- Status of renal hemodynamics in a full-term newborns with perinatal pathology
Status of renal hemodynamics in a full-term newborns with perinatal pathology
PERINATOLOGIYA I PEDIATRIYA. 2017.2(70):113-120; doi 10.15574/PP.2017.70.113
Babintseva A. G.
HSEE of Ukraine «Bukovinian State Medical University», Chernivtsi
Purpose — to determine the peculiarities of renal hemodynamics in the full-term newborns with perinatal pathology of varying severity on the basis of Doppler ultrasonographic features of the blood flow in the major renal arteries at the end of the first day of life.
Materials and methods. Clinical and paraclinical examination of 146 full-term newborns was conducted. The neonates were divided into four groups. The first group included 22 babies with clinical signs of perinatal pathology of a moderate severity and relatively preserved renal functions. The 2nd group comprised 49 babies with adaptation disorders of the early postnatal period, 24 of whom had the renal dysfunction (IIA group) and 25 babies were diagnosed with an acute kidney injury (IIB group). The control group (the 3rd group) included 25 healthy newborns. At the end of the first day of life by means of the apparatus MyLabТМ 25Gold, made by ESAOTE (Italy), using a convex sensor on the frequency of 3.5-5.0 MHz color Doppler scanning and pulsed wave Doppler examination were performed with the analysis of velocity curves of the major renal arteries blood flow.
Results. In spite of no clinical signs of renal dysfunction, babies with adaptation disorders of moderate severity are characterized by the intensification of hemo-dynamic processes, which expressed by less velocity without activation of vasoconstrictive mechanisms. Newborns with severe perinatal pathology and renal dysfunction with "aggressive" therapeutic intervention were diagnosed with relative stability of the main velocity and resistant characteristics, which indicate a sufficient activation of compensatory hemodynamic mechanisms. Formation of the acute renal injuries in critically ill neonates is connected with severe disorders of the renal blood flow together with prevailing of renal vessels vasoconstriction and deterioration of general renal vascularization.
Conclusions. The results of research showed the necessity of routine pulsed wave Doppler with detection of the velocity curves of the blood flow in all the patients of neonatal intensive care units with the purpose of determining the status of renal hemodynamics and preclinical diagnosis of impaired renal function in full-term newborns with perinatal pathology of varying severity.
Кey words: full-term newborns, perinatal pathology, renal hemodynamics, Doppler ultrasound.
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