md-medicaldata

Authors

 

Goran Đenadić¹, Dušan Lalošević<sup>2

1</sup>Služba za patološko-anatomsku dijagnostiku, Opšta bolnica “Dr Laza K. Lazarević”, Šabac, Srbija
²Univerzitet u Novom Sadu, Medicinski fakultet, Katedra za histologiju i embriologiju, Novi Sad, Srbija

 

UDK: 618.5
616-001.8-053.31

The paper was received / Rad primljen: 13.12.2022

Accepted / Rad prihvaćen: 21.12.2022.

 

Correspondence to:

Dr sci. med. Goran Đenadić,
patolog i citolog
Služba za patologiju
Opšta bolnica Šabac
Popa Karana 4
15000 Šabac
e-mail: gorandjenadic@gmail.com

 

 

Sažetak

 

 

Uvod Perinatalna asfiksija predstavlja jedan od glavnih uzroka komplikacija u porođaju a jedan od njenih glavnih uzroka je aspiracija mekonijuma, tj. sindrom aspiracije mekonijuma kao glavni uzrok respiratornog distresa novorodjenčadi. Prikazujemo jedan ovakav slučaj koji se fatalno završio. Prikaz slučaja Posle četiri dana od prijema u bolnicu u terminu, u ranim jutarnjim časovima došlo je do porođajnih napona, prskanja vodenjaka i izlivanja iz vagine plodove vode zelene boje, a porođaj je praktično počeo u kasnim večernjim časovima. Kako se porođaj nije mogao obaviti prirodnim putem jer je ustanovljena dijagnoza: Disproportio capitopelvina, došlo je do produženog porođaja i Aphixyio feti imminens. Zbog navedenih dijagnoza, postupajući ginekolog je odlučio da se uradi carski rez. Međutim, iako je na rođenju utvrđen Apgar skor od 9, osam sati pole porođaja došlo je do patnje ploda sa simptomima respiratornog distresa i smrtnog ishoda. Zaključak Kod sumnje na cefalo-pelvičnu disproporciju potrebno je, kada je termin porodjaja očekivan, što pre uraditi carski rez. Kod sumnje na aspiraciju mekonijuma potrebno je uporno i savesno raditi njegovu aspiraciju da bi se respiratorni distres mogao lečiti.

 

Ključne reči:

Sindrom aspiracije mekonijuma, neonatalna bronhopneumonija, prikaz slučaja..

 

 

 

Abstract

 

Introduction Perinatal asphyxia is one of the main causes of complications in childbirth, and one of its main causes is aspiration of meconium, i.e. meconium aspiration syndrome as the main cause of respiratory distress in newborns. We present one such case that ended fatally. Case presentation Two days after admission to the hospital on time of delivery, in the evening there were labor pressures, splashing water and green amniotic fluid pouring out of the vagina, and labor practically began. As the birth could not be carried out naturally because the diagnosis was established: Disproportio capitopelvina, there was a prolonged birth and Aphixyio feti imminens. Due to the aforementioned diagnoses, the attending gynecologist decided to perform a caesarean section. However, although an Apgar score of 9 was determined at birth, eight hours after delivery, the neonate suffered with symptoms of respiratory distress and death on the second day. Conclusion In case of suspicion of cephalo-pelvic disproportion, it is necessary, when the childbirth date is expected, to perform a caesarean section as soon as possible. If meconium aspiration is suspected, its aspiration should be done persistently and conscientiously so that respiratory distress can be treated.

 

Key words:

Meconium aspiration syndrome, neonatal bronchopneumonia, case report..

 

 

 

 

References:

1. Neonatal and Perinatal Mortality, Country, Regional and Global Estimates. WHO, Geneva
2. (https://apps.who.int/iris/bitstream/handle/10665/43444/9241563206_eng.pdf?sequence=1&isAllowed=y, 01.03.2023.)
3. Lazarević K, Bogdanović D, Stošić L. Trends and Causes of Neonatal Mortality in Serbia, 1997-2016. Balkan Med J. 2020 Apr 10;37(3):144-149. doi: 10.4274/balkanmedj.galenos.2020.2019.5.145.
4. Pejović B. Sindrom aspiracije mekonijuma. Protokoli u neonatologiji, 81-84, http://www.neonatologija.rs/c_protokoli.htm (pristupljeno 01.03.2023.)
5. Cleary GM,  Wiswell TE. Meconium-stained amniotic fluid and the meconium aspiration syndrome: an update. Pediatric Clinics of North America 1998, 45(3):511-529.
6. Mokra D, Mokry J. Glucocorticoids in the treatment of neonatal meconium aspiration syndrome. European journal of pediatrics. 2011;170:1495-505.
   

PDF: 04-Đenadić G. and Lalošević D. MD-Medical Data 2023;15(1-2) 021-025.pdf