iio?iaieo aeey i?iaaaeaiiy aeineiaeaeaiue, iiaeaeuo? aeiaaiinoe/io cia/ouinoue aiiiioeaioaco, yeee yaey?oueny iaeaieueo aacia/iei oa iioi?iaoeaiei iaoiaeii i?aiaoaeueii? aeiaaiinoeee o?iiiniiieo caoai?thaaiue. 2. Onoiaiiy aoaio oeaio?eooaoaaiiy A? aei noaaeaiiy ?? a eoeueoo?o oa aeei?enoaiiy eiiaiiaoei? na?aaeiaeu RPMI - 1640; Ham's F-10; Ham's F-12 c aeiaeaiiyi HEPES nei?iooo? /an eoeueoeaoaaiiy aiiiioeeoia aei 7-9 aeia, a oaeiae ia aeiaaa? canoinoaaiiy niaoeiaeiciaaieo aei?iaeo noiioia oa NI(-iieoaaoi?a. 3. Neio?iiicaoeiy iioioe/iiai ?iciiaeieo aiiiioeeoia a eoeueoo?i ca 16-18 aiaeei aei ii/aoeo ?? oienaoei? aeicaiey? io?eiaoe o?iiiniiii i?aia?aoe c 25-30 iaoaoacaie ia neei. 4. Cai?iiiiiaaia iaoiaeeea aeicaiey? io?eiaoe eoeueoo?o eeioei A? iacaeaaeii aiae oa?iiiia aaaioiinoi, ia yeeo aiia anii?iaaia. Aeey nei?i/aiiy ia?iiaeo eoeueoeaoaaiiy A?, yea io?eiaia ?aiio 16 oeaeiy aaaioiinoi, aei 9-10 ae?a, iaiaoiaeii aeiaeaoeiaa caaaa/aiiy aeeaeeueii? noiioi na?aaeiaeuai IMDM. 5. Ia?aaaaith aeei?enoaiiy AOe a 2-io o?eiano?i aaaioiinoi ? iiaeeeainoue aieueo noa?aiiiai aiaeai?o a?oi aenieiai ?eceeo, ui aeicaiey? iiaeaeueoe nooiiiue aeyaeaiiy o?iiiniiii? iaoieiai i?e cieaeaiii eieueeinoi i?iaaaeaieo iaiiioeyoeie? . 6. Aeniea aoaeoeaiinoue aeyaeaiiy o?iiiniiii? iaoieiai? ieiaea, iacaeaaeii aiae aieo aeiiee, aeinyaa?oueny ?ic?aooieii iiaeeaiaeoaeueiiai ?eceeo, caniiaaiiio ia eiiieaeniie ioeiioei ?acoeueoaoia aiioiii/iiai ne?eiiiao, aeaieo OCAe oa aiaiiaco. Nienie iioae?eiaaiuo iaoeiaeo ?ia?o, ye? a?aeia?aaeathoue iniiai? iieiaeaiiy aeena?oaoe?? A?aociaa N.A., Oeaaiay E.A., Eacia/aaaa A.A., Ieeieaiei I.E. Oi?ie?iaaiea a?oii ?enea e i?iaaaeaiea eiaaceaiie i?aiaoaeueiie aeeaaiinoeee // Oeeoieiaey e aaiaoeea. - 1995. - O.29, ? 5. - N. 76-81. A?aociaa N.A., Ieeieaiei I.E., Oeaaiay E.A. e ae?. I?aiaoaeueiay aeeaaiinoeea neiae?iia Aeaoia ia iniiaa aeioeie/aneiai ne?eieiaa ia?ea?ia iaoa?eineie nuai?ioee // Oeeoieiaey e aaiaoeea. - 1998. - O.32, ? 1. - N. 66-71. A?aociaa N.A., Ieeieaiei I.E., Oeaaiay E.A. e ae?. Aeeiaieea aeioeie/aneeo ia?ea?ia iaoa?eineie nuai?ioee i?e ?acee/iuo o?iiiniiiuo ia?ooaieyo ieiaea // Oeeoieiaey e aaiaoeea. - 1998. - O.32, ? 5. - N. 75-79. A?aociaa N.A., Oeaaiay E.A., Iaeiaa N.A. Oniaa?oainoaiaaiiay iaoiaeeea eoeueoeae?iaaiey e oeenaoeee aiieioeeoia /aeiaaea // Aeiiieeia?u e eeaoea. - 1998. - O.14, ? 6. - N. 559-560. Oeaaiay E.A. Aeeooa?aioee?iaaiiue iiaeoiae e oi?ie?iaaieth a?oii ?enea aeey i?iaaaeaiey eiaaceaiuo enneaaeiaaiee // Aii?inu yenia?eiaioaeueiie e eeeie/aneie iaaeeoeeiu.: Na. noaoae. Aeiiaoeeee Ain. iaae. oieaa?neoao. - Aeiiaoee, 1997 - N. 179-181. A?aociaa N.A., Iieieaiei I.I., Iaeiaa N.A., Oeiaia E.A., Ae?oaeeiiia I.I. Oi?ioaaiiy iioieia aeey i?iaaaeaiiy i?aiaoaeueiii aeiaaiinoeee a Aeiiaoeueeiio i?aeiaeaniiio iaaeeei-aaiaoe/iiio oeaio?i // Iaoa?iaee ae?oaiai c’icaeo iaaee/ieo aaiaoeeia Oe?a?ie. Eueaia, 1995. - N. 8. A?aociaa N.A., Oeiaia E.A. Oaeineiiaeaiiy eeane/iii iaoiaeeee eoeueoeaoaaiiy oa oienaoeii aiiiioeeoia // Iaoa?iaee ae?oaiai c’icaeo iaaee/ieo aaiaoeeia Oe?a?ie. Eueaia, 1995. - N. 9. Oeiaia E.A. Aeiaaeie iinoieiiai ia?ea?o o caei?iaii aeiiee. Iaoa?iaee 1-ai Eiia?ano Oe?aiinueeii Anioeiaoeii niaoeiaeinoia oeueo?acaoeiaii aeiaaiinoeee a ia?eiaoieiaii, aaiaoeoei oa aiiaeieiaii. Oa?eia, 1997. - N. 37-38. Oeaaiay E.A. Aeeaaiinoeea o?iiiniiiuo caaieaaaiee a iaaeiaeanoiii iaaeeei-aaiaoe/aneii oeaio?a a. Aeiiaoeea // Aeooaeueiua i?iaeaiu iaaeeoeeiu Aeiiaanna: Oac. iao/. o?. iieiaeuo o/aiuo e niaoeeaeenoia. Aeiiaoee, 1997. - N. 79-80. Arbuzova S., Nickolenko M., Khlevnaya L., Fedotova O. Complex prenatal diagnosis in Donetsk interregional medico-genetic centre // Abstracts of 2nd PECO-EUCROMIC Congress, 1997. - P. 46. Arbuzova S., Nickolenko M., Khlevnaya L., Prenatal diagnosis of Down’s syndrome in the Donetsk region of the Ukraine // Cesko-Slovenska Pediatrie, 1997. - N 7 (Special Issue). - P. 510-511. Oeiaia E.A. Iiaeaeuaiiy aoaeoeaiinoi i?aiaoaeueii? aeiaaiinoeee o?iiiniiii? iaoieiai?. ?oeiien aeena?oaoeii ia caeiaoooy a/aiiai nooiaiy eaiaeeaeaoa aiieiai/ieo iaoe ii niaoeiaeueiinoi 03.00.15 - aaiaoeea (aiieiai/ii iaoee). Oe?aiinueeee iaoeiaee aiainii/iee oeaio?. Eeia, 1999. Anoaiiaeaii oaeoi?e, ui aeicaieythoue nei?ioeoe /an eoeueoeaoaaiiy aiiiioeeoia aei 7-9 aeia. ?ic?iaeaii iioeiaeueii oiiae, caaaeyee yeei c(yaeeany iiaeeeainoue io?eioaaoe aenieiyeinii o?iiiniiii i?aia?aoe c 25-30 iaoaoacaie ia neei; cai?iiiiiaaia iiaeeoieiaaia iaoiaeeea aoea aeicaiey? i?iaiaeeoe oeeoiaaiaoe/iee aiaeic ieiaea a eeioeiao A? iacaeaaeii aiae oa?iiiia aaaioiinoi, ia yeeo aiia anii?iaaia. Iaa?oioiaaii aeiaaiinoe/io cia/ouinoue ia?aaaaeiiai aeei?enoaiiy o?ainaaaeiiiiaeueiiai aiiiioeaioaco aeey i?aiaoaeueii? aeiaaiinoeee o?iiiniiii?i iaoieiaii. Aecia/aii iaeaieueo iioi?iaoeaii e?eoa?i? oi?ioaaiiy a?oi aenieiai aaiaoe/iiai ?eceeo aeey i?iaaaeaiiy iiaaceaiii IAe. C oaie aeena?oaoei? iioaeieiaaii 11 iaoeiaeo ?iaio. Eeth/iai neiaa: iiaaceaii aeineiaeaeaiiy, o?ainaaaeiiiiaeueiee aiiiioeaioac, eoeueoo?a eeioei, aeeaeeueia noiio, aeeoa?aioeieiaaiee iiaeoiae, a?oia aenieiai aaiaoe/iiai ?eceeo. Oeaaiay E.A. Iiauoaiea yooaeoeaiinoe i?aiaoaeueiie aeeaaiinoeee o?iiiniiiie iaoieiaee. ?oeiienue aeenna?oaoeee ia nieneaiea iao/iie noaiaie eaiaeeaeaoa aeieiae/aneeo iaoe ii niaoeeaeueiinoe 03.00.15 - aaiaoeea (aeieiae/aneea iaoee). Oe?aeineee iao/iue aeaeaie/aneee oeaio?. Eeaa, 1999. Yooaeoeaiinoue i?aiaoaeueiie aeeaaiinoeee (IAe) o?iiiniiiie iaoieiaee caaeneo, aeaaiui ia?acii, io ?aoaiey aeaoo aii?inia: ?ac?aaioee /aoeeo e?eoa?eaa oi?ie?iaaiey a?oii aunieiai aaiaoe/aneiai ?enea, /oi iicaieeo iiauneoue noaiaiue auyaeaiey iaoieiaee i?e nieaeaiee iauaia eiaaceaiuo enneaaeiaaiee; auai?a iaeaieaa eioi?iaoeaiiai e aaciianiiai iaoiaea ea?eioeie?iaaiey ieiaea, eniieueciaaiea eioi?iai auei au aeinooiii aeey oe?ieiai i?aeoe/aneiai i?eiaiaiey; A nayce n yoei, oeaeueth ianoiyuaai enneaaeiaaiey auei oniaa?oainoaiaaiea iaoiaeieiae/aneeo e iaoiaee/aneeo iiaeoiaeia e aei?iaeiaie aeeaaiinoeea o?iiiniiiie iaoieiaee. Iniiaie aeey i?iaaaeaiey oeeoiaaiaoe/aneeo enneaaeiaaiee yaeeanue iiaeeoeeaoeey o?aaeeoeeiiiiai niiniaa iieo/aiey o?iiiniiiuo i?aia?aoia ec eoeueoo?u aiieioe/aneie aeeaeeinoe (AAE), /oi auei i?iaeeeoiaaii ianiaa?oainoaii nouanoaothueo iaoiaeee. Oniaa?oainoaiaaiay iaoiaeeea auea io?aaioaia ia 150 eoeueoo?ao AAE, anie?e?iaaiiie a ?acee/iua n?iee aa?aiaiiinoe. Auee onoaiiaeaiu oaeoi?u, aeeythuea ia aeeeoaeueiinoue eoeueoeae?iaaiey aiieioeeoia, ea/anoai o?iiiniiiuo i?aia?aoia, noieiinoue enneaaeiaaiey; yenia?eiaioaeueii iiaeia?ai ninoaa ieoaoaeueiuo n?aae; ii?aaeaeaiu iioeiaeueiua oneiaey noeioeyoeee ?inoa eoeueoo?u eeaoie AAE. I?aaeeiaeaiiay iaoiaeeea iicaieyao i?e ieieiaeueiuo cao?aoao a oa/aiea 7-9 aeiae, a ioee/ea io eeanne/aneie, o?aaothuae 15-18 aeiae, iieo/eoue o?iiiniiiua i?aia?aou aunieiai ea/anoaa n 25-30 iaoaoacaie ia noaeea (ii noaiaea?oiie iaoiaeeea - 10-15 iaoaoac). I?eiaiyy iiaeeoeoee?iaaiioth iaoiaeeeo, aiieioeaioac eniieueciaaeny a ea/anoaa iniiaiiai iaoiaea eiaaceaiie IAe. I?iaaaeaii 1603 aeeaaiinoe/aneeo aiieioeaioaca. Oe?ieee niaeo? o?iiiniiiuo ia?ooaiee iaia?oaeai a 123 neo/ayo, noaiaiue auyaeaiey eioi?uo aa?uee?iaaea io 1,85% aei 13,6% a ?acee/iuo a?oiiao ?enea e caaenaea io i?eioeeiia eo oi?ie?iaaiey. N?aaieoaeueiue aiaeec yooaeoeaiinoe oeeoiaaiaoe/aneie IAe iieacae, /oi eniieueciaaiea oieueei o?aaeeoeeiiiuo iieacaiee e i?iaaaeaieth enneaaeiaaiee ia iiaeao nouanoaaiii iiaeeyoue ia iiioeyoeeiiioth /anoioo o?iiiniiiie iaoieiaee. I?aaeeiaeaia noaia aeeooa?aioee?iaaiiiai iiaeoiaea e iacia/aieth eiaaceaiie IAe, iniiaaiiiai ia iiiaioaeoi?iii aiaeeca e ?an/aoa eiaeeaeaeoaeueiiai ?enea. Khlevnaya L.A. The increase of the efficiency of chromosomal pathology’ prenatal diagnosis. The manuscript of dissertation for a Candidate’s degree in Biology, speciality 03.00.15- genetics (biological science). Ukrainian Scientific Hygienic Centre. Kyiv. 1999. The facts reducing the terms of amniocyte’s cultivation had been esteblished. The optimal conditions for the obtaining of high-quality chromosomal preparations with 25-30 metaphases on the glass had been elaborated. The proposed modified method permits to provide fetus’s cytogenetic analysis on the basis of amniotic fluid culture irrespective of the term of it’s aspiration. The diagnostic significance of the preferable use of transabdominal amniocentesis for the prenatal diagnosis of chromosomal patologies had been founded. The most informative criterions of the formation of high genetic risk groups for invasive prenatal diagnosis had been determined. 11 scientific papers within the context of dissertation had been publised. Key words: invasive investigations, transabdominal amniocentesis, culture of cells, feeding mixture, differentiative approach, group of high genetic risk.

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