PREDICTION OF THE COURSE OF THE OPEN ARTERIAL DUCT IN PREMATURE NEWBORNS

Abstract

Introduction. Timely diagnosis of congenital heart defects in newborns involves the development of highly informative methods of cardiological screening and prediction of their course. The aim of the study was to develop a method for predicting the long term preservation of an arterial ductus in premature newborns with very low and extremely low body weight. Material and methods. Clinical and neurological status, laboratory, radiological and instrumental examination data were evaluated in 69 premature newborns. The condition of OAP was assessed using echocardiography after 72 hours and in the first 2 hours of 5 days of life. There were 2 groups of patients: with hemodynamically significant and hemodynamically insignificant arterial ductus. Results. Using the analysis of A. Wald, 12 informative criteria for the long term preservation of the arterial duct were identified: gestational age at the time of birth ≤27 weeks; Apgar score at the end of the first minute ≤4 points; sharp weakening or absence of reflexes of the newborn; muscular hypotension; marbling of the skin; pasty or puffiness of soft tissues; the presence of moist, fine bubbled wheezing and/or crepitation during lung auscultation; strengthening of the pulmonary pattern on the X-ray due to the interstitial component and vascular component, an increase in the chambers of the heart due to body weight: the final diastolic size of the left ventricle ≥13.2 mm/kg; left atrium ≥8.7 mm/kg; right ventricle≥6.0 mm/kg. Conclusion. Based on these signs, a method has been developed for predicting the risk of long term preservation of a hemodynamically significant arterial duct in newborns with very low and extremely low body weight with a prediction accuracy of 85.7%.