Page 292 - Abstract Book KONIKA 18

Neonatology

P-NEO-012
Hyaline Membrane Disease and Pneumothorax in Aterm Baby: A Case Report

Eileen Erica Mardiharto, Pudji Andayani, Pricilia Gunawan H,. Ari Yunanto
Department of Child Health, Faculty of Medicine Universitas Lambung Mangkurat/Ulin General Hospital,
Banjarmasin, South Borneo, Indonesia
Abstract
Background Neonates with hyaline membrane disease (HMD) have higher risk of developing pneumothorax.
Incidence of pneumothorax in newborn with HMD is only about 15% with lower risk in aterm baby.
Pediatrician should predict the possibility of impending pneumothorax in newborn with HMD, especially
within first 24 hours of life. Objective To report a case of HMD complicated by the presence of pneumothorax
in aterm baby. Case Female baby with gestational age of 38 weeks, birthweight 2600 grams was born by
cesarean section, from diabetic mother. The baby cried immediately without active resuscitation with an
APGAR score of 7-8-9. Six hours after delivery, the baby had shortness of breath with Downe score of 4,
at that time, continuous positive airway pressure (CPAP) was given. Hence, respiratory distress worsened
progressively within 24 hours. Chest X-ray examination revealed grade III HMD and right pneumothorax.
The baby was intubated, surfactant was administered, and chest tube thoracostomy were placed. On the sixth
day of hospitalization the baby was extubated and chest tube thoracostomy was removed on the ninth day.
The baby was discharged in good condition after 14 days hospitalization. Conclusion HMD is one of the
most common underlying pulmonary disorder in pneumothorax of the newborn. Untreated pneumothorax
has a high mortality rate, early detection and prompt treatment ensure a better prognosis.
Keywords: pneumothorax; hyaline membrane disease; neonates

P-NEO-013
Determinants of Excessive Weight Loss in Breastfed Term Newborn
in Tambak Mother and Children Hospital, Jakarta

1
Ferry Liwang , Nabilah Syahidna Amelia , Nadya Rizki Pasha , Hifza Luthfiani , Yolanda Safitri ,
1
1
1
1
1
Shane Tuty Cornish , Adhi Teguh Perma Iskandar 1,2
1
Tambak Mother and Children Hospital and Child Health Department/
2
Dr. Cipto Mangunkusumo National General Hospital , Jakarta, Indonesia
Abstract
Background Neonates are expected to have weight loss in the first few days of life. Excessive weight
loss (EWL) is associated with poor outcomes (dehydration, hyperbilirubinemia). However, there are still
many controversies regarding factors that contribute to weight loss. Objective To determine the factors that
contribute to EWL in initial 72 hours of life. Methods A retrospective study was conducted at RSIA Tambak,
Jakarta with breastfed singleton term babies collected from medical records in 2020. EWL (≥7% of birth
weight) was calculated in 72 hours of life. Small for gestational age, large for gestational age, low birth
weight, congenital anomalies, and newborns admitted to Neonatal Intensive Care Unit (NICU) or Specialty
Care Nursing (SCN) were excluded from this study. Maternal factors consist of parity, maternal age, mode
of delivery, infertility, gestational diabetes mellitus (GDM), and oligohydramnion, while neonatal factors
consist of gender, gestational age, and breastfeeding were analyzed in this study. The data were analyzed using
logistic regression. Results Of 174 subjects with a proportionate gender (50%) and median of gestational
age 39 weeks, EWL occurred in 33.9% of newborn. In bivariate analysis EWL was associated with mode
of delivery, GDM, breastfeeding, and parity. Logistic regression revealed that cesarean section (OR 2.867;
95% CI 1.048 to 7.843; P=0.040) and primiparous (OR 2.138; 95%CI 1.105 to 4.316; P=0.024) significantly
predicted EWL. Conclusion Predominantly newborn delivered by cesarean section and primiparous women
are at risk of EWL. A comprehensive and better care plan in lactation is recommended to prevent EWL.
Keywords: excessive weight loss; cesarean section; primiparous; breastfeeding

244 KONIKA XVIII Abstract Book