Medical Report Muaz

Summary:

Baby Muaz was born by spontaneous vaginal delivery at 26+6 gestational weeks. Mother had no signs of intraamnial infection, she was covered by antibiotic shortly before delivery, and she received 1 dose of antenatal steroids. Baby boy was born by head presentation, he was appropriate for gestational age. He was intubated in the delivery room and mechanical ventilation was started. He was admitted to NICU.

1 dose of surfactant was given, the boy was weaned from ventilation to NIPPV/nCPAP. We continued with nCPAP for the next 7 days. He was on intermittent NCPAP during 2nd and 3rd week of life for apnea of maturity.

He had significant persistent ductus arteriosus(PDA). The PDA was ligated on 50th day of life. He was intubated and ventilated during perioperative period. After extubation(day 4 post surgery) he developed progressive dyspnea and stridor(both expiratory and  inspiratory) and mechanical ventilation was needed for another day. He was successfully extubated after 7-day course of Hydrocortison. After day 56 of life he required no respiratory support, stridor and dyspnea persistent during feed. Chest X-rays shows moderate bronchopulmonal dysplasia, combined inhaled bronchodilator and steroid therapy had no effect on stridor and dyspnea. Bronchoscopy showed normal airway anatomy and oedematousus arytenoids, the probable reason for stridor.

Echocardiography post surgery showed accelerated flow on LPA, reason for persistent systolic murmur 2/6.

There was no infectious complication during stay in our hospital.

Muaz receive enteral feeding with human breast milk from day 1 of life, he got to full enteral feeding on day 8 of life. Parental nutrition was needed for 7 days. The boy has been thriving.

2 blood transfusion were applied(6/7/2010 and 11/8/2010). Hyperbilirubinemia was treated with phototherapy.

Upon discharged baby Muaz tolerates bottle feeds by breast milk and Nutrilon 0 Nenatal. He has normal breathing, except for occasional mild stridor and dyspnea rarely-without desaturations. The systolic murmur persists.

DG:

Prematurity, GA 26+6 weeks

Respiratory distress syndrome

Hyperbilirubinemia

Anemia-transfused 11/8/2010

Hemodynamically significant persistent ductus arteriosus(HSPDA), PDA ligitation 7/7/2010

Recommendations:

Breast milk (bottle) or Nutrilon 0 Nenatal (as much as he likes, at least 50ml 7x a day)

Vitamin D and K supplement( according to treating pediatrician’s recommendation).

Padeatric check up wthin 2 days after discharge, routine controls of full blood count and biochemistry – Ca, P, ALP, Fe, Ferritin.

Paediatric, Cardiology, Pulmonary and Neurology checkups.

Vaccination and orthopedic check up (hip an ultrasound) according to common practice in country of residence.

Predischarge Bloods:

Blood group: B Rh negative

Full Blood Count (before blood transfusion): 10.08.10: LEOKOCYTY 8.2 10^9/1, MONOCYTY %: 8.70 %, LYMFOCYTY no: 5.40 10.9/L, MONOCYTY no: 0.70 10.9/L, ERYTROCYTY: 3.32 10^12/1, HEMATOKRIT: 0.262, MCV: 78.9 FL, MCH (Hb v 1 ery): 27.1 Pico grm, MCHC 344.00 g/L, distribution erytr: 15.700, TROMBOCYTY no: 146 10^9/L, retikulocyt: 74.000 promile, Lymfoblast: 0.00 1, segm: 7.00%, bars: 2.00%, eosinof: 1.00%, monocyt: 8.00%, lymfocyty: 82.00%, basofil: 0.000%, metamyelocyty: 0.00%, promyelocyt: 0.00%, myelocyt: 0.00%, plazm. Cells: 0.00%, normoblast: 0.00 nbl/100L, hemoglobin: 90g/L

Biochemistry: 10.08.10: Bilirubin total: 14 umol/L, ALP: 5.12 ukat/L, S-Glukosa: 5.0 mmol/L, S-Ca total: 2.47 mmol/L, S-Fosfor anorg: 2.08mmol/L, S-Cl: 104 mmol/L, Bilirubin conj. 4.8 umol/L, S-Zelezo: 13.20 umol/L, S-Na: 138.6 mmol/L, S-K: 5.3 mmol/L, Ferritin: 71.5 ng/mL

Optalmologic examination: Normal

Neurologic examination: Normal

Cranial ultrasound: Normal

Echocardiography: normal heart anatomy, PDA 0, acceleration LPA 2.5m/s,RPA 2 m/s, RVOT and LVOT normal., MV, TV, AoV normal flow,Mild stenosis of LPA, mild PAVI

Bronchoscopy: Normal anatomy of airways, oedematous arytenoids, probable reason for stridor

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2 Responses to “Medical Report Muaz”

  1. dr syed Says:

    Salam, masya-Allah syukur alhamdulillah, maha suci Allah yang telah mempermudahkan antum. Just nak share, babies kat Notts (or kat mana-mana in fact), kalau born at 26+6 weeks gestation, boleh dapat lebih banyak complications apart from yang Muaz hadapi. So, abu dan ummu Muaz, bersyukur laa pada Allah banyak-banyak atas anugerah-Nya (tak cakap pun insya-Allah antum buat punya)…. just nak share yang babies macam tu kekadang can be more complicated. Berdoalah banyak-banyak agar Muaz terdidik dengan didikan yang sempurna, semoga menjadi hamba Allah yang beriman dan beramal soleh. Amin.

  2. Abu Mu'az Says:

    wslm..alhamdulillah Allah dah beri banyak rahmatNya kepada kami sekeluarga..dan alhamdulillah di sekeliling kami ada orang-orang yg baik hati macam dr syed ni,hehe =)

    insyaAllah kami akan cuba menjadi ibu bapa yang terbaik buat Muaz..semoga dia membesar menjadi insan yang soleh dan musleh..amin..

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