Topic number
3 . 2017
Профилактика неонатальных инфекций
Content
Anniversary

To the 70th birthday of Nikolai Nikolaevich Volodin

Abstract

To the 85th birthday of Zinaida Vasilievna Sirotina

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News of Cochrane database

News of Cochrane database (# 3, 2017)

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Neonatology news

Neonatology news (# 3, 2018)

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International practice

Congenital chylothorax

Abstract

Congenital chylothorax (CC) results from multiple lymphatic vessel anomalies or thoracic cavity defects and may accompany other congenital anomalies. Fetal chylothorax may increase the risk of death and complications from pleural space lymphatic fluid accumulation, which compromises lung development, pulmonary, and cardiovascular function and from complications arising from the loss of drained lymphatic contents. Prenatal interventions might improve survival in severe cases of fetal chylothorax. The neonatal treatment strategy is generally supportive with interventions that include thoracostomy drainage and attempts to decrease chyle flow using a stepwise approach that begins with the least invasive means. Evidence-based treatment choices are lacking and are much needed. Most cases of CC resolve with time even without specific lymphatic system studies to identify the exact pathology. Expertise in performing lymphatic studies is not universally available. Data on both efficacy and safety of the various therapeutic options are needed to determine the best approach to the treatment of CC.

Pneumonia

Abstract

NeonataL pneumonia may occur in isoLation or as one component of a Larger infectious process. Bacteria, viruses, fungi, and parasites are aLL potentiaL causes of neonataL pneumonia, and may be transmitted verticaLLy from the mother or acquired from the postnataL environment. The patient's age at the time of disease onset may heLp narrow the differentiaL diagnosis, as different pathogens are associated with congenitaL, earLy-onset, and Late-onset pneumonia. Supportive care and rationaLLy seLected antimicrobiaL therapy are the mainstays of treatment for neonataL pneumonia. The chaLLenges invoLved in microbioLogicaL testing of the Lower airways may prevent definitive identification of a causative organism. In this case, secondary data must guide seLection of empiric therapy, and the response to treatment must be cLoseLy monitored.

Rewiews

Experience in the use of infant adapted formulae based on whole New Zealand goat milk

Abstract

The review presents the results of domestic and foreign studies of infant adapted formulae based on New Zealand goat milk and their influence on the formation and maintenance of healthy digestion and normal microbiocenosis, and correction of functional disorders of the gastrointestinal tract.

Allergy in preterm infants: predisposing factors and possible clinical manifestations

Abstract

The article discusses risk factors, developmental mechanisms and possible clinical features of cow's milk allergy in preterm infants. The focus has been made on physiological and immunological peculiarities of the preterm infant that may predispose to allergy development. Several observations from the scientific literature, describing clinical presentation of cow's milk allergy in preterm infants, similar to necrotizing enterocolitis, are presented.

Diagnosis and treatment of cytomegalovirus infection in pregnant women and newborns

Abstract

Cytomegalovirus infection (CMVI) is a common cause of intrauterine pathology and serious diseases in newborns and infants. In older children CMVI can lead to psychomotor development delays, cognitive disorders and marked hearing impairment. This review article presents clinical evidence, antenatal and intranatal CMVI diagnostics algorithms, pregnant women and newborns with active CMVI treatment strategies, as well as indications for administration of intravenous CMV immunoglobulin in pregnant women and newborns, ganciclovir and valganciclovir in suspension in newborns,infants and young children.

Original research

Peculiarities in the neonatal period of preterm infants with intrauterine growth retardation

Abstract

Premature children born weighing up to 1000 g at the gestational age (GA) 29-31 weeks were examined for intrauterine growth retardation (IUGR). The diagnostics of IUGR was performed using the Fenton growth chart (2013). Study revealed a trend in the neonatal period in 2 groups of premature children. The first main group includes 32 children with IUGR born at the GA 29-31 weeks. The second group includes 44 children with same GA without IUGR. Anamnesis of the mothers of the first group revealed the following rick factors: severe fetoplacental insufficiency (p=0.011), oligohydramnios (p=0.033), acute respiratory diseases complicated with bronchitis (p=0.032). In the early neonatal period children were more often noticed to have metabolic acidosis, hemodynamic instability and impaired consciousness (p=0.021). Children spent a longer time in the crisis care center (p<0.05), they received artificial lung ventilation for longer periods of time. In the first day of life premature infants were observed to have higher rates of red blood cells, a reduced number of platelets, an increase in sodium, an increase in aspartate aminotransferase (AAT) and in calcium (p<0.05). The fourteenth day of life revealed leucopenia, neutropenia, increasing the number of platelets, an increase of total bilirubin and indirect bilirubin, an increase of kreatinine, an increase of serum glutamic pyruvic transaminase (SGPT) and AAT (p<0.05). Analysis of morbidity showed a greater frequency of periventricular leukomalacia (p=0.043) and severe bronchopulmonary dysplasia (p=0.011). Premature infants with IUGR spent a longer time in the hospital (postconception age at discharge was 40.6+2.1 weeks) and in 100% of cases had postnatal hypotrophy.

Fetal growth restriction in smoking mothers

Abstract

Objective. To determine the characteristics of the perinatal history of infants with intrauterine growth restriction in smoking mothers.

Study design. 291 term infants of smoking mothers were included. 112 infants with intrauterine growth restriction were compared to 179 infants with average anthropometric parameters.

Results. There were statistically significant differences between two groups at the study. The factors significantly associated with intrauterine growth restriction are the combination mother's active and passive smoking in pregnancy (p<0.001), placental insufficiency (p<0.001), oligohydramnios (p<0.001), moderate degree mother's tobacco dependence (p=0.001) and male gender (p=0.037). In the early neonatal period in infants with intrauterine growth restriction was more common pathological hypoglycemia (p<0.001), a decrease of body weight (p=0.027), higher red blood counts (p<0.001) then in controls.

Conclusion. The prevalence of intrauterine growth in term infants of tobacco smoking mothers is 38.5% (95% CI: 33,0-44,2). The factors associated with intrauterine growth restriction are the combination mother's active and passive smoking in pregnancy, placental insufficiency, oligohydramnios, moderate degree mother's tobacco dependence and male child. There was more common pathological hypoglycemia, a decrease of body weight, higher red blood counts in infants with intrauterine growth restriction then in controls in the early neonatal period.

Hydro-lazes of umbilical cord blood in newborn digestive potential characteristics

Abstract

Enzymatic digestive potentiaL of newborn is one of indices of its functionaL abiLity to Lactotrophy. HydroLase of newborn and puerpera umbiLicaL cord bLood serum with normaL (36) and incompLete (40) gestation periods were determined: α-amyLase, Lipase (coLorimetric method according to Roche instruc­tion reagent set), pepsinogen I and II (chemiLuminicsent immunoassay method with Abbot reagent set).

At a normaL gestation period the hydroLase content in umbiLicaL cord bLood serum was Lower than in puerpera bLood serum: Lipase and α-amyLase in three times, pepsinogen I aLmost in 4.6 times, pepsinogen II onLy in 1.6 times. It indicates that periods of different enzymatic system formation differ.

In umbiLicaL cord bLood a premature newborn in comparison with normaL newborn dispLayed decreasing of amyLase content from 9.0 to 4.6 Unit/L, pepsinogen I content from 11.0 to 4.,7 mkg/L, pepsinogen II content from 5.5 to 3.4 mkg/L, but Lipase content was not change. It is proved that fetaL LipoLysis system is formed earLier.

HydroLytic enzyme content of digestive gLand in umbiLicaL cord bLood serum is an informative test of newborn digestive potentiaL.

Clinical case

Early manifestation of cow's-milk protein allergy in preterm infants: clinical cases

Abstract

We report 2 cases of cow's-milk protein allergy in preterm infants. This syndrome is less common among preterm neonates and is characterized by abdominal distension, vomiting, bloody stools, anxiety, eosinophilia, pneumatosis on abdominal X-rays in severe cases. Differential diagnosis with necrotizing enterocolitis is essential in order to start appropriate treatment.

Clinical practice guidelines

System for nosocomial disease prevention and control in resuscitation and intensive care units (patient’s rooms) for newborns in obstetric hospitals and children's hospitals. Methodical guidelines

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Lawyer column

I'm a consulting physician!

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Announcements

Announcements (# 3, 2017)

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All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Degtyarev Dmitriy Nikolaevich
Doctor of Medical Sciences, Professor, Deputy Director for Scientific Research of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Head of the Chair of Neonatology at the Clinical Institute of Children's Health named after N.F. Filatov, I.M. Sechenov First Moscow State Medical University, Chairman of the Ethics Committee of the Russian Society of Neonatologists, Moscow, Russian Federation

ORCID iD 0000-0001-8975-2425

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