Immaturity of connective tissue as a cause of damage to the dural mining in newborns with extremely low body weight

Abstract

Backgraund: As a result of the approval of the order of the Ministry of Health and Social Development of the RF dated 27.12.2011 No. 1687n “On medical criteria for birth, the form of the birth document and the procedure for its issuance,” newborns with extremely low birth weight (ELBW) from 500-1000 g. became full citizens of the RF. The article presents an analysis of cases of birth injuries in newborns with ELBW with a study of the structural features of the dura mater (DRM), and a comparison of the results obtained with full-term newborns. Aim: To identify the distinctive features of the structure of the DRM in newborns with ELBW and full-term newborns. To establish the existence of a connection between the structural features and its damage during childbirth. Materials and methods: A retrospective study was conducted. The main group consisted of newborns with ELBW; the comparison group included full-term newborns. The DRM was studied. They were compared with the counting of type 1 collagen fibers. The causes of premature birth in the main group and the nature of hemorrhages in the DRM were also assessed. Light and polarization methods were used microscopy, morphometry. Results: In newborns with ELBW, severe intradural hemorrhages were found in the DRM, indicating its overextension due to the configuration of the head. The DRM is represented by loose connective tissue, consisting of short type 3 collagen fibers.In the comparison group, the severity of subarachnoid hemorrhages in the projection of the sutures corresponds to the severity of damage to the septal parts of the DRM. The dura mater consists of dense fibrous connective tissue and predominantly type 1 collagen. Morphometry revealed anisotropy in polarized light in no more than 2-5% of collagen fibers in the main group, and no less than 30-50% in the comparison group. Statistically significant indicators were identified (p0.001). Conclusions: The discovered structural features indicate the morphofunctional immaturity of the dura mater in newborns with ELBW, which affects its strength characteristics and leads to damage during any type of birth. This injury should not be classified as a serious injury.