Implementarea standartelor europene privind înregistrarea copiilor cu masa extrem de mică (500-1000g) în Republica Moldova
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616-053.31 (10)
Pathology. Clinical medicine (2894)
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BOGDAN-MORARU, Aliona; PALADI, Gheorghe; CURTEANU, Ala; GURĂU, Valentina. Implementarea standartelor europene privind înregistrarea copiilor cu masa extrem de mică (500-1000g) în Republica Moldova. In: Buletin de Perinatologie. 2018, nr. 3(79), pp. 3-8. ISSN 1810-5289.
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Buletin de Perinatologie
Numărul 3(79) / 2018 / ISSN 1810-5289

Implementarea standartelor europene privind înregistrarea copiilor cu masa extrem de mică (500-1000g) în Republica Moldova

Implementation of the european standards in registration of the new-born with extremely low birth weight (500-1000 gr.) in the Republic of Moldova

Внедрение европейских стандартов регистрации новорожденных с экстремально низкой массой тела (500-1000 гр.) в Республике Молдова.


CZU: 616-053.31
Pag. 3-8

Bogdan-Moraru Aliona, Paladi Gheorghe, Curteanu Ala, Gurău Valentina
 
Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“
 
Disponibil în IBN: 19 septembrie 2018


Rezumat

This article presents the results of a retrospective and prospective research that included 830 preterm births between 22-28 gestation weeks and 853 extremely low birth weight newborns (500-1000g). The second stage of the investigation (2013-2015 years) deals with the infl uence of preterm deliveries with premature rupture of membranes on mortality and morbidity indicators among children depending on the gestation period and the method of delivery (spontaneous delivery or delivery with expectant management). The goal of the study: During this particular study were analyzed all the medical and socio-demographic particularities of the pregnant women, determining the incidence of such births, the evidence of particularities in pregnancy and birth evolution, perinatal losses establishment and survival rate of newborns dependent on the terms of gestation and birth weight. Materials and methods: It was used the information from the Statistic wear book of the National Bureau of Statistics of the Ministry of Health, the clinical and laboratory data obtained from the observation records of mother’s, newborns of Neonatal Departament of Intensive Care and Resuscitation and the data from the observation questionnaire. Results: The study results established a 0,4% incidence of premature birhs between 22-28 weeks gestation terms out of total number of births and 9,2% from the number of premature births. Most pregnant women included in the survey belonged to disadvantaged social group, with low level of education (64,9%). One of fi ve pregnant women was not on the recorded evidence of a family doctor and the fi rst time that they asked for medical care was in the early process of triggering the birth wirh premature rupture of the amniotic membranes preterm. Conclusions: The studied perinatal losses among children born with extremely low birth weight 500-1000g, showed a far lower rate (26,2%) of survival compared with similar indicators in the economic developed countries. Of all children born till 25 weeks of gestation, the survival rate was 10,3%. From 527 newborns alive, 60% died in the early neonatal period. Taking into consideration the results, conclusions and recommendations were formulated, aimed to improving the medical care of pregnant women with eminent abortion, as well as of children born with extremely low birth weight 500-1000g, 22-28 weeks of gestation terms. The comparative analysis of two methods of delivery showed no signifi cant differences in perinatal mortality. However, morbidity indicators proved to be much higher in case of preterm delivery with premature rupture of membranes with expectant management.

Введение: В этой работе представлены результаты ретроспективного анализа 830 случаев преждевременных родов при сроках беременности 22-28 недель и 853 детей, рожденных с экстремально низкой массой тела (ЭНМТ) (500-1000 г). Второй этап исследования (2013-2015 г.) посвящен оценке влияния преждевременных родов с разрывом плодных оболочек на показатели смертности и заболеваемости среди родившихся детей в зависимости от срока гестации и способа родоразрешения (спонтанные роды, роды с использованием выжидательной тактики). Материалы и методы: Были изучены медико-социальные и демографигеские особенности беременных, частота этих родов, особенности течения беременности и родов, перинаталыные потери и степенъ выживаемости этих детей в зависимости от срока гестации и массы при рождении. Целъ иследования: Определить медицинские, социальные и демографигеские при преждевременных родов в сроках гестации 22-28 недель. Резулътаты: резулътаты иследования показали, что болъшинство беременных женщин-64,9%, принадлежали к низкому социалъному классу и уровню оброзования. Каждая пятая женщина не находиласъ под наблюдением медицинских работников, несмотря на отягощенный соматический, акушерский и гинекологический анамнезы. Выводы: Полученные результаты показали высокий уровень перинаталъных потерь низкая частота выживаемости детей с экстремально низкой массой-26,2%, из рожденных детей в сроке 22-24 недель не выжил ни 1 ребенок, а выживаемость рожденных в сроке 25 недель, составили 10,3%. Сравнительный анализ этих двух методов родоразрешения показал отсутствие значимых различий в уровне перинатальной смертности. Однако, показатели заболеваемости оказались значительно выше в случае ведения преждевременных родов с излитием околоплодных вод с использованием выжидательной тактики

Cuvinte-cheie
premature births, children with extremely low birth weight, perinatal mortality.