International Journal of Medical Sciences And Clinical Research
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VOLUME
Vol.05 Issue06 2025
PAGE NO.
26-30
10.37547/ijmscr/Volume05Issue06-05
Dynamics Of Pathological Conditions In Children
Shorustamova Mokhira Mukhammadovna
5th Year Student, Faculty Of 1st Pediatrics And Traditional Medicine Tashkent Pediatric Medical Institute, Uzbekistan
Karataeva Lola Abdullaevna
Supervisor: PhD, Associate Professor, Department Of Pathological Anatomy, Tashkent Pediatric Medical Institute, Uzbekistan
Received:
14 April 2025;
Accepted:
10 May 2025;
Published:
17 June 2025
Abstract:
Our work reflects the data of a literature review on aspects of pathological conditions in children,
especially lung lesions, which are of great importance to physicians, especially pediatricians, as well as
pathologists.
Keywords:
Population, period, vessels, mortality, newborn, hypoxia.
Introduction:
Despite the development of technologies
in the medical field, the problem of diseases in young
children remains an open question. Pathological
conditions in children with perinatal hypoxia are
reflected in the activity of all organs and systems of the
div.
According to statistics, about 55% of infant mortality
cases worldwide are caused by perinatal pathology.
Certain conditions that arise in the perinatal period not
only occupy a leading place in the causes of infant
mortality, but also are at the origin of most childhood
diseases and disabilities. In the fetus and newborn,
they inevitably lead to the development of hypoxia.
And also analyzing literary sources, it can be noted that
among diseases of the cardiovascular system (CVS),
arterial hypertension (AH) occupies a special place. This
is due not only to its high prevalence, but also to the
fact that it serves as a leading risk factor occurrence of
myocardial infarction and stroke, which account for
40% of the causes of death among the adult population
and more than 80% of all deaths from cardiovascular
pathology. Moreover, recent years have been
characterized by a progressive increase in morbidity
and mortality from diseases of the circulatory system in
childhood and adolescence.
Numerous works described in both foreign and
domestic literature, which identify the origins of
hypertension in adults, have shown that their
formation occurs in childhood and adolescence.
Hypertension is observed in 8-12% of school-age
children and subsequently in 17-25% of adolescents it
acquires a progressive course.
The prevalence of hypertension among adolescents in
the United States is lower than in Russia, however, it
has increased significantly over time and reached 4.5%.
Among the factors that increase the risk of
hypertension, special attention is paid to genetic
aspects, chronic stress and physical inactivity, excess
div weight, bad habits, some biochemical parameters
that are indicators of early metabolic disorders in this
pathology. The influence of previously established risk
factors for CVD can explain the development of only 30-
50% of cardiovascular pathology.
The authors noted that the most significant links in the
pathogenesis of hypoxia are energy deficiency in cells,
metabolic shifts, and changes in intraorgan blood flow.
The development of ultrastructural, metabolic,
electrophysiological and a number of other disorders
can lead to cell death. Information that more than half
of newborns who have suffered perinatal hypoxia have
myocardial ischemia is presented by many scientists.
This is explained by the fact that the cardiovascular
system of a newborn, being an indicator of pathological
processes, reflects the adaptive capabilities of the
div.
An analysis of the literature has shown that various
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
diseases of the neonatal period lead to the
development of hemodynamic disorders. Essentially,
any factor that exceeds the functional potential of the
autonomic nervous system in a child in terms of
strength and duration can be considered as "stress"
that contributes to the implementation of the
syndrome of vegetative dysfunction and dysregulatory
disorders of the cardiovascular system.
Experts have noted the fact that transient myocardial
ischemia, developing in newborns with perinatal
hypoxic damage to the central nervous system,
significantly limits the functional capabilities of the
heart muscle
Cardiac dysfunction may occur both in the acute period
of perinatal damage to the nervous system and as late,
delayed complications. Children with symptoms of
post-hypoxic heart damage require dispensary
observation by a cardiologist.
In the neonatal period, early diagnosis and timely
treatment
can
prevent
long-term
adverse
consequences of existing disorders, which determines
the relevance of the problem of clinical and functional
research in the field of neonatal cardiology.
The structure of cardiovascular pathology in children
has recently undergone significant changes. As noted
by the authors of the literature, a decrease in the
proportion of rheumatic diseases and infectious lesions
of the heart against the background of an increase in
the frequency of congenital defects, rhythm disorders,
cardiopathies and metabolic disorders in the
myocardium.
In this regard, increasing attention is being paid to the
factors that lead to the occurrence and progressive
course of non-inflammatory cardiovascular lesions in
children. Thus, it has been shown that ante- and
intranatal hypoxia is a key etiopathogenetic link in the
development of a number of pathological conditions
affecting both the child's div as a whole, as well as the
cardiovascular system. According to various authors,
hypoxic damage to the cardiovascular system occurs in
a significant number of newborns (40-70%) who have
experienced perinatal hypoxia.
As clinicians note, the unfavorable impact of perinatal
hypoxia on the cardiovascular system is based on
disturbances in the neurohumoral regulation of the
heart and blood vessels, including coronary vessels,
energy depletion of cardiomyocytes and focal
myocardial dystrophy, leading to disturbances in the
processes adaptation of the cardiovascular system to
extrauterine existence. However, at an early age, due
to the complexity of the diagnostic and differential
diagnostic process, cardiovascular pathology is often
recognized untimely, which leads to more profound
disorders in the future.
At the same time, the long-term consequences of
hypoxic damage to the cardiovascular system in
newborns can be quite serious and consist of the
formation of focal cardiosclerosis, myocardial
dystrophy, functional cardiopathy and electrical
instability of the myocardium, contributing to the
implementation of cardiac mechanisms, sudden infant
death syndrome.
The combination of hypertension in adolescents with
lipid, purine and carbohydrate metabolism disorders is
especially unfavorable in terms of prognosis.
Therefore, the factors of CVD development and their
role in the formation of this pathology have been
intensively studied recently.
In this regard, the role of changes in the vegetative
status and the morphofunctional state of the
cardiovascular system in the development and
progression of hypertension in adolescents becomes
obvious, especially starting from the moment of birth,
for example, as hypoxic manifestations.
Foreign authors have noted the fact that post-hypoxic
lesions of the cardiovascular system occupy one of the
leading places in the structure of morbidity in
newborns, occurring, according to various data, in 40-
70% of children who have suffered intrauterine or
perinatal hypoxia, and are the source of many, often
serious, diseases in children and adults.
As noted by the authors of literary sources, to date the
mechanisms of formation of post-hypoxic cardiac
disorders are poorly studied and therefore a pressing
problem in pediatric cardiology.
Clinical manifestations described by the authors, who
note that post-hypoxic disorders of the cardiovascular
system in newborn children often do not have clear
specific manifestations, it is often necessary to conduct
differential diagnostics with congenital heart defects,
congenital carditis, cardiomyopathy.
Therefore, identifying the clinical, functional and
biochemical features of cardiovascular disorders in
newborns in stable and critical condition is of scientific
interest. Further analysis of literary sources showed
another interesting fact about pathologies, but now it
was about lung pathology.
The bronchopulmonary system is formed during the
intrauterine development of the embryo and fetus, as
well as some time after the birth of the child. The
occurrence of anomalies in the anatomical and
morphological structure of the respiratory system
organs, due to which their function suffers, can occur
at any of these stages.
In the 3rd to 7th week of pregnancy, the embryo
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
develops the trachea, main bronchi, lobes and main
lobes of the lung, and the pulmonary arteries develop.
Damaging effects on the embryo at these times can
lead to serious defects in these structures, including the
absence or underdevelopment of the entire lung.
At 7-16 weeks, smaller bronchi are formed. Teratogenic
effects during this period of pregnancy can cause
developmental
anomalies
of
segmental
and
subsegmental bronchi, and the development of
congenital bronchiectasis.
At 16-28 weeks, acini are formed - structural units of
the lungs, consisting of respiratory bronchioles and
alveolar passages, which end in saccular protrusions.
Gas exchange between the air and the baby's
circulatory system will take place in the acini after birth.
The influence of negative factors at this stage is
dangerous due to underdevelopment of the lung tissue
in the fetus.
Late intrauterine developmental defects of the
bronchopulmonary system in the fetus can appear
from the 6th-7th month of pregnancy, when the
alveolar tissue of the lungs continues to develop. The
respiratory system is finally formed by 4-8 years, so
some defects can occur after the birth of the child.
As noted by experts, defects of the lungs and bronchi
can be the result of developmental abnormalities at all
stages of organ formation: between the 3rd and 6th
weeks of embryonic development, when a tracheal
diverticulum appears on the primary intestine,
between the 6th and 16th weeks, when rapid division
of the bronchi occurs, after the 16th week, when active
formation of the alveolar apparatus begins.
Congenital hypoplasia and dysplasia of the lung
(synonyms:
Congenital
cystic
adenomatous
malformation of the lung, CAML). A defect in which the
terminal bronchioles grow to form cysts of varying sizes
that do not affect the alveoli.
The lung tissue involved in the pathological process is
supplied with air from the main respiratory tract
through the narrow pores of Kohn, and with blood from
the pulmonary artery. In almost all cases, the disease
affects one lung (80-95%).
Congenital pulmonary sequestration (CP) is a
developmental defect characterized by the fact that
part of the lung tissue, usually abnormally developed
and representing a cyst or group of cysts, is separated
from normal anatomical and physiological connections
(bronchi, pulmonary arteries) and is vascularized by
arteries of the systemic circulation originating from the
aorta. A mass of non-functioning embryonic or cystic
tissue that has no connection with the functioning
airways and is supplied with blood from the systemic
circulation is called a sequestrum.
The incidence of this defect varies from 0.15 to 6.4%
among all lung malformations. In almost all cases, the
lesion is unilateral and located in the lower lobe of the
lung; about 2/3 on the left.
Congenital
pulmonary
cyst
(CLC)
(synonyms:
bronchogenic, bronchopulmonary, bronchial, air
bronchogenic, etc.) is a developmental defect of one of
the small bronchi and is a round, hollow, thin-walled
formation lined from the inside with epithelium and
containing mucous fluid or air. Congenital lobar
emphysema can be caused by the following three
developmental defects: 1) aplasia of the smooth
muscles of the terminal and respiratory bronchi, in
which there are no smooth muscle bundles and only
single muscle cells; 2) absence of intermediate
generations of bronchi; 3) agenesis of the entire
respiratory section of the lobe. The changes consist of
the absence of intralobular bronchi, terminal
respiratory bronchioles and alveoli.
According to WHO, respiratory distress syndrome (RDS)
occupies one of the leading places in the structure of
perinatal mortality. The mortality rate of children with
RDS, according to various authors, ranges from 35 to
75%. It is more common in premature babies, less
common in full-term babies. K. A. Sotnikova points out
that the term “respiratory distress syndrome” is
conditional.
According to her definition, “respiratory distress
syndrome refers to a special clinical condition of a
newborn, which is characterized by the early onset (in
the first 2 days of life) and often rapid increase in
symptoms of respiratory failure against the background
of significant suppression of vital functions of the
div.”
One of the main causes of SDR is pneumopathy (hyaline
membranes, atelectasis, extensive hemorrhages in the
lungs, edematous-hemorrhagic syndrome, congenital
malformations
of
the
lungs,
spontaneous
pneumothorax) and intrauterine pneumonia In the
pathogenesis, regardless of the cause that caused the
SDR, the main significance is surfactant deficiency and
obstructive syndrome, hypoxia, metabolic acidosis,
metabolic disorders, leading to a change in
homeostasis and dysfunction of the central and
autonomic
nervous
system,
endocrine
and
cardiovascular systems, and a violation of the
relationship between
In the pathogenesis, regardless of the cause that
caused the SDR, the main significance is surfactant
deficiency and obstructive syndrome, hypoxia,
metabolic acidosis, metabolic disorders, leading to a
change in homeostasis and dysfunction of the central
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
and autonomic nervous system, endocrine and
cardiovascular systems, and a violation of the
relationship between ventilation and blood flow,
suppression of immunity. Of great importance are the
violation of the ratio between ventilation and blood
flow in the lungs, increased vascular permeability.
Deficiency of surfactant is currently given leading
importance in pathogenesis.
It is believed that the surfactant system fully matures
by the 35th-36th week of intrauterine development. In
a child born before this time, the available reserves of
surfactant ensure the onset of breathing, its deficiency
leads to the collapse of the alveoli during exhalation, a
sharp increase in the work of the respiratory muscles.
Due to the collapse of the alveoli, continuous gas
exchange in the lungs does not occur, which leads to
the development of hypoxemia and hypercapnia.
Foreign and domestic authors of the literature note
that
endothelial
dysfunction
underlies
the
development of many cardiovascular diseases. It has
now been proven that the vascular endothelium plays
a an important role in the regulation of vasodilation
and vasoconstriction, platelet adhesion, growth of
vascular smooth muscle cells, including during
pregnancy. Under the influence of hypoxia, infection
and other damaging factors, the functioning of the
endothelium, accompanied by the development of
pathology on the part of organs and systems, including
the cardiovascular system. However, literature data
concerning the role of the endothelium in the
development of cardiovascular pathology in newborns
are few and concern mainly congenital heart defects.
In this regard, it is advisable to assess the functional
state of the vascular endothelium in newborns with
post-hypoxic disorders of the cardiovascular system in
critical and stable conditions, as well as to assess the
role of vascular endothelial dysfunction during
pregnancy for antenatal prediction of these disorders.
Thus, at the end of our literature review we can say that
the relevance of this problem in medicine remains in
the first place.
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