No abstract

Respiratory distress is one of the most common causes of neonatal morbidity and mortality. The aim of this study was to determine perinatal factors and ultrasonographic features of newborn respiratory disorders. We examined 49 children aged 0-28 days who had manifestations of type 1 RDS (group 1 – 24 children) and pneumonia caused by intrauterine infection or massive meconium aspiration syndrome (group 2 – 25 children). The control group consisted of 20 newborn. The control group consisted of 20 newborns. Data analysis showed that the presence of extra genital pathology that had mother, significantly influenced on the development of respiratory disorders (group 1 – 75 % ,and group 2 – 60 % compared to the control group – 20 %), as well as a high frequency of chronic fetal hypoxia and placental dysfunction complicated by fetal distress (in group 1 – 75 % of cases, in group 2 – 40 %) It was found that ultrasound examination of the lungs is an informative, safe method for diagnosing pneumonia, pneumothorax, the presence of fluid in the pleural cavity of newborn respiratory disorders, and provides an opportunity to monitor pathological changes during treatment.

Summarizing the variety of diagnostic imaging methods in obstetrics, there are next main offensive positions. Urgent indications for CT during pregnancy. Appendicitis – during pregnancy of the first and second trimesters. Ultrasound and/or MRI should be performed before CT. Pulmonary artery thromboembolism – in this case low-dose CT angiography of the lungs (with X-ray protection of the fetus). If suspected – CT should be the primary method of examination. In renal colic, ultrasound is the method of choice. In case of injury, ultrasound may be sufficient for the initial assessment in pregnant women, but CT should be performed if more severe or polytrauma is suspected. All patients who undergo CT of the abdomen or pelvis during pregnancy must sign a written personal consent form. In a study that presents a minimal risk (including CT pelviometry, CT of other areas of the body and MRI), it is advisable to explain to the pregnant woman about the minimal risk. Intravenous gadolinium is contraindicated in pregnancy and should be used only when absolutely necessary. Pelviometry can be performed either by low-dose CT or by MRI. Key words: pregnant women, fetuses, ultrasound (ultrasound diagnostics), MRI (magnetic resonance imaging), CT (X-ray computed tomography).

Некомпактний мiокард лівого шлуночка-рiдкiсна та маловивчена форма кардiомiопатiї, для якої характерне порушення ендомiокардiального морфогенезу, гiпертрофiя мiокарда лівого шлуночка з його надмiрною трабекулярнiстю і формуванням широких мiжтрабекулярних просторiв. При цій патологiї мiокард лівого шлуночка складається з двох шарiв мiокарда-нормального i некомпактного. Причиною виникнення некомпактного міокарду лівого шлуночка є недосконалий ембрiогенез, унаслідок якого порушується нормальний розвиток мiокарда. Наведено клінічний випадок некомпактного мiокарда лiвого шлуночка в новонародженого. Встановлено, що серцева недостатнiсть-найбільш поширений симптомокомплекс у пацiєнтiв із некомпактним міокардом. Некомпактний мiокард являє собою дезорганiзований шар м'язових волокон, в якому порушена нормальна архiтектонiка, що призводить до значного зниження скоротливої здатностi. Отже, чим вищий вiдсоток некомпактного мiокарда вiд загальної маси серцевого м'язу, тим більш виражені ознаки хронiчної серцевої недостатностi. Крiм цього, відмічається хронiчна iшемiя мiокарда внаслiдок порушення мiкроциркуляцiї. Летальнiсть протягом перших 6 рокiв становить до 50%. Прогноз погiршують шлуночкові порушення ритму. Своєчасна пренатальна підозра на захворювання міокарда, уточнення діагнозу безпосередньо після народження дитини та призначення терапії суттєво впливають на запобігання розвитку серцевої недостатності. Автори заявляють про відсутність конфлікту інтересів. Ключові слова: некомпактний міокард, серцева недостатність, плід, вроджені вади серця, пренатальна ехокардіографія.

Purpose — to assess ultrasound criteria and diagnostic value at vein of Galen malformation (VGAM) throughout perinatal period with possible further mortality rate and psychomotor development prognosis. Materials and methods. This was retrospective study involving 9 cases of VGAM diagnosed prenatally and managed at two institutions over a 5-year period (2014–2019). All cases had undergone detailed prenatal and perinatal cerebral, cardiac and fetoplacental unit assessment by grayscale ultrasound, color and pulsed–wave Doppler. In order to determine further treatment tactics neurosurgical consultation was involved into all confirmed VGAM cases. Results. Pregnancy and fetoneonatal outcome were known in all cases. Minor size supratentorial arachnoid cysts were detected in 6 VGAM cases. Vascular origin of formations was confirmed with Doppler scan. However, no signs of parenchymal abnormalities, liquor system of the brain damage and heart failure have been identified. All newborns were discharged with further outpatient follow-up. Vascular malformation with cardiomegaly correlation, tricuspid regurgitation, dilation of the right atrium and upper cava vein, severe brain abnormalities were considered by definition to be associated with poor outcome in 3 cases. Poor outcome was defined as death. Conclusions. VGAM diagnosis in newborns is highly determined by timely prenatal diagnosis and must involve postnatal neurosurgical assessment. Clarification of the diagnosis contributes to establishing the prognosis and inpatient care tactics. Color and pulsed+wave Doppler assessment is necessary for differential diagnosis with other midline cystic abnormalities of the brain. It is recommended to consider delivery within the perinatal clinic. Care must be provided by highly qualified perinatal team of obstetricians, neurosurgeons and neonatologists with an extensive experience in managing high risk pregnancies. Fetoneonatal outcome is poor due to congestive heart failure, severe brain damage and neurological impairment with tendency to worsen if diagnosed prenatally. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: vein of Galen aneurysmal malformation, fetus, newborn, diagnostic value, ultrasound, perinatal care, fetoneonatal outcome.