L. K. Karimova

Periventricular hemorrhage is bleeding from the subependymal germinal matrix, which results in severe motor disorders, mental and speech developmental delay.Purpose. The study aims to evaluate risk factors, the trends of neurological disorders, and the outcomes of neonatal periventricular hemorrhage in children whose mothers were on gravidary anticoagulant and/or antiplatelet therapy.Material and methods. The study examined 160 newborns with PVH: Group I — 53 (37.9%) children born from pregnancy on the background of antiplatelet and/or anticoagulant therapy for hypercoagulation syndrome; Group II — 87 (62.1%) children born from pregnancy on the background of antiplatelet and/or anticoagulant therapy to treat degree 1A uteroplacental blood flow disorders; Group III — 20 children born from pregnancy without corticosteroids and antiplatelet and/or anticoagulant therapy. All newborns underwent clinical and neurological examination and neurosonography; data on somatic and obstetric anamnesis were obtained from accompanying medical records.Results. In children of Groups I and II a more severe condition of newborns with periventricular hemorrhage at birth was noted, a slower dynamics of restoration of muscle-postural tone and the pace of psychomotor development were observed compared to children in Group III. In Groups I and II a high incidence of epilepsy (5.7%) and cerebral palsy (6.4%) by 12 months of corrected age was revealed compared with the population.Conclusion. Gravidary anticoagulant and antiplatelet therapy might be considered as a risk factor for the development of intracranial hemorrhages and severe neurological disorders: epilepsy, cerebral palsy, mental and motor developmental delays.

The survival rate of children who require intensive care for life-threatening diseases or injuries has recently increased significantly. In pediatric intensive care, a decrease in mortality is accompanied by an increase in morbidity. This trend has led to a shift in focus of attention from reducing mortality to optimizing outcomes in critically ill patients. A broader approach and focus on outcome in critically ill survivors has been greatly facilitated by the development of a concept that integrates post-intensive care (PIC) diseases into Post Intensive Care Syndrome (PICS). The concept of PIC syndrome implies the occurrence of disorders in patients after IC in three main areas: mental health, cognitive functions and physical health, and also takes into account the state of the family of surviving patients, in particular, parents, who often have a deterioration in mental health. Diagnosis and treatment of this condition involves the work of a multidisciplinary team, in which it is desirable to include an osteopathic doctor in order to more effectively and timely diagnose and correct reversible functional disorders.

Особенности остеопатического статуса у недоношенных детей с внутрижелудочковым кровоизлиянием