Abstract
The article presents the results of an assessment of risk factors for the development of hypoxic-ischemic encephalopathy in premature newborns. We examined 75 pregnant women who gave 92 premature newborns, patients with hypoxic-ischemic encephalopathy (main group). The comparison group included 75 pregnant women, who gave birth to 82 preterm infants, did not have GIE symptoms. In pregnant women of the main group who gave birth to children with GIE, more accurate were such extragenital pathology as hypertension (9.3%), chronic pyelonephritis (18.6%), thyroid disease (12 0%), tuberculosis and HIV infection, trichomoniasis, chlamydia. Among the complications of pregnancy in both groups was a high percentage of the threat of termination of pregnancy in all trimesters. Placental dysfunction and fetal growth retardation were in every fifth pregnant woman in both groups. Complications of labor, such as preterm premature rupture of amniotic membranes (PPROM) was in 32% of women, placenta previa with bleeding (8%) and abruption of placenta (14 6%) were significantly more frequent in the main group. The urgent cesarean section was performed in 41.4% of cases in the main group, 2.5 times greater than in the comparison group. Pregnant of the main group significantly more often gave birth to children with extremely low body weight (up to 30 weeks of pregnancy), 2 times more likely to give birth to children at 32 weeks of gestation. Among the 92 children of the main group, the Apgar scores of 3 points were -5-5.4%, 4-5 points - 18-19.5%, 6 points-28-30.4%, 7 and higher - 41-44, 5%. One of four children had severe fetal distress at birth. In the comparison group, the Apgar scores of 4-5 points were only 9.7%, 6 points - 14.6%, the other 75.7% had a satisfactory condition at birth. Artificial ventilation was performed in 58-63.1% of the newborns in the main group and only 10% in the comparison groupThus, perinatal risk factors for hypoxic-ischemic encephalopathy in premature newborns are the factories that lead to the development of placental dysfunction, fetal growth retardation, antenatal fetal distress and premature birth. The most important factor in the development of GIE is gestation (up to 32 weeks gestation), placenta previa with bleeding and premature placental abruption in the given time.
Highlights
We examined 75 pregnant women who gave 92 premature newborns, patients with hypoxic-ischemic encephalopathy (main group)
Perinatal risk factors for hypoxicischemic encephalopathy in premature newborns are the factories that lead to the development of placental dysfunction, fetal growth retardation, antenatal fetal distress and premature birth
Summary
Мета дослідження – оцінити частоту та фактори ризику розвитку гіпоксично-ішемічної енцефалопатії у недоношених новонароджених та визначити профілактичні заходи щодо попередження даної патології. До групи порівняння увійшли 75 вагітних, які народили 82 недоношених дитини, що не мали симптомів ГІЕ. У обстежених вагітних основної групи, які народили дітей з ГІЕ, вірогідно частіше мала місце така екстрагенітальна патологія, як гіпертонічна хвороба (9,3%), загострення хронічного пієлонефриту (18,6%), захворювання щитоподібної залози (12,0%), а також туберкульоз та ВІЛ-інфекція. Перинатальними факторами ризику гіпоксично-ішемічної енцефалопатії у недоношених новонароджених є розвиток плацентарної дисфункції, затримка росту плода, антенатальний дистрес плода, загроза переривання вагітності та передчасні пологи. Частота несприятливих наслідків розвитку нервової системи складає 17% у недоношених новонароджених, а для дітей з вагою менше 1000 г при народженні - 42%. МЕТА ДОСЛІДЖЕННЯ оцінити частоту та фактори ризику розвитку гіпоксично-ішемічної енцефалопатії у недоношених новонароджених та визначити профілактичні заходи щодо попередження даної патології
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