The ìorpío-clinical analysis syndrome of respiratory frustration at
deep(deeply) premature
newborn
IU.S.Ismailova,
Ì.Ê. Serykbai
The Kazakh
national medical university by named S.D.Asphendiarova.Almaty, RÊ
Syndrome of respiratory
frustration (respiratory deestress-syndrome,RDS) borrows(occupies) in neonatal
of a pathology one of conducting places [1,2].
frequencies of development RDS newborn is
connected to term gestation, so at term gestation
29 weeks and less - on RDS it is necessary
on the average 65 %, 35 %- at term 31-32 weeks, 20 %- at 33-34 weeks and about1 %- at
37 weeks gestation [3,4].
On the data of the centralized children prosectorium.
Almaty hyaline of a membrane (GM) and
primary atelectasis easy (PA),
causing RDS, Borrow(occupy)
one of conducting places in structure neonatal mortality [5,6].
By the purpose of the given research was
the clinic-morphological analysis of a section
material deeply premature newborn, died in the age of
about 6 day after birth with a clinical picture RDS at
terms of pregnancy 22-28 weeks.
For revealing laws and statistical
analysis morphological differentiation easy in different terms gestation
the material on duration pre-natal of
development was distributed(allocated) according to the recommendations a CART,
on the following groups of research: 22-23, 23-24 and 26-28 weeks (table 1).
The table 1
Distribution GM and PA in the ratio with terms of pregnancy
|
Nosological form |
22-23 week |
22-23 week |
23-24 week |
23-24 week |
26-28 week |
26-28 week |
|
n |
% |
n |
% |
n |
% |
|
|
Primary atelectasis |
34 |
11,5 |
67 |
22,8 |
121 |
40,6 |
|
Hyaline membrane |
- |
- |
22 |
7,9 |
47 |
17,2 |
|
Total |
34 |
11,5 |
89 |
30,7 |
168 |
57,8 |
Is revealed, that among the surveyed
quota prevailed primary atelectasis and illness hyaline
of membranes at term gestation 26-28 weeks. At
22-23 weeks of pregnancy hyaline the membrane did
not meet.
All newborn (291 supervision) had
extremely low and low weight of a body, that is reflected in the table 2
The table 2. weight of a body and distribution nosologikal of the forms premature newborn with RDS
|
Nosological form |
22-23 week |
23-24 week |
23-24 week |
Total |
|||||
|
n |
% |
n |
% |
n |
% |
n |
% |
||
|
Primary atelectasis (222) |
500-750ã |
32 |
11,0 |
25 |
8,6 |
6 |
2,1 |
63 |
21,7 |
|
751-999ã |
3 |
1,0 |
41 |
14,0 |
115 |
39,6 |
159 |
54,6 |
|
|
Hyaline membrane (69) |
500-750ã |
- |
- |
4 |
1,3 |
- |
- |
4 |
1,3 |
|
751-999ã |
- |
- |
11 |
3,8 |
54 |
18,6 |
65 |
22,4 |
|
|
Total (291) |
35 |
12,0 |
81 |
27,7 |
175 |
50,3 |
291 |
100 |
|
From the data submitted in the table 2,
it is visible, what with the section diagnosis ÏÀ the greatest quantity(amount)
newborn with weight of a body 751-999ã was necessary for the term of gestation
26-28 weeks, then
23-24 weeks and on 22-23 weeks. Opposite(on the contrary), at extremely low weight
of a body (500-750ã) the greatest number with ÏÀ was necessary on 22-23: 23-24
weeks gestation and less whole - for the term of 26-28
week.gestation. The life expectancy newborn changed in
limits about 6 day, that is analysed in the table 3.
The table 3. life expectancy newborn and
distribution on a sexual accessory(belonging)
|
Nosological form |
Till 1 hour |
From 1 hour about 1 day |
From I day about 6 days |
Total |
|||||
|
m |
f |
m |
F |
m |
f |
m |
F |
||
|
Primary atelectasis (222) |
22-23 week |
3 |
5 |
8 |
12 |
2 |
3 |
13 |
20 |
|
23-24 week |
5 |
7 |
28 |
13 |
9 |
10 |
42 |
30 |
|
|
26-28 week |
9 |
3 |
31 |
22 |
33 |
22 |
73 |
47 |
|
|
Total |
17 |
15 |
67 |
47 |
44 |
35 |
128 |
97 |
|
|
Hyaline membrane (69) |
22-23 week |
- |
- |
- |
- |
- |
- |
- |
- |
|
23-24 week |
- |
- |
3 |
5 |
1 |
2 |
4 |
7 |
|
|
26-28 week |
1 |
5 |
14 |
10 |
14 |
13 |
29 |
28 |
|
|
Total |
1 |
5 |
17 |
15 |
15 |
15 |
33 |
35 |
|
|
total (291) |
|
18 |
20 |
84 |
62 |
59 |
48 |
161 |
130 |
According to submitted to the data, at GM and PA has
died more boys: at PA the majority newborn have died at term
of pregnancy 26-28 weeks with life expectancy of 1 hour about 1 day and from 1
day up to 6th. At GM
parameters same, mortality at the girl made practically equal
number.
The doubtless interest represented a
condition of health of the mothers newborn, that by us is analysed in the table
4.
The table 4. The analysis obstetric(al) and somatic(al) of a pathology of
the mothers newborn with primary atelectasis and hyaline by membranes
|
Analyzed parameters |
Primary atelectasis P-222 |
Hyaline membrane P-69 |
||
|
22-28 week |
22-28 week |
|||
|
n |
% |
n |
% |
|
|
Pregnancy first repeated |
62 160 |
27,9 72,1 |
18 51 |
26,1 73,9 |
|
Age up to 30 years and after 30 years |
120 102 |
54,0 46,0 |
33 36 |
47,8 52,2 |
|
Twins |
41 |
18,0 |
14 |
20,3 |
|
gestational toxicosis |
31 |
13,5 |
11 |
15,9 |
|
Anemia |
112 |
50,4 |
27 |
39,1 |
|
Threat fetus wastage |
41 |
18,0 |
18 |
26,1 |
|
Vaginitis |
41 |
18,0 |
13 |
18,8 |
|
chronic pyelonephritis |
52 |
23,4 |
23 |
33,3 |
|
persistent infection |
31 |
13,5 |
13 |
18,8 |
|
ORVI |
59 |
26,6 |
11 |
15,9 |
|
Cesarean section |
67 |
30,2 |
21 |
30,4 |
|
hydramnion oligo |
17 13 |
7,7 5,9 |
9 - |
13,0 |
|
preeclampsia |
29 |
13,1 |
21 |
30,4 |
|
adenoma of thyroid |
29 |
13,1 |
8 |
11,6 |
|
Carriage CMV |
27 |
12,2 |
- |
|
On the data of the table 4, greatest
densities in structure of a pathology of the mothers with PA and GM such
diseases as anemia (PA-50,4 of % were in the lead: GM-39,1 of
%), ÎRVI (PA -26,6 of
%: GM -15,9 of %), Vaginitis (PA-18,0 of
%: GM -18,8 of %), chronic pyelonephritis
(PA -23,4 of
%: GM -33,3 of %), and endemica craw (PA -13,1 of
%: GM -11,6 of %). Obstetric
the pathology was submitted by threat interruption of
pregnancy, it is a lot of and shallowness, preeclampsia.
In significant quantity(amount) the operation cesarean
of section is undertaken.
The received results testify to
necessity careful readjustment and treatment of the women
up to pregnancy, during pregnancy, realization of high-grade measures antenatal
of protection of a fruit for preservation of pregnancy and prevention(warning)
of birth is deep premature of children with low weight of a body dying in
significant quantity(amount) from pulmonary of a pathology at PA and GM.
Literature
1. Avdeeva R.A., Staryh
E.Ph. Pneumopathy as reason SDR and their outcome in premature newborns
2. Riumina I.I.,
Eigenson O.B., Zhitova E.P. Features of current of a syndrome of respiratory
frustration at premature children various gestational age.hight.Vest. perinat and the pediatrist. 1995;
3. Shabalova
N.P. Neonatology, Volume 1. SPb; 1997: 247-280
4. The
forecast premature children. Hiroshi
5. Chuvakova
T.K., Musurova Zh.K. The reasons of death rate of newborns in early neonatal
the period. Pediatrics and children's surgery
6. Ormantaev
K.S., Tursunov K., Litosh V.E.Problems of the organization and prospect of
development of surgery of newborns in