Morphology of placental villi and development of hemorrhages in very small preterm newborns.

We performed a comparative morphometric and immunohistochemical studies of the placentas collected in preterm labor after 27-33-week gestation. Predominating branched angiogenesis processes and more pronounced vascularization of the placental villi were found in the group of newborns with hemorrhagic complications. These changes were paralleled by high expression of VEGF in all villous structures.

[High-frequency oscillatory lung ventilation in complex therapy for congenital pneumonia and hyaline membrane disease in newborns].

Fifty-eight neonatal infants with hyaline membrane disease (HMD) and congenital pneumonia were examined in the critical status. In 32 of them, high-frequency oscillatory lung ventilation (HFOLV) was employed. The use of HFOLV was found to reduce the length of stay in neonates on toxic oxygen concentrations by more than 2 times and to accelerate the normalization of ventilation-perfusion relationships by more than 3 times. A study of the basic parameters of central and regional hemodynamics showed that HFOLV failed to affect the patients' hemodynamic status. The efficiency of correction of severe respiratory disorders in neonatal infants with HMD was ascertained to increase with the combined use of the Russian surfactant and HFOLV. A formula was developed to calculate the starting amplitude of oscillations when HFOLV was employed. The maximum allowable values of mean airway pressure at which HFOLV could be discontinued were determined, which prevented the regimens from toughening when HFOLV was changed to the routine artificial ventilation. The use of HFOLV was established to reduce the risk of severe cerebral structural and vascular lesions and mortality rates.

[Organization of neurologic services for newborn infants in the perinatal period]. / Organizatsiia nevrologicheskoi pomoshchi novorozhdennym v perinatal'nom periode.

The authors have demonstrated the current diagnostic potentialities in the assessment of the nervous system status of the fetus and neonate, based on the use of the latest known how. New methods of all-round examinations of perinatal brain injuries given an idea of the site, character, prevalence and gravity of structural and functional brain pathology in neonates, early recognition and estimation of compensatory potencies of perinatal cerebral injuries. The reserves of preventing neurological invalidism since childhood are shown. The role of close cooperation of obstetricians, neonatologists, neuropathologists and other specialists in enhancing the efficacy of rendering neurological assistance to the newborn is emphasized as is the necessity of succession in the work of all the links in the childhood neurological services.

[Clinical value of determining the levels of renin, aldosterone and vasopressin in newborn infants in critical conditions]. / Klinicheskoe znachenie opredeleniia renina, al'dosterona i vazopressina pri kriticheskikh sostoianiiakh u novorozhdennykh detei.

The concentrations of aldosterone, vasopressin and plasma renin activity were measured in cord blood and on days 1, 3 and 5 of life in 71 newborn infants from the risk group at the development of critical conditions. Vasopressin was discovered to play a substantial role in the development of critical conditions. The lack of a considerable vasopressin ejection in response to a delivery trouble and the growth of its concentration by day 5 of life are prognostically unfavourable. Hyperactivity of the renin-aldosterone system determines the newborns' proneness to liquid and sodium retention.

[A method of studying the visual evoked potentials in the evaluation of the status of the central nervous system in newborn infants]. / Metod zrite'lnykh vyzvannykh potentsialov v otsenke sostoianiia tsentra'lnoi nervnoi sistemy novorozhdennykh.

In 15 healthy mature babies and 15 newborn babies with cerebral pathology the visual evoked potentials (VEP) were investigated. The light diodes were used for stimulation. The curves preprocessed using a simple configurations technique were analysed with an euristic technique on a microcomputer. The high information value (88.5%) was attributed to VEP in cases of perinatal brain lesions. This suggested the inclusion of VEP techniques into the routine neurological investigation of the newborns.

[Creatine kinase BB and lactate in the cerebrospinal fluid of neonates and infants with perinatal injuries of the CNS]. / Kreatinkinaza-BB i laktat v spinnomozgovoi zhidkosti u novorozhdennyki u detei rannego vozrasta s perinatal'nymi porazheniiami TsNS.

A study was made of the content of creatine kinase-BB (CK-BB) and lactate in cerebrospinal fluid (CSF) of 202 neonates and infants with perinatal CNS injuries. The relationship was found between the rise of the CK-BB content and the gravity of perinatal CNS injuries. The highest content of CK-BB in CSF was marked in neonates with cerebral disorders complicated by infectious and inflammatory diseases (pneumonia, sepsis). Within the first 5 days of life, the children of this group demonstrated the relationship between the content of CK-BB and lactate of CSF. The measurement of the content of CK-BB in CSF should be used for early diagnosis, assessment of the gravity and course of perinatal CNS injuries in neonates and in infants.

[Prospective and retrospective analysis of prognosis in perinatal hypoxic lesions of the brain]. / Prospektivnyi i retrospektivnyi analiz prognoza perinatal'nykh gipoksicheskikh porazhenii mozga.

The article presents data on the prospective and retrospective analysis of the dynamic structure of neurological syndromes in 211 children with perinatal hypoxic lesions of the brain in the preschool period. The complex of examinations included electroencephalography, echoencephalography, psychological examination, as well as measurement of lipid peroxidation products and immunoglobulin levels in the cerebrospinal fluid. It has been demonstrated that transformation of neurological symptom complexes at the most important stages of postnatal ontogenesis plays the decisive diagnostic and prognostic role. On the basis of the findings the authors consider optimal terms for screening children with a history of perinatal hypoxic impairment of the nervous system.

[Significance of risk factors in the development and formation of permanent organic lesions of the central nervous system in infants during the 1st few months of life]. / Znachenie faktorov riska vozniknoveniia i formirovaniia stoikogo organicheskogo porazheniia tsentral'noi nervnoi sistemy u detei pervykh mesiatsev zhizni.

Data obtained from examining 350 full-term newborns and infants of up to 4 months of age with pre- and perinatal encephalopathies were processed mathematically. As a result, factors pointing to a high risk of development of functional cerebral disorders and formation of early organic syndromes in infants of the first 4 months of life were specified. As the basis for this a chart devised with the aid of the expert evaluation method was taken. The chart included 42 signs with 98 gradations (occupational unhealthy factors, family and obstetrical history, course of pregnancy and childbirth, clinical characteristics of the neurological manifestations in the acute and early restorative periods). A high prognostic value of combining some factors, symptom complexes, clinical and laboratory findings is demonstrated: such combinations are very important for early diagnosis of organic cerebral pathologies. The use of those combinations has made it possible to identify (with the aid of a computer) 95.6% of infants with a threat of early development of organic changes in the central nervous system.

[Diagnosis and course of convulsive states in children]. / O diagnostike i techenii sudorozhnykh sostoianii u detei.

In 129 children convulsive states were examined with the use of a set of additional examination methods. The age structure of the convulsions and their course in young children are described. Different origin of the convulsive states is shown. The role of pre- and perinatal factors, mineral metabolism disturbances, infectious and other diseases, as well as of aggravated heredity is demonstrated. The importance of the premorbid background for the formation of the character and the course of the convulsive seizures in children, and for the formation of epileptiform syndrome is stressed.