scholarly journals DIAGNOSTICS AND TREATMENT OF CONGENITAL MALFORMATIONS OF THE LUNG AND MEDIASTINUM IN NEWBORN CHILDREN AND INFANTS

2015 ◽  
Vol 174 (1) ◽  
pp. 40-42 ◽  
Author(s):  
S. A. Karavaeva ◽  
T. K. Nemilova ◽  
A. N. Kotin ◽  
T. V. Patrikeeva ◽  
S. V. Starevskaya ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Congenital Malformations ◽  
Distress Syndrome ◽  
Neonatal Period ◽  
Clinical Manifestations ◽  
Prenatal Period ◽  
Term Infants ◽  
Main Method ◽  
Fetal Malformations ◽  
Newborn Children

The article presents the experience of treatment of newborn children and infants with congenital malformations of the lung and mediastinum, which required a surgery. Children (138 cases) were treated during recent 18 years. There was a prevalence of full-term infants (73%). Fetal malformations were diagnosed in prenatal period in majority of cases. Computed tomography was the main method of diagnostics after delivery. Children (110 cases) were operated out of 138. Children with extrapulmonary sequestration didn’t undergo surgery in case of absence of clinical manifestations. The authors made a conclusion that malformations of the lung and mediastinum should be included in number of differentiated diseases in case of respiratory distress syndrome in newborn children. The indications to early surgery should be the danger of contamination and malignant transformation, presence of intrathoracic tension syndrome in neonatal period.

PERINATAL ASPECTS OF INTRAUTERINE INFECTIONS

2021 ◽  
Vol 74 (10) ◽  
pp. 2668-2673
Author(s):  
Oksana O. Korchynska ◽  
Stefania Andrashchikova ◽  
Sylvia Zhultakova ◽  
Alena Shlosserova
Keyword(s):  
Medical Care ◽  
General Condition ◽  
Clinical Picture ◽  
Congenital Malformations ◽  
Neonatal Period ◽  
Clinical Manifestations ◽  
Perinatal Period ◽  
Perinatal Infection ◽  
Duration Of Infection ◽  
Intrauterine Infections

The aim: To analyze Ukrainian and foreign literature data on the consequences of perinatal infection and the peculiarities of their manifestation. Materials and methods: Literature sources on the peculiarities of the course of infection that occur in the perinatal period and are a threat of congenital malformations or diseases in the newborn are collected. Conclusions: The analyzed data of the clinical picture and management of the early neonatal period fully reflect the coherence and timeliness of medical care for infants born with signs of perinatal infection. It should be noted that the tactics of such a newborn depend on the clinical manifestations, the general condition of the baby, and the duration of infection of the mother with a particular infection.

Surfactant Therapy in Full-term Neonates With Severe Respiratory Failure

PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 135-139
Author(s):  
Hatem Khammash ◽  
Max Perlman ◽  
Julian Wojtulewicz ◽  
Michael Dunn
Keyword(s):  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Oxygenation Index ◽  
Meconium Aspiration Syndrome ◽  
Full Term ◽  
Surfactant Therapy ◽  
Term Infants ◽  
Meconium Aspiration

Objective. In light of the paucity of published data on the use of surfactant in full-term infants with respiratory failure due to meconium aspiration syndrome and respiratory distress syndrome, we report our experience with this therapy. Our goal was to explore possible justification for randomized controlled trials of surfactant treatment in similar patients at an earlier, less severe stage of the disease. Methods. Retrospective consecutive case series of 20 infants with severe meconium aspiration syndrome and 29 infants with severe respiratory distress syndrome who received bovine surfactant between March 1990 and December 1992 in three neonatal intensive care units in a regionalized setting. Outcome of treatment was assessed by comparing changes in several respiratory indices including the oxygenation index, between 4 and 6 hours and 1 and 3 hours before and after the first dose of surfactant. Differences were analyzed using analysis of variance for repeated measures, with treatment and time as co-variates. Results. In the meconium aspiration group the mean oxygenation index decreased from 36 ± 12 at 1 to 3 hours presurfactant to 24 ± 14 at 1 to 3 hours postsurfactant (P < .001). In the patients with respiratory distress syndrome the mean oxygenation index fell from 30 ± 17 at 1 to 3 hours presurfactant to 12 ± 6 at 1 to 3 hours postsurfactant (P = .0001). Three of 20 patients with meconium aspiration syndrome and 3 of 29 patients with respiratory distress syndrome received extracorporeal membrane oxygenation. Conclusions. Surfactant therapy in full-term infants with respiratory failure due to the meconium aspiration and respiratory distress syndromes is often effective in improving gas exchange. A randomized controlled trial of surfactant therapy at an earlier stage in the course of the illness should be performed.

Abstract 18291: Computed Tomography Angiography Can Replace Cardiac Catheterization in the Surgical Planning of Select Neonates with Major Aortopulmonary Collaterals

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Holly Bauser-Heaton ◽  
Lynn Peng ◽  
Stanton B Perry ◽  
Jeffrey A Feinstein ◽  
Frank L Hanley ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Angiography ◽  
Cardiac Catheterization ◽  
Surgical Planning ◽  
Surgical Intervention ◽  
Neonatal Period ◽  
Aortopulmonary Collaterals ◽  
Initial Hospitalization ◽  
The Cost ◽  
Major Aortopulmonary Collaterals

Introduction: Neonates with Tetralogy of Fallot (TOF) and major aortopulmonary collaterals (MAPCAs) routinely undergo cardiac catheterization in the neonatal period. We have recently incorporated CT angiography into the neonatal evaluation with the hope of eliminating catheterization in those not needing neonatal intervention. We reviewed our experience with CT angiography and its accuracy in determining the need for neonatal intervention. Methods: Retrospective review of all patients from April 2005-October 2013 with MAPCAs who had both CTA and cardiac catheterization during the first 120 days of life and within 14 days of one another. The radiologist and interventionalist responsible for reading the studies were blinded to the results of the procedures and each other’s readings. The need for neonatal intervention as predicted by CTA was compared to the ultimate, cath-based decision. Results: 19 patients (mean age 3.73 days, range 1-9 days of age) were included in the study. In all patients CT was able to predict the need for surgical intervention correctly. CTA was found to be 87% sensitive, 93% specific and 91% sensitive with respect to number of MAPCAs, origin and distribution. Conclusion: CT angiography can accurately predict the need for neonatal intervention. In those not requiring neonatal intervention, neonatal cardiac catheterization is not required. CTA may also aid in guiding the subsequent, pre-operative catheterization but cannot replace it. This algorithm eliminates neonatal catheterization in the majority of TOF/MAPCAs patients, and with it the associated risks, and radiation, as well as substantially reducing the cost of the initial hospitalization.

Oligohydramnion in the First Half of Pregnancy in the Fetuses with Congenital Abnormalities: Ultrasound Diagnostics and Obstetric Outcomes

2021 ◽  
Vol 76 (4) ◽  
pp. 341-350
Author(s):  
Sergey M. Voevodin ◽  
Tatiana V. Shemanaeva ◽  
Alyona V. Serova
Keyword(s):  
Amniotic Fluid ◽  
Congenital Malformations ◽  
Fetal Death ◽  
Congenital Abnormalities ◽  
Neonatal Period ◽  
Perinatal Outcomes ◽  
Main Group ◽  
Obstetric Outcomes ◽  
Fetal Abnormalities ◽  
4D Ultrasound

Background.Oligohydramnion in the first half of pregnancy, combined with congenital abnormalities in the fetus has objective difficulties in diagnosis. The morphology features and type of defects associated with oligohydramnion, which manifests in the first half of pregnancy, are not sufficiently studied at the present stage. Aims to evaluate the clinical significance of diagnosing oligohydramnion in the first half of pregnancy in women with congenital fetal malformations. Materials and methods.The analysis of the course of pregnancy and perinatal outcomes in 77 women with low water content in combination with congenital malformations of the fetus and 72 patients with a normal amount of amniotic fluid and no congenital malformations of the fetus was performed. The patients of the main group were divided into two subgroups depending on the severity of oligohydramnion: the 1st subgroup (n = 54) patients with severe oligohydramnion and the 2nd subgroup (n = 23) patients with moderate oligohydramnion. The amount of amniotic fluid was determined by 3D/4D ultrasound (1321 weeks of gestation) and the structure of fetal abnormalities associated with oligohydramnion was analyzed. We evaluated perinatal outcomes in women with congenital malformations of the fetus in combination with oligohydramnion and the effect of its severity on the outcome of pregnancy. Results.In the main group (n = 77), fetal abnormalities were detected in patients: urinary system 39 (50.6%), respiratory system 4 (5.2%), heart 1 (1.3%), chromosomal and genetic abnormalities 14 (18.2%), central nervous system 3 (3.9%), osseous system 3 (3.9%), multiple 13 (16.9%). In the main group (n = 77), pregnancy was terminated for medical indications in 47 (61%) cases, in 6 (7.8%) spontaneous miscarriage occurred, in 5 (6.5%) antenatal fetal death. 19 (24.7%) children were born alive, and surgical treatment in the neonatal period was required in 8 (10.4%) cases. In the 1st subgroup (n = 54) in 53 (98.1%) cases, there was a loss of the fetus, in 1 (1.9%) the newborn died on the 9th day. In the 2nd subgroup (n = 23), fetal death occurred in 5 (21.7%) cases, 18 (78.3%) children were born alive, and 8 (44.4%) newborns were operated on in the neonatal period. In the control group, all pregnancies ended with the birth of healthy children. A decrease in ultrasound imaging of internal organs in the fetus was observed when a pregnant woman was obese (BMI more than 35). Conclusions.Oligohydramnion in the first half of pregnancy in combination with fetal malformation should be considered an extremely unfavorable clinical sign for the prognosis of pregnancy and the health of the fetus and newborn. 3D/4D ultrasound scanning allows you to reliably determine oligohydramnion in the first half of pregnancy, and the degree of its severity to assume the nature of complications.

ANALYSIS OF FETAL AND NEONATAL DEATHS IN 4117 CONSECUTIVE BIRTHS

PEDIATRICS ◽  
1950 ◽  
Vol 5 (2) ◽  
pp. 184-192
Author(s):  
HERBERT C. MILLER
Keyword(s):  
Cause Of Death ◽  
Premature Infants ◽  
Neonatal Death ◽  
Causes Of Death ◽  
Neonatal Period ◽  
Full Term ◽  
Maternal Complications ◽  
Term Infants ◽  
Neonatal Deaths ◽  
Postmortem Examinations

An analysis of the significant causes of death in 4117 consecutive births was made; there were 66 fetal deaths and 85 neonatal deaths. A significant cause of death was determined in 51 fetuses and 56 live-born infants. Eighty-five per cent of the live-born infants who weighed over 1000 gm. at birth and had postmortem examinations had causes of death which were considered to be significant. Almost half of the live-born premature infants with birth weights between 1000 and 2500 gm. were considered to have had more than one significant cause of death. The so-called significant causes of death among live-born infants differed from those determined for fetuses dying before birth. Among the former, pathologic conditions in the infants were determined four times more frequently than in those dying before birth and, in the latter, maternal complications of pregnancy and labor were diagnosed as significant causes of death five times more frequently than in infants dying in the neonatal period. Hyaline-like material in the lung was considered to be the most frequent significant cause of death in live-born premature infants; congenital malformation and anoxia resulting from complications of labor were the most frequently determined significant causes of death in live-born full term infants. No differences were found in the significant causes of death in premature and full term fetuses. Anoxia resulting from accidental and unexpected interruption of the blood flow in the placenta and umbilical cord and from dystocia was the most frequently determined significant cause of death in both groups. A plea has been made for the adoption by obstetricians, pathologists and pediatricians of a formal uniform plan of classifying the causes of fetal and neonatal death which would divest current efforts to determine the cause of death of as much vague terminology and arbitrary opinion as possible.

PECULIARITY OF ADAPTATION OF BABIES ARE BORN PREMATURELY FROM MOTHERS WITH UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA

2021 ◽  
Vol 74 (10) ◽  
pp. 2566-2568
Author(s):  
Tunzala V. Ibadova ◽  
Vitalii V. Maliar ◽  
Volodymyr V. Maliar ◽  
Vasyl V. Maliar
Keyword(s):  
Connective Tissue ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Main Group ◽  
Phenotypic Markers ◽  
Group I ◽  
Neonatal Respiratory Distress ◽  
Connective Tissue Dysplasia

The aim: To evaluate the peculiarity of clinical manifestations of neonatal respiratory distress syndrome (NRDS) in deeply premature infants from mothers with phenotypic markers of undifferentiated connective tissue dysplasia (UCTD). Materials and methods: The study represent the results of a retrospective clinical and statistical analysis of 268 premature birth report card and newborn report sheet. .The main (1 group) included 50 pregnants with obvious phenotypic markers of UCTD, the comparison group (group 2) consisted of 50 pregnant women without phenotypic markers of UDCTD. Results: According to the study, in 12 (24%) pregnant women of the main group at the time of admission to the clinic had contractions,which required specific therapy. Cervical cerclage was performed in 38 (76%) patients of the main group due to the presence of cervical insufficiency (CI). In these cases, the severity of the CI on the Steinber scale was 7.2 ± 0.4 points in the main group against 4.4 ± 0.2 points in the comparison group (p <0.05). Group I patients were more likely to have complications of labor such as:premature rupture of membranes, uterine contraction abnormalities and fetal distress, which required in most cases cesarean delivery (7% and 2%), respectively (p <0.05). The incidence of neonatal complications requiring respiratory support was 67% in group I and 48% in group II. According to our observations, the clinical manifestations of bronchopulmonary dysplasia were twice as high in infants of the main group (66%) against (44%) of the comparison group (p <0.05). Conclusions:1.Neonatal respiratory distress syndrome in premature infants is more often associated from mothers with UDCTD. 2. The high importance of steroid prophylaxis of NRDS and antioxidant therapy in reducing the frequency of mechanical ventilation and the development of bronchopulmonary pathology, especially in infants from mothers with UDCTD syndrome, has been proven. 3. The possibility of diagnosing disorders of functional maturation of the lungs in the fetal period using a non-invasive method of ultrasonography has been confirmed.

CLINIC AND COMPLICATIONS OF COVID-19 CORONAVIRUS DISEASE WITH PATHOGENESIS ELEMENTS

2020 ◽  
pp. 72-79
Author(s):  
I. V. Аndrusovich
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Tract ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Second Phase ◽  
Upper Respiratory Tract

The longer the COVID−19 coronavirus pandemic lasts, the more information about its clinical manifestations is accumulated. The incubation period of COVID−19 ranges from 2 to 14 days, rarely up to 3 weeks, but in a significant number of cases an infection is not accompanied with the appearance of clinical symptoms. Currently, the following variants of the clinical course of COVID−19 can be identified as follows: viral load; subclinical; slight; uncomplicated with damage to only the upper respiratory tract; mild pneumonia, severe pneumonia, acute respiratory distress syndrome, etc. The clinical course of COVID−19 depends on the severity, the criteria of which are the intoxication manifestation, the degree of fever and the dominant syndrome. Mild / moderate forms are manifested by frequent increase in body temperature up to 38 ° C, respiratory symptoms, headache, myalgias, palpitations and general malaise. Patients stop distinguishing smells and feel the taste of food. Approximately from the 7th to the 9th days of the disease there are problems with breathing, which indicates the impairment of the lower respiratory tract and the beginning of the second phase of the disease, and its course is regarded as severe. Severe forms of the disease can also be manifested by impaired coordination of movements, slurred speech. In 1 to 4 % of patients there is developed the psychosis in the form of hallucinations. In the elderly, COVID−19 may be accompanied by delirium, lowering blood pressure. The risks of adverse disease are associated with somatic diseases: cardiovascular and nervous systems, respiratory tract, hormonal disorders, etc. Otitis, sinusitis, sepsis, bronchopulmonary infection, thrombosis, myocarditis etc. can be the complications of COVID−19. Computer tomography is an instrumental test that demonstrates the damage of lungs with coronavirus and allows to assess its severity. Key words: coronavirus infection, COVID−19, clinical variants, severity, pneumonia, acute respiratory distress syndrome.

Respiratory distress syndrome in neonates with extremely low body weight: non-invasive respiratory therapy in the early neonatal period

2020 ◽  
Vol 15 (6) ◽  
pp. 94-102
Author(s):  
O.V. Zavyalov ◽  
◽  
V.V. Marenkov ◽  
A.A. Dementyev ◽  
I.N. Pasechnik ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Body Weight ◽  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Neonatal Period ◽  
Respiratory Therapy ◽  
Non Invasive ◽  
Early Neonatal Period

The aim of this study was to evaluate the efficacy of non-invasive respiratory therapy using the method of dual positive airway pressure (DuoPAP) via nasal prongs performed in the intensive care unit and neonatal intensive care unit in premature newborns with extremely low body weight and respiratory distress syndrome in the early neonatal period. We conducted a retrospective analysis of 55 medical records of premature newborns treated in the intensive care unit of the Perinatal Center at S.S. Yudin City Clinical Hospital during the first 7 days of their life. We included patients treated between January 2018 and December 2019. All newborns had extremely low body weight (850 ± 149 g); mean gestational age was 28 ± 4 weeks; Apgar score at the first minute of life varied between 3 and 6; Silverman Anderson score (severity of respiratory disorders) was between 3 and 5 s. Standard examination was performed in accordance with current protocols developed by Russian and foreign specialists in neonatal medicine. A specially developed clinical protocol of the study was approved by the local ethics committee. Study participants were divided into 3 groups according to their type of spontaneous respiratory efforts, target level of preductal saturation, and Silverman Anderson score. Patients in Group I received synchronized intermittent mandatory ventilation (SIMV); patients in Group II received ventilation using DuoPAP via nasal prongs (if it was ineffective, we considered SIMV via tube); patients in group III received ventilation using DuoPAP only. In this study, we have identified indications and contraindications for initial and prolonged respiratory therapy with DuoPAP and developed main practical recommendations for effective and safe application of DuoPAP. The efficacy and safety of non-invasive respiratory therapy with DuoPAP via nasal prongs in extremely premature infants with respiratory distress syndrome in the early neonatal period is primarily determined by the newborn’s readiness for active spontaneous and productive respiratory movements, but not only by the compensated parameters of the acid-base state and gas composition of the capillary blood. The assessment of feasibility and limitations of non-invasive respiratory therapy with DuoPAP is an important step towards developing a clinical protocol for respiratory therapy in the early neonatal period in a neonatal intensive care unit; it will help to reduce the use of invasive lung ventilation. Key words: premature newborns, non-invasive respiratory therapy, respiratory distress syndrome, extremely low body weight

scholarly journals Recurrent posterior elbow dislocation caused by congenital abnormalities in a 7-year-old child

2021 ◽  
Vol 9 (2) ◽  
pp. 211-219
Author(s):  
Yaroslav N. Proshchenko ◽  
Yulia A. Sigareva
Keyword(s):  
Surgical Treatment ◽  
Elbow Joint ◽  
Clinical Case ◽  
Neonatal Period ◽  
Clinical Manifestations ◽  
Elbow Dislocation ◽  
Primary Diagnosis ◽  
First Episode ◽  
Minor Trauma ◽  
Congenital Origin

BACKGROUND: Congenital posterior elbow dislocation in children is a rare and scarcely reported condition. Owing to the difficulties of an early primary diagnosis and the lack of a standardized management, we present a clinical case of an analysis of surgical treatment according to literature and based on our experience. CLINICAL CASE: We present a case of congenital posterior elbow dislocation in a 7-year-old child. In the absence of a universal algorithm for surgical treatment, we performed an arthrotomy for visual assessment of articular surfaces, intervention on the capsule and tendons of m. brachialis, m. biceps brachii, m. brachioradialis, and modeling of the proximal epiphysis of the right radius. DISCUSSION: We analyzed surgical treatment options and made an overview of the main stabilizers of the elbow joint that prevent elbow dislocations. There are few publications on this condition; to our knowledge, over the past 10 years, only two clinical cases of a similar pathology in children had been published. Not a single case of congenital elbow dislocation in the neonatal period has been described. We analyzed early clinical manifestations and possible causes of delayed primary diagnosis. CONCLUSIONS: Recurrent posterior elbow dislocation of the congenital origin is associated with a functional deficiency of elbow joint stabilizers. In the neonatal period, these abnormalities are usually not detected. The first episode of dislocation may be triggered by a minor trauma without damaging the bone structures. Delayed primary diagnosis may be associated with the paucity of clinical symptoms and compensatory functionality in children. The decision on surgical correction should be based on the analysis of structural anatomical changes in the assessment, of which magnetic resonance imaging plays an important role.

Sign in / Sign up

Export Citation Format

Share Document