Consilium Medicum (Nov 2024)
The prevalence of the symptom of "hyperechoic pyramids" in children born with very low and extremely low body weight
Abstract
Aim. To determine the frequency and factors contributing to the formation of c-ma "hyperechoic pyramids" in children born with very low and extremely low body weight, as well as to assess kidney function in this contingent of children in a three-year catamnesis. Materials and methods. A comparative analysis of the ultrasound pattern of the urinary system was carried out in 756 premature babies, from birth to 3 years of age, two groups were identified: group I – 133 children who had hyperechoic pyramids in the neonatal period; group II – 643 children without hyperechoic pyramids in the neonatal period; group III – the comparison group – 3000 full-term neonates. Results. The symptom of "hyperechoic pyramids" was detected in 15% of premature babies (group I) by the end of 1 month of life (25±6 days), in full-term babies (group III) – in 23 at the age of the first 3–10 days of life. In 2% of premature infants up to 2 months of age, hyperechoic inclusions were diagnosed, giving an acoustic shadow, which were interpreted as kidney concretions. It was revealed that the need (100% vs 71%) and duration (9.7 days vs 2.8 days) for mechanical ventilation, drug load and frequency of artificial feeding (92% vs 19%) in the I group were higher than in the II group. By 12 months of age, signs of nephrocalcinosis with hypercalciuria in group I were detected in 74% of patients and by 36 months were preserved in 23%. In 2% children with renal nodules detected in the first months of life, these changes up to 36 months of life and by 3 years of age, the frequency in group I was 6.6%. Conclusion. In children born with very low and extremely low body weight, there is a high frequency of detection of "hyperechoic pyramids," which tends to decrease with the growth of the child. In some children, the changes are persistent with a risk of progression in the absence of proper observation and treatment. Among the aggravating external influences, a significant role belongs to long-term mechanical ventilation and oxygen dependence, high drug load by various groups of drugs, as well as artificial feeding in neonatal and infancy.
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