Page 304 - Abstract Book KONIKA 18

Neonatology

P-NEO-034
A Preterm Baby with Hyaline Membrane Disease, Perinatal Infection,
and Ladd’s Band Malrotation: A Case Report

Tasya Gitaputri Pranoto, Nancy Napitupulu, Eric Gultom, Naomi E. F. Dewanto
Department of NICU, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia

Abstract
Background Malrotation can be symptomatic or not occur between 1/200 and 1/500 live births. Approximately
50 to 70% of cases are diagnosed during the neonatal period. Objective To report is to familiarize with
variations in the presentation of malrotation to optimize outcome in many cases. Case A baby girl weighing
1554 g was born 32 weeks from a 26-year-old mother via sectio caesarean due to pre-eclampsia and
oligohydramnios. Four hours after birth the baby was put on CPAP due respiratory distress. Meconium and
urine was noted from the first day. At 2 days of age, abdominal distension, orogastric tube (OGT) production
was 12 mL dark green brownish, weakened peristaltic movement was found. Procalcitonin (PCT) level was
0.57 ng/mL. The baby fasted, blood culture was taken, antibiotics were given. At the 4 days of age, PCT level
decreased to 0.14 ng/mL, blood culture was sterile but abdomen was still distended, OGT production was
still dark green, X-ray still showed gastric, small bowel, colon dilatation and abdominal ultrasound showed
ascites and weak peristaltic movement. Laparotomy exploration, Ladd’s procedure, and Ladd’s band release
were performed on the 6 days of age. Postoperative was uncomplicated. She was fully breastfed and was
released after 44 days of hospital stay. Conclusion Early recognition and right time decision can prevent
further complications and improve patients outcomes as well as reduce the costs.
Keywords: bowel obstruction; preterm; malrotation; perinatal infection

256 KONIKA XVIII Abstract Book