Saratov JOURNAL of Medical and Scientific Research

Chernenkov Yu.V.

Saratov State Medical University n.a. V.I. Razumovsky Vice-rector for Research Work, Head of Department of Hospital Pediatrics and Neonatology Professor, Doctor of Medical Science

Twin-to-twin transfusion syndrome: A clinical case

Year: 2019, volume 15 Issue: №2 Pages: 236-240
Heading: Pediatrics Article type: Case report
Authors: Nechaev V.N., Chernenkov Yu.V.
Organization: Saratov State Medical University
Summary:

At the heart of the development of twin-to-twin transfusion syndrome (TTTS) is the presence of pathological anastomoses in the placental vascular network. The article presents a clinical case of TTTS development in monochorionic twins with placental vessel abnormality with a diagnostic search and a plan of further management.

AttachmentSize
2019_02_236-240.pdf284.04 KB

Congenital megakaryoblastic leukemia: A clinical case

Year: 2019, volume 15 Issue: №1 Pages: 34-40
Heading: Pediatrics Article type: Case report
Authors: Nechaev V.N., Chernenkov Yu.V., Mishina O.A., Fedorova Yu.A., Averyanov A.P.
Organization: Clinical Perinatal Center of the Saratov Region, Saratov State Medical University
Summary:

Leukemia in children (leukemia) is a systemic hemoblastosis, accompanied by a violation of bone marrow hemato- poiesis and replacement of normal blood cells with immature blast cells of the leukocyte series. Acute megakaryoblastic leukemia-one of the rarest forms of acute leukemia (1-3% of all leukaemias), which is characterized by the presence in the blood and bone marrow, along with undifferentiated blasts also megakaryoblasts, ugly megakaryocytes and platelet clusters. The work presents a clinical case of congenital acute megakaryoblastic leukemia in the child S., combined with the mosaic form of Down syndrome and a congenital heart defect.

AttachmentSize
2019_1_034-040.pdf856.94 KB

Perinatal lesions of the central nervous system in newborns according to the data of Clinical perinatal center of the Saratov region

Year: 2018, volume 14 Issue: №4 Pages: 639-645
Heading: Pediatrics Article type: Original article
Authors: Nechaev V.N., Chernenkov Yu.V., Averianov А.Р., Utts I.A.
Organization: Saratov State Medical University
Summary:

The purpose was to analyze the risk factors for the development of perinatal lesions of the central nervous system and to identify cause-effect relationships. Material and Methods. The retrospective analysis of primary documentation: history of childbirth and history of development of newborns is carried out. The work is based on the results of a comprehensive clinical and neurological examination, neurosonographic data and individual laboratory parameters. Results. In 2017 in the clinical perinatal center of the Saratov region 3301 births were conducted, of which the first delivery was performed in 69,4%, repeated in 30,6% and cesarean section in 41,2% of women. Hypoxic-ischemic disorders were observed in 928 newborns (27,7%). Children with low Apgar score had a combined genesis of chronic intrauterine hypoxia and acute asphyxia in childbirth in 3.8% of cases. Intraventricular hemorrhages (IHD) were diagnosed in 4,3% of cases, birth injuries in 3,6%. Congenital malformations of the central nervous system (CNS) were detected in 31 children (24,4%). Conclusion. The pathological course of pregnancy, problematic natural childbirth and emergency cesarean section are the most frequent risk

AttachmentSize
2018_4_639-645.pdf643.93 KB

Organization and work of the department of catamnesis of Clinical Perinatal Center of the Saratov region

Year: 2018, volume 14 Issue: №2 Pages: 226-223
Heading: Pediatrics Article type: Original article
Authors: Chernenkov Yu.V., Nechaev V.N.
Organization: Saratov State Medical University
Summary:

Objective: to examine the catamnesis of infants born with very low and extremely low birth weight, as well as undergoing critical conditions in the early neonatal period. To assess the health status of children observed, recommendations for further rehabilitation and prognosis. Material and Methods. At the department of catamnesis 4373 children were observed (total 21343 admissions), 62% of them were preterm infants. Children with extremely low body weight and very low body weight (157 patients, 20.3%) were evaluated for physical development, somatic and psychoneuro-logical status. Results. Analyzing the structure of morbidity observed in children hematologic violations are revealed in the form of anemia of prematurity moderate and severe degree in 15 patients (11.4%), slowing growth and development 25 (19.4%), respiratory disorders (19 children, 14.5%). In the assessment of physical development, growth disharmony revealed in 20.9%, weight disharmony in 29.4% of patients. Neuro-psychological development corresponded to the postconceptual age at 49.2% of children. Breastfeeding saved in 44.6%, mixed and in vitro were transferred in 55.4%. In a group of children follow-up observations identified numerous pathological conditions and high morbidity, requiring subsequent mandatory correction. Many of the children belong to the Group of infectious diseases patients (28.4%), with lots of somatic pathology (78.1%). A direct impact of the dynamics of body weight during the first months after birth was revealed in figures physical development of a child and the incidence in the future. The most vulnerable preterm infants from multiple pregnancies, small for gestational body weight deficiency which recovers slowly and have them marked lower psychomotor development. Conclusion. Improving rehabilitation technology, previously early steps, the integrated use of various methods and means, phases taking into accountthe stage of the disease process and individual approach to a child significantly improve the efficiency and effectiveness of rehabilitation therapy.

AttachmentSize
2018_2_226-233.pdf285.23 KB

Inadequate motivation for maternity is the risk factor for a perinatal fetus pathology and a newborn

Year: 2017, volume 13 Issue: №4 Pages: 857-859
Heading: Sociology of Medicine Article type: Short message
Authors: Panina O.S., Privalova I.V., Chernenkov Yu.V., Pozgaleva N.V., Cherednikova E.N.
Organization: Saratov State Medical University
Summary:

One of the important social risk factors for the birth of a child with pathology in our time is tobacco smoking, with both mother and father. Goal: assess the formation of motivation for motherhood by questioning women with tobacco. Material and Methods. To carry out the research, we used the "Methods of Investigating Motives for Preserving Pregnancy" according to L. N. Rabovalyuk, N.A. Kravtsovoy; methodology "Motives for the conception of a child" by OA. Urusova. Results. When analyzing the results using the method "Motives for conceiving a child" (OA Urusova), in 45.7% of the women studied, an inadequate type of motivation for motherhood was revealed. An unconstructive motive is the high desire of the subject to have a being that will embody her unrealized dreams and plans. 54.3% of mothers, as the predominant type, have an adequate type of motivation for maternity. In addition, the motives for responsibility for the life of the child, the joy of motherhood, the awareness of the child's own values, the desire to have it for the sake of positive life goals and himself are revealed. Conclusion. Timely detection of inadequate motivation for motherhood and proper prioritization will reduce the percentage of pathological pregnancy, increase the birth rate of healthy newborns.

AttachmentSize
2017_04_857-859.pdf229.29 KB

Health status of newborns after vacuum extraction

Year: 2017, volume 13 Issue: №3 Pages: 498-501
Heading: Pediatrics Article type: Original article
Authors: Chernenkov Yu.V., Nechaev V.N., Kuchekov F.A.
Organization: Saratov State Medical University
Summary:

Objective: to study the outcome of labor and neonatal status after obstetric operations of vacuum extraction method KIWI. Material and Methods. The research and treatment of 58 newborns after the operation method KIWI were carried out. Conducted survey and evaluation of neurological status of newborn, analysis of medical documents (medical card of the pregnant, findings of ultrasound screening of the fetus, birth history and development of the newborn) were performed. Results. Indications for obstetrics KIWI included: narrow pelvis (17.2%), uterine inertia and discoordination (25.9%), fetal distress — 33 (56.9%). The KIWI application was a complete opening of the uterine mouth, the absence of membranes, a living fetus, clinical according to the size of the fetal head and pelvis of mother. The results of the assessment of children by Apgar scale: 1-3 points from 1.7%; 3-6 points of 25.9%; 7 or more points 72.4% of children. Cerebral ischemia 1 degree was diagnosed in 63.8%; of the 2 degree of 34.5%, grade 3 in 1.7% of children. The average stay of children in the Department of physiology was 6.5 days, the 2nd stage is 11.6 days. Generic tumor from the apparatus KIWI was observed in 36.2%, cephalohematoma in 31,0%; no serious complications have to 32.7% of children. All patients were discharged from hospital. Examination of 29 children at the Department of Catamnesis showed that 13.7% of them noted a neurological deficit in the form of small brain dysfunctions. Conclusion. The introduction of new models of vacuum extraction, enhance the delivery through natural patrimonial ways. No significant impact on the course of the neonatal period, which allows us to recommend the method for more widespread use. However, the vacuum extraction of the fetus may be effective and safe only if indications, conditions and technique are strictly followed.

AttachmentSize
2017_03_498-501.pdf527.1 KB

Portrait of V.I. Razumovsky: to the 160th anniversary of the birth of the first rector of Saratov State Medical University

Year: 2017, volume 13 Issue: №2 Pages: 309-313
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Popkov V.M., Kochetkova T.V., Chernenkov Yu.V., Bugaeva I.O., Yerugina M.V.
Organization: Saratov State Medical University
Summary:

Saratov Journal of Medical Scientific Research 2017; 13 (2): 309-313. The article is devoted to the role of professor V. I. Razumovsky in the development of Saratov University and the development of medical science in the Saratov province.

AttachmentSize
2017_02_309-313.pdf1.3 MB

Organization of educational process at the department of human anatomy of Saratov State Medical University n.a. V. I. Razumovsky

Year: 2017, volume 13 Issue: №2 Pages: 306-308
Heading: Pedagogics and Education Article type: Short message
Authors: Bugaeva I0, Aleshkina OYu, Chernenkov YuV, Bikbaeva TS., Zagorovskaya TM.
Organization: Saratov State Medical University
Summary:

Human anatomy is one of the basic disciplines in the system of medical education. Knowledge in this area is necessary for the development of related theoretical subjects and constitutes a basis for studying clinical disciplines. Therefore the priority task of department of human anatomy is qualitative training of students at the modern level using classical and innovative pedagogical and computer technologies, being based on competence-based approach to training. In the article the features of organization of educational process at department of Human Anatomy of Saratov State Medical University n.a. V. I. Razumovsky, within the Federal state educational standard of the 3rd generation which key differences are considered: acquisition by students of cultural and professional competences.

AttachmentSize
2017_02_306-308.pdf239.73 KB

The role of biomarkers in early diagnostics of inflammatory diseases of intestine in newborns

Year: 2017, volume 13 Issue: №2 Pages: 256-259
Heading: Pediatrics Article type: Review
Authors: Chernenkov Yu.V., Pozgaleva N.V. Panina OS.
Organization: Saratov State Medical University
Summary:

Information on noninvasive biomarkers and methods for studying inflammatory bowel diseases in newborns has been summarized. It is based on the analysis of data taken from foreign and Russian literature. The need for additional study of factors affecting the level of fecal protein production in newborns is substantiated.

AttachmentSize
2017_02_256-259.pdf262.79 KB

Analysis of status of preterm infants with bronchopulmonary dysplasia

Year: 2017, volume 13 Issue: №2 Pages: 251-255
Heading: Pediatrics Article type: Original article
Authors: Chernenkov Yu.V., Nechaev V.N., Nesterova D.l.
Organization: Saratov State Medical University
Summary:

Objective: the combination frequency of BPD in premature infants, assessment of the degree of functional lesion of the respiratory tract and the efficiency of respiratory support. Material and Methods. The survey included 36 women and 38 preterm infants (two twins). Results. In 99% of the surveyed women pregnancy was complicated by chronic intrauterine fetal hypoxia, 2.1% — RH-conflict. At 43.2% of cases acute respiratory viral infection during pregnancy was revealed, 15.3% of bad obstetric history, 5% of women who had bad habits (smoking, alcohol intake). In 2015 there were 5 deaths (13.2%). 14 children (36.8%) were transferred to other hospitals for further treatment, the remaining 19 (50%) were discharged from the hospital. One child — full-term, the other— premature. At 87.7% of children with BPD, the diagnosis was RDS, in 4.2% — aspiration of meconium, 8.1% — congenital pneumonia. 15 children (30.5%) received therapy with surfactant once, including 9 newborns (23.7%) received medication twice. All newborns were carried out intensive care, including respiratory support. Mechanical ventilation in 14 children had been conducting for 8.4±2.3 day, in 13 cases for 17.3±3.8 day, in 11 cases for 23.4±4.1 day. Nasal CPAP was conducted in 23 newborns: from 4 to 6.8±1.9 day, 13 — less of 16.8±2.9 per day, 6 children have had more than 23.2±3.8 day. Conclusion. There is necessity for prevention during pregnancy with glucocorticoids, the prolongation of pregnancy; preterm neonates — surfactant therapy; adequate provision of resuscitation care in the delivery room and respiratory support. The reduction of time of mechanical ventilation and the expansion of the indications for non-invasive methods of respiratory therapy reduced the incidence of BPD, the severity of the disease and improve the prognosis.

AttachmentSize
2017_02_251-255_1.pdf561.89 KB