Intraventricular hemorrhages in children with extremely low body weight: a comprehensive perinatal assessment in a comparative analysis of respiratory therapy tactics in the 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

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Comparative analysis of neonatal sequelae after classic M. Stark and modified cesarean section

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2019-23(3)-13 ◽

2019 ◽

Vol 23 (3) ◽

pp. 414-419

Author(s):

I.Z. Gladchuk ◽

A.G. Volyanskaya ◽

Y.V. Herman ◽

D.O. Grigurko

Keyword(s):

Comparative Analysis ◽

Caesarean Section ◽

Cesarean Section ◽

Program Analysis ◽

Confidence Level ◽

Neonatal Period ◽

T Test ◽

Obstetrics And Gynecology ◽

Clinical Group ◽

Early Neonatal Period

Over the last twenty years, a sharp perinatal birth rate has registered high perinatal morbidity and mortality in the country. Despite the fact that the number of cesarean sections is constantly increasing, the perinatal mortality rate in the country remains positive and in 2017 was 7.9%%. The purpose of the study was a comparative analysis of the features of the course of the early neonatal period and the frequency of neonatal complications in classical cesarean section according to M. Stark and according to a modified method for improving perinatal outcomes. The selection of patients for the comparative study was performed by type of surgery (classic M. Stark technique or modified technique), which was conducted at the clinical basis of the Department of Obstetrics and Gynecology №1 ONMedU for the period from 2015 to 2018 according to a randomized principle in the obstetric department of the Kherson Regional Clinical Hospital (clinical base of the Department of Obstetrics and Gynecology No. 1 ONMedU). The formation of clinical groups was carried out according to retrospective data from 205 birth histories, the delivery of which was carried out by caesarean section. Statistical processing of the results was carried out using application R of the Microsoft Exel 2003 program. Analysis of quantitative indicators was analyzed using the arithmetic mean value (M) and the error in determining the average value (± m). Qualitative indicators were measured in absolute and relative (percentage) values. The significance of differences in the parametric characteristics in the appropriate groups was evaluated using Student's t test (t - test) and analysis of variance (ANOVA). In the calculations, the differences were considered statistically significant at p <0.05 (95% confidence level (CI) and at p <0.01 (99% confidence level). By using modified access to the abdominal cavity, which involved grasping the peritoneum with the index finger and stretching all layers of the anterior wall in a blunt fashion by two surgeons at the same time, it was almost twice possible to reduce the time to fetal extraction in the main study group (p˂0.001). The condition of newborns on the Apgar scale at 1 and 5 minutes of life in the first clinical group of the study was better (p=0.005). Due to the modified features of fetal extraction, it was possible to reduce the incidence of HID CNS in newborns (p=0.022), to 6 times reduce the need for treatment at the III level (p=0.004). The indicator of early neonatal mortality in the newborns of the first clinical group was zero, whereas in the comparison group 2 cases were recorded. However, the difference is not significant (p=0.223). Thus, the modified Caesarean section improves the overall condition of the newborns according to the Apgar scale at 1 and 5 minutes of life, is accompanied by a decrease in the frequency of some complications in the early neonatal period, creates a certain additional reserve for the improvement of perinatal complications and requires further comprehensive studies.

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Influence of pain on the development in preterm infants

Pediatrician (St Petersburg) ◽

10.17816/ped12111-19 ◽

2021 ◽

Vol 12 (1) ◽

pp. 11-19

Author(s):

Artem V. Andreyev ◽

Natalya V. Kharlamova ◽

Semen S. Mezhinskij ◽

Natalya A. Shilova

Keyword(s):

Body Weight ◽

Pain Intensity ◽

Preterm Infants ◽

Gestational Age ◽

Airway Pressure ◽

Neonatal Period ◽

Pain Intensity Score ◽

Early Neonatal Period ◽

Group I ◽

Group Ii

Introduction. The influence of uncontrolled exposure to pain in newborns in the first days of life on the long-term consequences for both the brain and the development of the nervous system as a whole is of interest. The aim of the study was to assess the intensity of pain in preterm infants who need respiratory care in the early neonatal period and to determine its impact on the development of the child by the end of the first month of life. Materials and methods. From December 2018 to December 2019, 92 preterm infants requiring respiratory support in the early neonatal period were examined. Pain intensity was assessed on the EDIN6 scale, and neuro-muscular maturity was assessed on the J. Ballard scale. The preterm infants were divided into 2 groups: Group I 34 children who underwent invasive ventilation (body weight 1120 [865; 1390] g, gestational age 29 [26; 31] weeks); group II 58 newborns who used non-invasive respiratory therapy (CPAP) (body weight 1160 [875; 1400] g, gestational age 29 [28; 31] weeks). Group I newborns had a lower Apgar score at 5 minutes (p = 0.001) and a higher Silverman score (p = 0.001). Results and discussions. In all newborns, the maximum pain intensity score on the EDIN6 scale was registered on the 3rd day of life: in group I, it was 9, and in group II points (p = 0.041), which corresponds to moderate pain. Group I children underwent more manipulations (20.8 2.14 vs 17.7 2.05; p = 0.016). An increase in the average airway pressure of 10 cm H2O in group I children and 6.5 cm H2O in group II patients is accompanied by an increase in the intensity of pain to severe and moderate, respectively. In both groups of children, an inverse correlation was found between the number of manipulations, head circumference (R = 0.64; p = 0.004) and the J. Ballard score on the 28th day of life (R = 0.57; p = 0.008). The number of painful manipulations in the early neonatal period, exceeding 21 procedures per day, increases the risk of delayed child development by more than 3.5 (p = 0.009; OR = 3.68; CI = 1.128.36). Conclusion. The number of manipulations performed and the value of the average airway pressure are the main factors affecting the intensity of pain in preterm infants and determining their development in the neonatal period.

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Neonatal hypoglycemia in children with risk factors

Pacific Medical Journal ◽

10.34215/1609-1175-2021-4-80-84 ◽

2022 ◽

pp. 80-84

Author(s):

E. V. Antsiferova ◽

T. E. Taranushenko ◽

N. G. Kiseleva ◽

E. A. Belyaeva ◽

T. I. Donskaya

Keyword(s):

Risk Factors ◽

Body Weight ◽

Blood Glucose ◽

Growth Retardation ◽

Intrauterine Growth Retardation ◽

Neonatal Period ◽

Large Body ◽

Neonatal Hypoglycemia ◽

Intrauterine Growth ◽

Early Neonatal Period

Objective: The analysis of clinical-laboratory peculiarities and the dynamics of glycemia clarifying the terms of blood glucose stabilization during the early neonatal period in children having risk factors of the development of such state.Methods: Open, retrospective , continuous, single-center study was conducted. It was aimed at getting preliminary data that is important for planning further tactics of examining newborns having risk factors on hypoglycemia development (kids having large body weight at birth, children whose mothers have diabetes, newborns having intrauterine growth retardation).The target group of the survey included 522 newborns of both genders in the early neonatal period (from 0 to 7 days of life).Results: There is data on the frequency of first indicated hypoglycemia in newborns having risk factors of the development of such state, clinicallaboratory peculiarities, the dynamics of glycemia during early neonatal period, and also the period of blood glucose stabilization (the age of reaching normoglycemia). Neonatal hypoglycemia was detected in 40.2% of examined children. Laboratory manifestation during the first day of life was noticed 62.9% of cases with the further normalization of glucose level in blood in 24 hours in 73.3% of newborns. Significant reduction of blood glucose was observed in 54.8% of cases requiring hypoglycemia therapy with parenteral prescription of 10% glucose solution. Hypoglycemia jugulated against oral correction of 5% glucoses solution in 40.5 % of cases. 4.8% of children got the level of glucose stabilized after introduction of supplementary feeding.Conclusion: The results of the newborns having risk factors on hypoglycemia development (kids having large body weight at birth, children whose mothers have diabetes, newborns having intrauterine growth retardation) examinations are presented. The peculiarities of neonatal hypoglycemia are: the absence of a typical clinical symptoms among 89% of children. Asymptomatic course of hypoglycemia confirms the importance and necessity of glycemia monitoring in the early neonatal period in order to conduct timely and adequate therapy.

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Influence of pregnancy and birth factors on the development of acute kidney injury in premature infants

Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) ◽

10.21508/1027-4065-2019-64-2-57-62 ◽

2019 ◽

Vol 64 (2) ◽

pp. 57-62

Author(s):

S. V. Aborin ◽

D. V. Pechkurov ◽

N. S. Koltsova ◽

Yu. V. Tezikov ◽

I. S. Lipatov ◽

...

Keyword(s):

Body Weight ◽

Neonatal Period ◽

Acute Hypoxia ◽

Kidney Injury ◽

Intrauterine Infection ◽

Kidney Damage ◽

Early Neonatal Period ◽

Birth Factors ◽

Pregnancy And Birth

The Objective of this article is to assess the influence of the factors of pregnancy, childbirth and the early neonatal period on the development of acute kidney damage in premature newborns with very low and extremely low body weight. In addition, this disease significantly affects the prognosis and quality of life of the child. In addition, acute kidney damage significantly increases mortality among patients of the intensive care unit for newborns. There has been established a connection between acute hypoxia in childbirth, extremely low body weight at birth, intrauterine infection and III severity on the NTISS scale with the development of acute kidney damage in the early neonatal period. Early detection of this condition requires a comprehensive study of the mechanisms of its development and possible risk factors.

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Non-invasive pulmonary ventilation in the treatment of neonatal respiratory distress syndrome

Voprosy ginekologii akušerstva i perinatologii ◽

10.20953/1726-1678-2021-3-92-99 ◽

2021 ◽

Vol 20 (3) ◽

pp. 92-99

Keyword(s):

Body Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Premature Infants ◽

Distress Syndrome ◽

Neonatal Period ◽

Invasive Ventilation ◽

Non Invasive ◽

Early Neonatal Period ◽

Non Invasive Ventilation

Objective. To assess the effectiveness of differentiated approach and the safety of non-invasive ventilation in the DuoPAP mode in infants with respiratory distress syndrome and extremely low birth weight in the early neonatal period. Patients and methods. A retrospective and prospective analysis in the period from January 2018 to April 2020. 80 children were included in the study (46 girls and 34 boys), who were born prematurely at the gestational age of 24 to 29 weeks with a body weight of 700 to 999 grams and with the main clinical nosology of the early neonatal period – respiratory distress syndrome (68.7%; n = 55) and congenital pneumonia (31.3%; n = 25). Results. The clinical manifestations and features of the diagnosis of respiratory distress syn-drome in premature infants with extremely low body weight in the early neonatal period were studied. A differentiated approach to the tactics of conducting initial respiratory therapy in the ventilation mode with biphasic positive airway pressure was presented. Indications, contraindications and clinical and laboratory predictors of the effective and safe implementation of initial respiratory support in the DuoPAP mode (analogous to the BiPAP regimen) in premature infants with respiratory distress syndrome were formed. Conclusion. Generation of indications, contraindications and timely developed clinical and laboratory predictors make it possible to personify the initial tactics of respiratory therapy in premature infants with extremely low body weight in the conditions of neonatal intensive care unit. A differentiated approach to initial non-invasive ventilation in infants with respiratory distress syndrome is an important preventive tool to minimize ventilator-associated lung injury and intraventricular hemorrhage in the early neonatal period. Key words: premature birth, premature infants, extremely low body weight, respiratory support, respiratory distress syndrome in infants, non-invasive mechanical ventilation, surfactant

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FUNCTIONAL STATE OF KIDNEYS WITH DESYNCHRONY NEURONOGENESIS IN CHILDREN EXTREMELY LOW BODY WEIGHT IN THE EARLY NEONATAL PERIOD

SCIENTIFIC MEDICAL BULLETIN OF UGRA ◽

10.25017/2306-1367-2019-22-4-31-37 ◽

2019 ◽

Vol 22 (4) ◽

pp. 31-37

Author(s):

Tatyana Nikolaevna Ugleva ◽

◽

Vladimir Leonidovich Yanin ◽

Liliya Aleksandrovna Alekseenko ◽

Elena Dmitrievna Hadieva ◽

...

Keyword(s):

Body Weight ◽

Functional State ◽

Neonatal Period ◽

Early Neonatal Period

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A Case of Congenital Glucose Galactose Malabsorption with a New Mutation in the SLC5A1 Gene

Journal of Pediatric Genetics ◽

10.1055/s-0040-1719161 ◽

2020 ◽

Author(s):

Hasan Akduman ◽

Dilek Dilli ◽

Serdar Ceylaner

Keyword(s):

Mutation Analysis ◽

Autosomal Recessive ◽

Glucose Transporter ◽

Neonatal Period ◽

Autosomal Recessive Disorder ◽

Homozygous Mutation ◽

New Mutation ◽

Early Neonatal Period ◽

Sodium Dependent ◽

Hypernatremic Dehydration

AbstractCongenital glucose-galactose malabsorption (CGGM) is an autosomal recessive disorder originating from an abnormal transporter mechanism in the intestines. It was sourced from a mutation in the SLC5A1 gene, which encodes a sodium-dependent glucose transporter. Here we report a 2-day-old girl with CGGM who presented with severe hypernatremic dehydration due to diarrhea beginning in the first hours of life. Mutation analysis revealed a novel homozygous mutation NM_000343.3 c.127G > A (p.Gly43Arg) in the SLC5A1 gene. Since CGGM can cause fatal diarrhea in the early neonatal period, timely diagnosis of the disease seems to be essential.

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