The brain is the main organ in the body. The work of all organ systems, the general condition and quality of life depend on its functioning. With the development of certain pathologies, the brain begins to suffer due to a lack of oxygen, and this can lead to serious consequences. One of these diseases is cerebral ischemia of the 2nd degree in newborns, the consequences can be deplorable if urgent measures are not taken and therapy is not started. Let's look at what this pathology is and whether it is possible to get rid of it.
The concept of cerebral ischemia
Not everyone understands the name of the disease as "cerebral ischemia of the 2nd degree in newborns." What can the doctor explain and choose the tactics of treatment. This pathology is a condition in which the supply of blood to the brain is disrupted. In newly born babies, this pathology, as an independent disease, is not often diagnosed.
Most often, newborns are diagnosed with ischemic encephalopathy, in which brain cells are damaged due to poor blood supply, that is, lack of oxygen.
If "cerebral ischemia of the 2nd degree in newborns" is diagnosed, how to treat this pathology is determined by the attending physician, depending on the state of the body and concomitant diseases.
Causes of ischemia
This pathology in newborns can develop for several reasons:
- If placental blood flow was disturbed during gestation.
- Respiratory distress was observed after birth.
- Respiratory distress syndrome.
- Congenital pneumonia.
- Frequent bouts of respiratory arrest.
- Aspiration.
- Congenital malformations.
Whatever the cause, grade 2 cerebral ischemia in a newborn can be serious if not treated promptly.
Development of pathology in a child
Oxygen is transported through the body along with the blood. It is vital for the normal functioning of all organs. With a lack of it, the blood flow is redistributed and, first of all, the heart and brain receive oxygen-rich blood. It turns out that the rest of the organ systems begin to suffer from its lack.
If the pathology is not detected in a timely manner and the causes that provoked it are not eliminated, then the lack of oxygen will gradually begin to negatively affectstate of nerve cells - they begin to die. This is how cerebral ischemia of the 2nd degree develops in newborns, the consequences depend on the severity of the condition and the quick response of doctors. The prognosis for the baby will also depend on the number of dead cells. If a brain hemorrhage occurs, then the chances of recovery and survival are significantly reduced.
Provoking factors
Associated factors that can push the development of ischemia can be grouped into three groups:
The course of labor. The risk of pathology increases if:
- bleeding occurred while carrying a baby or during labor;
- emergency caesarean section;
- high temperature in a woman in labor;
- preterm birth;
- little baby weight;
- cloudy amniotic fluid;
- premature placental abruption;
- rapid labor activity.
2. The mother's condition can cause ischemia in the baby, especially when:
- future mom suffers from neurological problems;
- there are pathologies in the work of the endocrine system;
- late pregnancy;
- presence of chronic pathologies in the mother.
3. The course of pregnancy is also very important: if preeclampsia or eclampsia was observed, then there is every chance for the development of such a pathology as cerebral ischemia of the 2nd degree in a newborn. The consequences may bedifferent.
These factors are not a 100% guarantee of the development of pathology. Even intrauterine disorders do not always end with the development of cerebral ischemia after birth, the consequences can be eliminated if the pathology is detected in time and all measures are taken.
How the disease manifests
This pathology has varying degrees of manifestation. Grade 2 cerebral ischemia has severe neonatal symptoms, and immediate treatment is required. Here's what should alert doctors and mommy:
- Lower muscle tone.
- Large pauses in breathing.
- Tendon reflexes are poor.
- Slow Moro reflexes.
The following syndromes are also noted:
- Syndrome of increased excitability, which manifests itself in crying for no reason, restless and superficial sleep, startling.
- Hydrocephalic syndrome can be recognized by an increase in the size of the head and a large fontanelle.
- There is a convulsive syndrome.
- If there is cerebral ischemia of the 2nd degree in newborns, the depression syndrome reduces sucking and swallowing reflexes, muscle tone is weakened, strabismus may occur.
- The most serious syndrome is comatose. If it is present, the baby's condition is severe, there are no reflexes, no reaction to external stimuli, low pressure, breathing problems appear.
When the lack of oxygen threatens the baby's life
Ifthis pathology has 1 degree, then it is considered a mild lesion, and doctors assess the condition of the newborn on the Apgar scale at 6-7 points. Such a degree of excitation of the nervous system is manifested if the child was born on time, and oppression in premature babies. This condition can be observed for 5-7 days.
Cerebral ischemia of the 2nd degree in newborns has more serious consequences, clinical convulsions, respiratory arrest, floating hand movements may appear. If laboratory tests are carried out, then lesions of the brain parenchyma, a violation of the blood flow velocity are detected.
If there are long periods of impaired motor activity, poor appetite, impaired swallowing, an urgent consultation with a neurologist is necessary.
Severe degree can end in a coma, which is dangerous for the life of the baby. Increasing symptoms increase the risk of developing hydrocephalus.
How the disease is diagnosed
Almost always, the manifestation of cerebral ischemia begins immediately after childbirth. If the disease has a mild degree, then the signs can go away on their own, but the severe form can slightly ease their symptoms, but only for a while, and then flare up again with renewed vigor. Therefore, if ischemia is suspected, various diagnostic procedures should be performed, these include:
- Examining the child for reflexes and assessing the condition on the Apgar scale.
- Complete blood count.
- MRI if expected to be moderate or severe. This study helps to consider the structuresbrain and determine the extent of their damage.
- Ultrasound - allows you to detect cerebral edema or hemorrhage.
- Electroencephalogram - mandatory for newborns with severe disease.
If a diagnosis of cerebral ischemia of the 2nd degree in newborns is suspected, treatment will be prescribed after all studies.
Main goals of ischemia therapy
If the diagnosis is confirmed after all studies, then measures begin to maintain normal temperature, humidity, protection from external stimuli.
Therapy in newborns should be as less aggressive as possible. It has the following goals:
- Perform adequate ventilation.
- Support hemodynamics.
- Carry out constant monitoring of biochemical parameters of analyzes.
- Practice seizure prevention.
Where cerebral ischemia is treated
We have already found out that this disease has several degrees, which differ in the severity of the course. Therapy will depend entirely on the symptoms.
- If there is a mild degree, then even in the maternity ward, doctors take the necessary measures and discharge the baby. Subsequently, it is recommended to visit a neurologist and get the necessary consultations. The most commonly recommended massageand compliance with the daily routine.
- Cerebral ischemia of the 2nd degree in newborns, what it is already found out, requires treatment in the hospital and continues in the hospital, as the symptoms are already more serious.
- In severe cases, the child is immediately placed in intensive care after birth.
Ischemia treatment methods
This pathology is characterized by the fact that there is no conservative treatment for it, since dead brain cells cannot be replaced with viable ones. But timely prescribed maintenance therapy allows you to stop the progression of the disease and makes it possible to rehabilitate.
If the pathology is severe, it is visible immediately after birth. In such cases, do the following:
- Carry out artificial ventilation of the lungs, which will help restore spontaneous breathing. After that, they constantly monitor the condition of the baby.
- Needs cardiac supportive therapy to prevent irregular heart rhythm prescribes Dopamine, Dobutamine.
- Phenobarbital and Phenytoin will help prevent seizures.
- One of the new methods is hypothermia. It is believed that it reduces the rate of death of brain cells. But it must be carried out only under the supervision of a doctor. If the temperature is lowered by a few degrees, then the child is gradually warmed up.
If the disease is mild, then it is enough to take drugs that will improvecirculation to the brain and prevent further neuronal damage.
When there is a threat of developing hydrocephalus, Furosemide, Manitol are prescribed.
2 and 3 degrees of the disease threaten with more serious consequences, so it is important to take all measures and prescribe therapy that will prevent the development of complications of ischemia. They can be mild, such as attention deficit disorder, or more severe, including dementia and disability.
Komarovsky's opinion about the disease
If there is cerebral ischemia of the 2nd degree in newborns, Komarovsky believes that drug therapy gives a result, but not the same as everyone expects. It is very important in the acute period, when the impact of the damaging factor on the brain is observed, but, as a rule, pathology is detected much later, when the so-called recovery period begins for the brain. At this time, massage and physiotherapy will be more effective, which will help the process of brain recovery. Dr. Komarovsky believes that all neurological manifestations in newborns are associated with the immaturity of the brain, which will gradually subside if there are no serious chronic pathologies.
Consequences of cerebral ischemia
Currently, medicine is at a level of development that allows avoiding the serious consequences of cerebral ischemia, but on condition that the diagnosis was detected in a timely manner. Many babies who have had this disease experience fatigue, hyperactivity, memory problems, which can affectschool performance. Even when there are (if cerebral ischemia of the 2nd degree in newborns is diagnosed) consequences, mothers' reviews confirm that they can be de alt with if you consult a doctor and drink the necessary drugs.
With their help, you can significantly affect the excessive activity of the baby, improve his memory and attention, respectively, the performance at school will also improve. It is very important to find a competent specialist who will help to cope with the accompanying symptoms.
The most severe consequences of cerebral ischemia are cerebral palsy and epilepsy. But this most often happens in the most severe cases and with an untimely diagnosis.
What parents can do for their child
Even the 2nd degree of pathology is not a sentence. After completing the course of drug therapy, the recovery period begins. At this time, parents play an important role, it often depends on them how severe the consequences of the pathology will be. In order for the development of the baby to enter into a normal course, parents should:
- Visit a neurologist regularly with your child.
- Give your baby medicines prescribed by the doctor.
- Carefully monitor psychomotor development in order to notice deviations in a timely manner.
- Strictly follow the recommendations on the regime of the day.
- If the child is hyperexcitable, then provide him with a calm environment, eliminate sources of noise.
- Be outdoors more often.
- Take massage courses.
- Do exercises with your baby, a doctor can recommend a set of exercises.
Any neurological problems can be solved, because the child's nervous system is not yet fully formed, it is quite flexible and able to recover, so you can not give up. Even with a diagnosis of "cerebral ischemia of the 2nd degree in newborns," the consequences may not be so terrible. The care and love of parents, and, of course, the help of doctors, will surely work a miracle, and the child will not lag behind his peers.
