Newborns death risk factors after surgical interventions in the early neonatal period

Abstract

BACKGROUND: The mortality rate of children operated on in the early neonatal period remains high, despite the combined efforts of surgeons, anesthesiologists, clinical pharmacologists, and many other specialists. AIM: to determine the risk of death of children in the period of birth, after surgical interventions carried out in the period of the neonatal period. MATERIALS AND METHODS: A retrospective study was conducted between two groups of children treated at the Perinatal Center of the Pediatric University. The main group included 77 newborns operated on in the early neonatal period and died in the first 28 days of life. The control group included 287 children operated on in the perinatal period and survived 28 days. RESULTS: In the main group, the percentage of defects detected prenatally was statistically significantly lower; statistically significantly more often multiple congenital malformations and congenital malformations of the cardiovascular system were diagnosed. Risk factors for the death of newborns after surgery performed in the perinatal period have been established: features of the somatic status of mothers (chronic nicotine intoxication, hypertension and arterial hypertension, chronic serum hepatitis B and C, pathology of the urinary system and thyroid gland, cervical ectopia), obstetric gynecological history (chronic inflammation of the organs of the lower floor of the genital tract, two or more abortions in multiparous women, placental insufficiency in history during a previous pregnancy, previous delivery by caesarean section), course of pregnancy (threatening abortion, acute respiratory viral infections, exacerbations of chronic infectious diseases, early toxicosis, carriage of Cytomegalovirus and Herpes simplex types 1 and 2, asymptomatic bacteriuria, gestational anemia, circulatory failure, fetal malnutrition, abnormalities in the amount of amniotic fluid diagnosed by ultrasound study in the 3rd trimester of pregnancy), childbirth (breech presentation of the fetus and meconium staining of amniotic fluid), afterbirth conditions (chlamydial and ascending infection). CONCLUSIONS: In pregnant women with prenatally diagnosed congenital malformations of the fetus, it is necessary to conduct bacteriological studies, emergency histological examination of the placenta to identify possible microbial damage, as well as timely examination and treatment of newborns and upcoming / undergone surgery.