Department of Pathology of Newborns and Premature Children No. 2

Location:

Kolomensky proezd, building 4, building 13, 2nd floor of children's boxed building

Operating mode:

24/7

Telephone:

(from 13.00 to 14.00)

Number of beds

: 40 beds

Profile diseases

: infectious and non-infectious pathology characteristic of newborns and children born prematurely

Information about the department

: the department of pathology of newborns and premature babies deals with the treatment and care of newborns and premature babies and is represented by 19 boxes for newborns and premature babies, of which 11 boxes for mother's day care on a free basis (8:00-16:00), 4 boxes for joint round-the-clock stay mothers on a commercial basis, 4 boxes for shared round-the-clock stay on a free basis (the box is designed for two mothers).

Mothers who have been examined for pathogenic enterobacteria are allowed to breastfeed (Order of the Department of Health dated April 21, 2014 No. 365, paragraph 2.1.2).

The department has: one manipulation room for laser coagulation of the retina, a treatment room, an ultrasound diagnostic room, a room for pumping, a milk room for preparing formula for newborns and premature babies, a rest room for mothers, a dining room for mothers (free food)

Manipulations performed

: diagnosis, treatment and nursing of newborns, including the use of high-tech techniques, nursing of children born with extremely low body weight (less than 1000 g).

Scientific activity:

Department of Neonatology of the Russian Medical Academy of Postgraduate Education (head of the department, Professor Efimov M.S.)
Department of Ophthalmology, Faculty of Pediatrics, Russian National Research Medical University. N. I. Pirogova (head of the department, professor Sidorenko E. I.)
Department of Neurology, Neurosurgery and Medical Genetics, Faculty of Pediatrics, Russian National Research Medical University. N. I. Pirogova (head of department Zavadenko N. N.)

Hospitalization

: planned, 24-hour joint stay of mother and child in luxury boxes

Feeding premature babies

The article presents our own experience of using the drug "Palivizumab" (Synagis) for passive immunoprophylaxis of ARVI, complicated by frequent episodes of obstructive bronchitis or pneumonia in young children with bronchopulmonary dysplasia. The justification for the use of Synagis is the undoubted fact of the presence of respiratory syncytial virus in the structure of ARVI pathogens, which served as a recommendation for the use of the drug in 50 countries around the world and in most countries “Palivizumab” was included in the standards for the prevention of RSV infection.

Experience with the drug Palivizumab (Sinagis) for passive immunization RSV-infected at bronchopulmonary dysplasia in infants

The article provides a personal experience with the drug palivizumab (sinagis) for passive immunization of SARS, complicated by frequent episodes of obstructive bronchitis or pneumonia in infants with bronchopulmonary dysplasia. The rationale for the use of sinagis is undoubtedly the presence in the structure of the SARS causative of respiratory syncytial virus, which was the recommendation for the use of the drug in 50 countries around the world and in most of palivizumab agents entered the standards of prevention RSV - infection.

Bronchopulmonary dysplasia (BPD) is a chronic disease of the immature lungs that develops in newborns, mainly very premature infants, after respiratory distress syndrome and/or pneumonia in the early neonatal period. With this disease, the bronchioles and lung tissue are affected: in some areas of the lung, the healthy structure is replaced by connective tissue and fibrosis develops, in others, swelling of the lung tissue occurs, resulting in emphysema. The alternation of areas of fibrosis and emphysema creates a characteristic pathomorphological and clinical picture of bronchopulmonary dysplasia. Often, pulmonary vessels are involved in areas of fibrosis: damage to the lung tissue occurs due to impaired oxygen saturation of the tissue and release of carbon dioxide. The frequency of BPD depends on the child’s body weight at birth: with a weight of 500-1000 g, the disease occurs in 33-64% of children, with a weight of 1000-1500 g - in 3-6%, with a weight of more than 1500 g - in 1-2%. In rare cases, BPD also develops in children born at term. Predisposing factors to the development of BPD in full-term infants, as well as in premature infants, are mechanical ventilation during meconium aspiration, pneumonia, or surgery. A feature of the clinical picture of BPD is respiratory failure in newborns who are on mechanical ventilation or after mechanical ventilation, when children receive oxygen through a mask for a long time. Cough, wheezing, shortness of breath, i.e. signs of pulmonary obstruction often persist despite spontaneous breathing. The severity of BPD is determined by the state of oxygen dependence at 36 weeks of postconceptional age for children under 32 weeks of age or at 56 days of life for children born after 32 weeks of gestation. The most common manifestation of exacerbation of BPD in the form of obstructive syndrome is observed during acute respiratory viral infection, among the causative agents of which the respiratory syncytial virus selectively affects this contingent of children. Respiratory syncytial virus (RSV) infection is a significantly more common cause of death in children in their first year of life than influenza virus (1). RSV infection can be life-threatening in infants under 12 weeks of age, premature infants, infants with congenital heart defects, and those with bronchopulmonary dysplasia (2). Today there is an effective method for preventing RSV infection: this is passive immunoprophylaxis in children at high risk by introducing antibodies to the RSV virus into the child’s body to prevent severe forms of infection caused by RSV. Palivizumab (Synagis) is the world's first drug with proven effectiveness for passive immunoprophylaxis of severe forms of RSV infection in children from high-risk groups (3). The mechanism of action of Synagis is the suppression of the activity of the F protein, which ensures the penetration of the virus into the cell. In most countries (there are more than 50), where the use of Synagis is recommended, it is included in the standards for the prevention of RSV infection.

17 children from 3 to 16 months of life were under observation: 16 children were born premature at a gestation period of 28-32 weeks and weighing 760-1720 g. One child was born from a full-term pregnancy with multiple malformations that were compatible with life and required resuscitation care. All children in the neonatal period were on mechanical ventilation. These children were diagnosed with “Bronchopulmonary dysplasia” according to the criteria of the modern domestic working classification of bronchopulmonary diseases in children 2008 (Moscow) already during their stay in the intensive care unit for newborns or in the department of the second stage of nursing at the 1st Children's City Hospital Kazan. Moderate course was observed in 11 (64.8%), severe - in 6 (35.2%). Among the concomitant pathologies in all premature children, the following were identified: retinopathy of prematurity - children were examined with a retinal camera, consulted with an ophthalmologist and, if necessary, they underwent surgical correction; cerebral pathology, mainly of hypoxic or mixed origin, of varying severity, but without severe, incurable complications. Children with BPD were admitted to the pulmonology department with acute bronchitis, bronchiolitis or pneumonia. Before this admission, each child had several episodes of acute respiratory viral infection complicated by obstructive bronchitis or pneumonia. A thorough analysis of the medical history, the results of clinical, instrumental and laboratory examinations did not exclude complicated RSV infection in the observed patients, which served as a rationale for passive immunoprophylaxis of its relapses. For this purpose, 9 patients with BPD, after the elimination of the acute bronchopulmonary process clinic, received the drug "Synagis": 1 child - 4 injections, one child - 3 injections, 6 children - 2 injections each and one child - one dose. The choice of "Synagis" was determined by the severity of BPD, the age of the child, the number of episodes of ARVI and its complications and the time of year - from November to March inclusive. "Synagis" was administered intramuscularly into the outer lateral region of the thigh, a single dose was 15 mg per 1 kg of body weight with an interval of 1 month. For repeated injections, children were admitted to a day hospital for 2 days: on the first day they underwent a clinical examination and examination; in the absence of contraindications, Synagis was administered and the child was observed for another day. No early side effects were observed. During the month following the introduction of Synagis, contact with the child’s parents was carried out via mobile communications: no complications were identified in any case. Observation of children who received passive immunoprophylaxis of RSV infection since November 2011. to June 2012 inclusive, showed that only one child had a relapse of ARVI with obstruction syndrome.

The study showed the undoubted clinical effectiveness of the use of the drug "Palivizumab" (Synagis) for the purpose of passive immunoprophylaxis of recurrent acute respiratory viral infections and, in particular, RSV infection in children with BPD. This contributed not only to a reduction in the number of episodes of exacerbation of the disease, but also, obviously, to a reduction in the risk of chronicity of bronchopulmonary pathology in young children. Continued follow-up of patients until the age of three will contribute to a final judgment about the development of chronic lung disease or its prevention in children with BPD who received Synagis.

A.V. Kuznetsova, I.V. Rusakova, I.V. Sitdikova, A.R. Khaertynova, F.S. Pirogova, L.F. Netfullova, K.Z. Zakirov

Children's City Hospital No. 1, Kazan

Kuznetsova Alevtina Vasilievna - Doctor of Medical Sciences, Consulting Professor

Literature:
1. Thompson WW, Shay DK, Weinttaub E. et. al. Mortality associated with influenza and respiratory syncytial virus in the United States // JAMA. - 2003. - Vol. 289. - P. 179-86.
2. Patrusheva Yu.S., Kulichenko T.V. Laboratory diagnosis of respiratory syncytial viral infection in children // Questions of diagnostics in pediatrics. - 2009. - T. 1, No. 1. - P. 24-27.
3. Modified Recommendations for Use of Palivizumab for Prevention of Respiratory Syncytial Virus Infections Committee on Infectious Diseases // Pediatrics. - 2009. - Vol. 124. - P. 1694-1701.

Department of Vaccination Prevention for Children with Health Disabilities and Family Vaccination

Breaking news

10/07/2021: Ultrix Quadri (quadrivalent flu vaccine) is available for adults and children from 6 months! Protect yourself and your children from the flu during the 2021-2022 epidemiological season.
08/02/2021: In stock BCG-m (NPO MICROGEN, Russia) - tuberculosis vaccine for gentle primary immunization of children from 0 months
04/30/2021: INFANRIX HEXA vaccine (GlaxoSmithKline Biologicals, Belgium) is available - a combined acellular pediatric vaccine for the prevention of whooping cough, diphtheria, tetanus, polio, Haemophilus influenzae, hepatitis B
04/30/2021: The vaccine VACTRIVIR (NPO MICROGEN, Russia) is available - a combined vaccine for the prevention of measles, rubella and mumps
04/30/2021: Vaccine ALGAVAK-M (VECTOR-BIALGAM, Russia) is available - a vaccine for the prevention of viral hepatitis A
The vaccine for the prevention of dysentery "SHIGELLVAK" is available, intended for travelers, food industry workers, medical workers (for children from 3 years of age and adults)
The vaccine against meningococcal infection "MENAKTRA" is available, as well as the vaccine against human papillomavirus "GARDASIL"

National calendar of preventive vaccinations of the Russian Federation Calendar of preventive vaccinations according to epidemic indications of the Russian Federation

Vaccines used

The department is guided in its work by international immunization standards. Since the vaccination calendar of foreign countries is much wider than the domestic one, all vaccines registered in the Russian Federation that are suitable for the national vaccination calendar are used.

AD-m, ADS, ADS-m, AS
Adasel
BiVac Polio
BCG-m, BCG
Vaxigrip
Varilrix
Gardasil
Live measles vaccine
Live rubella vaccine
Live mumps vaccine
Live mumps measles vaccine
Infanrix
Infanrix Hexa
Mite-E-Vac for children
Mite-E-Vac for adults
Menactra
Pentaxim
Pneumovax 23 (temporarily out of stock)
Prevenar
Rotatek
Havrix 720
Havrix 1440
Cervarix
Euvax B

The cost of services is indicated in the price list.

The price of the service includes:

Consultation with a pediatrician, vaccinologist on vaccination issues
Examination before vaccination
Manipulation (drug administration)
Check-up after vaccination

Types of diseases

Today, preventive measures, one of which is vaccination, are the main tool in solving the problem of combating infectious diseases. Vaccination of children is an outstanding public health success. Thanks to vaccinations, millions of children have been saved and given the right to a healthy life.

The Family Vaccine Prevention Center vaccinates children from birth to 17 years of age, children with various chronic pathologies, as well as adults.

Vaccination of adults

The Family Vaccination Center also provides services for adults:

Vaccination of adults;
Consultations for future parents on vaccination of newborns in the maternity hospital;
Consultations with parents on issues of immunization, in general, and the vaccination schedule for their children, in particular.

Types of diagnostics

Tuberculin diagnostics:

Setting and evaluation of the Mantoux test
Setting and evaluation of Diaskintest

Types of treatment

ADS, ADS-m
Adasel
BiVac Polio
BCG-m, BCG
Vaxigrip
Varilrix
Gardasil
Live measles vaccine
Live rubella vaccine
Live mumps vaccine
Live mumps measles vaccine
Infanrix
Infanrix Hexa
Mite-E-Vac for children
Mite-E-Vac for adults
Menactra
Pentaxim
Pneumovax 23 (temporarily out of stock)
Prevenar
Rotatek
Havrix 720
Havrix 1440 (temporarily out of stock)
Euvax B

The cost of services is indicated in the price list.

The price of the service includes:

Consultation with a pediatrician, vaccinologist on vaccination issues
Examination before vaccination
Manipulation (drug administration)
Check-up after vaccination

Wards of the department and daily routine
1st floor of the CDC, rooms 110 to 117.

Why us?

An individual approach when drawing up a vaccination schedule for children with health problems: children of health group 2 (children with functional disorders of the gastrointestinal tract, MARS, compensated chronic tonsillitis, adenoid vegetations, frequently ill children); 3 health groups (atopic dermatitis, bronchial asthma, autoimmune thyroiditis, compensated congenital heart defects); children of the 4th health group (Hirschsprung's disease, storage diseases, epilepsy, delayed psycho-speech development, nephrotic syndrome, cerebral palsy, severe congenital malformations); with perinatal pathology, including very premature babies; with severe neurological pathology; with oncohematological diseases; with chromosomal diseases and rare diseases; children vaccinated before organ transplantation.
Vaccinal prevention of disabled children according to an individual schedule using modern foreign-made vaccines under the joint cooperation program of the National Medical Research Center for Children's Health and the Safmar Charitable Foundation.
Family vaccination according to modern global standards, including vaccinations against 17 infectious diseases, such as: rotavirus infection, meningococcal infection, chickenpox, viral hepatitis A, human papillomavirus infection.
Vaccine prophylaxis for 24-hour hospital patients from different regions of the Russian Federation with provision of recommendations for further vaccination according to an individual scheme.
Carrying out seasonal types of vaccinations against influenza, tick-borne encephalitis, viral hepatitis A.
Conducting an analysis of the course of the post-vaccination period, studying indicators of the immune response to correct the vaccination. All children with health problems are carefully examined before preventive vaccinations in order to minimize post-vaccination phenomena.
Multidisciplinary approach to vaccination of children with health problems. Using all the capabilities of the National Medical Research Center for Children's Health: advisory assistance from highly specialized specialists with the involvement of heads of departments and the teaching staff of the Center; carrying out the necessary laboratory and instrumental studies.
Availability of all modern vaccines in the department.

History of the department In the mid-90s of the last century, a voluntary immunoprophylaxis office was first organized at the Institute's clinic, in which, along with calendar ones, non-calendar vaccinations of an ever-expanding range were carried out.

In 2000, a vaccination room was created on the basis of the consultative and diagnostic department. Since 2007, the office was transformed into a department that received the status of a Family Vaccine Prevention Center, the main focus of which was the immunization of children with chronic pathologies. In 2022, the Family Vaccine Prevention Center was renamed the Department of Vaccination Prevention for Children with Health Disabilities and Family Vaccination.

The staff of the department includes 6 senior researchers from the National Medical Research Center for Children's Health, 7 pediatric vaccinologists, as well as 3 medical registrars of the department.

Areas of scientific activity Every year, the staff of the department issues methodological recommendations on current issues of immunization. Understanding the importance of informing the population about family vaccination issues, the department carries out active scientific and educational work. Topics of scientific work: “Tactics for managing children with irregular vaccination schedules against viral hepatitis B”, “Improving methods of vaccine prevention in children.” The specialists of the department carry out regular work to assess the safety and effectiveness of vaccination of children outside the national calendar, and develop individual vaccination regimens by assessing antibody responses.

Information for parents of premature babies born before 35 weeks gestational age

Dear parents, Your baby was born premature.
From the first minutes of his life, he is monitored and the necessary assistance is provided by experienced specialists: anesthesiologists-resuscitators and neonatologists. Their main task is to save the life of your child and try to prevent possible serious diseases that arise due to the immaturity of the body at the time of premature birth. Such diseases of premature newborns also include pathological development of the eyes - retinopathy of prematurity (ROP). ROP is one of the main causes of blindness, low vision and visual impairment in children from an early age in all developed countries of the world. The main cause of ROP is the premature birth of a child: the earlier the child is born and with a lower body weight, the more often he develops retinopathy and the more severe it is. Thus, the incidence of ROP among children with a birth weight of less than 1000 g reaches 90%. In addition, if a child has concomitant diseases from other organs, the severity of retinopathy is aggravated.

Thus, premature babies need a mandatory and timely examination by an ophthalmologist!

All premature babies normally have signs of eye immaturity and the process of retinal formation is not complete. After the birth of a child, the retina can develop in two ways: 1) normal growth of retinal vessels, or 2) pathological - development of ROP. Using modern examination techniques, an ophthalmologist identifies all changes in the maturing retina in a premature baby.

The first examination by an ophthalmologist of a premature baby is carried out, regardless of the location of the child, at 3-4 weeks of his life, and for extremely premature babies (born at 22-26 weeks of gestational age) at 30-31 weeks from conception. As a rule, during this period only signs of immaturity of the child’s eyes are revealed, but sometimes the first signs of ROP can be observed, which in most cases appear at 4-6 weeks of a premature baby’s life.

Medical observation program for premature infants in the first year of life “Catching up and growing”

Medical observation program for premature infants in the first year of life “Catching up and growing”

“Catching up and growing” program

is aimed at solving the problems of children born prematurely or with pathology in the neonatal period. The program is implemented on the basis of a department created for children under 3 years of age, with the involvement of doctors specializing in the treatment and rehabilitation of children born with low and extremely low body weight.

The program includes scheduled preventive examinations, instrumental and laboratory tests in accordance with the schedule provided by the Order of the Ministry of Health of the Russian Federation*, home visits by a pediatrician for illnesses, and telephone support.

1. Preventive examinations by a pediatrician/neonatologist are carried out

in the first month of life – once every 10 days – at home,
in the second month – 2 times – at home
;
from the third month
–
1 time per month
– in an outpatient setting.

2. In the period from 1 to 3 months of life, taking into account the corrected age and depending on the timing determined by the pediatrician, a full medical examination is carried out, including:

Examinations by an ophthalmologist, neurologist, orthopedic surgeon, otorhinolaryngologist;
General clinical blood test, general urine test;
Ultrasound examinations of the brain (neurosonography), abdominal cavity and genitourinary system, hip joints; echocardiography;
Audiological screening;
A routine examination by a pediatrician/neonatologist, including a clinical examination, antopometry, consultation with parents regarding the health and development of the child, recommendations for care, preventive measures, feeding, daily routine and further dynamic observation.

Next, comprehensive preventive examinations are carried out:

at 6 months of age:

Examinations by a pediatrician, ophthalmologist, orthopedic surgeon, neurologist;
General clinical blood test, general urine test;
Electrocardiography

at 9 months:

Examination by a pediatrician, neurologist;
General clinical blood test, general urine test;

at 12 months:

Examinations by a pediatrician, neurologist, ophthalmologist, otorhinolaryngologist, orthopedic surgeon, psychologist, dentist;
Electrocardiography, echocardiography;
General clinical blood test with glucometry, general urinalysis;
Coprological examination, scraping for enterobiasis, stool analysis for helminth and lamblia eggs.

3.
On the recommendation of the attending physician, the plan of preventive examinations may include consultations with a cardiologist, endocrinologist, gastroenterologist, nephrologist, urologist, as well as unscheduled consultations with a neurologist, ophthalmologist, orthopedic surgeon, and otolaryngologist.
In addition, the program provides:

Assigning a personal pediatrician
with the ability to contact him by phone daily from 8.00 to 19.00
Additional laboratory tests
- as prescribed by the attending physician;
Additional ultrasound and functional diagnostic tests -
on the recommendation of a doctor;
General massage with a specialist visiting your home
(10 sessions);
Outpatient appointments with a pediatrician for illness
- without restrictions;
Consultation with a psychologist
for mother/parents as part of family support after the birth of a child;
Preparation of medical documentation (certificates, medical reports of established forms);
Support by the curator of medical observation programs by phone +7(499)110-29-67, +7
on weekdays from 9.00 to 18.00

The cost of the program is 180,000 rubles.

When paying, installment payment may be provided:

50% - upon concluding an annual service agreement,
you can pay the remaining 50% within 3 months.

To prevent severe RSV-associated lower respiratory tract infections, children at high risk of RSV infection who have permanent registration in Moscow can receive injections of palivizumab (Synagis). The procedure is carried out at the Center for Restorative Treatment of children under 3 years of age born with low and extremely low body weight, free of charge, under the compulsory medical insurance policy.

You can receive all necessary studies and consultations not included in the Annual Medical Care Program, as well as vaccinations with vaccines from foreign manufacturers, with a 10% discount.

You can get detailed information about medical monitoring programs for children by calling:
+7(499)110-29-67, +7.
*Order of the Ministry of Health of the Russian Federation dated August 10, 2017. No. 514n, section “On the Procedure for conducting preventive medical examinations of minors”