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Premature newborns have a high risk of developing visual impairments. This study presents the experience of an organization dispensary ophthalmological observation as a stage of providing medical care to premature children in St. Petersburg and the prospects for its development. AIM: To analyze the effectiveness of the organizational model of dispensary ophthalmological observation of premature children in St. Petersburg for 20202022. MATERIAL AND METHODS: Reporting forms of the activities of interdistrict ophthalmological cabinet and reporting forms of medical and social expertise of Rosstat No. 7D were used. RESULTS: In 2010, a system of specialized ophthalmological care for premature infants at the hospital stage was organized in St. Petersburg (screening and laser treatment of active ROP using telemedicine technologies; surgical treatment of late disease stages). In 2018, for the subsequent dispensary observation of premature children aged up to 3 years, six inter-district ophthalmological cabinets of follow-up were organized. A developed routing scheme for children at risk and with active and cicatricial ROP in St. Petersburg and preliminary results of ROP incidence were presented. CONCLUSION: The activities of specialized inter-district follow-up cabinets primarily ensure continuity between hospital and outpatient services in the dynamic monitoring of children at risk and children with active ROP. In addition, professional competencies allow ophthalmologists to avoid mistakes in diagnosing the stage, monitoring the ROP course, and promptly referring patients for emergency treatment (laser or anti-VEGF therapy).
Premature newborns have a high risk of developing visual impairments. This study presents the experience of an organization dispensary ophthalmological observation as a stage of providing medical care to premature children in St. Petersburg and the prospects for its development. AIM: To analyze the effectiveness of the organizational model of dispensary ophthalmological observation of premature children in St. Petersburg for 20202022. MATERIAL AND METHODS: Reporting forms of the activities of interdistrict ophthalmological cabinet and reporting forms of medical and social expertise of Rosstat No. 7D were used. RESULTS: In 2010, a system of specialized ophthalmological care for premature infants at the hospital stage was organized in St. Petersburg (screening and laser treatment of active ROP using telemedicine technologies; surgical treatment of late disease stages). In 2018, for the subsequent dispensary observation of premature children aged up to 3 years, six inter-district ophthalmological cabinets of follow-up were organized. A developed routing scheme for children at risk and with active and cicatricial ROP in St. Petersburg and preliminary results of ROP incidence were presented. CONCLUSION: The activities of specialized inter-district follow-up cabinets primarily ensure continuity between hospital and outpatient services in the dynamic monitoring of children at risk and children with active ROP. In addition, professional competencies allow ophthalmologists to avoid mistakes in diagnosing the stage, monitoring the ROP course, and promptly referring patients for emergency treatment (laser or anti-VEGF therapy).
The article presents the analysis of the health status of children born prematurely during the first year of their life. There is the comparison of morbidity rates for five years of the operation of the catamnesis center of Kazan. Profoundly premature children demonstrated the highest level of morbidity with more frequent pathologies of the central nervous system, respiratory organs, eyes and anemia of premature children. In 2017 there was a decrease in the frequency and severity of respiratory diseases (bronchopulmonary dysplasia with chronic respiratory insufficiency 1.6 times), the nervous system (severe ischemic and hypoxic-hemorrhagic lesions of CNS 2.7 times), eyes and its adnexa (a complicated retinopathy of premature children 1.7 times) in extremely premature infants.
Premature infants born before 32 weeks of gestation with very low and extremely low birth weights are at higher risk for several neurodevelopmental disorders, including cerebral palsy and sensory, cognitive, and behavioral problems. The more complications are observed in the neonatal period, the higher is the likelihood of long-term complications of prematurity. Studying the factors that influence the outcome of neurological development is the only way to develop better treatment approaches.Purpose. Assessment of correlations between the brain ultrasonography data in children with very low and extremely low birth weights at birth with perinatal and neonatal risk factors, to predict neurodevelopmental outcomes and neuropsychic disorders at 2 years of corrected age.Material and methods. The material of the study was premature babies with very low and extremely low birth weights (≤32 weeks, ≤1500 g) who were born and received treatment and care in two large perinatal centers in Yerevan. Neurodevelopmental outcome in children was assessed using the Bayley-III developmental scale at 2 years of age.Results. 64% of ex-premature babies had completely normal development. 10% had cerebral palsy, 21% of children had a speech delay, 5% developed mental deficiency. Socio-emotional and behavioral problems were more common, especially in the social and practical areas (27% and 25%, respectively). 85.7% of children with motor disorders and 60% of children with speech delay had concomitant behavioral disorders. Deviations in behavior were found in 34.4% of children with normal (mental, motor, speech) development. More than 9% of children had very good results, 2% had a high level of mental development, and 3% — a high level of motor development.Conclusion. Predictors for the development of motor disorders and cerebral palsy were Grade 2 and 3 intraventricular hemorrhages, cystic periventricular leukomalacia, ventriculomegaly. Ventriculomegaly at term equivalent age, expansion of the extracerebral space and interhemispheric fissure led to combination of cerebral palsy and delayed speech development.
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