Abstract
The purpose of the study is to determine early non-invasive (ultrasound) diagnostic criteria of splenomegaly in neonates with a high risk of congenital or postnatal infection.Materials and methods. In the prospective study, 163 newborn infants of the first week of live were included. All neonates included in the study were classified as possessing a high risk of an intra-uterine infection (IUI). Depending on the birth weight, the infants were split into two groups: group «А» — 80 full-term newborns with normal birth weight, and group «В» — 83 full-term newborns with fetal growth restriction (FGR). A comprehensive examination of newborns including spleen ultrasound was carried out.Results. An increased spleen weight coefficient (Km) was found in newborns with high risk of infection development that included congenital oromaxillofacial and gastrointestinal defects, perinatal contacts with various microorganism. The increased spleen weight and Km reflected conditions of the immune system organ of the newborn in response to an adverse exposure including infection.Conclusion. Ultrasound examination of morphometrical characteristics of the spleen in newborns with various medical conditions represents a convenient and simple method of early diagnosis of splenomegaly. The most sensitive index is the spleen weight coefficient (Km), which reflects the immune system organ response to an adverse perinatal exposure including contact with an infectious agent. The mean spleen weight coefficient is within the range of 1.1 to 3.0. When the index exceeds 4, the risk of development of an infectious disease increases. This method can be used as a screening approach for newborns of different gestation age who have been included in the high-risk group based on a congenital or early postnatal infection.
Highlights
Congenital intra-uterine infections (IUI) and sepsis are the main causes of newborns’ morbidity and mortality because neonates are most susceptible to various pathogenic microorganisms [1,2,3]
The study revealed that the spleen length and thickness are significantly larger in the newborns of group ‘A’ compared to the newborns of group ‘B’
Analysis of calculated indices established that the spleen weight — Kl and Ks — is significantly increased in the infants of group ‘A’ versus the infants of group ‘B’ because these indices depend on the anthropometric data of a newborn (P
Summary
Congenital intra-uterine infections (IUI) and sepsis are the main causes of newborns’ morbidity and mortality because neonates are most susceptible to various pathogenic microorganisms [1,2,3]. In IUI, the infection targets are the fetus lungs, gastrointestinal tract and skin where an antenatal inflammation develops most frequently [3]. In this connection, research for early diagnostic criteria of intra-uterine infections remains a priority [4,5,6]. More biomedical studies focus on more comprehensive understanding of the immunity and function of immunocompetent organs at an early stage of life. These studies might find something new in the immunity ontogenesis, and assist development of new methods of early diagnosis and treatment
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