Page 316 - Abstract Book KONIKA 18

Neonatology

P-NEO-054
Perforated Necrotizing Enterocolitis in Extremely Low Birthweight Baby
with Hyaline Membrane Disease: A Case Report

Lastri Ronauli Sitompul
Siloam Sriwijaya Hospitals, Palembang, South Sumatera, Indonesia

Abstract
Background Necrotizing enterocolitis (NEC) is one of life-threatening emergency of gastrointestinal tract in
neonates that was found in 5-10% extremely low birthweight (ELBW) baby. NEC can be progressive to stage
of perforation, peritonitis, septicemia, and death. There is no definitive treatment for NEC, but rapid initial
supportive therapy is required when NEC diagnosis established. Objective To report clinical presentation and
initial treatment of perforated NEC in ELBW newborn with HMD. Case A baby boy, weighed 851 g, was
born from a mother second pregnancy through sectio caesaria because severe pre ecclampsia at 28-weeks
gestation. He hospitalized in NICU with NCAP oxigenation support. Some signs and symptoms of RDS
appeared such as tachypnea, grunting sound, intercostal retraction, and periferal sianotic. From the chest
X-ray examination showed appearance of Hyaline Membrane Disease grade I. On the 6th day of care, he
suffered significant abdominal distention that was followed with decreasing of bowel passage and redness of
abdominal wall. From the plain abdomen X-ray founded appearance of pneumoperitoneum that was sign of
perforated necrotizing enterocolitis. He was treated with total parenteral nutritions, antibiotics (meropenem
and metronidazole), esomeprazole and primary peritoneal drainage was performed as initial treatment.
Although clinical improvement occured for several days, but when the drainage was detached his condition
and abdominal distention get worst. At this rate, he was planned to undergo exploratory laparotomy and
stoma creation, but the patient parents refused this procedure, and then he was referred to referral hospital.
Conclusion The onset of NEC in ELBW baby might appear at the 1st week of life, even before initiation
of enteral feeding, so early intervention was essential especially when haemodynamic instability occured.
Keywords: necrotizing entercolitis; extremely low birthweight; hyaline membrane disease

P-NEO-055
Salivary Cortisol Levels in Low Birth Weight with Kangaroo Mother Care

Verly Hosea, Ema Alasiry, A. Dwi Bahagia Febriani, Dasril Daud
Department of pediatric, Faculty of Medicine, Universitas Hasanuddin/Dr. Wahidin Sudirohusodo,
Makassar, South Sulawesi, Indonesia

Abstract
Background The most common cause of low birth weight (LBW) is premature birth, which is can trigger
stress. Stress in babies will cause an increase in the cortisol hormone. Continuously elevating cortisol
levels can increase the risk of cognitive and behavioral disorders. Kangaroo Mother Care (KMC) is
an alternative to incubators in LBW treatment, with several advantages so that it is expected to reduce
stress on LBW babies. Objective To assess the effect of KMC on salivary cortisol levels in LBW.
Methods This study used prospective cohort design at the Dr. Wahidin Sudirohusodo Hospital and Universitas
Hasanuddin Hospital Makassar. The population of this study were all neonatal patients diagnosed with LBW
without comorbidities.This study compared the effect of KMC and conventional on salivary cortisol levels
before and after treatment in each group. Results This study involved 23 LBW babies in the KMC group
and 22 LBW babies in the conventional care group. Based on the bivariate analysis on the characteristics of
KMC and non-KMC groups before treatment, the p value was > 0.05, which means there was no significant
difference. Comparative analysis of salivary cortisol levels before and after KMC obtained a value of P=0.00
(P<0.05) which indicates that there is a significant difference in terms of reducing salivary cortisol levels.
Comparative analysis of salivary cortisol levels before and after conventional treatment obtained P value =
0.01 (P<0.05), which indicates that there is a significant difference in terms of increasing salivary cortisol
levels. Conclusion There is an effect of KMC on LBW babies in terms of reducing salivary cortisol levels.
Keywords: kangaroo mother care; low birth weight baby; cortisol; stress

268 KONIKA XVIII Abstract Book