A clinical example of the management of a premature baby born after IFV

Abstract

Babies born through in vitro fertilization (IVF) treatment are most often born preterm [1]. Most authors state that these children are more likely to have congenital malformations, bronchopulmonary dysplasia (BPD), hypoxic central nervous system damage, hyperbilirubinemia. It is known that these children are 6 times more likely to have an extremely low birth weight and intrauterine growth retardation [2]. More than 35 years have passed since the birth of the first child through the IVF treatment. During this time, the assisted reproductive technologies have improved and therewith the number of children conceived in vitro has also increased. In this regard, the issues relating to the study of the health of children conceived through IVF treatment are growing more urgent. In the Russian Federation, the share of premature babies averages 6–8% among all newborns. Children born prematurely should always be in the center of attention of pediatricians, since it is among them that the highest percentage of perinatal pathology is observed and deviations in subsequent development are detected much more often [3].Objective of the study: to study the state of health of a premature baby in the first year of life born through IVF. Material and methods: the researchers performed a continuous, documentary, retrospective analysis of the medical history of a child treated in the Special Care Nursery of the City Children’s Clinical Hospital in Ufa, and afterwards monitored the child in the Catamnesis Unit. The child underwent clinical examination, assessment of physical development using the centile method, laboratory tests, analysis of primary medical documentation (hospital neonatal record f. 097/u, outpatient medical record f. 112/u). The premature baby was examined taking into account the adjusted age (from the calendar age to 40 weeks of gestation).Results: the health and age of the mother are crucial in forming the health of the child. The mother had a combined pathology. The 3rd pregnancy (the 1st pregnancy ended in childbirth at 35 weeks, the child grows in a family, the 2nd pregnancy ended in spontaneous abortion) through IVF treatment developed against the threat of interruption starting from 8 weeks, combined gestosis, grade 1B placental violation, low placentation, isthmic-cervical insufficiency (ICI), antiphospholipid syndrome, which resulted in early, premature birth at 29 weeks’ gestational age. The child was born prematurely with perinatal nervous system damage, the development of acute pneumonia, respiratory distress syndrome of the newborn.Findings: A clinical case determines the need for targeted observation of a premature child from a risk group, timely advanced training of a pediatrician regarding the features of management of premature babies born through the IVF treatment, taking into account the adjusted age.

Keywords

• premature baby
• extremely low birth weight
• adjusted age
• organic lesion of the central nervous system