MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-26
Часть–1_Май –2025
204
CLINICAL AND ANAMNESTIC FEATURES OF THE COURSE OF
SEVERE PNEUMONIA IN EARLY AGE CHILDREN WITH CONGENITAL
ANOMALIES OF CLEFT LIP AND PALATE
Akmalova Nasiba Alisherovna
Tashkent Pediatric Medical Institute
Scientific supervisor: Associate Professor of Medical Sciences
Aliyev A.L.
Annotation:
In this study, clinical and anamnestic features of the course of
severe pneumonia in early age children with congenital anomalies of the cleft lip and
palate were observed with analysing of life history and current condition of the
children. Research methods are analysis, clinical observations, x-ray studies. Clinical
and anamnestic features of the course of severe pneumonia in early age children with
congenital anomalies of the cleft lip and palate were determined. It was revealed that
the severity of the condition of examined children was due to a burdened maternal
history, premorbid background, artificial feeding and prematurity factor itself and
such conditions of the microflora of the gastrointestinal tract.
Key words:
pneumonia, congenital anomalies of cleft lip and palate, young
children, clinic, X- ray studies.
Relevance:
Acute pneumonia in young children remains a significant cause
of morbidity and mortality, despite the introduction of potent broad-spectrum
antimicrobial agents, comprehensive supportive treatment regimens, and preventive
measures (4). An unfavorable background for pneumonic dysbiosis is a cause of
recurrent pneumonia in children, prolonged disease duration, and a tendency toward
exacerbations, relapses, and complications (2).
Patients with congenital anomalies of the maxillofacial tissues and organs
occupy a special place. Of particular interest is the assessment of the clinical course
of acute pneumonia in these premature infants. However, despite this, there are few
studies or literature data with theoretical or practical significance regarding the
treatment of this group of patients. Treatment is associated with particular difficulties
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-26
Часть–1_Май –2025
205
and requires the involvement of highly qualified specialists, consistency, and a
comprehensive approach.
Since ancient times, external factors have been thought to play a certain role
in the origin of congenital anomalies such as cleft lip and palate (CLP), as well as
maternal illnesses during pregnancy (infectious diseases, uterine pathology,
spontaneous or induced miscarriages), psychological trauma, malnutrition, and other
factors (1).
CLP represents a severe developmental defect that leads to serious
consequences. From birth, there are pronounced dysfunctions of the lip and palate.
Sucking and swallowing are impaired, and later on, chewing functions are also
affected, which in turn leads to developmental delays in the child and, in some cases,
death within the first weeks of life. In CLP, nutrition, swallowing, and breathing are
severely disrupted. This can lead to aspiration of oral cavity contents and various
complications involving the respiratory tract and lungs (1;3).
The above facts highlight the need to study the clinical and anamnestic
features of acute pneumonia in the context of CLP in young children.
Research Objective:
To analyze the clinical and anamnestic features of the
course of acute pneumonia in young children with congenital cleft lip and palate
anomalies.
Materials and Methods:
A total of 45 archived medical records of children
with severe acute pneumonia and congenital cleft lip and palate anomalies (CLP) were
analyzed, along with 18 premature infants weighing between 1500g and 1800g and
aged from 3 to 11 days.
Results and Discussion:
The age of the mothers ranged from 19 to 49 years:
5% were under 20, 23% were 20–25 years old, 51% were 26–30, and 17% were 30–
35. About 28% of the children were born from a first pregnancy. The outcome of
previous pregnancies was unfavorable (miscarriage, stillbirth, or premature birth) in
3% of cases. Fetal protein-energy deficiency was noted in 17%. Gynecological
diseases were present in 11% of the mothers.
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-26
Часть–1_Май –2025
206
Chronic infections and conditions such as pyelonephritis, glomerulonephritis,
rheumatism, diabetes mellitus, obesity, and acute/chronic bronchitis were observed in
24.6% of women. Acute respiratory viral infections (ARVI) with high fever in the
first half of pregnancy were reported by 16.2% of women, and 6% in the second half.
The pregnancies were often complicated: early toxicosis occurred in 32.6% of cases;
gestosis of varying severity in 27%; the threat of miscarriage in 18%; chronic
intrauterine hypoxia in 8%; and infectious diseases in 20%. Labor was timely in
67.1% and premature or delayed in 33%. The most frequent complications were
premature rupture of membranes (12%) and anhydrous intervals of 6 to 12 hours
(11%). Abnormal labor activity was observed in 4% of women, requiring labor
stimulation in 2% of cases. At birth, 7% of newborns had an Apgar score of 7–8, 25%
had 4–5, and 5% had 3–4 points.
The study of the clinical course showed that the majority of children (12) had
a normal div temperature throughout the illness, 4 had subfebrile temperatures, and
only 4 cases were accompanied by high fever (up to 39°C). All premature infants with
CLP showed clinical signs of pneumonia accompanied by respiratory distress
syndrome, cyanosis (2 cases), acrocyanosis (6 cases), weakened breathing in the
lungs, and abdominal distention (13 cases) either at admission or within 2–3 days.
Intestinal syndrome developed at the onset of the illness or within 2–3 days after
admission and remained a leading feature during the entire acute phase. The diagnosis
of pneumonia was radiologically confirmed: in 14 children, focal shadows were found
on chest X-rays, and in three children, even confluent lesions were observed.
Conclusion:
The findings indicate that the severity of the children's condition
was due to a complicated maternal history, premorbid background, artificial feeding,
and the very fact of prematurity. Children with low birth weight and various forms of
immunodeficiency have intestinal flora that becomes pathogenic, triggering
inflammatory processes in both the intestines and lungs. The effectiveness of therapy
depends on an individualized approach, considering the etiology of the disease, the
course and stage of the pathological process, the child’s age, and the severity of
extrapulmonary organ involvement.
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-26
Часть–1_Май –2025
207
References:
1. Bazhanov N.N. Dentistry. Moscow: Medicina, 1978. pp. 410–414.
2. Geppe N.A. Respiratory infections: problems and prospects. Proceedings of the
VIII Congress of Pediatricians of Uzbekistan, Tashkent, 2019.
3. Murtazaev S.M. "Condition of intestinal digestion and absorption in children with
congenital cleft lip and palate", Conference materials “Ibn Sino - Avicenna”, No. 1-
2, 2005, p. 37, Tashkent.
4. XXV National Congress on Respiratory Diseases, October 13–16, 2015, Moscow.
Proceedings edited by Acad. A.G. Chuchalin. Moscow, 2015, pp. 10–15.
