O.S. POKUSAYEVA^{1, 2}, S.YU. ZAKHAROVA¹

 ¹Ural Research Institute for Maternal and Child Health, Yekaterinburg

²Children’s City Polyclinic No. 13, Yekaterinburg

  Contact details:

Pokusayeva O.S. — post-graduate student

Address: 1 Repin St., Yekaterinburg, Russian Federation, 620028, tel.: +7-901-431-71-39, е-mail: pokusaeva93@list.ru

One of the important problems of premature babies is the state of the cardiovascular system, which provides blood circulation, blood supply to organs and optimal growth and development of children.

The purpose — to study the structural-geometric and functional features of heart in children of the first year of life, born at the age of extremely early premature birth (22-27.6 weeks) according to echocardiography data.

Material and methods. 51 children born at the age of extremely early premature birth were examined. The main group was divided into 2 subgroups. Subgroup 1 consisted of children weighing 500–750 g (n = 15). Subgroup 2 consisted of children weighing 751 g and more (n = 36). The comparison group included 28 children born at the gestational age of 32–36 weeks.

Results. In the first year of life, all observed children of the main group had clinical manifestations in the form of vegetative-vascular dysfunction syndrome (64.7%) and heart rhythm disturbances (62.75%). According to echocardiography, 60.8% of children showed functioning fetal communications, 78.4% of children had multiple abnormal chords of the left ventricle, and 51% had dysfunction of the valvular apparatus of the heart in the form of mitral regurgitation of the first degree and tricuspid regurgitation of the first and second degrees. It was found that during the first year of life, there is an increase in the spherization index of the heart chambers. 27.45% of children showed reduced indicators of systolic function of the heart.

Conclusion. In the observed children born at the term of extremely early premature birth, echocardiography reveals a high frequency of minor anomalies in the development of the heart, long-term persistence of fetal communications, remodeling of the heart with the formation of relative cardiomegaly, in the form of chambers spherization. The presented results indicate the need for cardiological monitoring, ultrasound examinations of the heart, and consultation with a cardiologist aimed at early detection of children in need of dispensary observation.

Key words: children, extremely early premature birth, premature birth, echocardiography parameters, cardiovascular system.

REFERENCES

1. Vsemirnaya organizatsiya zdravookhraneniya. Informatsionnyy byulleten’. Prezhdevremennye rody, 10 maya 2023 g. [World Health Organization. Fact sheet. Preterm birth. May 10, 2023], available at: https://www.who.int/ru/news-room/fact-sheets/detail/preterm-birth
2. Klinicheskie rekomendatsii. Prezhdevremennye rody. Pod redaktsiey Khodzhaeva Z.S. (utv. Minzdravom RF) [Clinical guidelines. Preterm birth. Edited by Khodjaev Z.S. (approved by the Ministry of Health of the Russian Federation)], 2020. ID: 331.
3. Radzinskiy V.E., Orazmuradov A.A., Savenkova I.V., Damirova K.F., Khaddad Kh. Preterm birth — an unsolved problem of the 21st century. Kubanskiy nauchnyy meditsinskiy vestnik, 2020, no. 27 (4), pp. 27–37 (in Russ.). DOI: 10.25207/1608-6228-2020-27-4-27-37
4. Mironova A.K. et al. Echographic features of brain structures in children born with very low and extremely low birth weight, in comparison with the clinical picture. Rossiyskiy vestnik perinatologii i pediatrii, 2021, vol. 66, no. 5, pp. 118–126 (in Russ.). DOI: 10.21508/1027-4065-2021-66-5-118-126
5. Filyushkina M.N. et al. Features of the morphofunctional state of the heart in premature infants (literature review). Vestnik Rossiyskogo nauchnogo tsentra rentgenoradiologii Minzdrava Rossii, 2014, vol. 3, p. 4 (in Russ.), available at: https://cyberleninka.ru/article/n/osobennosti-morfofunktsionalnogo-sostoyaniya-serdtsa-u-nedonoshennyh-detey-obzor-literatury
6. Pisareva S.E. et al. Minor anomalies in the development of the heart in newborns depending on the gestational age. BMZh, 2007, no. 2 (in Russ.), available at: https://cyberleninka.ru/article/n/malye-anomalii-razvitiya-serdtsa-u-novorozhdennyh-v-zavisimosti-ot-sroka-gestatsii
7. Kovtun O.P. et al. Remodeling of the heart of premature infants. Vestnik RAMN, 2020, no. 6 (in Russ.). DOI: 10.15690/vramn1268
8. Valenzuela-Alcaraz B. et al. Assisted reproductive technologies are associated with cardiovascular remodeling in utero that persists postnatally. Circulation, 2013, vol. 128 (13), pp. 1442–1450. DOI: 10.1161/CIRCULATI0NAHA.113.002428
9. Diagrammy INTERGROWTH-21st (Mezhdunarodnyy konsortsium po rostu ploda i novorozhdennogo) [INTERGROWTH-21st (International Fetal and Newborn Growth Consortium) diagrams], available at: https://intergrowth21.tghn.org/interpractice-21st/interpractice-21st-study-documents/
10. Chernaya N.L. et al. Normativy otsenki antropometricheskikh pokazateley u detey ot 0 do 19 let v sootvetstvii s rekomendatsiyami Vsemirnoy organizatsii zdravookhraneniya [Standards for assessing anthropometric indicators in children aged 0 to 19 years in accordance with the recommendations of the World Health Organization]. Yaroslavl, 2018. 116 p.
11. Milovanova O.A. et al. Risks of developing neurological pathology in extremely premature infants: literature review and clinical cases. Meditsinskiy Sovet, 2021, no. 1, pp. 20–29 (in Russ.). DOI: 10.21518/2079-701X-2021-1-20-29
12. Zharikhina M.P., Vertinskiy E.A. Ekhokardiograficheskaya otsenka sistolicheskoy funktsii zheludochkov: ucheb.-metod. posobie [Echocardiographic assessment of ventricular systolic function: a teaching aid]. Minsk: BelMAPO, 2023. 26 p., available at: https://rep.bsmu.by/bitstream/handle/BSMU/42118/978-985-584-875-3.pdf?sequence=1