Page 297 - Abstract Book KONIKA 18

Neonatology

P-NEO-021
Predicting Mortality and Length of Stay of Very Low Birth Weight Babies
in a Tertiary Hospital

Lucia Nauli Simbolon, Engkie Achmad Djauharie
Department of Child Health, Harapan Kita Women and Children Hospital, Jakarta, Indonesia

Abstract
Background The most frequent cause of morbidity and mortality in the neonatal care units worldwide
is prematurity. Prediction of length of stay (LOS) among preterm infants is important for counselling
of parents and for assessing neonatal intensive care unit (NICU) census and economic burden.
Objective To predict length of stay (LOS) and risk of mortality for very low birth weight babies admitted
to the neonatal intensive care units in tertiary hospital. Methods A retrospective observational study was
conducted from April 2020 to March 2021 on all preterm babies weighed <1500 gram born in Harapan Kita
Mother and Child Hospital. We calculated the actual median LOS and analyze the correlation using Pearson
test. Results There were 94 preterm infants, with 28 babies (30%) < 1000 g and 66 babies (70%) weighed
1000 – 1500g. The median LOS for infants < 1000 g was 47 days while for infants weight 1000-1500g was
29 days. Six of extremely low birth weight babies died (21%) while 9 (14%) of very low birth weight babies
died. There was significant correlation between birth weight and the length of stay in the hospital and the
mortality risk according to Pearson test with p 0,00 (correlation is significant P < 0.01). Conclusion These
results can be used in the counselling of parents about length of stay and the risk of mortality.
Keywords: length of stay; low birth weight; mortality

P-NEO-022
The Role of Conservative Treatment as the Management of Hemodynamically
Significant Patent Ductus Arteriosus in A Premature Baby: A Case Report

Arina Kartika, Adhi Teguh Perma Iskandar
Departement of Child Health, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital,
Jakarta, Indonesia

Abstract
Background Hemodynamically significant patent ductus arteriosus (hs-PDA) is associated with poor outcomes
and a higher mortality rate in premature babies. Pharmacological treatment to close PDA is related to side
effects such as impaired renal function and gastrointestinal bleeding. Conservative treatment is considered
for hs-PDA management with the assumption that the duct can be physiologically closed and it can reduce
the side effects of pharmacological treatment. Objective To demonstrate a case of conservative treatment in
the management of hs-PDA in premature babies. Case A 32-week-gestation baby was born in our hospital,
weighed 1325 g, with Apgar score of 7/8. The baby got continuous positive airway pressure (CPAP) 7 cmH O
2
and fraction of inspired oxygen (FiO ) 21%. On day 1, the CPAP setting could be reduced to PEEP 5 cmH O
2
2
and the baby was hemodynamically stable without desaturation. His echocardiography on day 3 showed the
PDA diameter was more than 1.5 mm, the left atrium-to-aortic root ratio was 1.67, and the left pulmonary
diastolic flow 0.5 cm/s. There was no sign of systolic murmur, hypotension, oliguria, and pulmonary edema.
The baby was managed conservatively by closely monitoring the hemodynamic, optimizing oxygen delivery
and positive airway pressure, maintaining daily fluids administration less than 130 mL/kg/day, keeping the
hematocrit more than 45%, and echocardiographic evaluations every day. The echocardiography on day 8
showed the PDA has closed. Conclusion The conservative treatment can be used for hs-PDA management
in premature babies with considerations, such as gestational age, PDA risk factors, other clinical factors
accompanied hs-PDA, and echocardiography results.
Keywords: hs-PDA; conservative treatment; premature baby

KONIKA XVIII Abstract Book 249