Functional state of the liver in congenital cytomegalovirus infection in dead full -term newborns

Aim. To assess the functional state of the liver in congenital cytomegalovirus infection in dead full-term newborns.

Materials and methods. 59 newborns who died on the 2-5 day of life were examined. 25 of them (the first, control group) did not have intrauterine viral aggression and sexually transmitted infections against the background of the absence of a negative impact of moderate and severe somatic and obstetric pathology in their mothers during gestation; in 18 (second group, comparison), markers of congenital infection were not determined against the background of an exacerbation of cytomegalovirus infection in their mothers in the second trimester of pregnancy; 16 (the third group, the main group) were diagnosed with intrauterine cytomegalovirus infection. The cause of death of children in the first group was complications of childbirth, intrapartum hypoxia, atelectasis and hyaline membrane lung; in the second one there were utero, intrapartum and postnatal hypoxia, and atelectasis of the lungs; in the third group there was cerebral ischemia, ven-triculomegaly, choroid plexus pseudocyst and subarachnoid hemorrhage, local and generalized forms of congenital infection. The content of total protein, albumins, total, indirect, and direct bilirubin, medium-molecular peptides, and lactate dehydrogenase activity were determined in blood serum from the umbilical vein using a biochemical method.

Results. It was found out that the second group of newborns in comparison with the first group did not show significant differences in the concentration of total protein and albumins. At the same time, in the third group, there was a drop in the total protein content to 52.8±1.28 g/L (in control it was 61.8±1.42 g/L; p<0.05) and albumins to 31.2±1.34 g/L (in control it was 38.2±1.21 g/L; p<0.05) against the background of the maximum increase in total bilirubin to 40.0±2.05 mmol/L (in control it was 26.5± 2.18 mmol/L; p<0.001), indirect bilirubin to 37.9±2.04 mmol/L (in control it was 24.6±2.17 mmol/L; p<0.001), direct bilirubin to 2.61±0.18 mmol/L (in control it was 1.89±0.07 mmol/L; p<0.001), lactate dehydrogenase to 267.6±12.41 IU/L (in control it was 210.6±10.12 IU/L, p<0.001) and medium-molecular peptides to 0.312±0.012 units of optical density (in control it was 0.278±0.005 units of optical density; p<0.001).

Conclusion. The above-mentioned biochemical changes indicate that the predominance of anaerobic processes and more pronounced endotoxemia play an important role in the pathogenesis of disturbances of the liver's protein synthesis and pigment functions in newborns with intrauterine cytomegalovirus infection.

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