Aim Analysis of adaptive process indices in the early neonatal period in children from the group of high perinatal risk.
Methods 66 newborns without signs of CNS injury in the early neonatal period (Group I), 90 children with cerebral ischemia of severity level II (Group II), and 44 children with cerebral ischemia of severity level III (Group III). Adaptation indices in the neonatal period were studied, including the state of the cardiovascular system that plays a significant part in adaptive reactions. Electrocardiography and echocardiography were used for objective evaluation of the functional state of the cardiovascular system.
Results Duration and degree of the initial weight loss, presence of toxic erythema, breast engorgement, transitory fever of newborns, duration of jaundice, and umbilical wound healing were studied as criteria of adaptation of newborns. Adaptive processes were characterised by vegetative-visceral dysfunctions, which were registered in newborns of Group II and III and declared themselves in dryness, heightened humidity, “marble” skin pattern, acrocyanosis, tachypnoea and bradypnoea, tachycardia or bradycardia, and disorders of thermoregulation. Functional disorders on the part of the cardiovascular system were the most evident in children of Group II and especially of Group III. Clinical signs of disturbed blood circulation in children of Group II (17.8%) and, predominately, of Group III (59.1%) were retained to a greater or lesser degree within the whole neonatal period. In Group III, signs of hypertrophy and right ventricular overload (20.5%), hypertrophy and right atrium overload (13.6%) were registered. Variability of morpho-functional state indices of the cardiovascular system was revealed during the study of volumetric parameters of central and peripheral hemodynamics, which made it possible to single out 4 variants of central hemodynamics types.
Conclusion The revealed character of adaptive processes was determined by the peculiarities of the perinatal period and severity of cerebral deficiency. The most significant changes were detected on the part of the cardiovascular system that created prerequisites for the occurrence of functional and structural disorders already at the very early stages of the postnatal ontogenesis both in the cardiovascular system itself and in other systems.
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