The state of neonatal neurosonography in infants with perinatal nervous system damage

Аннотация

In this study, the authors conducted ultrasound examinations of the central nervous system in newborns with perinatal nervous system damage. It was observed that infants born to mothers with a complicated obstetric history and pathological course of delivery constitute a high-risk group for perinatal nervous system damage. To early detect structural brain changes, neurosonographic examinations of the central nervous system are recommended for all newborns in the high-risk group. Keywords: Hypoxia, asphyxia, depth of the anterior horns of the lateral ventricles, intraventricular hemorrhage, brain edema. in perinatal nervous system pathology, cerebral Introduction: Perinatal hypoxia occupies a prominent vascular disorders, leading to the development of place among perinatal factors that affect not only the hemorrhagic and ischemic CNS injuries in newborns fetus's condition but also the characteristics of the [2,4]. neonatal period, ultimately impacting the child's health and future development [5]. More than half of all cases Objectives of central nervous system (CNS) dysfunction in infants The aim of this study was to investigate the clinical are attributed not to acute hypoxia during childbirth manifestations and neurosonography features in but to prolonged, chronic hypoxia in the fetus and newborns with perinatal nervous system injuries. newborn [1,3]. Among perinatal brain injuries, METHODS cerebrovascular pathology takes a leading role. One of the primary causes of hemorrhagic and ischemic brain A total of 60 newborns with various gestational ages injuries is cerebral hemodynamic disturbances [4]. and perinatal nervous system injuries were observed in Hypoxia is recognized as the primary etiological factor the Physiological and Neonatal Intensive Care International Journal of Medical Sciences And Clinical Research 75 https://theusajournals.com/index.php/ijmscr International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265) Department of the Samarkand Regional Perinatal The diagnosis of perinatal encephalopathies, Center. depending on the nervous system lesions, was established according to the classification of perinatal The criteria for including children in the study groups nervous system injuries in newborns by Sarnat and were as follows: Group I consisted of 20 healthy Sarnat in 1976. newborns born to healthy mothers aged 21 to 33 years, with no complicated obstetric history, and a normal The structural ultrasound examination of the brain course of pregnancy and delivery. Among them, 12 using B-mode (neurosonography) was performed on were full-term infants, and 8 were "conditionally the GE Logic F 8 device (USA) with the use of multi- healthy" preterm infants. The group of "conditionally frequency convex probes of 5.5 MHz. healthy" preterm infants included children born with a Statistical data analysis was carried out using gestational age between 35 and 37 weeks and a body specialized SPSS software (version 29, IDV Co., Armonk, weight ranging from 1500 to 2500 grams. NY, USA). The second group consisted of 20 children who RESULTS AND DISCUSSION experienced acute asphyxia during childbirth but were During the analysis of neurosonography parameters, born to healthy mothers. The causes of acute hypoxia including the depth of the anterior horns (right and left) were as follows: cesarean section (5); umbilical cord and the depth of the lateral ventricles (right and left), entanglement around the neck (5); prolonged labor (7); in healthy newborns and those with acute and chronic foot and breech presentation (3). Group II comprised hypoxia, significant alterations were identified, 20 newborns born to healthy mothers who demonstrating statistically significant differences. experienced acute asphyxia during childbirth, with Conversely, data for the parameters of the third and Apgar scores averaging below 6-7 points. The clinical fourth ventricles in healthy infants and those with picture manifested as a syndrome of increased neuro- acute or chronic hypoxia did not exhibit statistical reflex excitability characterized by regurgitation, sleep variance. disturbances, chin tremors, restlessness, spontaneous Moro reflex (phase I), and a syndrome of depression Specifically, the depth of the right anterior horn of the characterized by muscle hypotonia, hypodynamia, lateral ventricles in healthy subjects was 0.3 cm, while weak suckling, horizontal nystagmus, and in cases of acute asphyxia, it averaged 0.388 ± 0.100 gastrointestinal dyskinesias. cm, with statistical significance (p ≤ 0.05), and in instances of chronic hypoxia, it measured 0.418 ± 0.124 The third group included 20 newborns who cm (p ≤ 0.05). On the left side, the depth of the anterior experienced chronic intrauterine hypoxia. The causes horns of the lateral ventricles was 0.3 cm in healthy of chronic intrauterine hypoxia were severe anemia (5); subjects, 0.388 ± 0.103 cm in cases of acute asphyxia (p exacerbation of chronic pyeloneph