Improving of resuscitation and intensive care of premature babies allowed their survival. Bronchopulmonary dysplasia (BPD) is the significant complication of low-birth newborns. Identification of early predictors of disease can optimize of treatment and decrease of quantity of appearance and severity of BPD. Quantity of BPD is 5-97%. The significant predictors from hereditary and genetic factors are family bronchopulmonary pathology, dysplasia of connective tissue, gene polymorphism of VEGF, EPNX-113 Hiss, Nos3-786C, GCLC, 58 Т/С sod2, minore allele - 460 of T-gene (VEGF); from clinical and immunological factors - lung immaturity, alveolarization and vascularization disorders, hemodynamically significant ductus arteriosus; from biochemical factors - hyperoxy, lipid peroxidation and decreasing of antiperoxidation, disorder of angiotensin-1/endostatin; from therapeutic factors - overexertion of lungs during ventilation, avoiding of antiperoxid protection, insufficiency of nutrition. Contemporary methods of BPD diagnostic are clinical data (oxygen dependence at 28 days after birth), X-ray sings, identified by X-ray examination and tomography and bronchophonography. More of identified factors and predictors of BPD are difficult for examinations, haven’t 100% result or low predictive power, that is why further study is needed.
Minimizing infant mortality (IM) is the primary national objective of the Russian Federation. Aim: This study aimed to analyze IM indicators in the Russian Federation and identify factors that influence the dynamics of IM. The level of leading regional indicators of socioeconomic development and provision by doctors and hospital beds in the Russian Federation was studied and compared with the similar factors in foreign countries. Materials: Official and operative reports of Rosstat for 2011-2016 were assessed. Results. The coefficient of IM was 6.0 per 1000 live births in the Russian Federation, and varied from 4.8-9.2 in federal districts. The indicator increased in 2012 in connection with the transition to a new system of newborn registration. The indicator witnessed a permanent decline in 2016 and revealed a negative correlation between the regional bulk products and the coefficient of IM and a positive correlation with the overall IM. However, the relationship among the indicators of IM and the size of the region, the number of highways, the number of patients per one hospital bed or assigned to one doctor could not be established. Conclusion. In the Russian Federation, IM is higher than that indeveloped countries; has permanent tendency to decline; correlates with regional bulk products; does not depend on transport availability, provision with doctors, and hospital beds; and is determined by the organization and the quality of medical care.
Uterine bleeding caused by placenta previa is one of the main causes of massive blood loss and death in obstetric practice.Objectives. To analyze the efficacy and safety of various therapeutic strategies to stop uterine bleeding in women in labor and puerperants on the basis of research results.Materials and Methods. Available researches on the diagnosis and treatment of uterine bleeding with placenta previa between 2000 and 2015 were included in the study. The search was carried out in medical databases PubMed and Cochrane Library with free access to the publication.Results. 61 publications were included in the analysis. The basic principles of diagnosis and intensive therapy of uterine bleeding with placenta previa are presented from the position of obstetrician and anaesthesiologist-resuscitator. Particular attention is paid to the analysis of studies evaluating the efficacy and safety of infusion-transfusion therapy in this category of patients. Main indications and contraindications to blood clotting factors and antifibrinolytic agents are shown.Conclusion. The combined use of all available modern methods of stopping uterine bleeding can significantly reduce blood loss and help to improve disease outcomes. The most promising therapy is a targeted assignment of clotting factors concentrates under the control of thromboelastography which indicates the need for further research.
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