Intrauterine pneumonia in newborns, the consequences of which can be very dire, is a very common pathology. This infection, which develops in the first days of a child’s life.
The cause of this type of pneumonia is the child’s ingestion of infected amniotic fluid at the time of birth or hematogenous penetration of the pathogen from a sick mother.
Main diagnostic criteria for intrauterine pneumonia:
Auxiliary diagnostic criteria:
Symptoms appear on the second or third day after birth. Already during childbirth, it is noticeable that the child is lethargic, weak, and the skin is bluish. Swallowing and sucking reflexes and muscle hypotonia may be absent.
Other symptoms include:
Most often, pneumonia can develop due to streptococcal infection in the womb.
With the development of respiratory failure, three phases of its formation are distinguished:
Treatment of congenital pneumonia may not always give a favorable result. There are often consequences even timely treatment. These include the formation of atelectasis, which is characterized by areas of adhesive lung tissue and the formation of connective tissue in the affected areas of the lungs. In the future, with such pathologies, the lungs are not able to fully perform their functions, which leads to emphysema. With this disease, the child develops toxicosis, which is difficult to treat.
Basic therapeutic measures for pneumonia and its consequences:
Consequences of pneumonia in children with delayed diuresis.
Most often the consequences of this disease manifest themselves through difficulty urinating. Delayed diuresis is treated with diuretics, which should be prescribed by a doctor. Often, the assistance of a catheter is required, which is inserted into the bladder.
Forced diuresis is carried out in three directions, such as:
If pneumonia is suspected, the child is isolated from the mother and transferred to the neonatal department. There he is placed in an incubator, where humidified oxygen is supplied. To a small child a course of antibiotics is prescribed. If the condition worsens, artificial ventilation is used; this process is most often carried out in the intensive care unit, where a seriously ill baby is transferred. If the treatment was not carried out entirely correctly, then pneumonia can progress to the chronic stage.
Most often, the causative agents of the disease are streptococci from group B, as well as influenza and parainfluenza viruses, adenoviruses, and mycoplasma. Infection of the fetus can occur if a pregnant woman in the last stages of pregnancy falls ill with influenza or ARVI.
Other causes of infection in a child include:
A child can get an infection that leads to pneumonia in two main ways:
Another route of infection may be when a child passes through birth canal and ingestion of infected amniotic fluid. There are cases of infection after the birth of a baby.
Preventive measures for this disease include protecting the body of a pregnant woman in order to prevent her from becoming infected with influenza or acute respiratory disease, especially in the second half of pregnancy.
Other preventive measures for a pregnant woman include the following:
During delivery, doctors must take all measures to avoid fetal asphyxia. After the child is born, do not allow infection to enter the room where he is located. It is very important not to overcool the baby during this period. And the importance of mother’s milk in raising immune system child.
Features of the bronchopulmonary system in the fetus and newborn.
In utero, the fetal lungs do not contain air. But he begins to make breathing movements already from 23 weeks of pregnancy. However, before this period, gas exchange in the lungs of the fetus cannot yet occur due to anatomical and functional immaturity.
At birth, the baby's lungs are filled with amniotic fluid. When a full-term baby takes his first breath, the inhalation volume is approximately 70 ml, with almost all alveoli opening. Amniotic fluid is quickly absorbed into the blood and interalveolar space. In premature babies, taking the first breath is more difficult because, in addition to the immaturity of the respiratory system, their nervous system is imperfect. the cardiovascular system and many metabolic processes.
The newborn baby's breathing is intermittent and uneven. There are pauses; in full-term babies they last 1-6 seconds, in premature babies - 5-12 seconds.
Reasons why newborns are susceptible to pneumonia:
These features, as well as the peculiar response of the immune system, make newborns especially vulnerable to pneumonia. The vulnerability of babies exists, even if the pregnancy proceeded well, the birth was not complicated, and there is no hereditary pathology.
Pneumonia of newborns is treated by neonatologists. They define this disease as infectious, although sometimes it can develop as a result of aspiration, but sooner or later the infection still attaches.
Pneumonia in newborns is an acute infectious lung disease that can develop as an independent disease or as a complication. It is quite difficult. The mortality rate from the disease in children 1 month old is 30-40%. The incidence rate in full-term infants ranges from 0.5-1%, in premature infants - up to 10%.
Pneumonia in newborns is classified into the following forms:
By causative factor:
Depending on the circumstances of infection, the following types of pneumonia are distinguished:
Causes of pneumonia in new born child:
In most cases, mixed pneumonia is observed, for example, bacterial-viral. In terms of frequency, adenoviruses, influenza and parainfluenza viruses predominate among viruses. Bacteria include Staphylococcus aureus, pneumococcus, and alpha-hemolytic streptococcus. The proportion of Klebsiella, intestinal bacteria, and Proteus in the structure of pathogens has increased significantly.
Pneumonia in newborns will manifest itself differently depending on the pathogen and the conditions of infection.
Congenital pneumonia is characterized by the development of suffocation at birth. The child is born with a bluish tint to the skin, does not scream immediately, screams weakly or not at all, moves his arms and legs little, and has weak reflexes. When feeding, such children experience profuse regurgitation. Breathing is weakened, a groan is heard when exhaling, and sometimes a semblance of cough appears. In addition to the respiratory system, the child’s cardiovascular and digestive (bloating, abdominal pain, enlarged spleen) systems are also affected. Body temperature is normal or reduced. Full-term infants may have fever from the second day of illness. Symptoms last about 3-4 weeks. This type of inflammation is characterized by severe course and high mortality.
Pneumonia that develops in the first days of a child’s life has a long latent period. The first signs can be observed only on the 5th day of life and later. The severity of the course depends on the infection that caused the disease.
The diagnosis of viral pneumonia is difficult to make because it is quickly associated with a microbial infection. Influenza pneumonia in a newborn has an unexpected onset. Body temperature rises to 39 °C and higher, convulsions, anxiety, refusal to eat, and meningeal symptoms appear. An atypical course with a temperature of up to 38 ° C and without strong signs of intoxication is also possible. A feature of this type of pulmonary inflammation is damage to blood vessels and hemorrhages in all organs of the child. Such children may have consequences in the form of encephalitis, meningitis, hemorrhages in vital organs, otitis, and pyelonephritis.
Pneumonia caused by the parainfluenza virus develops in parallel with inflammation of the pharynx. Clinically, it is milder than influenza, intoxication is less pronounced, and the temperature rises slightly. But weakness, decreased reflexes, and pallor of the limbs are still present.
Staphylococcal pneumonia in children can be a complication of sepsis or occur as an independent disease. It is difficult to high temperature, severe toxicosis, hemorrhages, pleurisy. The heart, nervous system, and kidneys are also affected.
Chlamydial and mycoplasma pneumonia most often occur in utero. They are not only difficult, but also difficult to treat. These pneumonias are characterized by cough, swelling, and sometimes a rash. These diseases are often fatal.
What are the differences in the course of pneumonia in full-term and premature infants? In premature newborns:
The main thing in the treatment of pneumonia is antibacterial therapy. Most often, the causative agent of the infection is not yet known at the time the antibiotic is prescribed, so the doctor makes his own assumptions. If the drug is chosen correctly, the condition will improve within 2-3 days. Otherwise, the medications need to be changed to others.
Three groups of antibiotics are used in newborns: penicillins, cephalosporins and macrolides. Protected penicillins (amoxiclav, augmentin, flemoclav, unasin) are considered the most effective for initial therapy. If there is a suspicion of chlamydia or mycoplasma, then the choice falls on macrolides (azithromycin, clarithromycin, roxithromycin). Cephalosporins are used as alternative drugs. The child is treated with antibiotics for at least 10-14 days.
If a pathogen is identified, treatment can be added to antibiotic therapy specific immunoglobulins(antistaphylococcal, antiinfluenza, antipseudomonas, etc.).
Inhalations are an integral part of the treatment of lung diseases. Oxygen is inhaled through aqueous solutions, sodium bicarbonate, saline, acetylcysteine, lazolvan, trypsin, chymotrypsin. Oxygen reduces respiratory failure, and mucolytics thin sputum.
The position of the child also matters. If the pneumonia is unilateral, then the baby is placed on the healthy side, and if it is bilateral, the side is changed every 2 hours. It is advisable that the mother or medical staff gave the child a chest massage by tapping. This will also make the mucus easier to clear. In physical therapy in the acute phase, only microwave therapy on the chest area is allowed.
Time has vital importance. The earlier treatment is started, the better the prognosis for the child. If treatment is started on the first day, then pneumonia can be cured without a trace. But if antibiotic therapy is started late, the consequences can be very different. The infection can spread to healthy areas of the lungs, to the pleura, and then pleurisy develops. Sepsis is a fairly common and serious complication. With prolonged tissue destruction, cavities form in the lungs. The characteristics of the lung tissue of babies cause the rapid development of pulmonary edema and respiratory failure.
Long-term consequences develop months and years after the illness. These may be: transition to a chronic form, adhesions between the lungs and pleura, disruption of normal lung function, frequent pain in adulthood.
Pneumonia in newborns is a fairly common disease that a baby can become infected with while in the womb or directly during childbirth.
Just a few decades ago, this diagnosis jeopardized not only the health, but also the life of the child, but today the situation has changed radically. Of course, the baby will have to undergo complex treatment, but the chances of his survival will be much higher.
As a rule, pneumonia in newborns is diagnosed within the walls of a medical institution and is then under the control of medical workers. If the illness makes itself felt when the baby is already at home, the parents simply cannot help but notice the problem! The child becomes capricious, his body temperature rises significantly, accompanied by a severe cough. Trying to cope with the disease on your own is categorically not recommended, because in the vast majority of cases this only leads to a worsening of the baby’s condition.
Among the most common routes of infection are:
No matter how dangerous and frightening intrauterine pneumonia may be for parents, it should not put parents into a state of stupor. The problem can and should be dealt with! However, this will take time.
As soon as pneumonia is diagnosed in newborn babies, the doctor immediately places them in medical institution where they will receive qualified assistance. Try to challenge the doctor’s decision and convince him that it will be done at home best care, will be an unforgivable mistake! A fragile child's body is in the development stage and simply cannot cope with a severe infection. He should definitely be helped, but only on the condition that drug treatment will not harm other body systems.
In this case, a correctly prescribed course of antibiotics plays a key role in this matter, allowing to normalize the temperature and stop progressive inflammation. This course is prescribed to children without fail, regardless of the form of the disease and its severity. At the same time, the child will take powerful vitamin therapy to support the body and give it the strength to fight the disease on its own.
Usually, visible signs pneumonia goes away within a week, while full recovery takes several weeks. A small patient can be discharged home for further rehabilitation in about 10 days. However, this does not mean at all that at home, in case of pneumonia in newborns, parents will need to give their baby exclusively medications!
Methods can also provide significant assistance traditional medicine, being evaluated as an alternative treatment. One of them is mustard plasters, well known to many, which, in agreement with the pediatrician, can also be placed on infants. However, parents should be extremely careful in this matter so that after using them there are no burns left on the baby’s delicate skin.
Honey can also help in the fight against pneumonia. healing properties known to almost every person. It should be mixed with birch buds and boiled for 10 minutes. The child should be given this mixture immediately before going to bed. The good thing about a mixture of honey and birch buds is that it does not cause allergies and can be used not only when treating pneumonia, but also for any other infectious disease. However, before using it, consultation with a pediatrician is an essential procedure!
The development of intrauterine pneumonia in newborns in no way depends on the baby and falls entirely on the conscience of the parents. The expectant mother should be extremely careful and not once again provoke the development of diseases. On a bad day or during the progression of infections, it is advisable to refrain from contact with large numbers of people! After all, often these are the causes of infection. What is truly important for a woman during pregnancy is the health of her child. All other desires can wait.
If parents suffer from an infectious disease, they should minimize contact with the child and be sure to wear gauze bandages on their faces!
Such, at first glance, simple methods of protection make it possible to exclude the presence of a disease in a child such as intrauterine pneumonia, which is categorically not recommended at such a tender age!
The health of a newborn child should be given due attention, because at this age many surprises are possible. If the symptoms of pneumonia have already made themselves felt, do not despair! After all, a timely visit to a doctor will certainly solve all problems and give the baby a healthy and happy childhood.
Pneumonia in newborns - infectious inflammation of lung tissue - is one of the most common infectious diseases. It is dangerous for any baby, especially when it comes to bilateral pneumonia in newborns. Unfortunately, the statistics today are as follows: pneumonia in newborns is diagnosed in 1% of full-term and 10-15% of premature babies.
In medicine, the following types of pneumonia are distinguished depending on the cause of the disease:
The most common causes of pneumonia in newborns are:
Acquired domestic pneumonia most often occurs against the background of ARVI (acute respiratory viral infection) caused by adenoviruses.
Secondary pneumonia, which is a manifestation or complication of sepsis, aspiration syndrome, is often caused in newborns by streptococci, staphylococci or gram-negative flora.
In the case of intrauterine infection, doctors will detect signs of pneumonia in a newborn even before discharge, because often the first signs of pneumonia begin to appear immediately after the birth of the child.
If a mother and child are discharged home, a doctor must come to their home for patronage during the first month. He will monitor the baby's condition, and he needs to talk about everyone alarming symptoms, for example, about the child’s lethargy, frequent regurgitation and loose stools, refusal to breastfeed, and rapid fatigue when sucking.
If your child’s temperature rises, you should not wait for the doctor’s next visit. Call urgently ambulance. Cough in infants may be mild, but it is important to immediately pay attention to coughing. The appearance of nasal discharge and shortness of breath in a child should also alert you. Shortness of breath leads to symptoms of blueness on the feet, face and hands. A sick child develops diaper rash more quickly.
There is no need to be afraid of missing pneumonia in your child, because signs of the disease rarely appear without a rise in temperature. And it needs to be measured periodically for preventive purposes.
A doctor who regularly examines and listens to a child can easily detect pneumonia.
Antibiotics are always used to treat pneumonia wide range actions. The child needs careful care to avoid hypothermia and overheating. It is important to monitor the hygiene of his skin, often change the position of his body, and feed exclusively from a horn or using a tube. Doctors will allow breastfeeding of a sick baby only if its condition is satisfactory, namely, if intoxication and respiratory failure have disappeared.
Besides transferred funds Treatments also include physiotherapy (microwave and electrophoresis), vitamins C, B1, B2, B3, B6, B15, the use of immunoglobulins, mustard and hot wraps twice a day, and blood plasma transfusions.
Children who have had pneumonia (especially double pneumonia in newborns) are prone to recurrent illnesses. After discharge, they should be given repeated courses of vitamin therapy and bioregulators (aloe and eleutherococcus extract) for 3-4 months. And for 1 year the child will be under medical supervision.
INTRAUTERINE PNEUMONIA is an infectious lung disease that occurs during intrauterine infection of the fetus and manifests itself in the first hours and days of a newborn’s life. More often observed in premature babies.
The causative agents of the disease are most often group B streptococci, influenza viruses, parainfluenza, adenoviruses, respiratory syncytial virus, mycoplasma. Infection of the fetus occurs when pregnant women become ill with respiratory viral diseases in the last weeks of pregnancy and shortly before childbirth.
Symptoms of the disease most often appear at birth or within 24-48 hours after birth. Children are born in serious condition, lethargic, pale or cyanotic. From the first hours after birth, a sharp decrease in reflexes (including sucking and swallowing) and muscle hypotonia are observed. Physiological erythema is mild or absent, dry skin is often noted, hemorrhagic rash, pyoderma. On lower limbs and in the abdomen, many children develop swelling of the subcutaneous tissue, caused by metabolic disorders and increased permeability of the vascular wall. Body temperature in full-term infants rises to 37-40 °C, in premature infants it is reduced to 34-35 °C. From the moment it is established, breathing is rapid and shallow, sometimes arrhythmic, groaning, shortness of breath is accompanied by retraction of the pliable parts of the chest, and attacks of respiratory arrest. Regurgitation and vomiting are often observed in newborns. Physiological loss of body weight exceeds 15-30%. As the severity of the general condition increases, the manifestations of respiratory failure intensify. Breathing becomes shallow and arrhythmic. Along with pneumonic symptoms, newborns show signs of cardiovascular disorders. Prognostically unfavorable symptoms include changes in the boundaries of the heart (narrowing or expansion), the appearance of systolic murmur, attacks of cyanosis, signs of peripheral circulation disorders (pallor of the skin, acrocyanosis, marbling, hypothermia of the extremities).
The vast majority of patients have an enlarged liver. In the blood - leukocytosis or leukopenia.
When pneumonia develops due to aspiration of infected amniotic fluid during childbirth, signs of the disease appear quickly. Pallor and cyanosis of the skin, shortness of breath, attacks of asphyxia, and increased body temperature are noted. Pneumonia is often combined with atelectatic and edematous-hemorrhagic changes in the lungs.
The course of pneumonia caused by group B streptococci differs in some ways. Infection occurs in utero - as a result of an ascending infection or through contact of the fetus with infected tissues of the birth canal - during childbirth. The disease usually progresses quickly and often ends fatal in 1-2 days.
Recognized on the basis of medical history that predisposes the fetus to early infection (acute and chronic infectious diseases of the mother, uterine bleeding during pregnancy, etc.), factors of early clinical signs of the disease, results of X-ray, bacteriological, virological research contents of the respiratory tract, detection of pathogenic flora in the amniotic fluid.
Pneumonia of newborns.
Forecast. The outcome of intrauterine pneumonia depends on the degree of maturity and reactivity of the newborn’s body, as well as on the type of pathogen and the timeliness of the use of therapeutic measures.
Why not ask your doctor this question IMMEDIATELY?? ? There is a lot of information in the search engine. It is treatable, not fatal.
Apparently, the baby is in a hospital, i.e., under the constant supervision of doctors, so be patient and under no circumstances doubt his recovery.
In general, pneumonia is treated within 21 days; the course of treatment includes antibiotics. Don't rush to be discharged home. After discharge, the recovery period will begin. Find a good pediatrician and gastroenterologist (dysbacteriosis usually appears after antibiotics).
Olga, EVERYTHING WILL BE OK!!!
It is very unpleasant when a child is sick, and even at such an early age, my daughter, at 3 years old, had left-sided pneumonia and was treated for 21 days. 4 days is not enough, wait and don’t be upset, hope for the best, pray for good things, go to church, light a candle for yourself and your baby, if you can’t do it yourself, your relatives will do it for you. Hope for the best!
antibiotics and time, if one antibiotic is not enough, then add a second one and donate blood again for ESR
My daughter also had unilateral pneumonia, she was treated right in the maternity hospital for 18 days, first she was injected with one antibiotic for 7 days, then with a second, stronger one. The only side effect we had was dysbacteriosis, which was quickly cured. There, in the maternity hospital, I talked with the mothers of children who also had pneumonia (some had unilateral, some bilateral), everyone was cured and discharged, but in general, of course, I don’t know the statistics on pneumonia. 4 days is not a long time, everything will be fine, let the baby recover.
Firstly, a lot depends on your confidence that your child will recover! Secondly, if the baby is strictly under the supervision of doctors and nurses, then there is no need to worry too much. If the child was born healthy, there are no pathologies, then the chances are especially good. Consequences: the baby is registered after this disease for a certain time, the downside is that the immune system is greatly weakened. Get well soon baby!
Necessarily!! ! Rub your feet and hands every two hours. You also need to rub and massage the back and chest 3-4 times a day. As your condition improves, the number of rubbing your legs and arms can be reduced to eight.
Thanks girls for your feedback
Intrauterine pneumonia is the most common cause of death in newborns. After birth the lungs are the most important body, which helps the child adapt to life in the environment. Lung damage disrupts this process, so often such children are immediately admitted from the delivery room to neonatal intensive care units for intensive care and artificial ventilation.
Causes of intrauterine pneumonia in newborns
Most common reasons intrauterine pneumonia is the presence in the body of a pregnant woman of viruses and bacteria that can penetrate the hematoplacental barrier to the fetus and infect the lungs. We can assume the likelihood of intrauterine pneumonia if a pregnant woman has had an acute respiratory viral infection or other infectious disease during pregnancy. later pregnancy.
The cause of pneumonia in newborns can be aspiration (swallowing) of amniotic fluid during prolonged labor or post-term pregnancy. Meconium (original feces) entering the respiratory tract of a newborn is especially dangerous. The risk of fetal pneumonia is higher in premature babies.
Signs of intrauterine pneumonia in newborns
The first signs of intrauterine pneumonia may appear in the first hours or days after birth. These symptoms include:
Treatment of intrauterine pneumonia in newborns
Having suspected pneumonia in a newborn child, a neonatologist should transfer him to the neonatal department, place him in an incubator with a constant supply of humidified oxygen, and immediately prescribe antibacterial therapy. If the condition worsens and it is necessary to transfer the child to artificial ventilation, the child is transferred to the neonatal intensive care unit.
Consequences of intrauterine pneumonia
Even if timely medical care helps the baby survive, it can leave consequences in the form of the formation of atelectasis (areas of collapsed lung tissue) or replacement of areas of inflammation connective tissue. The altered areas of the lung tissue of such a child cannot perform their function, and subsequently emphysema (areas of increased airiness of the lung tissue) may develop in such lungs.
Prevention of intrauterine pneumonia is the prevention of acute respiratory viral infections and influenza in the mother, especially in the last weeks of pregnancy.
You are a fairly active person who cares and thinks about your respiratory system and health in general, continue to play sports, lead a healthy lifestyle, and your body will delight you throughout your life, and no bronchitis will bother you. But do not forget to undergo examinations on time, maintain your immunity, this is very important, do not overcool, avoid severe physical and strong emotional overload.
You are at risk, you should think about your lifestyle and start taking care of yourself. Physical education is required, or even better, start playing sports, choose the sport that you like most and turn it into a hobby (dancing, cycling, gym, or just try to walk more). Do not forget to treat colds and flu promptly, they can lead to complications in the lungs. Be sure to work on your immunity, strengthen yourself, be in nature as often as possible and fresh air. Do not forget to undergo scheduled annual examinations; treating lung diseases in the initial stages is much easier than in neglected form. Avoid emotional and physical overload; if possible, eliminate or minimize smoking or contact with smokers.
You are completely irresponsible about your health, thereby destroying the functioning of your lungs and bronchi, have pity on them! If you want to live a long time, you need to radically change your entire attitude towards your body. First of all, get examined by such specialists as a therapist and pulmonologist, you need to take radical measures otherwise everything may end badly for you. Follow all the doctors’ recommendations, radically change your life, perhaps you should change your job or even your place of residence, completely eliminate smoking and alcohol from your life, and reduce contact with people who have such bad habits to a minimum, toughen up, strengthen your immunity as much as possible spend more time in the fresh air. Avoid emotional and physical overload. Completely eliminate all aggressive products from everyday use and replace them with natural ones. natural remedies. Do not forget to do wet cleaning and ventilation of the room at home.
Pneumonia in newborns- this is purely pathological condition, which occurs as a result of intrauterine infection of the fetal respiratory tract with pathogenic pathogens or occurs immediately at the time of surgical delivery. Until recently, the pathological condition “pneumonia in a newborn child” occupied a leading position among the causes of neonatal mortality, and with the introduction of the latest preventive measures And effective ways With drug correction, these indicators decreased significantly. At this time, pneumonia in a newborn child, which occurs without complications, can be quite effectively controlled by taking modern antibacterial synthetic agents.
Children born before the gestational age and having signs of malnutrition are prone to developing pneumonia in the newborn phase, and the prognosis for recovery in this situation directly correlates with the correctness and appropriateness of drug therapy.
If we consider the nature of the etiopathogenetic mechanisms of the formation of pneumonic infiltration, then it is worth noting the polyetiological nature of this pathology. Thus, the main category consists of patients suffering from such a disease as “intrauterine pneumonia in newborns,” the development of which becomes possible only through transplacental transmission of the pathogen from the mother. Antenatal infection of a child with pneumonia pathogens occurs through the entry of infected amniotic fluid into the lumen of the fetal respiratory tract. And a separate category of patients are those who become infected with pneumonia pathogens directly during surgical delivery. An extremely rare form of pneumonia in newborns is postnatal, in which the child is infected after discharge from the hospital, that is, on an outpatient basis.
The development of such a pathology as pneumonia in newborns after cesarean section occurs when viral particles, fungal infections, chlamydia and streptococci penetrate into the child’s body. In some situations, intrauterine pneumonia in newborns acquires chronic course, which is due to the activation of a mixed infection, which is difficult to correct with medication.
Among possible reasons The vast majority of the development of pneumonia in a newborn are community-acquired forms of the disease, which are provoked by the activation of endogenous flora, which has at least minimal signs of pathogenicity, or are the result of exogenous infection. Based on the findings of numerous randomized studies, epidemiologists have obtained results that even newborn children who completely show no signs of the disease are transient carriers of pneumococci in 10% of cases, and the carriage rate of staphylococci reaches 45%.
Activation of endogenous conditionally pathogenic flora in the body of a newborn child, as the initial etiological factor in the development of pneumonia, occurs against the background of any acute respiratory infectious pathology, as well as during hypothermia. In general, in most situations, practicing neonatologists are extremely rarely able to determine the etiopathogenetic form of pneumonia in newborns due to the rapid increase clinical symptoms and the duration of most laboratory tests that allow identification etiological pathogen. In the case when the formation of pneumonic infiltration in a newborn occurs in outpatient setting, one should, first of all, assume the streptococcal nature of the disease. In the structure of possible pathogens of pneumonia in newborns, the leading position in terms of frequency of occurrence belongs to Haemophilus influenzae, although in Lately Cases of combined pneumococcal-hemophilic etiology of pneumonia have become more frequent.
Atypical pneumonia in newborns after cesarean section, occurring without an intoxication symptom complex, but with the presence of a persistent cough and increasing shortness of breath, is usually provoked by the specific pathogen chlamydia. If a newborn child has a tendency to frequent regurgitation, caused primarily by neurological symptoms, aspiration pneumonia may be observed, the causative agent of which is gram-negative flora. Severe complicated course of pneumonia in newborn children in most situations is observed when infected with mixed viral-bacterial flora.
The clinical course of such a pathological condition as “pneumonia in newborns” is usually extremely severe, which explains the high percentage of deaths. For the most part, it is pathomorphologically more correct to talk about bronchopneumonia in children, since in addition to the characteristic intoxication and respiratory manifestations a broncho-obstructive component is observed.
The debut of the clinical symptom complex of pneumonia in newborns is acute occurrence and rapid increase in intoxication manifestations in the form of complete failure from taking breast milk, regurgitation, weight loss and, somewhat less frequently, loose stools. In most situations, in the initial period, pneumonia in newborns occurs without an increase in the body’s pyretic reaction, although low-grade fever may be observed.
Somewhat later, the child develops a cough, during which paleness of the facial skin and increasing cyanosis of the nasolabial triangle are noted. The appearance of rapid breathing in a child, the frequency of which exceeds 120 movements per minute with some loss of its depth, indicates an increase in respiratory disorders, which are pathognomonic for pneumonia. During respiratory movements, there is a pronounced swelling of the wings of the nose with synchronized movements of the head, which characterizes the inspiratory nature of shortness of breath. Against the background of increasing respiratory disorders, the development of hemodynamic disorders in the form of embryocardia and muffled heart sounds during auscultation is noted.
Objective visual markers of pneumonia in newborns are the determination of the tympanic shade of percussion sound over the affected area of the lungs. Auscultatory signs undergo changes depending on the pathomorphological stage of development of pneumonia and consist of listening to hard breathing at the onset of the disease and limited fine-bubble crepitant rales at the height of clinical symptoms.
The most pathognomonic clinical marker of the aspiration form of pneumonia in a newborn child is the development of segmental or lobar atelectasis. Clinical signs of pneumonia in this situation are short-term attacks accompanied by severe cyanosis. The clinical symptom complex of asphyxial pneumonia in a newborn child is so pronounced and specific that establishing a diagnosis is not difficult for an experienced neonatologist, even without fluoroscopy. Auscultation of aspiration and asphyxial pneumonia is manifested complete absence vesicular breathing in the affected half of the chest. Unfortunately, this clinical type of pneumonia is characterized by a high percentage of death, which occurs a few days after birth.
The congenital variant of pneumonia in newborns is distinguished by the most severe course of clinical symptoms and is exclusively infectious in nature. Contamination of the fetus with infectious agents occurs in utero and after birth the child either develops independently or develops a whole complex of infectious and inflammatory pathologies.
More recently, children born with markers of intrauterine pneumonia died from acute respiratory failure in the first day of life in almost 90% of cases. Experts have developed algorithms for resuscitation measures in neonatology that can increase the survival rate, although this category of patients still develop long-term negative consequences of a physical and neurological nature.
Considering the etiopathogenetic mechanisms of the development of congenital pneumonia, it should be noted the dominant role of the woman’s health status during the pregnancy phase. Thus, if she has chronic inflammatory and infectious foci and their activation during pregnancy, a large concentration of pathogens freely penetrates from the mother’s blood through the fetoplacental barrier into the child’s body with further concentration in the fetal lung structure. Extremely negative consequences for the fetus have acute viral pathologies type or, since the risk of developing intrauterine pneumonia in this case reaches 50%. Among the most common infectious provocateurs of the development of pneumonia in newborns of congenital origin, viruses and protozoa categories should be noted.
Of course, the health status and degree of development of the fetus are of no small importance in relation to the risk of developing congenital pneumonia. Thus, children born before the gestational age, as well as persons with developmental anomalies of the bronchopulmonary system, are more likely to develop congenital pneumonia. Regardless of at what point the newborn baby was infected (during pregnancy or at the time of delivery), clinically this pathology manifests itself as infiltrative lesions of both lungs, predominantly interstitial in nature.
The main diagnostic markers of pneumonia in newborns of congenital origin include: the fact that the mother had an infectious disease or a chronic inflammatory focus during pregnancy, the appearance in the child immediately after birth of increasing inspiratory shortness of breath, a subfebrile or febrile pyretic reaction and, of course, the presence of pathognomonic skialological signs during fluoroscopy.
A neonatologist who has some experience in caring for newborns suffering from pneumonia can, even at the pre-laboratory stage, reliably verify the diagnosis only based on physical examination data. Thus, during quiet percussion over the infiltration zone, a dullness of the percussion sound is revealed, which is clearly visible against the background of general tympanitis, caused by a compensatory increase in pneumotization of the pulmonary fields surrounding the infiltration. Indisputable diagnostic markers of pneumonia in newborns are the presence of crepitant wheezing, which can be both widespread and clearly localized. It should be noted that the appearance of pathognomonic physical data occurs only on the fifth or sixth day of the development of pneumonic infiltration, which makes early verification of the diagnosis difficult.
The so-called skialological markers of pneumonia in newborns, which are visualized during chest X-ray, have the maximum information content and specificity. Thus, indisputable diagnostic markers are the visualization of infiltration of the pulmonary parenchyma of a focal or interstitial type, located on a pronounced pulmonary pattern and compensatory vicarious emphysema of the upper pulmonary fields. Among the laboratory components of the diagnosis of pneumonia in newborns, as well as in adults, useful information can be obtained by performing a general clinical analysis of peripheral blood, which often reveals a pronounced and increased ESR.
Neonatological treatment tactics for patients who suffer from pneumonia consist primarily of early prescription of drugs from the category of antibacterial synthetic drugs, the choice of which directly correlates with the etiopathogenetic form of the disease. Based on some pathognomonic clinical and laboratory markers, a doctor can assume a possible causative agent of pneumonia from the first contact with a newborn child, and otherwise it is necessary to resort to the empiric method of prescribing antibiotics.
Regardless of the etiopathogenetic and pathomorphological form of pneumonia, the pharmacological effectiveness of any antibacterial drug is analyzed after the first two days from the start of use. Thus, ampicillin in combination with an aminoglycoside is used as a drug for empirical antibacterial therapy of intrauterine pneumonia in a newborn child. When clinical and laboratory signs of pneumonia appear in a child three days after birth, preference should be given to a combination of third-generation cephalosporins and aminoglycosides. If laboratory diagnostics has identified pseudomonas as the causative agent of pneumonia, then Ceftazidime should be added to the general antibacterial correction regimen.
The atypical clinical form of pneumonia is considered a reason to prescribe macrolide antibacterial agents from the first day, since the causative agent in this situation is often chlamydia. The maximum pharmacological activity of Azithromycin in neonatal practice occurs when the calculated dose is 10 mg/kg, and the duration of therapy is five days. In a situation where the prescription of a macrolide during the first day is not accompanied by an improvement in the patient’s condition, it is necessary to supplement therapy with Co-trimoxazole at the calculated daily dose 10 mg/kg.
Mandatory component therapeutic therapy pneumonia in newborns is an expansion of the drinking regime. When a child is breastfed, it is necessary to increase the frequency of episodes of attachment to the breast with a decrease in the single volume of breast milk. Among the common complications of pneumonia in newborns, the development should be noted, the appearance of signs of which is the basis for prescribing Heparin at a daily calculated dose of 200 U/kg subcutaneously.
Such a pathological condition as pneumonia in newborns, in a fairly high percentage of cases, has a negative prognosis for recovery, which is due to several pathogenetic mechanisms. Prolonged hypoxic damage has extremely negative consequences for both the physical and psychomotor health of the child. important centers central nervous system, which is caused by prolonged respiratory disorders. In second place among the negative consequences of pneumonia in newborns are hemodynamic disorders in the form of cardiac rhythm disorders.
We should not forget that even the minimal intensity of intoxication manifestations is accompanied by a gradual increase in the concentration of toxic substances in the child’s general bloodstream, which inevitably provokes the development of dysmetabolic and toxic secondary damage to various structures child's body. In order to avoid the development of the above negative consequences, all newborn children in whom the attending physician suspects signs of pneumonia are immediately subject to hospitalization in an intensive care bed.
A special category of increased risk for the development of early and long-term negative consequences are children born before the expected gestational age, who show signs of pneumonia. The complexity of the course of this pathology in this situation lies in the lightning-fast increase in general intoxication manifestations and the severity of respiratory disorders. As a result of a significant increase in the content of carbon dioxide in the bloodstream of a newborn child, pronounced swelling of the soft tissues of the periorbital region develops, and with prolonged hypercapnia, the child exhibits signs of irreversible inhibition of the central nervous system.
Among the complications of the pulmonary profile, spontaneous hydropneumothorax, discoid atelectasis and accumulation of pleural effusion, which belong to the group of emergency conditions and require immediate correction, are in first place in terms of frequency of registration.
Pneumonia in newborns - which doctor will help
? If you have or suspect the development of pneumonia in a newborn child, you should immediately seek advice from doctors such as a neonatologist or an infectious disease specialist.Pneumonia in newborns occurs when infected with pathogenic bacteria in utero or during childbirth. Just a few decades ago this state caused high mortality among children, but the pharmaceutical industry created effective drugs. Modern drugs capable against pneumonia within short terms destroy most pathogens of congenital pneumonia.
Congenital pneumonia is diagnosed in 10-15% of children. Very often the disease is observed in premature infants and with fetal malnutrition.
The prognosis for a child’s life depends on the correctness of treatment tactics and timely detection of pathology. The problem is relevant enough to leave its causes unattended, so we invite readers to read the article to the end.
The causes of disease in premature infants can be divided into the following categories:
Pneumonia in newborns is caused by a special spectrum of microorganisms, which requires the prescription of a special group of antibiotics in the treatment of the disease. At viral infections The prognosis for the course of the disease in newborns depends on the state of the baby’s immune system and has specific features, which we will consider below.
After Caesarean section Congenital pneumonia occurs when infected with the following microorganisms:
With a long course, congenital pneumonia is caused by a combination of flora, which is difficult to treat, which in ancient times led to high mortality in newborns.
Inflammation of the lung tissue that occurs after a Caesarean section in the mother is caused by streptococcus. The pathogen causes purulent foci and sepsis ( bacterial infection blood) with rapid reproduction even against the background of antibiotics.
Home types of pneumonia in premature infants occur against the background respiratory infections, adenoviral lesions, streptococcal infections.
When a child is born healthy, this does not mean that he or she has a strong immune system. Some bacteria are antagonists to other pathogens of respiratory tract diseases. Thus, Proteus is able to destroy gram-negative bacteria.
In premature babies, there is underdevelopment of the protective factors of the alveolar tissue: surfactant defects are visible, there are no alveolar macrophages (cells that destroy microbes in the alveoli), the bronchial wall is weak. Against the background of such changes, it is difficult to assume that an encounter with infectious agents will not cause inflammatory reactions. The only salvation is the struggle of some representatives of the microbial world with others.
With bacterial contamination of the respiratory tract with Proteus, pneumonia caused by gram-negative bacilli cannot be traced for several months. Proteus is a pathogenic bacterium and can independently cause pneumonia in infants.
Interaction in the microbial world – complex mechanism, which has not been reliably studied by humans. It is obvious that the widespread use of antibiotics is not rational. The peculiarities of prescribing these drugs require control of the dosage and course of therapy. Due to a violation of the treatment regimen for infections antibacterial agents, many bacteria have developed resistance, which complicates the process of their therapy.
A negative prognosis for pneumonia in newborns is formed by the following symptoms:
If at least one of the above symptoms appears, the child is placed in the intensive care unit, as artificial ventilation may be required.
Pneumonia in premature babies has its own characteristics, unlike infants and infants under 1 year of age:
The above-described signs of pneumonia in newborns depend on the cause of the pathology. If the inflammation is caused by pneumococcus, there is a high probability of complications or death. With this form, inflammatory foci quickly penetrate from one lung to another.
Congenital pneumonia in newborns is dangerous condition. If the doctor does not prescribe antibacterial drugs, the child will quickly develop the following symptoms:
The list of changes that pneumonia causes in premature newborns is endless. The final stage of the pathology is death (without adequate treatment).
Pneumonia at birth in full-term infants is benign. Its duration is 1-2 weeks, and then the patient’s condition gradually improves. Signs of respiratory failure rarely require relief with artificial ventilation.
In a full-term baby, the acute period of inflammatory changes in the lungs lasts 5-7 days. After the use of antibiotics, resorption of infiltrative foci in the alveolar acini is observed, which provides a favorable prognosis.
Segmental pneumonia at birth in premature infants best case scenario cured in 4 weeks. Due to this course of the disease, it is obvious that the fetus should be preserved in utero until the time of physiological labor, but this is not always possible.
Symptoms of pneumonia in premature newborns can be divided into the following morphological types:
In premature infants, any of the above forms rapidly progresses and can cause death, so it is necessary to identify and treat the pathology in the early stages.
Bilateral pneumonia in premature babies is dangerous high probability lethal outcome. Serious consequences also occur against the background of primary immunodeficiency, severe malnutrition and prematurity.
The risk of respiratory failure increases with the presence of infiltrative fluid in the lungs, foreign bodies, liquid sputum (against the background of cystic fibrosis). To empty purulent foci when antibiotics are ineffective, open sanitation of the formations is necessary operative method. Surgical intervention It is very difficult for premature babies to tolerate, but it is a necessary measure to save the life of the child.
With bilateral pneumonia in premature infants, the following complications are often observed:
The consequences of the disease in premature babies are too serious. Only with early detection of signs of infiltrative changes in the pulmonary parenchyma and the absence of provoking factors can it be guaranteed complete cure pathology.
Congenital pneumonia is treated as long as pathogenetic symptoms of the disease exist. Acute period The disease lasts about 2 weeks, after which the symptoms of respiratory failure decrease. When the condition of premature babies improves, their appetite increases and the central nervous system is restored. The resolution stage lasts 1-2 weeks.
Pneumonia in a newborn baby is a fairly common infectious disease of the perinatal period. It can be classified as special dangerous pathologies, especially when it comes to bilateral inflammation. The statistics today are not particularly reassuring; inflammation is diagnosed in 1% of full-term and 15% of premature babies (i.e. those born before the 37th week of gestation).
It is worth considering that children during the newborn period are especially susceptible to various viruses and bacteria. Signs of pneumonia may differ depending on when the infection occurred (prenatal period, childbirth, neonatal period). Cases of intrauterine pneumonia cannot be called rare. In such a case, signs will be noticeable immediately after birth. Among the main factors provoking inflammation of the lung tissue, the first place is taken by the acute respiratory infections suffered by a pregnant woman during gestation (gestation).
However, not every colds leads to the formation of intrauterine pneumonia, so do not panic. But you shouldn’t let the course of the disease take its course.
Among the causative agents of pneumonia in children, the most common are staphylococci and streptococci. It should be taken into account that, based on anatomical features, the lungs of a child born prematurely are less developed, and accordingly, he is more susceptible to the occurrence of this disease.
Among the main predisposing factors that provoke pneumonia, it is worth pointing out:
It should be remembered that pneumonia is extremely dangerous for children. Hospitalization is mandatory. Carrying out treatment on an outpatient basis is dangerous, little patient together with the mother must be under constant supervision of specialists.
The development of the disease in newborns, as well as in older children, is provoked by various viruses, fungi, microbes, protozoa and bacteria.
Among the reasons that increase the risk of pneumonia are:
Conclusion - the risk of pneumonia in a newborn child increases under the influence of various unfavorable factors.
It is worth considering that the risk of pneumonia in premature babies is increased several times.
Pneumonia in newborns - excessive dangerous disease, in the absence of timely treatment, it can cause death due to acute respiratory failure. Among the reasons that provoke the occurrence of pneumonia in babies during the newborn period are:
The danger of pneumonia at an early age is that the pathology can lead to a lot of complications. To prevent such consequences, if the first symptoms of the disease are present, you should show the baby to the doctor.
The duration of treatment is determined depending on the stage pathological process. Therefore, the sooner you consult with a specialist, the faster the baby can be cured.
As is known, pneumonia is characterized by damage to the walls of the alveoli under the influence of infectious process, occurring in lung tissue. Symptoms of pneumonia in infants may differ depending on the type of pathogen that has entered the baby’s body, the method of infection and the general resistance of the body.
With the intrauterine form of infection, babies are born with pathological processes already occurring in the lungs. The likelihood of this form increases significantly if the mother also became ill with pneumonia, especially viral pneumonia, during pregnancy.
Diagnosing the presence of pneumonia in a baby is not easy. Among characteristic features can be distinguished:
Neonatologists will notice manifestations of inflammation in the baby after birth even before the mother and child are discharged from the hospital (maternity hospital). If signs of pneumonia are present in a child under one year old, you should immediately go to the hospital and undergo an examination, because inflammation is especially dangerous not only in the first month of the child’s life, but also during the first three years.
If your baby's body temperature rises rapidly, you need to call an emergency vehicle.
The cough at the onset of the disease may not be pronounced, but this symptom should be paid attention to. Nasal discharge and difficulty breathing should also alert the mother. Shortness of breath leads to bluish extremities due to lack of oxygen in the body.
It is easier to make an accurate diagnosis based on examination of the newborn and x-ray data than on the basis of an objective examination of the child alone. To confirm the presence of infection, a series of tests should be carried out laboratory research to prove the presence of infection. In any case, a child, even with suspected pneumonia, should be hospitalized without delay. It is important to remember that the risk of death is too high.
Diagnosis of this disease in children early age should include the following activities:
Particular attention should be paid to x-ray examination. In many cases, parents are looking for ways to refuse of this event, but this is not true. Only radiography will help doctors identify the presence of foci of inflammation in the lungs of a newborn and help eliminate the possibility of congenital abnormalities of the lungs and bronchi that aggravate the course of inflammation.
X-ray examination cannot be called useful procedure for infants, but if pneumonia is suspected, it is unreasonable to refuse this activity.
At this stage of development of medicine, more gentle and precise methods diagnosis of pneumonia in pediatric practice does not exist. The first thing parents should think about is possible consequences in case of late detection of the disease.
Early diagnosis of pneumonia in an infant is extremely important for successful recovery. If manifestations of pneumonia become noticeable in a newborn while still in the maternity hospital, he is placed in a special incubator to maintain and constantly monitor breathing and temperature.
Treatment of pneumonia involves active tactics. It is impossible to cure pneumonia in a child in the first days of life without the use of antibiotics. Depending on the condition, the use of the drug is prescribed, active substance which is penicillin or cephalosporin (in some cases, other active ingredients). Possibly oral, intramuscular and intravenous administration. The appropriateness of using one or another form of the drug is determined by the doctor. Complex vitamin therapy is indicated; the child’s body must be provided with all the vitamins necessary for normal development.
Some bacteria and viruses are resistant to penicillin, so administration of drugs from other groups is recommended.
Features of therapy are determined based on the severity of the disease and the individual characteristics of the baby’s body. However, reception antibacterial drugs indicated for all forms of the disease. The temperature in the first days of the pathological process almost does not drop; it drops only after the antibiotic “kills” most of the infectious agents. The baby’s body begins to recover after the body temperature drops - the child’s appetite returns, his breathing gradually returns to normal.
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