SOVREMENNAYA PEDIATRIYA.2016.7(79):102-105; doi 10.15574/SP.2016.79.102 

Prognosis of cardiovascular disorders development in newborns with seizures

Teslenko T., Gonchar M., Ohnev V., Zinchuk A.

Kharkiv National Medical University, Ukraine

Introduction. The article is devoted to topical issues of modern neonatology such as a prognosis of cardiovascular disorders in newborns. The formation of lesions of the cardiovascular system in many cases starts in the perinatal period. Severe damages of the CNS, especially followed with seizures, impair the cardiovascular system condition due to violation of its nervous regulation. Risk prognosis and an early detection of cardiovascular disorders help to beginning of necessary treatment and prevention of severe complications.

Purpose of the Study: to improve diagnosis of cardiovascular disorders in newborns through the creation of prognostic model.

Materials and Methods. The study involved 82 newborns in the early neonatal period (the analysis of obstetric history, clinical and laboratory examination, ECG, amplitude integrated EEG, Doppler echocardiography, neurosonography with Doppler of the cerebral vessels).

Results and Discussion. Among the 82 examined children there are 44 (53.7%) neonates with seizures (22 (50.0%) of them had subclinical seizures, confirmed with the presence of convulsive patterns on the amplitude-integrated EEG). All newborns were divided into 2 groups according to systolic index by Doppler: the first group consisted of 39 (47.6%) infants with hypokinetic type of the central hemodynamics (as unfavorable for the development of cardiovascular disorders), the second — 43 (52.4%) newborns with hyperkinetic and normorkinetic type. Infants of both groups were rated according to the list of clinical, anamnestic, laboratory and instrumental criteria. Significant prognostic criteria were detected after statistical processing. These criteria were included in the proposed model for prognosis of cardiovascular disorders.

Conclusions. Developed prognostic model can be used for detection of newborns who need more careful examination and observation for the prevention of cardiovascular disorders.

Key words: newborns, infants, prognosis, cardiovascular disorders, hemodynamics, seizures.

REFERENCES

1. Abalova VV, Degtyareva MN, Volodin NN. 2012. Modern views on the diagnostic and prognostic informativeness of amplitude-integrated EEG in newborns with perinatal damage of the central nervous system. Voprosy prakticheskoy pediatrii. 7; 4: 17-26.

2. Korzhynskyy YuS, Vaysberh YuR, Zdvyzhkova VM, Laponoh SP. 2013. Amplitude-Integrated EEG in Neonatology. Ukraine, Lviv: 60.

3. Boichenko AD, Riha OO, Senatorova AV. 2011. Formation of central hemodynamics in healthy newborns. Zdorovye rebenka. 2(29): 103-106.

4. Gubler YeV. 1990. Informatics in pathology, clinical medicine and pediatrics. Russia, Leningrad: 176.

5. Kireev SS, Larchenko VI. 2011. Cerebral hemodynamics and possibilities for its optimization in newborns from intensive care unit with critical condition. Neonatolohiia, khirurhiia ta perynatalna medytsyna. 1; 2: 51-54.

6. Kleinman ChS, Seri I. 2015. Hemodynamics and Cardiology: Neonatology Questions and Controversies. Transl. fr. Engl. Russia, Moscow: Logosfera: 512.

7. Znamenska TK, Tolstanov OK, Pokhylko VI, Kovalova OM, Slabkyi HO, Kurilina TV, Znamenska MA. 2015. Neonatology from the position of the family doctor. Kyiv: Polosatkot: 432.

8. Senatorova HS, Gonchar MO, Boichenko AD, Kondratova IYu. 2014. Cardiovascular disorders in perinatal period: pathogenesis and treatment directions. Neonatolohiia, khirurhiia ta perynatalna medytsyna. 4; 3(13): 37-44.

9. Primary aid, resuscitation and postresuscitation assistance for newborns in Ukraine: unified clinical protocol of neonatal care providing. 2014. Ukraine, Kyiv, MOH of Ukraine, no 225. http://www.moz.gov.ua.

10. Tretyakova OS, Zadnipryanyiy IV, Eng Lu San, Emerodi Chidera Kenechukvu Roze. 2012. Phenomenon of the «stunned» myocardium at transitional ischemia of the myocardium of newborns. Neonatolohiia, khirurhiia ta perynatalna medytsyna. 2; 1(3): 65-70.

11. Hellstrom-Westas L, de Vries LS, Rosen I. 2008. An Atlas of Amplitude-Integrated EEGs in the Newborn. UK: 187. https://doi.org/10.3109/9781439813898