Institute of Perinatology and Pediatrics

 
Irina Zazerskaya
Deputy Director of the Institute of Perinatology and Pediatrics, Head of Reproduction and Woman Health Laboratory, Physician of Superior Merit, MD, PhD

Along with specialized medical care to the adult population Federal Almazov North-West Medical Research Centre helps young children with congenital cardiovascular disorders. In recent years the number of reproductive age women with cardiovascular and endocrine disorders significantly increased, indications for pregnancy preservation were extended, including those who were previously operated on heart defects.

New technologies for endocrine and hematological diseases treatment appeared, and all this determined the need for the Institute of Perinatology and Pediatrics as a structure part of the Federal North-West Medical Research Centre.

The Institute's main objectives are:

  • New approaches development for the women with somatic pathology from the planning stage of pregnancy until delivery. At the same time we provide standardized methods for women with cardiovascular, hematologic and endocrine abnormalities throughout three gestation trimesters, selection the delivery method, postpartum period management together with the relevant experts.
  • Improvement and implementation of the methods for newborns with low and extremely low body weight, the first minutes of life treatment of children with congenital and hereditary diseases, including the use of surgical correction of malformations.

Structure of the Institute:

The main research themes and projects are:
  • Comprehensive assessment of metabolic syndrome predictors in children depending on age, family history of metabolic syndrome and cardiovascular complications. We study the lipid and carbohydrate metabolism, genetic markers typical for metabolic syndrome.
  • Myocardial defect in newborns. We study the newborns ECG features on the 3-4th day of life in order to identify hypoxic changes in myocardium.
  • Erythroid lineage in children of the first year of life with the iron deficiency anemia factors.
  • Molecular-genetic mechanisms of cardiomyopathy development in children and adults: sarcomeric and cytoskeletal proteins role.
  • Molecular-cellular mechanisms of heart failure associated with diabetes and obesity (in the framework of SICA Project).
  • Body composition study to assess newborn fat and lean components growth to evaluate the energy consumption of the newborn. We study the component composition of newborns body according to birth weight, perinatal pathology, special aspects of children physical development and biological maturation at different stages of ontogenesis.
  • Health assessment of the children after pelvic presentation. We study the features of physical health and physical and psychomotor development depending on the delivery way.
  • Remote catamnesis and life quality of children and adolescents after a serious illness and extreme states in the perinatal period, as well as children born as a result of assisted reproduction technologies.
  • Immuno-hematology relationships in the mother-placenta-fetus system and their role in the development of mother and child diseases.
  • Calcium and phosphorus metabolism during pregnancy and lactation. We study calcium-phosphorus metabolism in physiological and complicated pregnancy and identify the risk factors for postpartum osteopenia and osteoporosis.
  • The role of vitamin D deficiency in the development of pregnancy pathology: miscarriage, pre-eclampsia and combined pre-eclampsia. We study the role of vitamin D deficiency in the immune status regulation in women with recurrent pregnancy loss, correlations with gene polymorphism of vitamin D.
  • Ovarian reserve in women with hypo- and hypergonadotrophic failure. We conduct the research to investigate the predictors of ovarian function depletion and identify the markers for early diagnosis.
  • Ovarian reserve preservation in women with hematological malignancies. We study the technique of ovarian cortex fence when performing laparoscopy in women before the chemotherapy.
  • Complex training methods for women with infertility to perform assisted reproductive technologies. We mastered the embolization technique of uterine vessels during angiography for treating uterine leiomyoma.
  • Endotoxemia syndrome in the biological system “mother-fetus” in pre-eclampsia.
  • Study the mechanisms of endogenous intoxication and positioning methods of extracorporal detoxification in complex treatment of pre-eclampsia and hepatosis.
  • Blood saving technologies in the “mother-fetus” system
  • Stem cells obtaining method for scientific and practical purposes.
  • Clinical management of pregnancy and childbirth in women with obstetric complications (uterus scar, breech presentation).

The main scientific themes and projects results:
  • We developed functional morphological criteria for determining the level of the child biological maturity; the method for assessing the child biological maturity in his anthropometric indicators. We submitted the new technology of assessing the child biological maturity on his anthropometric indicators.
  • The estimation algorithms of ECG signal repolarization in a newborn.
  • We developed the methods of diagnosis and treatment of children with severe perinatal pathology. New classification of broncho pulmonary dysplasia and neonatal sepsis.
  • The features of calcium and phosphorus and bone metabolism during normal pregnancy. We identified risk factors for osteopenia and osteoporosis in the postpartum period; established dose-dependent effect of exogenously supplied calcium and vitamin D on bone health; identified biochemical markers in early pregnancy — predictors of osteopenia in the postpartum period.
  • We studied the role of weight loss and the use of metformin in restoring menstrual function in women with polycystic ovary syndrome and overweight; received the new medical technology approval: “Method of predicting the effectiveness of treatment improving insulin sensitivity in patients with polycystic ovary syndrome.”
  • We studied the feasibility and relative safety of hormone replacement therapy in women with hypoestrogenemy to treat osteoporosis; developed the methods of diagnosis, prognosis and therapy (hormone or combined) in patients with osteoporosis in a natural and surgical menopause:

o We use molecular genetic, biochemical and radiological examination methods. We developed an algorithm for patients with postmenopausal osteoporosis

o We identified gene mutations that determine the rate of bone loss in postmenopausal women.

  • An algorithm for management of pregnant women with breech presentation. An improved method for prophylactic external rotation.
  • We completed the formation of biomechanics labor pains concept.
  • We began the work on the cervix states study during pregnancy and childbirth in order to develop new diagnostic algorithm for estimating the degree of cervix maturity in normal and pathological pregnancy as well as various methods and ways of preparing pregnant women for childbirth.
  • We mastered the technique of studying cervix and uterus hemodynamics during pregnancy and childbirth in order to obtain information on the lower uterine segment role in the birth process and problems revealing the role of various uterus cavities (uterine cavity, the lower segment) in the physiology and pathophysiology of labor.