DIAGNOSTIC FEATURES OF NEUROSONOGRAPHY IN INTRAUTERINE INFECTION IN NEWBORNS

Аннотация

In the article are given date 60 newborns with gestation period from 28 to 41 weeks with hypoxic lesion of the CNS of the early period. At all stages of the study and observation of newborns conducted a collection of gynecological, obstetric anamnesis, studied the specifics of the course of pregnancy and childbirth. The early neonatal period was assessed by taking into account the data of gestational age, mass and length of the body at birth, the circumference of the head and stem cells, physiological destruction of the mass of the body, analyzed the state of recurrence of childbirth. The dynamics of the neuropsychological status of the examined children was assessed. Keywords: hypoxia, central nervous system, neonatal period, gestation period. Introduction. Intrauterine infections (IUIs) are characterized by polyetiology, the absence of specific signs and a wide variety of clinical manifestations, which complicates their antenatal diagnosis and, as a consequence, preventive measures and treatment of a realized infection [8,9,12]. Neurosonography (NSG) is currently the primary screening method of research, due to its ease of implementation and relative availability. Neurosonography is a https://scientific-jl.com/luch/ 2 1 2 Часть-42_ Том-1_ Апрель-2025 method of two-dimensional ultrasound examination of the anatomical structures of the brain, which uses the property of sound to be reflected from the boundaries of tissue structures [3,4,14]. Acoustic windows: large and small fontanelles, defects in the bones of the skull, enlarged sutures, foramen magnum in newborns. The method is non-invasive, does not require preliminary preparation and allows you to trace the dynamics of the pathological process in real time. The image is presented on the monitor screen in the form of signals of hyper- and hypoechoic density [10,15]. The method is used for prenatal and postnatal diagnostics of cerebral malformations; hypoxic-ischemic, hemorrhagic, traumatic and inflammatory brain injuries and their consequences; tumors, ventriculomegaly. A sign of cerebral ischemia is the presence of diffuse hyperechoic foci, more often in the periventricular region, expansion of the interhemispheric groove, subarachnoid spaces, symmetrical expansion of the ventricular system [1,2,7,10]. Intraventricular hemorrhages (IVH) and parenchymal-hyperechoic formations with clear contours, located intraventricularly, subcortically or cortically. Has great diagnostic value in assessing the severity of GIE in newborns [5,6,11,13]. Objective: Determination of the nature of neurosographic data in hypoxic- ischemic encephalopathy in newborns with intrauterine infection. Materials and methods: A study was conducted in 24 full-term newborns who had intrauterine infection and with signs of DIE according to anamnestic, clinical and paraclinical data. All children underwent neurosonographic studies on the 3rd, 5-7, 14-16 days of life. Research results: The overall frequency of neurosonographic changes in newborns with HIE was 55.6%. The predominant symptom in the early neonatal period was a local increase in echogenicity, the frequency of which significantly decreased by the end of the first week of life. The neurosonographic picture had a https://scientific-jl.com/luch/ 2 1 3 Часть-42_ Том-1_ Апрель-2025 certain staging in the dynamics of the neonatal period, which made it possible to identify 2 NSH variants of its course in newborns with moderate HIE. The first option: a local increase in echogenicity - expansion of the interhemispheric groove. The latter could indicate the presence of atrophic changes in the brain tissue. The presence of this variant could be determined in 24 newborns who had changes in the NSH picture. The second option: a local increase in echogenicity - an increase in the echogenicity of the choroidal plexuses - a moderate increase in the lateral ventricles, subarachnoid space. This variant was more common in 24 children with neurosonographic changes (Fig1.). Figure 1. Ultrasound of the brain. The advantages of ultrasound methods in examining the brain in children of the first year of life are obvious. Non-invasiveness, absence of radiation exposure, and the possibility of dynamic research make echography one of the main diagnostic methods in perinatal neurology. No special training or anesthesia is required. Modern ultrasound methods make it possible to assess not only the structure of the brain, but also the state of cerebral blood flow. The severity of the underlying disease is not a contraindication for neurosonography (Table 1). Table 1. https://scientific-jl.com/luch/ 2 1 4 Часть-42_ Том-1_ Апрель-2025 Characteristics of neurosonography data in newborns on the 5-7th day of life Indicators 1st group 2nd group Group 3 Periventricular edema 18 (90%) 16 (80%) 13 (65%) IVH of 1 degree 5 (25%) 3 (15%) 2 (10%) IVH of the 2nd degree 3 (15%) 2 (10%) 15%) Dilation of the lateral ventricles 5 (25%) 4 (20%) 3 (15%) Periventricular cerebral