Browsing by Author "Rakonjac, Zorica (19639071300)"

Introduction/Objective Vitamin K deficiency is common in newborn infants and without prophylaxis there is a risk of vitamin K deficiency bleeding (VKDB). The most frequent prophylactic approach is an intramuscular (IM) injection of vitamin K1 immediately after birth. Its efficiency to prevent late VKDB has been recently questioned by several reports. Based on our experience, we discuss the need for additional vitamin K1 supplementation after its IM administration at birth. Methods We present a retrospective review of 12 infants, 11 with confirmed and one with probable late VKDB despite IM prophylaxis at birth, who were treated in the two largest tertiary care pediatric hospitals in Serbia during the last 15 years. Results All the patients were exclusively breastfed. In 11 patients, daily weight gain was normal or increased, and one patient had failure to gain weight. Six infants were previously healthy, three infants received antibiotics prior to bleeding, and in two diarrhea and cholestasis, respectively, existed previously. An intracranial bleeding was documented in nine infants, four of whom died. Conclusion Low content of phytomenadione in human milk could occasionally be attributed to late VKDB despite postnatal IM injection of vitamin K1 in otherwise healthy, exclusively breastfed infants. This might be aggravated by transient disturbance of vitamin K turnover due to antibiotic use, acute diarrhea, or transient cholestasis. We suggest that an additional vitamin K1 supplementation after postnatal IM prophylaxis could be justified in exclusively breastfed infants. © 2017, Serbia Medical Society. All rights reserved.

Generalized lymphatic anomaly (GLA) is a rare congenital disorder of lymphatic development, presenting with multiple lymphatic malformations in different organs and tissues. Here, we present a case of a female neonate prenatally diagnosed with foetal hydrops and a mediastinal cystic lymphatic malformation that showed postnatal expansive and infiltrative growth into the major airways, compromising mechanical ventilation and further management of the neonate. Complications that arose during surgical treatment of mediastinal structures led to the patient’s death. Lymphatic malformations were also noted in the skin at birth. Furthermore, a skin biopsy performed immediately after birth and the autopsy revealed an extremely rare diagnosis of combined macrocystic and microcystic forms of GLA with skin involvement. Copyright © The Korean Dermatological Association and The Korean Society for Investigative Dermatology

Neonatal encephalopathy is a manifestation of acute neurological disorder in newborn infants and is commonly presented with decreased level of consciousness (lethargy or comma) and seizures. Etiology of neonatal encephalopathy is versatile. The most common cause is hypoxic-ischemic encephalopathy which is a cause of more than 50% of cases of neonatal encephalopathy. Other causes include infections, inborn errors of metabolism, cerebrovascular infarcts, bilirubin induced neurological disfunction, va-rious neurodegenerative disorders and epileptic syndromes. Because of a wide spectrum of etiology, newborn with encephalopathy must be carefully examined and immediate laboratory analysis, electroencephalographic and neuroradiological investigation must be performed, as well as further specific investigation if needed. Management of newborn with acute neurological disorder consists of stabilization of vital parameters, symptomatic therapy which includes correction of hypoglycemia, electrolyte disturbances, aci-dosis and anemia and treatment of seizures. Specific therapy of neonatal encephalopathy depends on etiology, so multidisciplinary team of pediatric specialists is commonly involved in diagnostic and therapeutic procedures. In many cases of neonatal encephalo-pathy, prompt diagnosis can be life-saving. © 2021, Croatian Paediatric Society. All rights reserved.

Introduction/Objective Air leak syndrome is more frequent in neonatal period than at any other period of life. Its timely recognition and treatment is a medical emergency. We present results of a tertiary medical center in treatment of air leak syndrome in term and late preterm neonates. Methods Neonates born between 34th 0/7 and 41st 6/7 gestational weeks (g.w.) who were treated for air leak syndrome in the Neonatal Intensive Care Unit of Mother and Child Health Care Institute, from 2005 to 2015 were included in the study. Antropometric data, perinatal history, type of respiratory support prior to admission, chest radiography, type of pulmonary air leak syndrome and its management, underlying etiology, and final outcome were analyzed. Results Eighty-seven neonates of an average gestational age 38.1 ± 1.9 g.w. were included in the study. The average birth weight was 3182.5 ± 55.5 g. Fourty-seven (54%) were born by cesarean section and 40 (46%) were born by vaginal delivery. Prior to admission, 62.1% received supplemental oxygen, 4.6% were on nasal continuous positive airway pressure, and 21.8% were on conventional mechanical ventilation. Type of delivery did not significantly affect the appearance of pneumothorax, nor did the type of respiratory support received prior to admission (p > 0.05). The majority (93.1%) had pneumothorax, which was unilateral in 79%. The length of mechanical ventilation significantly affected the appearance of pneumothorax (p = 0.015). Low Apgar score in the first minute and the presence of pneumopericardium were significant factors predisposing for an unfavorable outcome. Conclusion Improving mechanical ventilation strategies and decreasing the rate of perinatal asphyxia in term and late preterm neonates could diminish the incidence of pulmonary air leak syndrome in this age group. © 2019, Serbia Medical Society. All rights reserved.