Page 310 - Abstract Book KONIKA 18

Neonatology

P-NEO-045
Pneumothorax in A Newborn With Meconium Aspiration Syndrome:
A Case Report

Azaria Amelia Adam, Martono Tri Utomo, Risa Etika, Dina Angelika, Kartika Darma Handayani
Department of Child Health. Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital,
Surabaya, East Java, Indonesia

Abstract
Background Pneumothorax is the dissection of air into the pleural space. Meconium Aspiration Syndrome
MAS has become 20% cause of pneumothorax. The thick, viscid meconium can result in partial airway
obstruction with air-leak syndrome as the complication. Objective To report the case of pneumothorax as
complication of meconium aspiration syndrome in a newborn, focusing on the early diagnostic approach
and intervention. Case We found respiratory distress in a term infant who born through meconium-stained
amniotic fluid (MSAF). The risk factor of this case was amniotic membrane rupture three days before delivery,
oligohydramnion and preeclamsic mother. Neonatal resuscitation was done until the baby got positive pressure
ventilation and put on nasal CPAP with PEEP 5 mmH 0. During the observation, the baby became more
2
cyanotic and respiratory distress. Chest X-Ray examination revealed avascular lucent area at right lateral
hemithorax, as a sign of pneumothorax. The baby got chest tube insertion and intubated with oxygen support
ventilator. The serial thorax X-ray evaluation showed improvement of lung expansion, without air leakage in
right pleural. After seven days, the chest tube was taken off. Conclusion Pneumothorax as complication of
Meconium Aspiration Syndrome in newborn has been reported. The early recognition of clinical deterioration
is an important observation. Although there was no specific clinical finding of pneumothorax, chest X-Ray
examination revealed avascular lucent area at right lateral hemithorax. Pleural air drainage is mandatory in
case of secondary pneumothorax with cardiorespiratory involvement.
Keywords: pneumothorax; meconium aspiration syndrome; newborn

P-NEO-046
Congenital Diaphragmatic Hernia Prognostic at the NICU
in the Tertiary Care Center Hasan Sadikin General Hospital: A Case Series

Anggun Puspita Dewi, Fiva Aprilia Kadi
Department of Child Health, Faculty of Medicine,Universitas Padjadjaran/
Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia

Abstract
Background Congenital Diaphragmatic Hernia (CDH) is a condition characterized by a defect in the chest
diaphragm that causes the contents of the stomach to protrude or move into the chest cavity. Mortality and
morbidity remain high. Infants with CDH also have long hospital stays which require a multidisciplinary
approach for management. This case report will discuss what factors that influence the success of therapy
and the prognosis of patient based on clinical findings in CDH patients admitted to the Neonatal Intensive
Care Unit (NICU) HSGH. Objective Factors that affect the CDH prognostic. Case In this article, we report 11
case of CDH, in neonates who were hospitalized in the NICU HSHG over last 4 years (2017 to 2021). Male
were dominant. There are two types of defects Is Bochdalek type was leading with total 10 patients (90%)
while only 1 patient (10%) was and Morgagni type. The defect size was ranging from 2 to 4 cm in diameter,
whilst length of treatment was ranging from 2-50 days. We observed that 7 patients with CDH survived
while only 4 CDH patients died. It is found that the prognostic will be better and the length of stay will be
shorter, if the CDH repairment was done in the earlier age. Conclusion The prognostic of CDH patients
depends on several factors including the type of CDH defect, the size of the CDH defect, and comorbidities
that aggravate the patient's condition.
Keywords: congenital diaphragmatic hernia (CDH); prognostic; CDH type; CDH survival rate

262 KONIKA XVIII Abstract Book