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

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.

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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.

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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.

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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.

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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.

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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.

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Features of newborns with intrauterine growth restriction (according to the data of perinatal center of the Saratov region)

Year: 2017, volume 13 Issue: №1 Pages: 062-067
Heading: Pediatrics Article type:
Authors: Chernenkov Yu.V., Nechaev V.N., Dudukina E.S.
Organization: Saratov State Medical University
Summary:

Objective: to identify risk factors that adversely affect the development of fetus and child small for gestational age; to assess the incidence of the intrauterine development of fetus and newborn; to analyze the health indicators of these children. Material and Methods. Cases of 226 children (6.6%) with diagnosed intrauterine growth restriction of the fetus were examined, including 134 of prematurity (59%). Results. The most common risk factors for the intrauterine development of the fetus were: violation of the utero-placental circulation — 196 cases, the uterine scar — 78 women, urinary tract infection — 94. Extragenital pathology was found in all women, the threat of termination of pregnancy in 109 cases, medical history of abortions in 106 women and 83 anaemia in women. Birth asphyxia was observed in 102 children (45%), prematurity in 71 cases (31.4%). Asphyxia of severe degree accounted 1 (0.5%) premature and 1 (0.45%) full-term baby. Asphyxia of moderate severity (4-6 points) accounted 70 (30.9%) preterm and 31 (13.7%) full-term infants. The most common form of the intrauterine development of the fetus asymmetrical revealed 178 cases (79.1%). Conclusion: Perinatal factors such as medical abortion, urinary tract infection, extragenital pathology are preventable. The predominant form of the intrauterine development of the fetus is asymmetric form, symmetric and dysplastic revealed to a greater degree in premature infants. Children with low weight for gestational age should be adequately provided with the necessary nutrients, fortifiers, vitamins and in the process of rehabilitation — cerebropro-tective therapy.

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Rubinstein-Taybi Syndrome at a 4-year-old child: a clinical case

Year: 2016, volume 12 Issue: №4 Pages: 578-581
Heading: Pediatrics Article type: Case report
Authors: Chernenkov Yu.V., Eyberman A.S., Belova G.Yu., Maltseva L.A.
Organization: Saratov State Medical University
Summary:

The aim of the article is to present clinical experience of studying the patient with a genetic syndrome of Rubinstein — Taybi at the department of Hospital Pediatrics at Saratov Clinical Hospital n.a. S. R. Mirotvortsev. It is necessary to mention that the described pathology is a rare autosomal dominant disease shown by plural developmental anomalies and determines great attention from the practical point of view.

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A clinical case of hereditary hydrocephalus (Dandy-Walker's syndrome)

Year: 2016, volume 12 Issue: №4 Pages: 571-574
Heading: Pediatrics Article type: Case report
Authors: Chernenkov Yu.V., Nechaev V.N., Lysova Yu.V.
Organization: Saratov State Medical University
Summary:

Congenital malformations are considered as one of the main causes of mortality and disability in early childhood. Congenital anomalies resulting in serious disorders often accompany pathology of the brain. The results of clinical observation and treatment of the patient with significant malformation of the central nervous system, hereditary hydrocephalus (Dandy — Walker's syndrome) have been presented in the work. The issues on early prenatal diagnosis and correction of this malformation in the neonatal period have been stressed.

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Congenital malformations in a fetus and a newborn according to the data of Perinatal Center of the Saratov region

Year: 2016, volume 12 Issue: №3 Pages: 393-398
Heading: Pediatrics Article type: Original article
Authors: Chernenkov Yu.V., Nechaev V.N., Katkova E.M.
Organization: Saratov State Medical University
Summary:

The aim: to study the frequency of birth defects in Perinatal Center of the Saratov region from 2014 till 2015, the possibility of prognosing, early diagnosis and optimization of programs for the prevention and correction of congenital malformations, the evaluation of treatment outcomes. Materials and Methods. The study included newborn babies and fetuses with birth defects for the period 2014-2015 according to data received from Perinatal Center. The data on ultrasound examination of pregnant women and about 149 fetuses with malformations in case of early terminated pregnancies were analyzed. Results. In 2014 Perinatal Center of the Saratov region found 77 newborns with congenital malformations, in 2015-72; 24 children (16.1%) required early surgical intervention. The comprehensive assessment of the health status of women and their children, the assessment of placental blood flow and fetal development, the identification of chromosomal and genetic abnormalities were conducted. 5 children of 149 children with congenital malformations died at the stage of the maternity hospital where average mortality accounted for 3.3%. Congenital malformations of central nervous system and sense organs accounted for 13.4%, malformations of the face and neck — 5.4%, malformations of the cardiovascular system — 28.8%, malformations of the respiratory system — 2.7%, malformations of the gastrointestinal tract — 4%, malformations of the musculoskeletal system — 9.4%, malformations of the urinary system — 27.5%, genital malformations — 4%, defects of the skin and its appendages — 1.3%, other malformations — 2.7%. Multiple malformations accounted for 4.7%. During 2014-2015 due to congenital malformations 311 births (4.4%) were interrupted, the main cause was determined as chromosomal abnormalities. Training, diagnosis, management of pregnant women and their delivery is carried out in Perinatal Center of the Saratov region in accordance with the complex program and algorithm methods for the prevention and correction of congenital malformations. Conclusion: This study has shown that there is a growth of small anomalies and reduction of frequency of multiple malformations. Comprehensive preventative program is possible to reduce the number of infants with untreated birth defects (13,5%), increase the percentage of defects detected by ultrasound from 51.7 to 66.7%.

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