DIFFICULTIES IN THE DIAGNOSIS OF COARCTATION OF THE AORTA IN THE NEWBORN IN THE EARLY NEONATAL PERIOD: ANALYSIS OF CLINICAL CASES

Abstract

Introduction. The problem of diagnosing coarctation of the aorta in the early neonatal period is still relevant and presents certain difficulties due to the peculiarities of hemodynamic adaptation to extrauterine life.The aim of the study is to evaluate own clinical observations with emphasis on the difficulty in diagnosing coarctation of the aorta in neonates in the early neonatal period and to perform differential diagnosis with coarctation (pseudocoarctation) of the aorta.The study was carried out according to the ethical norms and principles for conducting medical researches involving human subjects.The research was conducted within the framework of the National Development Program of the Department "Quality of life and course of somatic diseases in children under conditions of social stress", implementation period 2023-2025, state registration number: 0123U101768.Results. The article presents two clinical observations: the first case is a newborn with coarctation of the aorta in a non-emergent state during the first days of life in the presence of evictive morphological changes of the descending aorta; the second case is a newborn with clinical signs of hemodynamic disorders with diagnosed hemodynamic pseudocoarctation (kinking) at the stage of hemodynamic adaptation to extrauterine life. Adequate medical support helps to avoid the development of a serious, potentially dynamic hemodynamic situation.Conclusions. Diagnosis of critical coarctation of the aorta in newborns has certain difficulties associated with the peculiarities of hemodynamics in the early neonatal period and the functioning of fetal communication. In order to avoid mistakes in the diagnosis of the emergency of the defect and to perform timely surgical intervention, dynamic monitoring of blood pressure and saturation indicators of the upper and lower extremities, central hemodynamic parameters is necessary. Differential diagnosis of coarctation of the aorta with kinking (pseudocoarctation) of the aorta should be based on the results of dynamic monitoring of pressure gradient in the descending part of the aorta with control of blood pressure and saturation in the four limbs during the neonatal period.