Aspecte de diagnostic şi conduită în cazul copiilor cu masa extrem de mică la naştere

Abstract

Background: The birth of children with extremely low weight (500-1000 g) is an important problem, which is caused by the combination of numerous ethiopathogenetic factors. In 35% of cases the genesis is difficult to be assessed. In these situations it is extremely important to diagnose and prevent a prematurity in order to prolong the pregnancy and decrease the perinatal risk indicators. Material and methods: The study has been conducted on a total of 331 cases, including the research of some aspects of diagnosis and conduct of children with extremely low birthweight. The following diagnostic steps have been taken: screening for TORCH complex infections, the analysis of bacteriological discharges from vagina and of urine, ultrasound examination (cervical length, fetal biometry and placental complex condition), macroand microscopic examination of placenta. Results: The women, who have given biths to the children with birth weight of 500-1000 g, had the pregnancy complicated by exacerbation of somatic diseases, TORCH complex infections, bacterial vaginosis, hypertensive conditions, the premature rupture of membranes and fetal and placental pathology. Conclusions: The ultrasound assessment of the cervical length along with the clinical expression of imminent termination of the pregnancy are important diagnostic and prognostic markers, allowing the inclusion of pregnant women into the risk group and the determination of the potential risk of delivering children with the birth weight of 500-1000 g. The authors have analyzed the influence of extremely low birth weight on perinatal indicators, its influence on the degree of prematurity, the connection of the birth weight and maternal and/or fetal concomitant pathology. An important aspect is the involvement of doctors in the process of the delivery of children with the birth weight of 500-1000 g, so that all suspected cases can be considered, a step that will prevent the excessive expectations concerning the perinatal indicators and will allow the survival of children with subsequent high potential of life quality.