CLINICAL AND PARACLINICAL CRITERIA FOR LIKELYHOOD OF INFECTION AND DEVELOPMENT OF CONGENITAL PNEUMONIA IN NEWBORN CHILDREN WITH CHLAMYDIAL INFECTION

Abstract

Introduction. Issues of the prevention of intrauterine diseases, and, in particular, congenital pneumonia, in newborns with Chlamydia infection, is still remaining unsolved due to the insufficiently developed criteria for diagnosis of the infection and identification of this pathology progression. The aim of this study is to develop clinical, laboratory and instrumental factors of the Chlamydia infection and the development of congenital pneumonia in newborns. Materials and methods. We examined 77 newborns (38 (49.3%) premature children, 39 (50.7%) full-term children). In the main group 54 newborns were diagnosed to have with congenital pneumonia, on them 25 (46.3%) premature and 29 (53.7%) full-term children. The control group included 23 "conditionally healthy" newborns, of the 13 (56.5%) premature and 10 (43.5%) full-term children. The diagnosis of congenital pneumonia in newborns with Chlamydia infection was confirmed based on the anamnesis, clinical criteria, risk factors over the ante-, intra- and postnatal periods, pathological changes detected on neurosonography, disorders of the intestinal microbiocenosis. Specific diagnosis was performed by the method of polymerase chain reaction with the detection of Chlamydia DNA in the blood serum of newborns. Results and discussion. Comprehensive examination of newborns with congenital pneumonia demonstrated that all newborns in this group were born to mothers infected with Chlamydia, who had burdened obstetric and gynaecological history, complicated pregnancy (due to the presence of a large percentage of extragenital and genital pathology and pathological course of childbirth of pregnant women). It was found that ventricular dilatation, cysts of vascular plexuses and leukomalacia, movement disorders and organic lesions of the central nervous system occurred only in children with congenital pneumonia. It has been demonstrated that the severity of congenital pneumonia in the examined newborns is determined by the contamination of the body with pathogenic flora (Pseudomonas aeruginosa, St. aureus, Klebsiella, Candida). Conclusion. Applying a set of diagnostic criteria for early detection of congenital pneumonia and its progression in children with Chlamydia infection enables to verify the diagnosis and timely prescribe etiotropic therapy in the first days of newborns’ life.