Abstract
Objective: to provide the comparative characteristics of neurological impairments in infants born in the I and II obstetric positions and to follow them up in the neonatal period. Subjects and methods. A total of 133 infants born by vaginal delivery at 38–41 weeks» gestation in 2014 to 2016 were followed up. All the examinees were divided into 2 groups: 1) 71 neonates born in the I obstetric position; 2) 62 babies born in the II position. Their clinical examination encompassed an analysis of the course of delivery, neurological examination of the newborn in the first hours of life with a subsequent follow-up evaluation at the time of his/her discharge from the maternity unit. Results and discussion . The examined groups were comparatively analyzed in terms of a number of indicators. The data of objective neurological examination showed a significant difference in some symptoms: cephalohematoma and torticollis were more common in the group of infants born in the II position. Comparison of the frequency of neurological impairments at different follow-up stages (at birth and at discharge from the maternity unit) revealed their statistically significant reduction in both groups. However, the frequency of neurological symptoms among Group 1 infants (born in the I position) at their discharge from the maternity unit was significantly reduced (from 77.5 to 38.0 %; p < 0.001), and those in Group 2 infants (born in the II position) substantially unchanged (from 87.1 to 79.0 %; p = 0.125). The slight regression of neurological symptoms in Group 2 suggests that intranatal nervous system damage is more severe in the infants born in the II position. Conclusion . To define the position of a fetus during labor is an important component in the prevention of intranatal injuries
Highlights
Objective: to provide the comparative characteristics of neurological impairments in infants born in the I and II obstetric positions and to follow them up in the neonatal period
All the examinees were divided into 2 groups: 1) 71 neonates born in the I obstetric position; 2) 62 babies born in the II position
Their clinical examination encompassed an analysis of the course of delivery, neurological examination of the newborn in the first hours of life with a subsequent follow-up evaluation at the time of his/her discharge from the maternity unit
Summary
Сравнительная характеристика неврологического статуса детей, рожденных в I и II физиологических позициях. Несмотря на недостаточную изученность механизма родов при разных вариантах предлежания, авторы единодушны в признании очевидного факта – важности динамического осмотра новорожденного с первых часов жизни, топической диагностики ранних неврологических симптомов, а также в понимании того, что регрессия неврологической симптоматики у новорожденных не может свидетельствовать о полном благополучии [11]. При осмотре новорожденного в родильном доме признаки натальной травмы шейного отдела позвоночника и спинного мозга могут складываться из нескольких симптомокомплексов:. Результаты При сравнении оценки состояния новорожденного по шкале Апгар на 1-й и 5-й минутах после рождения в зависимости от позиции были получены следующие данные. Не установлено статистически значимых различий показателей в зависимости от позиции (p = 0,685 и p = 0,723 при сравнении оценок на 1-й и 5-й минутах соответственно). Data of the neurologic examination of newborns at the 1st day of life depending on the fetus position at birth
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