Abstract
Objective: to study the causes of acute intranatal hypoxia and reveal a relationship of placental changes to respiratory failure (RF) in newborn infants. Subjects and methods. The investigation included 252 neonates with the complicated course of an early neonatal period. Their gestational age was 26 weeks to 40 weeks, birth weight varied from 850 g to 4100 g. 95.3% of the newborn infants were born with a low Apgar score and RF, which required mechanical ventilation immediately after birth. The neonatal status was clinically evaluated; the values of blood gas composition and acid-base balance were recorded; the pathogen was discharged from the tracheobronchial tree; chest X-ray survey and placental morphological examination were performed. Results. The main cause of neonatal respiratory failure is chronic intrauterine hypoxia caused by placental inflammatory changes and fetal-placental blood circulatory disorders, which gives rise to preterm delivery, cerebral hemodynamic disorders, and neonatal amniotic fluid aspiration. Bacteriological examination of tracheobronchial aspirations showed that no microflora growth occured in the majority of the newborns acute intranatal hypoxia. Enterococcus faecalis and Staphylococcus epidermidis were isolated in 12.3% and 8.7%, respectively. Growth of в-hemolytic streptococcus was observed in 2.8% of cases. The rate of microbial association specific only for rate premature infants with neonatal respiratory distress syndrome (NRDS) was 4.8%. Conclusion. Placental changes causing fetal-placental circulatory disorders were ascertained to be responsible for acute intranatal and postnatal neonatal hypoxia. Placental inflammatory changes occurred in the majority of cases, as confirmed by bacteriological examinations of neonatal infants. Isolation of the varying microbial flora in infants with RF to a greater extent is, indicative of the infectious process occurring in the maternal body. Key words: acute intranatal hypoxia, neonatal amniotic fluid aspiration, intrauterine infection.
Highlights
The investigation included 252 neonates with the complicated course of an early neonatal period. Their gestational age was 26 weeks to 40 weeks, birth weight varied from 850 g to 4100 g. 95.3% of the newborn infants were born with a low Apgar score and respiratory failure (RF), which required mechanical ventilation imme diately after birth
The neonatal status was clinically evaluated; the values of blood gas composition and acid base bal ance were recorded; the pathogen was discharged from the tracheobronchial tree; chest X ray survey and placental morphological examination were performed
The main cause of neonatal respiratory failure is chronic intrauterine hypoxia caused by placental inflammatory changes and fetal placental blood circulatory disorders, which gives rise to preterm delivery, cerebral hemodynamic disorders, and neonatal amniotic fluid aspiration
Summary
Цель исследования — изучить причины развития острой интранатальной гипоксии, выявить взаимосвязь измене ний в плаценте с дыхательной недостаточностью у новорожденных. Установлено, что причинами развития острой интранатальной и постнатальной гипоксии у но ворожденных являются изменения в плаценте, вызывающие нарушения плодово плацентарного кровообраще ния. В большинстве случаев имеют место воспалительные изменения в плаценте, что подтверждается при бакте риологическом обследовании новорожденных. Objective: to study the causes of acute intranatal hypoxia and reveal a relationship of placental changes to respiratory failure (RF) in newborn infants. Bacteriological examination of tracheobronchial aspirations showed that no microflora growth occured in the majority of the newborns acute intranatal hypoxia. Placental inflammatory changes occurred in the majority of cases, as confirmed by bacteriological examinations of neonatal infants. Цель исследования — изучить причины развития острой интранатальной гипоксии, выявить взаимосвязь изменений в плаценте с развитием дыхательной недо статочности у новорожденных
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