Aim of the study – comprehensive assessment of factors harming the newborns of mothers in COVID-19. The definition of perinatal and neonatal outcomes in newborns exposed to SARS-CoV-2.

Material and methods. A retrospective study was conducted in the Department of Neonatal Intensive Care (3^rd level) of the Regional Clinical Hospital #2. The ward is a separate division of the Perinatal Center (Ministry of Health of the Krasnodar Territory). Ninety-two newborns were included in the study. The gestational age was between the 22^nd and 41^st weeks of gestation (average 35 weeks). Mothers have confirmed new coronavirus infection or in the group of risk.

Results and discussion. Clinical experience received in the health management of newborns has shown that there were different criteria of disadaptation in the early neonatal period. Children have had a high incidence of respiratory disorders and can require respiratory therapy, early hemodynamic failure, and a tendency to hemorrhagic complications. A significant proportion of them had the signs of infectious diseases specific to the perinatal period. Babies from mothers with severe COVID-19 had at high risk of severe perinatal asphyxia. Adverse neonatal outcomes in newborns were associated with severe prematurity or the presence of co-morbidities.

Conclusion. The differential diagnostics of the new coronavirus infection in a newborn without the specific clinical manifestations and the violence of adaptation in the early neonatal period will require the development plan of the routing and assistance for the third-level institutions.

Birth and survival rates of very preterm infants with extremely low birth weight (ELBW), and very low birth weight (VLBW) are increasing all over the world. Premature babies are a risk group for neurodevelopmental disorders. This fact determines the necessity for dynamic monitoring in the time frame for the detection and correction of neurological deficits.

Purpose. Evaluation of indicators of the neurodevelopment of premature babies with birth weight less than 1500 grams at the 5 years of corrected age.

Material and methods. A prospective assessment of neurodevelopment indicators was researched in a group of 35 patients born at a gestational age of less than 32 weeks, and weighing less than 1500 grams. Patients were followed up by a neurologist at corrected ages (CA) of 2, 4, 6, 9, 12, 18, 24, 36, 48, and 60 months. Griffiths’s mental development scale was used at 24 months of corrected age. The second version of Denver’s test was performed at 36, 48, and 60 months of the corrected age.

Results. At 12 months, neurodevelopment according to the Griffiths scale corresponded to the age norm in 12 (34.2%) children but at 24 months of age – in 21 (60%) patients.

The developmental delay was recognized by the Denver test at 36 months in the group of 12 (34.2%) children, 6 (17.1%) children – with questionable development, and 17 (48.7%) children – with normal development.

To the time of 48 months of the corrected age, the developmental delay was diagnosed in 10 (28.6%) patients, and questionable development in 6 (17.1%) patients. According to the results of Denver’s test, it was found that at 5 years of the corrected age in 23 (65.7%) patients the development corresponded to the age norm, and in 12 (34.3%) patients neurodevelopmental disorders were diagnosed.

Conclusion. Premature babies with ELBW and VLBW constitute a high-risk group for the formation of various neurodevelopmental disorders, the prevalence there is 34.3%. The data obtained in our study showed the importance of testing the cognitive functions of premature babies using the Denver test for the timely detection of developmental disorders.

Premature newborns are more vulnerable to disorders of hemostasis and the development of hemorrhagic disorders.

The study aimed to make the assessment of risk factors for the formation of hemorrhagic disorders that include intraventricular hemorrhages in the group of extremely premature newborns in the early neonatal period.

Material and methods. 97 extremely low birth weight babies were included in the study. They are divided into 2 main groups: the first (study) group – 50 children with hemorrhagic disorders during the early neonatal period, and the second (control) group – 47 children without hemorrhagic disorders. Hemorrhagic disorders, the different combinations of them have been classified according to ICD-X: P52.0–52.6, P54.3, P26.9, P51.9, and P54.5 and studied.

Results. Risk factors for the development of hemorrhagic disorders in newborns with a gestation age of up to 32 weeks were researched. They are lower gestational age, lower parameters of physical development, birth weight less than 1000 grams, lower Apgar score (1 and 5 minutes), severe respiratory disorders, and the ventilation support in the delivery room and neonatal intensive care unit, and high concentrations of oxygen in the oxygen-air mixture, the exogenous surfactant replacement. Factors predisposing to the development of hemorrhagic disorders according to the anamnesis of mothers were clarified: exacerbation of chronic diseases of the digestive system (OR 7.49, 95% CI 0.88–63.4), isthmic-cervical insufficiency (OR 5.63, 95% CI 1.16–27.22), fetal distress with a change in heart rate (OR 8.76, 95% CI 1.05–73.03), prenatal hemorrhages (OR 2.45, 95% CI 0.90–6.69).

Conclusion. According to the results of the work, significant risk factors for the formation of hemorrhagic disorders in extremely premature newborns have been clarified.

Dilation of the renal pelvis of the fetus is detected by antenatal ultrasound screening in 1–4% of pregnant women. In most cases, pyelectasia is transient, but it can be a sign of a wide range of obstructive and non-obstructive uropathies in a child after birth. To separate patients with physiological pelvicalyceal system dilation and patients requiring examination and treatment, clear criteria of norm and pathology are necessary. However, today there is a significant range of opinions regarding the definition of the norm, as well as the management of such patients, especially with a small and moderate pelvicalyceal system’s dilation. The review briefly highlights the main classifications of pelvicalyceal system’s dilation in children with an analysis of their advantages and limitations; provides recommendations from various authors on the timing and frequency of ultrasound and other studies after birth, the duration of observation of patients with antenatal pelvicalyceal system’s dilation, antibiotic prophylaxis of urinary tract infections and diagnostics of vesicoureteric reflux.

The article summarizes modern approaches in medical follow-up for preterm infants in outpatient departments after discharge from children's hospital. Particular attention is paid to nutritional support for preterm infants, how long the enriched nutrition formula should be provided, and the optimal timing for complementary feeding.

Late premature newborns remain the focus of attention of neonatologists around the world. Improving methods of providing medical care to pregnant women at high perinatal risk and changing approaches to monitoring them in recent decades will rely on the significantly increased number of newborns born near term. Therefore, the prognostic markers of the delivery have been actively sought in numerous numbers of studies in this group of newborns, as well as decreasing the risk of morbidity. In this article, we have presented discussions about the prolongation of pregnancy in the development of menacing obstetric conditions and the feasibility of antenatal prevention of distress syndrome during the pregnancy near term.

In the third part of the material devoted to the observance of citizens’ rights in the field of health protection, the procedural features of the implementation of state control (supervision) over the observance of these rights by medical organizations and medical workers are considered.

The article presents a detailed analysis of such a concept as professional burnout among medical staff. Ways of its prevention and assistance in its presence are proposed.

Lung ventilation is a standard sign of life in newborns. Post-mortem computed tomography (PMCT) is highly sensitive to the presence of gas in the body including the lungs. Current standard examinations to determine the pulmonary ventilation status in newborns are the flotation test and histology. The purpose of this study was to compare the accuracy of PMCT with the flotation test for determining the lung ventilation status with histological control as reference standard. A cut-off value as CT number in Hounsfield Units (HU) determining lung ventilation of newborns in PMCT should be established.

Methods. A total of 38 infant lungs were examined of which 21 lungs were frominfants deceased shortly after live birth (control group) and 17 lungs belonged to infants where live birth was in question (study group). All lungs were examined using PMCT, flotation test, and histological examination.

Results. The control group showed an overall mean attenuation± standard deviation of –219±135 HU; the study group of 45±15HU in histologically nonventilated lungs versus –192±207 HU (p<0.001) in ventilated lungs. The best cut-off value for optimal discrimination of ventilated and nonventilated lungs in newborns was –35 mean HU.

Conclusion. PMCT is equally well suited to determine lung ventilation as the flotation test. It provides additional information regarding pulmonary infiltration, degree of putrefaction, or signs of trauma (fractures, pneumothorax). Histology remains mandatory in ambiguous cases.