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Characteristic features of physical development of newborns born by mothers with pre-eclampsia
pediatrician giving permission to the surgical treatment. His conclusion about contraindication or indication to the operation of a child having accompanying CDD or somatic diseases, the pediatrician confirmed conclusions of particular specialists (cardiologist, ne-phrologist, urologist, neurologist, pulmonologist, endocrinologist and others). Absolute contraindication to the operation is insufficiency of blood circulation IA and IIB degrees. Relative contraindications are: sharp evident dystrophic changes in myocardium, acute somatic and infectious diseases and not earlier 2 months after recovery hypotrophy I-III degrees, rickets I-III degrees in fastigium period, atopic dermatitis in the stage of recrudescence, anemia with containing of erythrocytes less 3.5x10 12/l, hemoglobin less 120g/l, colored finding less 0.75, chronic diseases during 6 months after recrudescence, chronic nephritis with manifestations of renal insufficiency, dermatitis and eczema in the facial area, affection of mu-cousa. Children with relative contraindications were carried out specific treatment accompanying pathology (in the out-patient or profile departments) and on favorable dynamic was allowed opera-
tive treatment [7; 10]. But in consideration of earlier address to the specialized medical aid from the first days of the life and timely diagnostics of accompanying defects of development, primary cheilo-rhinoplasty were carried out at the age of 2-3 months, but qualified surgical treatment of children with congenital cleft of upper lip and palate was finished during 12-16 months of life.
Conclusions. Detected in children with cleft of upper lip and palate external stigma of disembryogenesis — congenital defects of development of extremities, kidneys and other changes of organs have systemic character, progress which is conditioned with dysplasia of connective tissue. For extension of complex aid and provision complete rehabilitation of patients with congenital cleft of lip and palate is necessary synchronic work of specialists: geneticist, logo-pedist, hematologist, otorhinolaryngologist, orthodontist, pediatrician, psychiatrist, orthopedist, surgeon, for timely detection of accompanying defects of development and diseases with the purpose of conduction of full, active preoperative preparation and qualified staged correction of all defects of development.
Refernces:
1. Al Jamal G. A., Hazza'a A. M., Rawashdeh M. A. Prevalence of dental anomalies in a population of cleft lip and palate patients//The Cleft palate-craniofacial journal. - 2010. - T. 47. - No. 4. - C. 413-420.
2. Andreeva O. A. "Staged rehabilitation of children with congenital cleft of upper lip and palate"//Bulletin of Chuvash University -2012. - No 3. - C. 269-275.
3. Chuykin S. V. Clinic-anatomical forms of congenital cleft of upper lip and palate.//Ural MedicalJournal. - 2014. - № 5 (119). - P. 85-87.
4. Davidov B. N., Lavrikov V. G., Zernov A. V. and others. Basic principles of complex approach in the treatment of patients congenital clefts//Stomatology in children's age and prophylaxy. - 2009. - No. 3-4. - P. 18-20.
5. Epker B. N. Secondary surgery to correct CLP nasal deformity//3 th Biennial World Congress International Cleft Lip and Palate Foundation. Halifax. - 2004. - P. 66.
6. Kulikov A. M., Medvedov V. P. Dysplasia ofcongenital tissue in teenagers and their discrimination//Family doctor - No. 4. - 2000. - P. 37-51.
7. Leslie E. J., Marazita M. L. Genetics of cleft lip and cleft palate//American Journal of Medical Genetics Part C: Seminars in Medical Genetics. - 2013. - T. 163. - No. 4. - C. 246-258.
8. Mossey P. A., Modell B. Epidemiology of oral clefts 2012: an international perspective//Cleft Lip and Palate. - Karger Publishers, -2012. - T. 16. - C. 1-18.
9. Neville B. W. et al. Oral and maxillofacial pathology. - Elsevier Health Sciences, - 2015.
10. Stuppia L. et al. Genetics of syndromic and nonsyndromic cleft lip and palate//Journal of Craniofacial Surgery. - 2011. - T. 22. - No. 5. - C. 1722-1726.
11. Wehby G. L., Cassell C. H. The impact of orofacial clefts on quality oflife and healthcare use and costs//Oral diseases. - 2010. - T. 16. -No. 1. - C. 3-10.
DOI: http://dx.doi.org/10.20534/ESR-17-1.2-157-158
Ergashbaeva Dilrabo Abdurasulovna, The Head of the Chair of Neonatology, the Faculty of Doctor's Advanced Courses, ASMI Nasirova Feruza Djumabaevna, PhD the chair of obstetrics and gynecology ASMI Azizov Uriy Dalievich, The Head of the ChairMicrobiology, doctor of science, professor
Characteristic features of physical development of newborns born by mothers with pre-eclampsia
Abstract: Characteristic features of anthropometric indices of 100 new-borns born by women with pre-eclampsia (PE) according to their postnatal gestation age, in comparison with 30 children born by women without sign of PE and extra genital diseases were described in this work. The conclusion was that among the children born by women with pre-eclampsia (PE) there were immature children (full term and non-full term); their objective evaluation imitates the clinics of hypoxic ischemic encephalopathy and its complications.
Section 8. Medical science
Keywords: newborns, immature, pre-eclampsia.
Nowadays evaluation matters of monitoring of children's physical development has been of a great practical significance, anthropometric indices proved to be the main indicators of population's health [1; 3; 5].
Investigation of anthropometric indices in newborns taking into consideration their physiological maturation in different mother's pathologies during pregnancy would allow to determine the range of characteristic diseases and make prognosis of their status in the nearest neonatal period of life [4].
Aim of the Inquiry: To define the structure of newborns born by mothers with pre-eclampsia (PE) taking into consideration correspondence of body weight (BW) to postnatal gestation age (PGA).
Materials and Methods of Inquiry. 97 pregnant women (3342 weeks of gestation) with different manifestations of PE (main group) have been examined.
PE has been indicated according to the Gooke scale in G. M. Save-lyeva's and co-authors' modification; they have been divided according to the severity of the case: 38,1%, 54,6% and 7,3% (p>0,05, p<0,01).
30 pregnant women (35-41 weeks of gestation) constituted the control group without PE manifestations and extra-genital diseases before and during pregnancy.
Pregnant women of control and main groups have been statistically comparable according to the age (24,2±0,68 and 25,2±0,48 years old, p>0,05, number of pregnancy — gravid I (35,1±4,85% and 26,7±8,12%, p>0,05), gravid II (64,9±4,85 and 72,3±8,12, p>0,05).
Newborns' status in control group evaluated as 9-8 score in 80%, 7-6 score in 16,7%, 5-4 score in 3,5% according to Ap-gar's scale, average score constituted 7,73±0,19. Newborns' status in the main group evaluated as 9-8 score in 42%, 7-6 score in 24% (p>0,05), 5-4 score in 28% (p<0,001) and <3 score in 6% of children (p<0,001), on the 5' of life average score constituted 6,54±0,12 score (p<0,001).
PGA in newborns has been established according to 11 somatic and 10 neurologic parameters of J. L. Ballard [3] scale in modification of M. E. Abdullaeva and co-authors (1). In control newborns' group PGA >41 weeks has been revealed in 6, 38-40 weeks — at 23 and at 1 child — 35 weeks. In the main newborns' group PGA >41 weeks has been revealed in 8, 38-40 weeks — at 60, 3735 weeks at 17, 34-32 weeks at 14 and at 1 child <31 weeks.
Standard investigation of anthropometric indices has been carried out in both newborns' groups (1, 6): body weight (BW), body length (BL), body surface (BS), head and chest circuit (HC, ChC), weight-length index (WLI) and correspondence of HC, ChC (A. F. Tur's index) have been counted.
Material has been analyzed by parametric (Student's t-criteria) and non-parametric methods — Fisher's exact method (FEM) with angled reformation (9) for relative sizes [4;5] on Microsoft Office XP (Excel 2003) on personal computer «Samsung Sons 830».
Results and Discussion of the Inquiry. We stated that the main
anthropometric indices of newborns born by PE-mothers are considerably diminished in comparison with children born by healthy mothers (control group), accordingly: BW (2957,7±48,3, in comparison with 3470,3±92,8 gr, p<0,001), BL (49,9±0,42, in comparison with 52,8±0,37 cm, p<0,001), HC (32,8±0,16 in comparison with 35,1±0,23 cm), ChC (32,4±0,18 in comparison with 33,9±0,28 cm, p<0,001), but A. F. Tur's index proved to be increased (1,045± 0,001 in comparison with 1,035±0,002, p<0,001). We consider A. F. Tur's index (HC, ChC) to be very important for neonatologists; its 1,03 index corresponds to normal beared pregnancy (38-40 weeks); 1,05 index corresponds to unbeared pregnancy (37-35 weeks), 1,06 index (34-32 weeks) and 1,07 index (<31 weeks). We stated that in case of retention ofphysical development of newborns from PGA this index increases in any gestation, but MRP diminishes and, on the contrary, in case of excessive physical development of newborns from PGA this index decreases, but MRP increases. On the base of these methodical data we established the structure of newborns according to the PGA and development (normal, excessive or retarded).
We consider that the study of the structure of newborns born by PE-mothers in correspondence of body weight and PGA will give the possibility to make easier the work of neonatologists on differentiated diagnostics of CNS depressed syndrome in case of hypoxic ischemic encephalopathy (HIE) and clinical picture of physiologically immature full term baby. Difficulties in definite degree can appear in the work of neonatologists in diagnostics of syndrome of hyper-excitability — cramps — in immature full term children; it is considered as a consequences ofpost-hypoxic status not taking into consideration possible metabolic impairments (hypoglycemia, hy-pocalcaemia) characteristic to immature babies according to BW and gestation of pregnancy (PGA) which themselves can provoke excessive excitability and convulsive syndrome. Registration of these data in newborns born by PE-mothers will give children's doctors the possibility to understand correctly symptomatic complexes such as HIE, hypertension syndrome, which has been often revealed in practice of local neonatology — 16 and 88 to 1000 children, cor-respondently in mature and immature children [5], in comparison with foreign researches 1,6-8,0 to 1000 newborns [4].
Conclusion
1. At the moment of birth newborns have phenotypic differences varying in BW and PGA which is very significant for their postnatal development.
2. Among newborns born by PE-mothers there were really immature children as well as immature full term babies have been registered.
3. Registration of physiologically maturation newborns born by PE-mothers gives the doctors possibility to identify children's group (immature full term babies and immature) with false clinical neurological signs of hypoxic ischemic encephalopathy (HIE) with its multiple consequences.
References:
1. Kashirskaya N.Yu., Kapranov N. I.//Russian Pediatric Journal - 2002. - № 6. - P. 26-30.
2. Physiology of child's development//Under reduction of M. M. Bezrukih, D. A. Farber. - M. - 2000. - P. 31-59.
3. Ballard J. L., Nova K. K. Dzivar M. A. A simplified score for assessment of fetal maturation of newly born infants//J. Pediatries. - 1979. -Vol. 95. - P. 769-774.
4. Salundi U., Kaarma H., Koskal S. Anthropometrics investigation of the newborn//Papers of anthropology. - Tartu. - 1995. - 4. - P. 203-203.
5. Wong J., Thornton J. C., Kolesnic S. Anthropometry in body composition: an overview//Ann. N. J. Acad. - Sci. - 2000. - V. 904. - P. 317-326.
Correlation of hormonal status indicators of physical and sexual development in children with chronic bronchitis
DOI: http://dx.doi.org/10.20534/ESR-17-1.2-159-161
SharipovaOliyaAskarovna, PhD, Associate professor of the Pediatric Department of Samarkand Medical Institute, Uzbekistan E-mail: [email protected] BobomuratovTurdikulAkramovich, MD, Professor of the Pediatric Department of Tashkent Medical Academy, Uzbekistan E-mail: [email protected] MamatkulovaDilraboHamidovna, PhD, Assistant of the Pediatric Department of Samarkand Medical Institute, Uzbekistan Turaeva Nafisa Omonovna, Assistant of the Pediatric Department of Samarkand Medical Institute, Uzbekistan E-mail: [email protected]
Correlation of hormonal status indicators of physical and sexual development in children with chronic bronchitis
Abstract: The evaluation of physical, sexual development, has been carried out, hormonal status and the relationship between these parameters in patients with chronic bronchitis children have been evaluated. The study included 84 children with chronic bronchitis at the age of10 to 16 years and 230 practically healthy children matched by age and sex, of them, 37 (35,7%) — girls and 47 (64,3%) -boys. It was found that in children with chronic bronchitis the amount and force of significant correlations changed. Impairment of physical and sexual development in children with chronic bronchitis promotes activation of intraendo-crine relations in the absence of significant correlations between the content of the hormones of the studied links of endocrine system, may contribute to more frequent disturbance of physical and sexual development in children with chronic bronchitis.
Keywords: chronic bronchitis, physical and sexual development, blood hormones, correlation.
Epidemiological studies carried out in various countries of the old and more 13 (15,5%) children. By the degree of severity of the
world show a steady increase in the number of lower respiratory tract diseases, which have attracted attention due to a high prevalence, disability and mortality [6; 9].
The delay of physical development often leads to difficulties in psychological and social adaptation, the consequences ofwhich can persist even when they reach the normal physical development [1; 3; 7; 8].
Hormonal deviations are significant in the occurrence of various abnormalities in children's health. Chronic somatic diseases play an important role in the formation of the reproductive function of adolescents, there is significant relationship between the state of somatic and reproductive health of adolescents.
Complicated relationship of neurohumoral mechanisms require a comprehensive study of the hormonal profile and its evaluation, taking into account the impact of chronic pathology, including that on the part of broncho pulmonary pathology [2; 7; 9; 10].
Taking into account the above data, the correlation study was carried out aimed at exploring the relationship of indicators of hormonal status, physical and sexual development in children with chronic bronchitis (ChB).
Purpose of the research.To identify the features of the relationship between the parameters of physical, sexual development, and hormonal status in children with chronic bronchitis.
Materials and methodsA total of 84 (46 obstructive, 38 nonobstructive) children with chronic bronchitis at the age of 10 to 16 years were studied. Of them, 37 (35,7%) — girls and 47 (64,3%) — boys. According to duration of the disease, the patients were distributed as follows: 5-6 years old 32 (38%), 7 years old 14 (16,7%), 8 years old 13 (15,5%), 9 years old 12 (14,3%), 10 years
condition, the patients were divided as follows: moderately severe course of the disease was revealed in 48 (51,1%) children, severe — in 46 (48,9%). The control group consisted of practically healthy children (110 boys and 120 girls) of comparable age.
Indicators ofphysical development were evaluated by the absolute values oflength, weight and chest circumference. Body mass index was calculated using the formula BMI = weight/height (m2). The received data were compared for children's growth and development standards, recommended by WHO (2007). To check the status of sexual development in boys we carried out genetometric analysis and evaluation of the stages of sexual development by J. M. Tanner (1967). When evaluating the sexual development of girls we paid attention to the severity of the pubic and axillary hair distribution, the growth of the mammary glands, for a period of menarche.
In the blood serum of children surveyed,, hormone levels are de-finedby enzyme immunoassay (EIA): TSH (mlE/L), T3 (ng/ml), T4 (mcg/dl), growth hormone (ng/ml), follicle-stimulating hormone (FSH, mle/ml), luteinizing hormone (LH mle/ml), testosterone (nmol/l), estradiol (E2, pg/ml). Blood sampling was carried out from the cubital vein in the morning on an empty stomach.
To identify the relationship between the analyzed indicators we carried out a correlation analysis using the correlation coefficient r and test of its significance using Student's t test and Pearson 2.
Results of the research and their discussion. Harmonious physical development was determined in 14.3% of patients. Delayed physical development was revealed in 72 patients, accounting for 85,7% of the total number of examined patients, 32 of them (44,4%) — were girls and 40 (55,6%) — were boys. Individual
