Page 306 - Abstract Book KONIKA 18

Neonatology

P-NEO-037
Breastfeeding Preterm Baby in 25 Years Infertile Mother
with Severe Preeclampsia and Maternal Obesity: A Case Report

Zaneth Sugiri , Olivia Ekaputri , Yani Damayanthi , Naomi E. F. Dewanto 1,2
1
1
1
NICU Department, Siloam Hospitals Kebon Jeruk and Pediatric Department, Medical Faculty,
1
2
Universitas Tarumanegara , Jakarta, Indonesia
Abstract
Background Mother’s Own Milk (MOM) is very important for growth and development especially preterm
and sick babies, but it is not easy to get MOM for NICU babies. There are some obstacles due to mother-baby
separation, moreover if there are other delayed lactogenesis II factors, like preeclampsia, obesity, infertility,
and stress. Objective To share and remind the importance of lactation management in NICU for preterm
baby from mother with several factors that can cause delayed lactogenesis II. Case A 34 weeks baby born
by cesarean section from elderly primigravida with severe preeclampsia and maternal obesity, Apgar score
8/9, birth weight 1735 g. A 44-year-old mother and 51-year-old father have a history of twenty-five years
infertility with several times IVF procedures. In NICU, the baby was on CPAP for respiratory distress, treated
for perinatal infection, and given dextrose 10% for severe hypoglycemia state. Due to so many delayed
lactogenesis II factors, the baby was given donor human milk for supplementation while the mother was
still pumping her own milk every three hours after delivery. MOM production started at 0.3 mL on day 2-3
and gradually increased especially after kangaroo mother care. The baby went home with full of MOM. At
three weeks of age, the baby's weight is 2140 g and at six weeks of age baby's weight is already 3100 g with
only MOM. Conclusion Proper lactation management in NICU can overcome the obstacles to get MOM.
Keywords: preterm; delayed lactogenesis II; lactation management

P-NEO-038
Clinical Manifestations in Infants with Multipel Congenital Anomalies Suspected
of Patau Syndrome (Trisomy 13) in Limited Facilities: A Case Report
Bayu Puspita Rani
Department of Child Health Hospital, Pamanukan Medical Center, Subang, West Java, Indonesia
Abstract
Background Patau syndrome(trisomy 13)occurs due to disruption of the chromosome separation process.
Incidence of patau syndrome occurs in 1:12.000 live births, but cannot last long. More than 80% of children
with trisomy 13 die in the first year with an average lifespan of about 2.5 days.So the need for a good
pregnancy preparation maturity. Objective To report infants with multiple congenital anomalies suspected
of patau syndrome. Case Babies born to mothers aged 45 years G3P2A0 gravida 36-37 weeks with sectio
caesarea on indications of congenital abnormalities suspected patau syndrome.The baby was born at 12.20
p.m, single fetus, clear amniotic fluid, not crying, bluish skin, no muscle tone, gasping breath, obtained
pulse 70 times/minute, carried out neonate resuscitation with apgar score 2/4/8. On the examination of
vital signs obtained pulse 171 times/minute, breathing 68 times/minute, temperature 36°C,SpO 92%,
2
birth weight 2350 grams, body length 46 cm, head circumference 30 cm, chest circumference 28cm, and
abdominal circumference 26 cm. On physical examination obtained head microcrphaly, dismorfik face,
microtia, orofacial clefts, intercostal retraction, sound grunting, gallop, polydactyl bilateral, simian crease,
and micropenis, talipes equinovarus bilateral. Antenatal care history of pregnant women of 3 child has no
rd
history of congenital disease,weight gain during pregnancy 5 kg, routinely taking vitamins from obstetricians
diagnosed with congenital abnormalities are advised to go to the fetomaternal part but the family refuses.
Neonate resuscitation and inform concent the condition of the baby at birth with suspected Patau Syndrome.
Infants are given palliative care with oxygen 5 lpm/simple mask, infusion D10% 6gtt/micro, cefotaxime
2x100 mg, ampicilin 2x100 mg, and education of patient conditions according to ethics and treatment at the
end of family life decided to refuse to be referred and do not resusitation.The baby was pronounced dead
at 22:30 p.m. Conclusion There is no specific therapy in cases of patau syndrome. With a low chance of
living in intensive care, the need for family decisions on medical measures to be taken. Palliative care and
not resuscitation is an ethical act.
Keywords: congenital; trisomy 13; polydactyl; orofacial clefts; CTEV

258 KONIKA XVIII Abstract Book