Saratov JOURNAL of Medical and Scientific Research

premature infants

Organization and work of the department of catamnesis of Clinical Perinatal Center of the Saratov region

Year: 2018, volume 14 Issue: №2 Pages: 226-223
Heading: Pediatrics Article type: Original article
Authors: Chernenkov Yu.V., Nechaev V.N.
Organization: Saratov State Medical University
Summary:

Objective: to examine the catamnesis of infants born with very low and extremely low birth weight, as well as undergoing critical conditions in the early neonatal period. To assess the health status of children observed, recommendations for further rehabilitation and prognosis. Material and Methods. At the department of catamnesis 4373 children were observed (total 21343 admissions), 62% of them were preterm infants. Children with extremely low body weight and very low body weight (157 patients, 20.3%) were evaluated for physical development, somatic and psychoneuro-logical status. Results. Analyzing the structure of morbidity observed in children hematologic violations are revealed in the form of anemia of prematurity moderate and severe degree in 15 patients (11.4%), slowing growth and development 25 (19.4%), respiratory disorders (19 children, 14.5%). In the assessment of physical development, growth disharmony revealed in 20.9%, weight disharmony in 29.4% of patients. Neuro-psychological development corresponded to the postconceptual age at 49.2% of children. Breastfeeding saved in 44.6%, mixed and in vitro were transferred in 55.4%. In a group of children follow-up observations identified numerous pathological conditions and high morbidity, requiring subsequent mandatory correction. Many of the children belong to the Group of infectious diseases patients (28.4%), with lots of somatic pathology (78.1%). A direct impact of the dynamics of body weight during the first months after birth was revealed in figures physical development of a child and the incidence in the future. The most vulnerable preterm infants from multiple pregnancies, small for gestational body weight deficiency which recovers slowly and have them marked lower psychomotor development. Conclusion. Improving rehabilitation technology, previously early steps, the integrated use of various methods and means, phases taking into accountthe stage of the disease process and individual approach to a child significantly improve the efficiency and effectiveness of rehabilitation therapy.

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Analysis of status of preterm infants with bronchopulmonary dysplasia

Year: 2017, volume 13 Issue: №2 Pages: 251-255
Heading: Pediatrics Article type: Original article
Authors: Chernenkov Yu.V., Nechaev V.N., Nesterova D.l.
Organization: Saratov State Medical University
Summary:

Objective: the combination frequency of BPD in premature infants, assessment of the degree of functional lesion of the respiratory tract and the efficiency of respiratory support. Material and Methods. The survey included 36 women and 38 preterm infants (two twins). Results. In 99% of the surveyed women pregnancy was complicated by chronic intrauterine fetal hypoxia, 2.1% — RH-conflict. At 43.2% of cases acute respiratory viral infection during pregnancy was revealed, 15.3% of bad obstetric history, 5% of women who had bad habits (smoking, alcohol intake). In 2015 there were 5 deaths (13.2%). 14 children (36.8%) were transferred to other hospitals for further treatment, the remaining 19 (50%) were discharged from the hospital. One child — full-term, the other— premature. At 87.7% of children with BPD, the diagnosis was RDS, in 4.2% — aspiration of meconium, 8.1% — congenital pneumonia. 15 children (30.5%) received therapy with surfactant once, including 9 newborns (23.7%) received medication twice. All newborns were carried out intensive care, including respiratory support. Mechanical ventilation in 14 children had been conducting for 8.4±2.3 day, in 13 cases for 17.3±3.8 day, in 11 cases for 23.4±4.1 day. Nasal CPAP was conducted in 23 newborns: from 4 to 6.8±1.9 day, 13 — less of 16.8±2.9 per day, 6 children have had more than 23.2±3.8 day. Conclusion. There is necessity for prevention during pregnancy with glucocorticoids, the prolongation of pregnancy; preterm neonates — surfactant therapy; adequate provision of resuscitation care in the delivery room and respiratory support. The reduction of time of mechanical ventilation and the expansion of the indications for non-invasive methods of respiratory therapy reduced the incidence of BPD, the severity of the disease and improve the prognosis.

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Premature infants' health at multiple induced pregnancy.

Year: 2015, volume 11 Issue: №3 Pages: 305-309
Heading: Pediatrics Article type: Original article
Authors: Chernenkov Yu.V., Nechaev V.N., Stasova Yu.V., Tereshenko V.A.
Organization: Saratov State Medical University
Summary:

Objective: to define the risk factors adversely influencing prenatal development at premature birth at use of methods of assisted reproductive technology (ART); to estimate premature' infants health from multiple induced pregnancy according to Perinatal Center of Saratov for last 3 years. Material and Methods. Under supervision there were 139 pregnant women with application ART. 202 children (51 twins were born and 5 triplet babies), from them 83 premature infants born from multiple induced pregnancy have been analyzed. Results. The newborns examined by method ART, were distributed as follows: 22-28 weeks — 19 children; 29-32 weeks — 23; 33-36 weeks — 41. Asphyxia at birth was marked at all premature infants. Respiratory insufficiency at birth is revealed in 87,3% of cases. The most frequent pathologies in premature infants are revealed: neurologic infringements and bronchopulmonary pathology occured at all children, developmental anomaly — 33, 8%, retinopathies in premature infants — 26,5%. The mortality causes include: extreme immaturity, cerebral leukomalacia, IVN 3 degrees. Conclusion. The risk factors, premature birth at application of methods ART are revealed: aged primiparas, pharmacological influence, absence of physiological conditions of prenatal development; multifetation. The high percent of birth of children with ELBW and ULBW is revealed. RDCN with further BPD development, retinopathies in premature infants and CNS defeat is more often occured.

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Results of longterm follow-up of children with low birth weight

Year: 2014, volume 10 Issue: №4 Pages: 691-693
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Panina O.S., Chemenkov Yu.V., Lavrova D.B., Belyaeva N.A.
Organization: Saratov State Medical University
Summary:

The purpose of our research is a long-term follow up study of children with low birth weight. Materials and methods. 115 premature children from 0 to 7 years old took part in the research process. The children gestational age was 30-35 weeks and their birth weight was less than 2500 g. All children had thorough clinical and laboratory, instrumental and psychological examination up to the age of seven. Their parents took part in questionnaire survey. Results. Development of all aspects of mentality is retarded and such retardation can be observed in the first months of life as slow learning of new things and peculiarities of psychological interrelations with the world around in the form of negative response to the influence of sensory stimuli, behavioral disorders and difficulties in social adaptation. Conclusion. Children with low birth weight are included into the high-risk group of disabling abnormalities and persistent non-disabling disorders. These children need early comprehensive rehabilitation and, at the same time, extremely careful prognosis of their further development.

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Estimation of health indicators of children born by means of application of reproductive technologies

Year: 2014, volume 10 Issue: №4 Pages: 683-688
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Chernenkov Yu.V., Nechaev V.N., Stasova Yu.V.
Organization: Saratov State Medical University
Summary:

Objective: To examine health of children born by means of ART according to Perinatal Center of Saratov region for the last 2 years. Material and Methods: 70 pregnant women and 96 newborns with the use of ART were under examination. The causes of premature birth by women with ART, high degree of disease incidence among newborns and mortinatality are considered (рассматриваются) in the article. Results: The important factors of amnionic membranes breaking are distinguished: maternal age, multifetation, genital and extragenital pathology, antenatal infections and fetation anomaly. Highly premature babies cause not only high neonatal disease rate and disability, but also are key element in procreational loses. Women with congelated embryo transfer less often experience premature birth, also disease rate and neurologic abnormalities are less frequent. Two and more embryo transfer more often leads to habitual miscarriage. Conclusion: Mothers-to-children health indicators after using ART demonstrate the necessity of prenatal diagnostics improvement and taking measures in monitoring such women and newborns. High quality preimplantation preparation plays a major role in fetus pathology reduction. Prescriptions and counter indications to this procedure should be thoroughly evaluated; no more than 1-2 ova should be transferred.

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