The relevance of early ultrasound diagnosis in newborn infants with perinatal and surgical risk factors for thrombotic events
Objective. To assess the role of ultrasonography in the diagnosis of thromboses in newborn infants having risk factors for thrombotic events.Morozova N.Ya., Burov A.A., Podurovskaya Yu.L., Filippova E.A., Ushakova L.V., Pykov M.I., Vinogradova M.A., Degtyarev D.N.
Material and methods. A total of 1112 medical records of newborn infants admitted to the Unit of Neonatal Surgery, Department of Neonatology and Pediatrics, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, for surgery for congenital malformations in 2010 to 2015 were retrospectively analyzed. Thrombotic events were diagnosed using an expert-class SIEMENS ACUSON S2000 ultrasound device in B and color Doppler flow mapping modes, linear transducers at frequencies of 7–14 and 16–20 MHz.
Results. Of 971 neonates operated on for congenital malformation, 14 patients were diagnosed with thrombotic events on postoperative days 2–3. Thromboses were mixed in all the cases. All cases of thrombotic events, except 3 cases occurring and diagnosed intraoperatively, were diagnosed ultrasonographically.
Conclusion. Ultrasonography can quickly and objectively diagnose neonatal thromboses in the early postoperative period. The relatively high frequency of thrombotic events in neonates operated on for malformations and necessitates the introduction of ultrasound screening in these patients in the postoperative period. The introduction of ultrasound screening can assist in detecting thrombosis in the early stages, in preventing the generalization of thrombotic events, and in enhancing the efficiency of the treatment.
Keywords
ultrasound diagnosis
newborn infants
risk factors of thrombotic events
Supplementary Materials
- Fig. 1. Child N. 10 days. Neurosonography. Cross section of the superior sagittal sinus. Thrombotic masses in the lumen. Blood flow in color Doppler flow mode near-wall
- Fig. 2. Child M. 5 days. Diagnosis: Congenital diaphragmatic hernia on the left. Transabdominal longitudinal scanning of the trunk of the inferior vena cava. In the lumen, a floating thrombus is determined, reaching the level of the right atrium
- Fig. 3. Child 7 days. Diagnosis: Gastroschisis. Transabdominal examination of the left branch of the portal vein, in the lumen of which a hyperechoic inclusion of a rounded shape 6x4 mm with clear contours closely adjacent to the vessel wall is determined. The lumen of the vessel is not completely blocked - a hemodynamically insignificant fixed thrombus
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Received 16.12.2016
Accepted 23.12.2016
About the Authors
Morozova Natalia Yakovlevna, post-graduate student, anesthesiologist-resuscitator of the Department of Neonatal Surgery,Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79251158940. E-mail: n_morozova@oparina4.ru, natfrostig@gmail.com
Burov Artem Alexandrovich, Head on the clinical work of the Department of Neonatal Surgery, Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: a_burov@oparina4.ru
Podurovskaya Yulia Leonidovna, Candidate of Medical Science, Head of the Department of Neonatal Surgery, Research Center of Obstetrics, Gynecology,
and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: y_podurovskaya@oparina4.ru
Filippova Elena Aleksandrovna, Candidate of Medical Sciences, Head of the Department of ultrasound diagnostics in neonatology and pediatrics,
Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: e_filippova@oparina4.ru
Ushakova Lyubov Vitalievna, Ph.D., neurologist, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: u1v@bk.ru
Pykov Mikhail Ivanovich, MD, Professor, Head of the Department. Department of Ray Diagnostics of Childhood, Russian Medical Academy of Continuing Postgraduate Education, Ministry of Health of Russia. 125993, Russia, Moscow, Barrikadnaya str. 2/1, bld. 1. E-mail: pykov@yandex.ru
Vinogradova Maria Alekseevna, MD, doctor-hematologist, head of the Department of Reproductive Hematology and Clinical Haemostasiology, Research Center
of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: m_vinogradova@oparina4.ru
Degtyarev Dmitry Nikolaevich, MD, professor, Deputy Director for Scientific Work, Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia; head of the Department of Neonatology, State Medical University of Higher Professional Education, I.M. Sechenov
1st Moscow State Medical University, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: glav_neolog@yahoo.com, d_degtyarev@oparina4.ru
For citations: Morozova N.Ya., Burov A.A., Podurovskaya Yu.L., Filippova E.A.,
Ushakova L.V., Pykov M.I., Vinogradova M.A., Degtyarev D.N. The relevance of early ultrasound diagnosis in newborn infants with perinatal and surgical risk factors for thrombotic events. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (6): 111-6. (in Russian)
http://dx.doi.org/10.18565/aig.2017.6.111-6
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