Dziadyk T. The course, diagnosis and treatment of congenital pneumonia in newborns from mothers with TORCH-infections.

The work is supplemented with the data of perinatal risk factors, features of the course of early neonatal adaptation, the status of the cellular and humoral components of the immunity at birth and in the course of the disease in the newborns with congenital pneumonia from mothers with TORCH-infections. In micro- and macroscopic studies of women placenta with TORCH infections, significant changes were observed, manifested by an increase in the placenta mass (50 %), thickening of the umbilical cord (75 %), moderate edema of varton jelly (75 %), vasculitis (30 %), edema of amniotic shells (30 %) inflammatory infiltration in the decidua (25 %), chorionic plate (35 %), intervorsed space (30 %), stroma of villi (25 %), vessels (30 %); impaired blood circulation and dystrophic changes in the decidua (50 %); the spread of calcifications (30 %) in the marginal and in the paracentral zones of the placenta. Immunohistochemistry showed an increase in the expression level of the proliferative marker Ki-67, a significant increase in the index of the proliferative index in newborns from mothers with TORCH infections and bacterial infections in 4 and 5 times, respectively. In 60 % of the placenta, a significant increase in the proliferation index in syncytium, the decidual membrane and the stroma of the villi was observed, compared with the control group by a factor of 2. According to the neurosonography examination there were found features of the brain structures in newborns from mothers with TORCH-infections. There were revealed specific markers of intrauterine infections such as the presence of subependymal cysts and vascular plexus cysts in the brain. To improve early diagnostics of congenital pneumonia in newborns from mothers with TORCH infections, it is expedient to determine the immunohistochemical markers – the index of apoptosis, proliferation and regeneration of Ki-67 in the placenta of mothers with TORCH infections, then in the newborns of the risk group – the study of phagocytic activity of blood neutrophils, C4 component of the system of compliment, CD3HLA-DR and CD4CD45RA T-lymphocytes, Ig M and proinflammatory immunocytokines – FNPα. For the first time it is scientifically substantiated the expediency of usage of the antiviral drug interferon alpha 2 in the complex treatment of the newborns with congenital pneumonia from mothers with TORCH-infections.