Chuyko M. Optimization of perinatal care of preterm infants at risk of intraventricular hemorrhage development: prevention, diagnosis and treatment.

The thesis contains a new solution of the scientific problem, which is the theoretical summarizing of the results of investigation of the factors and mechanisms that contribute to the development of intraventricular hemorrhage (IVH) in premature infants and refining early diagnostic criteria of this type of hemorrhage. All this became the basis for pathophysiological justification and optimization of perinatal care and helped to reduce neonatal morbidity and mortality. This work presents new epidemiological data about the incidence and reliable risk factors associated with the development of intrauterine and postnatal IVH, survival rates of newborns depending on the severity of hemorrhage. Prognostic values of fetal biophysical profile and patterns of utero-placental, fetal-placental and cerebral blood flow for IVH development in preterm infants were determined. Diagnostic value of neurospecific S-100 protein serum concentrations, blood pH, pO2 and pCO2 for early diagnosis of IVH were evaluated. The relationship between the incidence of IVH and duration of interhospital transportation of preterm infants was studied. Postmortem changes in the brain that occurred in preterm infants with IVH depending on different methods of respiratory support were investigated. Based on the obtained results perinatal diagnosis of IVH was improved and a complex of preventive and curative interventions in preterm infants with the risk of IVH and with the present IVH was developed.