Extremely premature infant (22 weeks) and medical challenges: a clinical case

Abstract

The 22 week gestation, 350 g (<3 ‰) an infant female born to a 29 year old Gravida 2, Para 1 mother. Vaginal delivery occurred after preterm labor and presumed chorioamnionitis. The mother didn’t receive dexamethasone. Apgar scores were six and seven at 1 and 5 minutes of delivery. The baby was resuscitated and mechanically ventilated for severe respiratory distress syndrome. The baby had three doses of surfactant administered but ventilation parameters increased and high frequency oscillatory ventilation (HFOV) was initiated. Early onset pulmonary interstitial emphysema was apparent by day 4 and later it deployed mediastinum (Figure 1), disturbed blood circulation. A thoracotomy and the lower lobe of the right lung with cystic derivatives were removed by day 27 (Figure 2). At that time, the infant weighed 495 g. At 44 days of life the newborn was extubated, oxygen therapy was extended in the nCPAP, and later reintubated during infections. Patent ductus arteriosus, stage I retinopathy of prematurity, grade I intraventricular hemorrhage, ventriculomegaly ex vacuo anemia, hypergly ce mia, two times sepsis, tree times pneumonia, pyelonephritis. CMV infection was diagnosed after 63 days of age. An increase in DNA copy number was observed after 8 weeks of treatment. After the mother was tested, a high titre of immunoglobulin G against CMV was found in the blood, so the newborn started to be fed wit h mother's pasteurized milk. Continuing the appointment treatment, the number of copies of DNA decreased.[...].