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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">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2021-3-54-65</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-6074</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>ПРЕГРАВИДАРНАЯ ПОДГОТОВКА И БЕРЕМЕННОСТЬ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PREGRAVID PREPARATION AND PREGNANCY</subject></subj-group></article-categories><title-group><article-title>Клинико-патогенетические варианты задержки роста плода различных сроков манифестации</article-title><trans-title-group xml:lang="en"><trans-title>Clinical and pathogenetic variants of fetal growth restriction with different periods of manifestation</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7277-7431</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Липатов</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Lipatov</surname><given-names>I. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Липатов Игорь Станиславович - доктор медицинских наук, профессор, профессор кафедры акушерства и гинекологии №1.</p><p>443099, Самара, Чапаевская ул., д. 89</p></bio><bio xml:lang="en"><p>Igor S. Lipatov - Dr. Sci. (Med.), Professor, Department of Obstetrics and Gynecology №1.</p><p>89, Chapaevskaya St., Samara, 443099</p></bio><email xlink:type="simple">i.lipatoff2012@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8946-501X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тезиков</surname><given-names>Ю. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tezikov</surname><given-names>Yu. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тезиков Юрий Владимирович - доктор медицинских наук, профессор, заведующий кафедрой акушерства и гинекологии №1.</p><p>443099, Самара, Чапаевская ул., д. 89</p></bio><bio xml:lang="en"><p>Yuri V. Tezikov - Dr. Sci. (Med.), Professor, Head of Department of Obstetrics and Gynecology №1.</p><p>89, Chapaevskaya St., Samara, 443099</p></bio><email xlink:type="simple">yra.75@inbox.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7487-3280</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Амосов</surname><given-names>М. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Amosov</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Амосов Михаил Сергеевич – ординатор кафедры акушерства и гинекологии №1.</p><p>443099, Самара, Чапаевская ул., д. 89</p></bio><bio xml:lang="en"><p>Mikhail S. Amosov - Resident of the Department of Obstetrics and Gynecology №1.</p><p>89, Chapaevskaya St., Samara, 443099</p></bio><email xlink:type="simple">jyckee@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0140-5566</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зуморина</surname><given-names>Э. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Zumorina</surname><given-names>E. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зуморина Эллина Маратовна - врач акушер-гинеколог перинатального центра,</p><p>443095, Самара, ул. Ташкентская, д. 159</p></bio><bio xml:lang="en"><p>Ellina M. Zumorina – doctor obstetrician-gynecologist of the Perinatal Center.</p><p>159, Tashkentskaya St., Samara, 443095</p></bio><email xlink:type="simple">ellina.zumorina@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Самарский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Samara State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Самарская областная клиническая больница им. В.Д. Середавина</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Samara Regional Clinical Hospital named after V.D. Seredavin</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>14</day><month>04</month><year>2021</year></pub-date><volume>0</volume><issue>3</issue><fpage>54</fpage><lpage>65</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Липатов И.С., Тезиков Ю.В., Амосов М.С., Зуморина Э.М., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Липатов И.С., Тезиков Ю.В., Амосов М.С., Зуморина Э.М.</copyright-holder><copyright-holder xml:lang="en">Lipatov I.S., Tezikov Y.V., Amosov M.S., Zumorina E.M.</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://www.med-sovet.pro/jour/article/view/6074">https://www.med-sovet.pro/jour/article/view/6074</self-uri><abstract><p>В статье представлены данные о клинико-патогенетических вариантах задержки роста плода (ЗРП). ЗРП относится к типичным клиническим проявлениям больших акушерских синдромов, ассоциирована с высокой перинатальной заболеваемостью и оказывает значимое влияние на качество и продолжительность жизни человека. Сделан акцент на различиях патогенеза, особенностях прогнозирования, диагностики, акушерской тактики и оценке перинатальных исходов при раннем и позднем фенотипе ЗРП. В обзор включены материалы отечественной и зарубежной научной литературы, найденной в eLibrary и PubMed по данной теме, опубликованной за последние 10 лет. Обсуждается роль становления эмбрио(фето)плацентарной системы под влиянием действующих периконцепционных факторов риска в реализации различных фенотипов ЗРП. Анализ литературы показывает, что генетически, эпигенетически детерминированный потенциал роста плода в ходе беременности меняется в зависимости от материнских, плацентарных и плодовых факторов, которые в итоге и определяют конечные массаростовые показатели новорожденного. В дискуссионном плане рассмотрены вопросы информативности клинических и лабораторно-инструментальных предикторов, диагностических критериев, выбора рациональной акушерской тактики при ЗРП различных сроков манифестации. Представлены убедительные данные по перинатальным и отдаленным последствиям внутриутробной задержки роста. Патогенетический вариант ЗРП определяет особенности функционирования иммунной системы, оказывает существенное влияние на программирование метаболических и эндокринных процессов, формирование структур головного мозга плода. Выделение беременных группы риска по развитию ЗРП различных сроков манифестации, своевременная диагностика, выбор срока и метода родоразрешения должны соответствовать основным направлениям «4П-модели» современной медицины и представлять собой целостную предиктивную, превентивную и персонифицированную систему обследования и наблюдения, основанную на данных доказательной медицины и требованиях практического акушерства и перинатологии.</p></abstract><trans-abstract xml:lang="en"><p>The article presents data on the clinical and pathogenetic variants of fetal growth restriction (FGR). FGR is one of the typical clinical manifestations of large obstetric syndromes, is associated with a high perinatal morbidity and has a significant impact on the quality and duration of human life. The emphasis is made on the differences in pathogenesis, the features of prediction, diagnosis, obstetric management and the assessment of perinatal outcomes in the early and late phenotype of the FGR. The review includes materials from domestic and foreign scientific literature that found in eLibrary and PubMed on this topic and published for the last 10 years. This article discusses the role of the formation of the embryo(feto)placental system under the influence of existing periconceptional risk factors in the implementation of various phenotypes of FGR. An analysis of the literature shows that the fetal growth potential, which genetically and epigenetically determined, changes during pregnancy</p><p>depending on maternal, placental and fetal factors, which ultimately determine the final weight-growth parameters of the newborn. The issues of informativeness of clinical, laboratory and instrumental predictors, diagnostic criteria, the choice of rational obstetric management in case of FGR of various periods of manifestation are discussed in this article. Convincing data on the perinatal and long-term consequences of intrauterine growth restriction are presented. The pathogenetic variant of FGR determines the features of the functioning of the immune system, has a significant impact on the programming of metabolic and endocrine processes, the formation of fetal brain structures. Identification of pregnant women at risk for the development of FGR of various periods of manifestation, timely diagnosis, selection of the timing and method of delivery should correspond to the main directions of the "4P-model" of modern medicine and represent an integral predictive, preventive and personalized system of examination and observation based on evidence-based medicine data and the requirements of practical obstetrics and perinatology.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>задержка роста плода</kwd><kwd>ранний и поздний фенотипы</kwd><kwd>прогнозирование</kwd><kwd>пренатальная диагностика</kwd><kwd>акушерская тактика</kwd><kwd>перинатальные исходы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>fetal growth restriction</kwd><kwd>early and late phenotypes</kwd><kwd>prediction</kwd><kwd>prenatal diagnosis</kwd><kwd>obstetric management</kwd><kwd>perinatal outcomes</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">Zhang S., Hu Z., Tanji H.,Jiang S., Das N., Li J. et al. 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