Репозиторий Университета

© 2018, Dynasty Publishing House. All rights reserved. The objective. Was to develop echographic and Doppler prognostic markers of lesions of the central nervous system (CNS) in premature newborns. Patients and methods. In accordance with the objective of the study we conducted a complex prospective examination of 196 pregnant women diagnosed with threatened preterm labour. The treatment group consisted of 166 women, whose pregnancy ended with spontaneous births at terms 22–36 wks, and premature newborns later developed various disorders of CNS. Results. We found morphological ultrasound and Doppler ultrasound specificities of fetal CNS against the background of threatened preterm labour depending on the term of gestation at the moment of birth and subsequent neurological disorders in premature infants. The most significant were changes of the ventriculo-cranial index, width of anterior horns of lateral ventricles, thalamo-occipital distance, systolic-diastolic ratio between vertebrobasilar vessels of the brain. Conclusion. Such a detailed prenatal diagnosis contributes to noninvasive prognostication of the severity of neurological lesions of CNS in premature infants. The results showed interrelations between perinatal outcomes and initial blood flow impairment of fetal CNS in 97% of observations.

© 2018, Bionika Media Ltd. All rights reserved. Appropriate nutrition is essential for the health and optimal growth of preterm infants. Aim. To investigate the effectiveness of the application of clinical guidelines “Enteral feeding of preterm infants” in infants below 32 weeks’ gestation. Material and methods. The study comprised 114 extremely preterm infants born before (2013-2014, group 1, n=53) and after (2014-2015, group 2, n=61) introduction of the clinical guidelines. Comparative analysis included breastfeeding frequency, the time of initiation of enteral feeding and achieving enteral feeds up to a volume of 150ml/kg/d, the incidence of necrotizing enterocolitis (NEC), gastrointestinal dysfunction, gastric bleeding, the use of breast milk fortifier, and the dynamics of infant postnatal physical growth. A comparative assessment also included the length of hospital stay, postconceptional age (PCA) and body weight at the time of hospital discharge. Results. After the introduction of clinical guidelines, 47 (77%) children received maternal colostrum on the first day of life. Breastfeeding was initiated significantly earlier: within 1 (1-5) day after birth in group 2 compared with 9 (2-28) days in group 1. Most infants received enteral feeding on the first day of life, though the infants in group 2 were administered it significantly earlier [7.5 hours (3.5-51) vs. 12 (6-144)]. A significant part of the extremely preterm infants was fed with breast milk. Sixteen (30%) infants in group 1 and almost twice fewer children in group 2 [10 (16%)] were on artificial feeding. In group 2, full enteral feeding was achieved significantly earlier than in group 1 [12 days (6-48) vs. 18.5 (13-47)], while the incidence of NEC in group 2 decreased 1.7-fold (14.8% vs. 24.5%). By 36 weeks’ PCA, the infants in group 2 had significantly higher body weight than babies in group 1 [2220 g (1420-2818) vs. 2050 g (950-3190)]. Conclusion. The clinical implementation of the guidelines “Enteral feeding of preterm infants” has resulted in significantly higher feeding efficiency in extremely preterm babies.