Page 317 - Abstract Book KONIKA 18

Neonatology

P-NEO-056
Congenital Syphilis Presented as Early Onset Neonatal Sepsis
and Neonatal Jaundice: A Case Report

Yogi Priyatna Biantara, Romy Windiyanto, Ria Asprila Dewi
Department of Child Health, Faculty of Medicine, Universitas Warmadewa/Sanjiwani General Hospital,
Gianyar, Bali, Indonesia

Abstract
Background Congenital syphilis (CS) is diagnosed when Treponema pallidum were identified from body
fluid of neonates from mother-to-child transmission syphilis. In spite of being preventable, congenital syphilis
that overlapped with neonatal sepsis has worse prognosis and should be treatable to prevent the complication.
Objective To demonstrate the relation between sepsis and neonatal jaundice in congenital syphilis patient.
Case A baby girl has been born through caesarean delivery from a mother with a diagnosis of G2P0100 38
weeks 1 day, Rupture of membrane > 12 hours + syphilis infection latent phase on reatment. With a weight
2500 grams with an Apgar of 3-5. Patient's mother was diagnosed with Syphilis and received injection
therapy 8 times but had not finished yet. On initial examination, vital signs were normal, oxygen saturation
was 100% using cannula, Subcostal Retraction of the chest, moaning, and jaundice, leukocytosis 37,56 103/
μL, neutrophilia 78.2%, IT Ratio 0.27, VDRL 1/128, TPHA (+), and hyperbilirubinemia. Treatments include
oxygen 2 liter per minute, IV access with dextrose 10%, cefotaxim 150 mg every 12 hours and gentamicin
12 mg every 24 hours, BPG 125,000 IU single dose IM, phototherapy within 48 hours. On the sixth days
of hospitalized, the patient shown an improvement with absence of the icterus, and good feeding tolerance.
Conclusion There is no specific different shown from the symptoms of each CS, early onset sepsis and neonatal
jaundice, aside from their laboratory finding and birth history. After 8 days of hospitalized, improvement is
showed with absence of symptoms and good feeding tolerance.
Keywords: congenital syphilis; neonatal sepsis; neonatal jaundice

P-NEO-057
Case Report: Suspect Pierre Robin Sequence

Tiara Annisa Putri Mardhani, Nathalia Ningrum, Mila Hardiani Cahyaningrum
Brawijaya Duren Tiga Woman and Children Hospital, Jakarta, Indonesia
Abstract
Background Pierre Robin Sequence (PRS) is a condition which infant born with micrognathia, glossoptosis,
upper airway obstruction, and often with palatal malformation. This combination of features can lead
to respiratory and feeding problems early in life. The exact causes of PRS are unknown. The suggested
incidence of PRS is 1:8500 to 1:14000 live births. Objective To describe the clinical manifestation and early
management of Pierre Robin sequence in infants. Case A 1650 grams and 43 cm girl was born at 36 weeks
gestational age from 40 years old mother by caesarean section with indication of oligohydroamnion and
intrauterine growth restriction. The apgar score was 8/9. On physical examination were found micrognathia,
glossoptosis, small cleft palate, and hearing abnormality on left ear. Four hours after delivery, the baby
develop tachypnea. On laboratory examination was found increased anti-CMV IgG serum on TORCH
screening and the septic screening was normal. On x-ray an image of transient tachypnea of newborn was
found. On echocardiography, there was patent foramen ovale and patent ductus arteriosus. On opthalmological
examination was found retinopathy of prematurity stage 2 zone 2-3 without pus on both eyes. No family
history was reported. There was feeding difficulties causing the patient to have a problem on gaining
weight. Now the patient is still waiting for the result of chromosomal examination for PRS diagnostic.
Conclusion PRS cases must be observed and examined thoroughly because of the various abnormalities.
This abnormality should be discovered quickly by physician to be monitored more closely at birth.
Keywords: Pierre Robin eequence; rare disease; malformation syndrome

KONIKA XVIII Abstract Book 269