FEATURES OF THE CLINICAL COURSE OF HYPOXIC-ISCHEMIC ENCEPHALOPATHY 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. The children were divided into 3 groups: 1 group of 20 newborns with GIE with gestation period 28-31 weeks, 2 groups of 20 newborns with GIE with gestation period of 32-37 weeks and 3 group of 20 newborns with GIE period and 38-4 gestation period.Teaching,that the degree of gestational maturity of the fruit determines the morphological features of cerebral damage, as well as the spectrum of somatic pathology of the neonatal period, in the analysis and presentation of the results obtained by the group as the main results. Key words: hypoxia, central nervous system, neonatal period, gestation period. Introduction. Intrauterine fetal hypoxia occupies one of the first places in the structure of the causes of perinatal diseases and mortality. This pathology, as a rule, is a consequence of placental insufficiency, which accompanies almost all complications of pregnancy - miscarriage, gestosis, developmental delay or fetal https://scientific-jl.com/luch/ 1 9 5 Часть-42_ Том-1_ Апрель-2025 death, premature birth, acute or chronic infection [2,3,10]. Recent epidemiological studies indicate the leading role of brain lesions that occurred during the perinatal period in the further dysadaptation, and in some cases, disability in children. Thus, in the structure of children's disability, lesions of the nervous system account for about 50% [1,5,11]. Thus, 35-40% of disabled children are disabled due to perinatal lesions of the nervous system [4,6]. Therefore, the issues of hypoxic-ischemic encephalopathy remain relevant. In the scientific community, the study of the diagnosis and clinical consequences of perinatal lesions of the central nervous system (CNS) is actively continuing, and significant progress has been made in studying the mechanisms of development of certain forms of hypoxic - ischemic lesions of the central nervous system in newborns. Previous studies revealed that the central links in the pathogenesis of hypoxic lesions of the central nervous system are both cerebrovascular disorders and metabolic disorders [7,13]. Revealing the dynamics of metabolic disorders in CNS lesions in newborns with CHD remains an urgent task and opens up fundamentally new opportunities both for understanding the pathogenesis and for early diagnosis and correction of identified disorders [8,14,15]. The issues of the features of the clinical, instrumental and laboratory course of hypoxic lesions of the central nervous system in newborns, depending on the gestational age, both in the acute period and in dynamics, as well as the further neuropsychic development of children, remain poorly studied and require additional scientific substantiation [9,12]. Purpose of the study: to establish anamnestic and clinical features of hypoxic lesions of the central nervous system in newborns with different periods of gestation. Material and research methods. We observed 60 newborns with a gestational age of 28 to 41 weeks with hypoxic-ischemic lesions of the central nervous system (HIE). The children were divided into 3 groups: group 1 of 20 https://scientific-jl.com/luch/ 1 9 6 Часть-42_ Том-1_ Апрель-2025 newborns with HIE with gestational age 28-31 weeks, group 2 of 20 newborns with HIE with gestational age 32-37 weeks, and group 3 of 20 newborns with HIE and gestational age 38-41 weeks. The control group consisted of 20 healthy full-term newborns. At all stages of the study and observation of newborns, a gynecological and obstetric anamnesis was collected, the features of the course of pregnancy and childbirth were studied. The early neonatal period was assessed taking into account data on gestational age, birth weight and length, head and chest circumference, physiological loss of body weight, the state of the child at birth on the Angar scale, the presence of resuscitation measures, and the type of feeding were analyzed. In dynamics, the neuropsychic status of the examined children was assessed. To determine the degree of damage to the central nervous system, a neurosonographic study (NSG) was carried out. Results and their discussion. According to the results of clinical and instrumental examination, hypoxic lesions of the central nervous system of varying severity were diagnosed: in 14 newborns (in 23,3% of cases) there was a mild central nervous system lesion, in 26 (44,3%) - moderate, and in 20 (33, 3%) severe (Fig1). The severity of hypoxic encephalopathy was established on the basis of clinical syndromes and examination results according to the following criteria: - for mild degree, cerebral ischemia of the 1st degree (mild), intrapartum hypoxia, mild asphyxia at birth; excitation of the central nervous system is more common in full-term, depression - in premature, lasting no more than 5-7 days; moderate hypoxemia, acidosis; NSG - no pathological abnormalities; https://scientific-jl.com/luch/ 1 9 7 Час