BackgroundBody weight, length and head and thoracic circumference are routinely measured in obstetric and neonatal departments. Reference values for these measurements have been established for the neonatal population. Neonatal abdominal circumference is not routinely measured, and no reference values for this measurement have been determined. To evaluate the increase in abdominal circumference in newborns with abdominal pathology such as necrotizing enterocolitis, information about normal abdominal circumference in healthy neonates shortly after birth is needed. The aim of this study was to determine the correlation between abdominal circumference and birth weight by measuring the abdominal circumference of premature neonates soon after birth.MethodsAbdominal circumference was measured within 30 min of birth in 220 neonates born between 23 and 35 weeks’ gestation.ResultsThere was no statistically significant difference in abdominal circumference between boys and girls in the study population. A specific formula for estimating normal abdominal circumference was developed: y = 0.0053x + 14.83 (y = abdominal circumference in cm; x = body weight in g; 0.0053 = regression coefficient; 14.83 = regression constant).ConclusionA positive linear correlation between abdominal circumference and birth weight was found in infants at birth. The correlation can be summarized as a linear regression equation. Further studies are needed to investigate possible factors associated with abdominal circumference in fed versus unfed preterm infants.

47Summary Introduction. Neonatal anthropometric measurements, including body weight, length, head circumference and abdominal circumference are routine procedures in obstetric and neonatal departments. Standard values for neonatal population are established for body weight, length, head and thoracic circumference, however there are no reference values for neonatal abdominal circumference, futhermore, this measurement currently is not a routine procedure in every obstetric and neonatal unit. In order to evaluate the increase of abdominal circumference in newborns with a disease of organs of abdominal cavity including necrotizing enterocolitis (NEC), the abdominal girth of newborns soon after birth without pathology in the abdominal cavity should be ascertained. Thereby, the average value of the abdominal circumference of newborns in Latvia could be obtained. Aim of the Study. The aim of our study is to measure the abdominal circumference in premature and term-born neonates soon after birth and to define the correlation between abdominal circuit and birth weight. Materials and Methods. The measurement of waist girth was carried out in 460 neonates within 30 minutes after birth. Newborns were divided into 4 groups according to birth weight: extremely low birth weight (ELBW) -under 1000 g, very low birth weight (VLBW) -1001 g -1500 g, low birth weight (LBW) -1501 g -2500 g and term neonates with 2501 g -4590 g birth weight. The abdominal circumference was measured in 2 obstetric units in accordance with the previously established measurement methods.Results. There was no statistical difference between abdominal circumference in boys and girls in ELBW, VLBW and LBW groups (p>0.05). Mean abdominal circumference in ELBW group was 18,70 cm (SD=0,84) in boys and 18,67 cm (SD=1,40) in girls, VLBW group was 22,20 cm (SD=1,42) and 21,94 cm (SD=1,29) in boys and girls, respectively. Mean abdominal circumference in LBW group was 24.47 cm (SD=2.36) in boys, and 24.92 cm (SD=2.23) in girls. Independent Samples Test: Mean abdominal circumference was statistically different in boys and girls in 2500g -4590g birth weight group with median value 30.56 cm in boys, and 33.23 cm in girls (p<0,05). Mean value in girls was 3.33 cm higher than in boys. Dependent Variable linear regression: Specific formula for estimation of normal abdominal circumference was developed as a result of this study: y=0.0044x+16.38 (y -abdominal circumference, cm; x -body weight, grams; 0.0044 -regression coefficient; 16.38 -regression constant). Conclusions. The difference of mean abdominal circumference was not statistically significant in boys and girls in ELBW, VLBW and LBW groups, however, the difference was significant in the term-born neonates group. As a result of this study reference values and specific formula were established, which allows determination of normal abdominal circumference in neonates depending on birth weight.

Introduction. Congenital diaphragmatic hernia (CDH) - a relatively rare developmental defect due to a failure of pleuroperitoneal canal closure. The size of the defect between abdominal and thoracic cavities may be variable and it may have a significant impact on the clinical manifestation and prognosis. In this study we set out additional factors to determine if they affect the outcome of the newborns with CDH. Aim of the Study. To investigate and analyze the influence of selected postnatal prognostic factors for predicting the outcome. The primary outcome measure was survival. Material and methods. The present study is retrospective including the data collection and analysis of medical documentation of patients born with CDH and treated in the Children’s Clinical University hospital between 2012 and 2017. The selected prognostic factors included antenatal diagnostics, Apgar score at 1' and 5', need for an early intubation (≤ 3 h after birth), initial blood gases in first 24 h of life, time interval between delivery and surgical therapy, the stomach and liver presence in the thorax, additional congenital abnormalities, a type and duration of invasive ventilatory support. Outcome parameters were compared between survivors (S) and non-survivors (NS). Results. 19 patients (pts) were identified - 14 S and 5 NS. Total mortality rate - 26%. 17/19 had left-sided, 2/19 - right-sided CDH. 17/19 pregnancies were monitored, prenatal diagnosis was made in 8 pts - 3 of them NS. The mean Apgar score at 1’ in S group was 5,5, NS - 5,0. At 5’ - 6,7 and 5,6. Need for an early intubation was 64% for S, 100% - NS. Initial blood gases in S (n=11) and NS (n=5) showed the mean pH value of 7,18 and 7,02. Mean PaCO2 - 62,92 and 77,42 mm Hg. 16/19 underwent the operation. 2 pts died before and 3 after surgical therapy. The average time interval between delivery and surgical therapy in S group was 31,6 hours, NS - 73,7 h. The intrathoracic liver was observed in 3 pts, 2 of them died, the intrathoracic stomach - 2, none of them died. 14/16 pts had a primary surgical repair (PR), 2/16 - Silo closure before total repair. 6 pts had additional congenital defects - 2/14 S and 4/5 NS. 5 out of all 6 had cardiac anomalies. The average required conventional ventilation time in S (n=9) was 175,9 h, NS (n=3) - 25,7 h. High-frequency oscillatory ventilation for S (n=6) was applied for 255 h, NS (n=5) 157,3 h. The results showed statistically significant relationship between the outcome and additional abnormalities (r(17)=.623, p=0.017) and time interval between delivery and surgical therapy (r(11)=.768, p=.014). Conclusions. The possible predictors of outcome were additional abnormalities and time interval between delivery and surgical therapy.

Necrotising enterocolitis (NEC) is one of the leading causes of neonatal morbidity, mortality and surgical emergencies. As the survival rate of extremely low birth weight (ELBW) infants is rising, so is the risk of NEC. The aim of this study was to compare diagnostics parameters like clinical and radiological findings and laboratory indicators and the treatment and outcome of NEC patients from 2000 till 2007 (Group 1) and from 2008 till 2016 (Group 2) treated in Neonatology Clinic (NC) of Children’s Clinical University Hospital (CCUH). In the rectrospective study, 277 newborns were divided among Group I and Group II – 105 and 172 patients, respectively. There were no statistically significant differences between both study groups in mean gestational age and birth weight. In both groups the first signs of NEC appeared on average eight days after birth. Differences in the diagnostic method used in both groups were not statistically significant; specific radiological findings were seen in approximately 1/3 of the cases. There were statistically significant differences in the management of NEC and patient mortality. Conservative therapy was applied in 70.0% of patients in both study groups. Over time, peritoneal drainage (PPD) as the sole surgical treatment decreased by 6.4%, but PPD with following enterostomy decreased by 8.9%. In Group 2 mortality of NEC patients decreased by 17.4%. Mortality among surgically treated NEC patients decreased as well, by 9.0%.