2024-03-28T20:43:36Z
https://ijn.mums.ac.ir/?_action=export&rf=summon&issue=1496
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Study of Neurodevelopmental Outcomes at 10-14 Months of Age Using Bayley Scale of Infant and Toddler Development in Asphyxiated Newborns with Hypoxic Ischemic Encephalopathy Treated with and without Therapeutic Hypothermia
Jayashree
Purkayastha
Maitreyee
Dutta
Leslie
Edward Lewis
Ramesh
Bhat Y
Joshua
Rajan X
Gaurav
Ayappa
Background: Therapeutic hypothermia has become an established protocol for all neonates with moderate to severe Hypoxic Ischaemic Encephalopathy (HIE). There are very few studies comparing the neurodevelopmental outcomes in asphyxiated neonates who received therapeutic hypothermia or did not. This study aimed to assess the neurodevelopmental outcomes of asphyxiated neonates with features of HIE at 10-14 months of age using Bayley Scale of Infant and Toddler Development III (BSID III) and to compare this outcome between neonates who received therapeutic hypothermia and those who did not. Methods: Term infants with HIE admitted in neonatal intensive care unit (NICU) at a tertiary referral hospital were followed up at 10-14 months of age from December 2013 to August 2015. Neurodevelopmental outcomes were assessed using BSID III. Results: A total of 76 neonates with birth asphyxia were admitted to NICU between December 2012 and August 2014. These neonates were followed up from December 2013 to August 2015, and 34 of them were included in the study. At10-14 months of age, 8 neonates (23.5%) had cognitive delay, 14 cases (41.17%) had motor delay, and 9 newborns (26.4%) had language delay using BSID III score of < 85 as cut off. Twenty (58.82%) infants had normal development in all 3 domains. Higher percentage of infants (73.68%) who received therapeutic hypothermia had normal BSID Score as compared to 40% of the neonates with normal BSID score (>85) who did not receive therapeutic hypothermia. Statistical analysis using Chi-square test showed P-value of 0.048 as statistically significant. Conclusion: Neurodevelopment assessment at 10-14 months of age using BSID III of asphyxiated neonates with HIE showed significantly better outcome in infants who received therapeutic hypothermia than those who did not.
Bayley scale of infant development III
Hypoxic ischemic encephalopathy
Hypothermia
Neonates
2018
12
01
1
6
https://ijn.mums.ac.ir/article_11892_1672c73856ba881b93793f5fef0f0c9f.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Current Practices Regarding Treatment of Neonatal Jaundice by Neonatal Care Practitioners in Nigeria
Beatrice
Ezenwa
Yeside
Akinbolagbe
Iretiola
Fajolu
Patricia
Akintan
Luther
Agaga
Veronica
Ezeaka
Background: Neonatal jaundice is a common medical condition encountered in the neonatal period in Nigerian hospitals. Its management is not homogenous among healthcare providers. Therefore, this study aimed at evaluating current practices related to the treatment of neonatal jaundice among doctors and nurses caring for neonates in Nigeria. Methods: Healthcare providers managing neonates in Nigeria were surveyed during annual general and scientific meetings of the Nigerian Society of Neonatal Medicine in 2017. In addition, the Paediatric Association of Nigeria’s mailing list was utilized to disseminate a self-administered, pretested and structured questionnaire to doctors and nurses involved in taking care of newborns in Nigeria. Results: The results of the study showed that local guidelines / protocols were highly applied by the respondents. The majority of the health care providers would screen newborns for neonatal jaundice before discharge. The practice of early discharge within 24 hours was rampant with a high frequency of late follow up at 6 weeks. Conclusion: The practices regarding management of neonatal jaundice among healthcare professionals in Nigeria vary with better practices observed in specialist cadres. Newborn discharge and follow-up practices also vary and are sub-optimal. Therefore, there is a need for more awareness creation on neonatal jaundice treatment among cadres of health care practitioners. This should be complimented with the development of a national guideline on the management of neonatal jaundice in Nigeria.
Keywords: Health care practitioners
Neonatal Jaundice
Nigeria
2018
12
01
7
14
https://ijn.mums.ac.ir/article_11893_09a4d39e1b8b4673b805918910d99869.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Effect of Antenatal Dexamethasone on Serum Umbilical Cord C-peptide and Glucose Levels in Term Neonates Delivered by elective Cesarean Section
Ramadan
Mahmoud
Magdy A
Mohamed
Shereen P
Aziz
Background: Antenatal steroid therapy recently has been considered for term and late preterm neonates delivered by Cesarean section (CS), with the aim of preventing adverse respiratory morbidity. The main aim of this study was to investigate the metabolic effects of antenatal dexamethasone on blood glucose (BG), homeostasis, and serum C-peptide level when administered to term fetuses. Methods: Umbilical cord blood C-peptide and BG were measured in singleton newborns of 37 weeks gestational age or older with planned CS; furthermore, the history of dexamethasone receiving was taken from mothers. Other parameters, such as, Apgar score, neonatal birth weight, BG follow-ups, and admission to the neonatal nursery were collected. Results: Totally, 117 mothers met the inclusion criteria, of whom 60 had received antenatal dexamethasone. This study demonstrated that babies treated with antenatal dexamethasone had a decrease in umbilical cord BG (P=0.001) and BG follow-up three hours after birth (P=0.001) compared to untreated group. However, there was no statistically significant difference in the BG measurements within both groups in the first 24 h post birth (P=0.14). Furthermore, no statistically significant difference was observed within the two groups regarding umbilical cord C-peptide measurements (P=0.08), birth weight (P=0.17), and the numbers of neonates that needed admission to the nursery (P=0.36). Conclusion: Although antenatal dexamethasone causes immediate mild BG homeostasis alterations in term newborns delivered by elective CS, its use is not associated with a statistically significant effect on serum umbilical cord C-peptide measurements, neonatal birth weight, and the rate of neonatal nursery admission.
Keywords: Antenatal dexamethasone
Blood glucose
Cesarean section
Cord blood C-peptide
Full-term infant
2018
12
01
15
21
https://ijn.mums.ac.ir/article_11894_07cbcc7d500f2bf44640f0a723d8212e.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Effect of Bubble and Ventilator-derived Continuous Positive Airway Pressure on the Management of Respiratory Distress Syndrome in Premature Neonates
Gholamreza
Faal
Fatemeh
Eghbal
Background: In this study, we aimed to compare ventilator-derived and bubble continuous positive airway pressure (CPAP) in neonates with respiratory distress syndrome admitted to Neonatal Intensive Care Unit of Vali-e-Asr Hospital, Birjand, Iran, in 2014. Methods: This cohort study was conducted among 68 patients assigned into two groups. The neonates in group A (32 infants) were treated with bubble CPAP and those in group B (36 infants) were treated with a ventilator-derived CPAP. The protocol of treatment was applying CPAP with the positive end-expiratory pressure (PEEP) of 5-6 cm H2O and fraction of inspired oxygen equivalent to 30-40%, depending on the gestational age. In case of need for higher oxygen levels to maintain oxygen saturation of arterial blood (SpO2) (90-95%), surfactant was administered and additional PEEP was applied (up to 8 cm H2O). Data analysis was performed using independent t-test and Chi-squared in the SPSS software, version 18. Results: The duration of CPAP and oxygen therapy was 1.67±1.22 days and 3.57±2.67 days in group A and 2.09±1.53 days (P=0.21) and 4.67±3.74 days (P=0.16) in group B, respectively. There was a significant difference between the groups in terms of discharge weight and surfactant dosage (P=0.042 and P=0.007, respectively). Moreover, although the length of stay in hospital in the ventilation group was almost 4 days longer than the other group, there was no significant difference between the groups in this regard. Conclusion: There was no significant difference between bubble CPAP and ventilator-derived CPAP. Moreover, further studies with larger sample size are recommended.
Keywords: CPAP
Bubble CPAP
Prematurity
RDS
Ventilator CPAP
2018
12
01
22
27
https://ijn.mums.ac.ir/article_11895_f26e50e6090e9bba2de81c5de02ae574.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Comparison of Maternal Serum and Umbilical Cord Blood Leptin Level in IUGR Neonates
hedieh
saneifard
Mitra
Radfar
Sedigheh
Shahrivar
Marjan
Shakiba
Nooshin
Faraji
Background: Gestational weight gain is an impressive factor in the fetal outcome. Intrauterine growth restriction (IUGR) is one of the most important problems during fetal period that may lead to many perinatal and long-term complications and growing neonatal morbidities and mortalities. The aim of the study was to ascertain the relationship between umbilical cord blood leptin concentration and fetal growth in neonates born with intrauterine growth restriction. Methods: Maternal serum and umbilical cord blood leptin concentration were measured by immune radiometric assay at term gestation. The study was conducted on 22 women with uncomplicated singleton pregnancies as control group (group A) and 22 women with fetal growth restriction in singleton pregnancies as case group (group B). All subjects had normal pregravid body mass index (BMI). Results: The results of the study showed that maternal serum leptin concentrations were significantly higher in group B comparing to group A (44ng/ml [28.9-58.2] vs. 24.6ng/ml [18.8-33.3]; P<0.001). However, umbilical cord blood leptin levels were significantly lower in group B comparing to group A (8.6 ng/ml [range 4.5-12.7] vs. 14.6 ng/ml [11.7-16.7]; P<0.001). Moreover, umbilical cord blood leptin levels were directly correlated with maternal BMI and neonatal birth weight in both groups. Conclusion: In growth-restricted fetuses at term, umbilical cord blood leptin concentrations were significantly lower than normal fetuses, suggesting that fetal adipose tissue is a major source for leptin production. Maternal serum leptin concentrations were higher in the presence of a growth restricted fetuses. This increas may be due to early hypoxia or an intrinsic placental mechanism, by which small placenta produces more leptin as a compensatory mechanism. Human recombinant leptin may have some roles in the treatment of IUGR fetuses in future.
Keywords: Adipose tissue
Intrauterine growth restriction
Leptin
Umbilical cord
2018
12
01
28
32
https://ijn.mums.ac.ir/article_11896_c7d7d17282a710beb61604273696cc74.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
A Comparative Study of the Efficacy of Surfactant Administration through a Thin Intratracheal Catheter and its Administration via an Endotracheal Tube in Neonatal Respiratory Distress Syndrome
Roya
Choupani
Ghobad
Mashayekhy
Majid
Hmidi
Soleiman
Kheiri
Marzieh
Khalili Dehkordi
Background: The cornerstone of the treatment of respiratory distress syndrome (RDS) is respiratory support and surfactant replacement therapy. The administration of surfactant through a thin intratracheal catheter is one of the methods used to reduce one of the standard technique complications of a surfactant injection (Intubation-Surfactant-Extubation method [INSURE]). The aim of this study was to compare the effectiveness of this method on the treatment of RDS in neonates with one of the INSURE technique. Methods: In this double blind clinical trial, 104 neonates with RDS were randomly allocated to two groups, one group received surfactant via an endotracheal tube (INSURE) and the other received surfactant without intubation (SWI) via a thin intratracheal catheter. Subsequently the outcomes of the two groups were compared. Results: The incidence of hypoxemia during surfactant administration was significantly lower in the SWI group (11.5%) than in the INSURE group (28.8% , P< 0.05). no significant difference was observed in the need for intubation and mechanical ventilation during the first 72 hours of life, the duration of mechanical ventilation, the need for nasal continuous positive airway pressure (NCPAP), the need for oxygen, the incidence of bronchopulmonary dysplasia, intraventricular hemorrhage, pulmonary hemorrhage ,and death in the two groups. Conclusion: Administration of surfactant through a thin intratracheal catheter is a safe and easy technique. This method is as effective as the INSURE method in improving the outcomes of RDS treatment.
Keywords: Neonatal respiratory distress syndrome
Surfactant
Surfactant without intubation
2018
12
01
33
40
https://ijn.mums.ac.ir/article_11897_abe5f7dc3c5c94ca71bacfebe1aeaff3.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Effect of Massage Therapy on Transcutaneous Bilirubin Level in Healthy Term Neonates: Randomized Controlled Clinical Trial
Homa
Babaei
Mazyar
Vakiliamini
Background: Neonatal jaundice is a common condition in approximately 60% of term newborns during the first week after birth. Therefore, it is necessary to detect methods for the prevention of this problem.This study was conducted to evaluate the impact of massage therapy on transcutaneous bilirubin level in healthy term newborns. Methods: The present study was conducted on102 healthy term newborns. The newborns were randomly assigned to massage group and control group. The massage group received daily massage for five days from the first postnatal day while the control group received only routine neonatal care (without massage). In both groups, transcutaneous bilirubin level and frequency of defecation were the main studied variables. Results: The frequency of defecation in the massage group increased from 1.08 on the first day to 4.08 on the fifth day, whereas it increased from 0.865 on the first day to 2.731 on the fifth day in the control group, indicating a significant difference between the two groups (P<0.005). Moreover, transcutaneous bilirubin levels on the first and second days were not significantly different in both groups, while it was significantly lower during the third to fifth days in the massage group compared to that in the control group (P<0.005). Conclusion: The results of this study revealed that massage therapy could reduce transcutaneous bilirubin level and increase the frequency of defecation in healthy term neonates.
Keywords: Bilirubin
Jaundice
Massage
neonate
2018
12
01
41
46
https://ijn.mums.ac.ir/article_11898_2d4a475badcddccf7bf6ff1bf7aa4cdd.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Effects of Restrictive Fluid Management in Transient Tachypnea in Neonates
zahra
Akbarian rad
Mitra
Gorji Rad
mohsen
haghshenas
Background: The transient tachypnea is a common respiratory problem in the neonate. One of the significant issues in pathophysiology of this disorder is the delayed reabsorption of the fluid by the neonate’s lungs and the effusion of fluid in the lungs. The purpose of this study is to evaluate the effects of restrictive fluid management in transient tachypnea of the neonate. Methods: The present study was conducted on the neonates with the gestational age ≥ 34 weeks suffering from transient tachypnea during the first 6 h after birth. The amounts of total fluid in experimental and control groups were 50, 65 mL/kg and 65, 80 mL /kg for term and preterm neonates, respectively. In each group, a daily amount of 20 mL/kg fluid was added until 150 and 170 mL/kg for term and preterm newborns. Results: This study was carried out on 70 neonates, including 34 cases and 36 controls. The mean of hospitalization period in the experimental group was less than that of the control group. The mean period of respiratory support in the experimental group was less than that in the control group. Conclusion: The results of the present study revealed that the restrictive fluid management in the neonates with transient tachypnea might decrease the hospitalization period and the respiratory support period. Furthermore, it is a safe and effective method in treating transient tachypnea in neonates.
Keywords: Respiratory support
Restrictive fluid management
Transient tachypnea in neonates
2018
12
01
47
52
https://ijn.mums.ac.ir/article_11899_63a7fd385874f8d9b16648be75b5d80b.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Comparison of Nasal Non-invasive Ventilation Methods in Preterm Neonates with Respiratory Distress Syndrome
ahmad
shahfarhat
Ashraf
Mohammadzadeh
Gholam Ali
Mamuri
Reza
Saeidi
Shadi
Noorizadeh
Background: Humidified heated high flow nasal cannula (HHHFNC), nasal continuous positive airway pressure (NCPAP), and nasal intermittent positive pressure ventilation (NIPPV) are three nasal non-invasive ventilation methods. The purpose of this study was to compare these three methods in decreasing intubation and mechanical ventilation rate in preterm neonates with respiratory distress syndrome (RDS). Methods: This study was a randomized controlled study conducted on 160 neonates. The inclusion criteria for intubation in this study were persistent respiratory acidosis (arterial pH<7/2 or PCO2>60), hypoxemia, severe and repeated apnea episodes which did not respond to increasing respiratory rate and therefore required ventilation. Cranial Ultrasound was performed on the third day after birth. The data of all neonates were collected until the day of discharge and analyzed by SPSS (version 20) and statistical methods. Results: Based on the results,there was no significant difference among the three randomized methods. Out of all the cases, 72% of the neonates with NIPPV had successful non-invasive ventilation (35/53), compared to 73/6% in NCPAP (39/53) and 72/2% in HHHFNC (P=0/999). Similarly, there was no significant difference among the three methods in total ventilation time and the need for supplemental oxygen. Conclusion: The use of HHHFNC at birth in preterm neonates with RDS is safer than the other two methods. However, it is not more effective than the other two methods in the reduction of intubation rate.
Keywords: Humidified heated high flow nasal cannula (HHHFNC)
Nasal continuous positive airway pressure (NCPAP)
Nasal intermittent positive pressure ventilation (NIPPV)
Preterm neonates
Respiratory distress (RDS)
2018
12
01
53
60
https://ijn.mums.ac.ir/article_11903_5b70c1d5f00e5d32978a2e6c2061f8dc.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Effect of Phototherapy Treatment on Urinary Calcium Excretion in Neonates with Jaundice in Zahedan, Iran
Mahmoud
Imani
Simin
Sadeghi-bojd
Fathmeh
Khonamani Falahati
Alireza
Ansari Moghadam
Background: One of the recognized symptoms of phototherapy in neonates is hypocalcemia and hypercalciuria, and its etiology has not been identified yet. The present study investigated the recurrence of hypercalciuria among neonates with jaundice treated with phototherapy. Methods: This cross-sectional diagnostic examination was conducted on 100 newborns with jaundice treated with phototherapy in Ali-ibn-Abi-Talib hospital in Zahedan, Iran, during 2013 and 2014. In the present study, the subjects were collected in an accessible way after agreement and considering exclusion criteria. Calcium and creatinine (Ca/Cr) proportion in urinary tests of the neonates was estimated at the baseline and 24 h after the onset of phototherapy. The information was analyzed utilizing paired t-test. Results: The mean of gestational age was 38.5±2.5 weeks. Out of 100 cases, 53 newborns (53%) were male and 47 (47%) were female. The mean scores of birth weight was 2.52±0.59 kg and neonatal serum bilirubin level was 16.5±0.92 mg/dl. Ca/Cr ratios in neonates with jaundice were 0.28±0.21 and 0.40±0.34 before and after the phototherapy, respectively. Regarding that, the increase in Ca/Cr ratio was statistically significant (P<0.001). Hypercalciuria was not observed in the neonates before the phototherapy; however, it was noticed in 13 neonates after the phototherapy. Ca/Cr ratios in neonates with hypercalciuria and other newborns were 1.16±0.19 and 0.29±0.18, respectively. Furthermore, the difference between the two groups was statistically significant (P<0.001). Conclusion: Based on the results of this study, it was suggested that the neonates undergoing the phototherapy were at risk of hypercalciuria and the increased amount of urinary calcium excretion by means of phototherapy.
Keywords: Hypercalciuria
Jaundice
Phototherapy
2018
12
01
61
65
https://ijn.mums.ac.ir/article_11904_aa9ecbfe974be3067c367739d649348c.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Clinical Relevance of Faecal Calprotectin Level in Infantile Colic: A Cross-sectional Survey
Iraj
Shahramian
Ali
Bazi
Alireza
Sargazi
Omolbanin
Sargazi Aval
Alireza
Dechal
Mostafa
Bazzi
Masoud
Jahantigh
Background: There is limited knowledge on the potential applicability of fecal calprotectin (f-CP) as an inflammatory screening parameter in infantile colic (IC). This study aimed to evaluate f-CP in neonates with IC as a useful diagnostic indicator regarding this condition. Methods: The present study was conducted on 100 cases, including 50 newborns with IC and 50 non-colicky neonates. The diagnosis of IC was fulfilled by the Wessel Criteria. The level of f-CP was determined by a specific enzyme-linked immunosorbent assay kit (Calprotectin ELISA, EuroImmun, Germany). The statistical analysis was performed in SPSS software (version 19). Results: Out of 100 neonates, 57 cases were male and 43 subjects were female. The age spectrum ranged from 19-90 days (40.4±15.9). Colicky newborns were slightly younger (P=0.06) with higher birth weight compared to the infants without colic (P<0.0001). The level of f-CP was significantly higher in colicky neonates (113.7±98.2 µg/g) than non-colicky cases (71.4±45.5 µg/g) (P=0.007). Overall, 37%, 30%, 26%, and 7% of the newborns showed f-CP levels<50, 50-100, 100-200, and >200 µg/g, respectively. There was a significant difference regarding the distribution of these f-CP categories between neonates with IC and the cases without IC (P=0.02). There were no significant correlations between the f-CP and newborn age, pregnancy age, present or birth weights, and number of pregnancies. Receiver operating characteristic analysis rendered an area under the curve of 0.642 (95% CI: 0.534-0.748) (P=0.01). At the cut-off value of 74 µg/g, f-CP showed sensitivity of 60% and specificity of 59% for the detection of IC. Conclusion: The results of this study revealed that the f-CP might be useful in the diagnosis of the IC.
Keywords: Calprotectin
Infantile colic
Intestinal inflammation
Leukocyte L1 antigen complex
2018
12
01
66
71
https://ijn.mums.ac.ir/article_11905_ac09e440c18591fb8e874165781e3329.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
A Comparative Study of the Effects of Mint Tea Bag, Mint Cream, and Breast Milk on the Treatment of Cracked Nipple in the Lactation Period: A Randomized Clinical Trial Study
Tayebeh
Gharakhani Bahar
Khodayar
Oshvandi
Seyedeh
Zahra Masoumi
Younes
Mohammadi
Shirin
Moradkhani
Farzin
Firozian
Background: The results of the previous studies on the effects of mint on cracked nipple are contradictory. The purpose of the present study was to compare the effects of mint tea bag, mint cream and breast milk on the healing of cracked nipple during lactation. Methods: This study was a clinical trial with a control group , pre and post-test design conducted in health centers of Hamadan University of Medical Sciences, Hamadan, Iran from 2016 to 2017.Samples were divided into three groups (n=72 subjects in each group). Interventions were performed at least 4 times a day for 14 days after the start of treatment. Data were collected through the cracked nipple measuring checklist, the amount of wound and demographic questionnaire before the intervention and on 4, 8, and 14 days after the intervention. Data analysis was conducted using descriptive and inferential statistics in SPSS software (version 21). Results: There was a decreasing trend in the mean score of crack pain on days 0-14 in the groups of mint cream, mint tea, and breast milk after the intervention; however, there was a statistically significant difference in the breast milk group (P<0.001). Moreover, with regard to within group comparison, there was a decreasing trend with a significant difference in the mean score of wound in three groups before the intervention (P<0.001) and on the fourth day after the intervention (P= 0.003). Conclusion: The results of the present study indicated that breast milk was more effective than mint cream and mint tea in the treatment of cracked nipple.
Keywords: Cracked nipple
Mint cream
Mint tea
2018
12
01
72
79
https://ijn.mums.ac.ir/article_11906_97d0c78c0dc8f3ad8fa8e554515b8b9f.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Conservative Management in a Ventilated Preterm Neonate with Pneumopericardium, Pleural Effusion, and Pulmonary Collapse: A Case Report
Yazdan
Ghandi
Niloofar
alsadat Motamedi
Background: Neonatal pneumopericardium (PPC) is a rare clinical condition usually associated with other air leak syndromes. It increases morbidity and mortality due to cardiac tamponade. Case report: A preterm male neonate weighing 1260 g was born with the gestational age of 28 weeks. Cardiopulmonary resuscitation was routinely performed without any medical therapy. The newborn was transferred to the neonatal intensive care unit due to marked respiratory distress with tachypnea and cyanosis. Pulse oximetry showed oxygen saturation of 70%. A whiteout of the lung and air-bronchogram pattern was found on the chest X-ray. The arterial blood gases demonstrated PH=7.14, PCo2=51 mmHg, Po2=36 mmHg, bicarbonate=15.8 mg. The neonate was intubated with a tracheal tube size 2.5 and mechanical ventilation was initiated with 90% fraction of inspired oxygen (FiO2), PIP=14 cmH2O, and PEEP=4 cmH2O. After intubation, the newborn received two doses of surfactant. On the third day, patent ductus arteriosus was established and appropriate treatment was performed. After five days, the chest X-ray was repeated due to increasing respiratory distress and an increasing FiO2, which revealed a pneumopericardium with right-sided pleural effusion and left upper lobe collapse. Afterwards, pleurocentesis was performed. Left ventricular ejection fraction (65%) was preserved and no evidence of cardiac tamponade was observed. Serial chest X-ray and echocardiography were performed daily. After the next seven days, the chest radiograph demonstrated a complete resolution of the pneumopericardium, pleural effusion, and lung collapse. Conclusion: The present case study presented a preterm neonate suffering from pneumopericardium along with pleural effusion and lung collapse. Despite the complexity, the PPC was asymptomatic and eventually resolved without pericardiocentesis.
Keywords: Air leak syndrome
Pneumopericardium
Preterm
respiratory distress syndrome
2018
12
01
80
83
https://ijn.mums.ac.ir/article_11907_ec05e10c167fc01f30bb2b2dc5c6fb67.pdf
Iranian Journal of Neonatology
IJN
2251-7510
2251-7510
2018
9
4
Osteopetrosis Presenting with Neonatal Thrombocytopenia: A Case Report
Mohammad
Kazemian
Minoo
Fallahi
Seyed Hossein
Fakhraee
Samin
Alavi
Naeeme
Taslimi Taleghani
Sara
Sani
Background: Osteopetrosisis an inherited and rare bone disease, characterized by the impairment ofbone modeling and remodeling and the failure of osteoclasts to resorb bone. It also results in skeletal fragility despite increased bone mass, and may cause hematopoietic insufficiency, disturbed tooth eruption, nerve entrapment syndromes, and growth impairment. The infantile form of the disease is the most severe one with a poor prognosis. If untreated, it will result in death by the first decade of life. Case report: A term 10-day-old female neonate with a birth weight of 2850 grams delivered by caesarian section was reported without a history of parents' consanguinity from a healthy, gravida 2, para 1, abort 1 mother with no complication during pregnancy. The newborn admitted to the neonatal ward due to diffuse petechiae, purpura on the skin, and periorbital ecchymosis (raccoon eyes), without any other abnormal significant signs and symptoms. In laboratory findings except for frequent low platelet count as low as 10000-25000, there wasn’t any other abnormalities. Other coagulative tests were within normal ranges. In addition to antibiotics for probable sepsis, platelet transfusion was considered as the treatment, and due to the lack of proper response to the treatment, with suspicious of alloimmune thrombocytopenia, two courses of IV IgG were administered. Eventually, the persistent thrombocytopenia in spite of mentioned treatment led to further investigation , and finally osteopetrosis was diagnosed by the result of brain CTS. The patient was discharged from the hospital with a moderate thrombocytopenia while she needed frequent platelet transfusion. Eventually with bone marrow transplantation, the sign and symptoms of the disease subsided. Conclusion: In persistent and unjustifiable neonatal thrombocytopenia, diagnosis of osteopetrosis should be considered.
Keywords: Neonates
Osteopetrosis
Thrombocytopenia
2018
12
01
84
87
https://ijn.mums.ac.ir/article_11908_4f33e0408abc0c1ccf2babac93abf7d3.pdf