Modern Breastfeeding Options for Preterm Children in Neonatal Hospital

The literature overview on the issue of breastfeeding in neonatal departments, including neonatal intensive care units, is presented. The importance of breastfeeding for newborns with perinatal pathology is justified, as breast milk is vital for these children due to its unique sanogenetic properties. Data on special preventive and therapeutic role of breastfeeding for premature infants is presented. Reasons that complicate the use of breast milk in neonatal hospitals were analyzed (including those related to insufficient bacteriological and virological safety of native breast milk due to methodological errors during its collection and usage). Particular attention was paid to ensuring the breastfeeding safety during new coronavirus infection pandemic. This difficult period has demonstrated and confirmed the expediency of combining two breastfeeding approaches in perinatal centers: use of maternal milk and use of donor breast milk. Another section of review is devoted to modern breast milk processing technologies. Use of electric clinical breast pumps is crucial for promoting and supporting breastfeeding in the perinatal center.

Special Medical Food in Premature Child with Postnatal Malnutrition: Clinical Case

Background. Protein-calorie deficiency is common multifactorial medical condition in infants. Nutrition therapy of protein-calorie deficiency in premature infants with special medical food is not always quite effective. It can be associated with residual manifestations of overlapping perinatal pathology.Clinical case description. Extremely premature child with severe protein-calorie deficiency in the late period with combined perinatal pathology (perinatal central nervous system damage and bronchopulmonary dysplasia) was administrated with therapeutic highly nutritious (high-protein/high-energy) milk formula according to individual plan. The positive dynamics in clinical manifestations of the main and associated diseases was noted on nutrition therapy.Conclusion. High-calorie and protein-enriched therapeutic formula can effectively correct protein-calorie deficiency in premature infants with associated perinatal pathology in the recovery period (disfunction compensation).

The role of the psychoemotional stress during gestation in the development of obstetrical and perinatal patology

The complex investigation of the perinatal pathology at acute and c/1,1-onic psyclioemotliional stress dunng gestation has been perf 01 wed. Jt was sliown (by tlie metliod of the retrospective analyses) the inaease in the relat-ive 1-isf of tlie premature delivery (1,4-8,0), severe and mild gestosis (3,0-10,0), placental pathology (2,2-3,3 ), anomalies of delivery (2,0-7,0 ), obstetlical Blending (2,0- 2,8 ), late delivery (2,0-7,0) dunng the acute stress. The relationship between tlie pelinatal patology and gestation term was shown dunng the acute stress. Dm'ing- i-lie clironic stress tlie frequency and seventy of pennatal patliology is dependent upon the type of psyclioemotional reaction on the st-ress. The seventy of patliofog-y is more prominent at decompensated type of psychological reaction t-lian at subcompensated type. Tlie newbom infants of motlias witli psyclioemotional stress recuired long rehabilitation in 39,2-50,0% cases.

DIAGNOSTIC VALUE OF MALONIC ALDEHYDE IN URINE AS A MARKER OF RENAL DYSFUNCTION IN FULL-TERM NEONATES WITH PERINATAL PATHOLOGY

Introduction. One of the mechanisms of pathologic oxidative stress in neonates is intensification of membrane lipid peroxide oxidation. Malonic aldehyde (MA) is a secondary product used as an indicator of lipid peroxidation processes and therefore a marker of cellular membrane damage. Meanwhile, nowadays the mechanisms determining organ peculiarities of lipid and protein peroxidation as well as resistance to ischemic kidney damage are not studied completely and require further development. Objective: to determine diagnostic value of MA in urine as a marker of renal dysfunction in full-term neonates with perinatal pathology of various degrees of severity. Material and methods. One-centered cohort prospective study was carried out including 41 full-term children with disorders of general condition of a moderate degree of severity (І group); 36 full-term children with disorders of general condition of a severe degree without acute kidney damage (ІІА group); 30 full-term children with disorders of general condition of a severe degree with acute kidney damage (ІІB group) and 40 healthy children (ІІІ group). МА level in urine was determined by means of reaction with thiobarbituric acid at the end of the 3rd day of life. Results. The lack of a negative test diagnostic value with determination of MA in urine was determined when renal dysfunction had been found in full-term neonates with signs of perinatal pathology of a moderate severity. It was evidenced by AUROC 0,53 (95% CІ 0,50; 0,65, р>0,05) with a threshold value of the parameter ≤9,57 mcmol/L. A perfect discriminating ability to determine MA level in urine was demonstrated in diagnostics of disorders of the functional kidney state in children who had signs of severe postnatal adaptation disorders. It was evidenced by AUROC 0,81 (95% CІ 0,71; 0,91, р<0,001) with a threshold value of the parameter ≥ 9,58 mcmol/L; specificity 97,6% (95% CІ 87,1%; 99,9%), prognostic value of a positive result 95,7% (95% CІ 75,7%; 99,4%) and likelihood ratio of a positive result 25,1 (95% CІ 3,55; 76,7). Diagnostics of acute kidney injury in critically sick term neonates found a proper quality of the diagnostic pattern with determination of MA level in urine. It was evidenced by AUROC 0,80 (95% CІ 0,66; 0,89, р<0,05) with a threshold value of the parameter ≥12,9 mcmol/L; specificity 91,4% (95% CІ 76,9%; 98,2%), %), prognostic value of a positive result 85,7% (95% CІ 66,2; 94,9%) and likelihood ratio of a positive result 7,0 (95% CІ 2,28; 21,5). Conclusions. Considering the value of reactions of pathologic oxidative stress in the formation of maladjustment syndromes, determination of MA in urine is suggested to be used as one of the possible markers of renal dysfunction in neonates which reflects the state of lipid peroxidation processes in the kidney structures and degree of their damage.

CLINICAL AND GENETIC DETERMINANTS OF PERINATAL PATHOLOGY IN NEWBORNS

One of the pressing issues of healthcare nowadays is applying methods of molecular genetics aimed at identifying and assessing genetic risk factors and early diagnosis of perinatal pathology. Numerous studies have contributed to identifying risk factors that affect the health of newborns. The aim of this work is to investigate the associations between the development of perinatal pathology in premature and full-term infants with polymorphism of genes of the glutathione transferase family (GSTT1, GSTM1, GSTP1), renin-angiotensin system (ACE, AGT2R1). Materials and methods. The study included 110 full-term infants with asphyxia, 30 healthy full-term infants for the control group, and 125 preterm infants with perinatal infections, 21 preterm infants with broncho-pulmonary dysplasia, and 70 conditionally healthy preterm infants. A set of routine clinical and laboratory methods of research and determining gene polymorphism was performed. Results. The presence of a non-functional allele of the GSTT1 gene and DD variant of the ACE gene in newborns is associated with the development of severe perinatal asphyxia (p = 0.006 and p = 0.003, respectively). Children with GSTT1 "-" and AC AG2TR1 genotypes have significantly higher levels of diastolic pressure in the first day after birth than children with functional genotypes of these genes (p <0.05). The median mean duration of mechanical ventilation and CPAP in children with GSTT1 genotype "-" was significantly higher than that in children with GSTT1 genotype "+" (p = 0.01 and p = 0.001, respectively). Conclusion. Polymorphism studies of glutathione transferase and renin-angiotensin genes can be used to predict the severity of a child's condition after birth.

CHANGES IN ELECTROENCEPHALOGRAM INDICATORS IN ADOLESCENTS WITH VEGETATIVE DYSFUNCTION

This work is based on the results of a study of the assessment of physical parameters of the electroencephalogram in adolescents with autonomic dysfunction, depending on gender and the presence of perinatal pathology in the anamnesis. We examined 87 adolescents 12-18 years old with clinically and laboratory-instrumental confirmed dysfunction of the autonomic nervous system -autonomic dystonia syndrome (ADS). The average age of the clinical manifestation of ADS in girls was 12.2 ± 1.8 years, in boys -13.5 ± 2.1 years. As a result of the study, it was revealed that adolescents with a history of perinatal pathology have the maximum risk of disturbances in the processes of myocardial repolarization at the end of the recovery period after physical exertion, especially in females

Тhе features of a personalized approach to the treatment of cardiovascular diseases during pregnancy

Annotation. For the cases of cardiovascular pathology during pregnancy include hypertensive disorders, hypercholesterolemia, myocardial infarction, cardiomyopathy, arrhythmias, valve disease, thromboembolic diseases, aortic disease and cerebrovascular pathology. Cardiovascular disease (CVD) is the leading cause of death from pregnancy in the world. Raising maternal age and comorbid diseases contribute to increased maternal mortality, also. When searching for literature, we used Medline systems from PubMed (2011). The search was adapted for Embase (2015 - 2021) and Scopus (2017 - 2021). Inclusion criteria were as follows: the impact of diseases of the cardiovascular system on pregnancy; the impact of pregnancy on the course of cardiovascular disease; features of diagnosis and prevention of women with CVD at the stage of preconception and during pregnancy; safety of drugs for the treatment of cardiovascular pathology during pregnancy; choice of drugs to prevent perinatal pathology in women with CVD; features of antenatal observation in CVD. We excluded from the study: references to 2011 (more than 10 years); not English; all methods that were not directly related to the pathology of the cardiovascular system during pregnancy; concomitant diseases that can lead to aggravation of pregnancy; animal studies. As a result, 76 studies were identified that were subject to final inclusion in the systematic review. Analysis of the identified literature sources showed that the preconception reproductive strategy to be developed by a multidisciplinary cardio-obstetric team is becoming important for women with a history of cardiovascular disease or for those with a history of familial preeclampsia. Cardio-obstetrics has become as an important multidisciplinary industry that requires a team approach to optimizing the clinical management of cardiovascular disease during pregnancy. Timely involvement of the cardio-obstetric group is crucial to prevent maternal morbidity and mortality during pregnancy and 1 year after delivery. A general understanding of the importance of the impact of cardiovascular disease on pregnancy and the impact of pregnancy on existing CVD should be a basic area of expertise for family medicine professionals, cardiologists, obstetricians and gynecologists. The given scientific and clinical review of sources of evidence-based medicine contains certain features of predictor diagnosis, prevention and treatment of manifested forms of cardiovascular diseases during pregnancy.

Аналіз материнських чинників перинатальної патології серед жінок з порушенням менструального циклу

The analysis of the course, completion of pregnancy in women with reproductive losses and menstrual irregularities, the formation of risk groups with the aim of improving the prevention system, early diagnosis of perinatal pathology and predicting healthy offspring was carried out.