Bronchopulmonary dysplasia and severe intrauterine growth restriction in neonates of 850 grams at birth
Abstract
Introduction: Bronchopulmonary dysplasia is a chronic lung disease of neonatal age onset. Intrauterine growth restriction is defined as failure of the fetus to reach its genetically determined growth potential.
Objective: To describe the interdisciplinary management of bronchopulmonary dysplasia and review the literature on the subject.
Case report: The case of a newborn son of an adolescent mother, product of her first pregnancy, which had an adequate prenatal control, is presented. She presented grade IV intrauterine growth restriction characterized by alterations in the Doppler ultrasound in relation to severe placental insufficiency and oligohydramnios, which is why the pregnancy was terminated due to dystocic delivery by cesarean section at 34+1 weeks, with a ruptured bag at birth, liquid clear and very scanty amniotic. He was born in good clinical condition with a weight of 850 grams. In the first days of life, he began with clinical manifestations of sepsis; necrotizing enterocolitis was diagnosed, then he presented a sudden clinical deterioration due to the appearance of pulmonary hemorrhage. Weighing 695 grams, treatment with invasive mechanical ventilation was started, which lasted for a period of 30 days. After weaning from mechanical ventilation, the child remained oxygen dependent for a further 71 days; as a manifestation of bronchopulmonary dysplasia. Interconsultations were made with specialists in Cardiology, Hematology, Imaging, Nutrition, Immunology and Genetics; and, collectively, it was decided, the therapy developed. The neonate evolved satisfactorily.
Conclusions: The interdisciplinary management of bronchopulmonary dysplasia was shown. The updated literature was consulted.
DeCS: BRONCHOPULMONARY DYSPLASIA; INFANT, PREMATURE; FETAL GROWTH RETARDATION; LUNG DISEASES/embryology; RESPIRATION, ARTIFICIAL.
Downloads
References
1. Zavaleta-Gutiérrez FE, Concepción-Urteaga LA, Concepción-Zavaleta MJ, Aguilar-Villanueva DA. Factores de riesgo y displasia broncopulmonar en recién nacidos prematuros de muy bajo peso al nacer. Rev cuban pediatr [Internet]. 2019 [citado 28 Ene 2019];91(1). Disponible en: https://revpediatria.sld.cu/index.php/ped/article/view/600/256
2. Bassler D, Shinwell E, Hallman M, Jarreau PH, Plavka R, Carnielli V, et al. Long-Term Effects of Inhaled Budesonide for Bronchopulmonary Dysplasia. N Engl J Med [Internet]. 2018 Ene [citado 03 Mar 2022];378(2):148-157. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29320647/
3. Pizarro ME, Oyarzún MA. Actualización en displasia broncopulmonar. Neumol Pediatr [Internet]. 2016 [citado 02 Mar 2022];11(2):76-80. Disponible en: https://www.neumologia-pediatrica.cl/index.php/NP/article/view/305
4. Sucasas Alonso A, Pértega Díaz S, Sáez Soto R, Ávila-Álvarez A. Epidemiología y factores de riesgo asociados a displasia broncopulmonar en prematuros menores de 32 semanas de edad gestacional. An Pediatr [Internet]. 2022 [citado 25 Feb 2022];96:242-251. Disponible en: https://www.analesdepediatria.org/es-pdf-S1695403321001533
5. Sánchez Luna M, Moreno Hernando J, Botet Mussons F, Fernández Lorenzo JR, Herranz Carrillo G, Rite García S, et al. Displasia broncopulmonar: definiciones y clasificación. An Pediatr [Internet]. 2013 [citado 23 Feb 2022];79(4):e1-e6. Disponible en: https://www.analesdepediatria.org/es-displasia-broncopulmonar-definiciones-clasificacion-articulo-S1695403313000751
6. Cabrera Rojas LAJ. Ventilación mecánica prolongada como factor de riesgo para displasia broncopulmonar en neonatos prematuros [tesis]. Trujillo: Universidad Nacional de Trujillo; 2019 [citado 03 Mar 2022]. Disponible en: https://dspace.unitru.edu.pe/bitstream/handle/UNITRU/17473/CabreraRojas_L.pdf?sequence=3&isAllowed=y
7. Aparcana-Pisconte EJ, Ybaseta-Medina J. Retardo del crecimiento fetal: diagnóstico y manejo obstétrico. Rev méd panacea [Internet]. 2020 Sep-Dic [citado 03 Mar 2022];9(3). Disponible en: https://revistas.unica.edu.pe/index.php/panacea/article/view/376
8. Hernández Herrera R, Flores Santos R, Martínez-Marrufo AM, Chávez-Cruz O. Retardo grave en el crecimiento intrauterino en un neonato de 480 g al nacer. Bol Med Hosp Infant Mex [Internet]. 2010 Sep-Oct [citado 30 Ene 2022];67(5). Disponible en: https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-11462010000500008
9. Bhunwal S, Mukhopadhyay K, Bhattacharya S, Dey P, Dhaliwal LK. Bronchopulmonary Dysplasia in Preterm Neonates in a Level III Neonatal Unit in India. Indian Pediatr [Internet]. 2018 Mar [citado 04 Mar 2022];55(3):211-15. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29242415/
10. Brener Dik PH, Niño Gualdron YM, Galletti MF, Cribioli CM, Mariani GL. Displasia broncopulmonar: incidencia y factores de riesgo. Arch argent pediatr [Internet]. 2017 Oct [citado 31 Ene 2022];115(5). Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S0325-00752017000500012&lng=es
11. Diggikar S, Aradhya AS, LokanadhaReddy V, Jaganathan P, Mulage L. Risk Factors for Bronchopulmonary Dysplasia in a Level-III Neonatal Unit. Indian J Pediatr [Internet]. 2021 [citado 31 Ene 2022];88:497-8. Disponible en: https://doi.org/10.1007/s12098-021-03664-1
12. Dong D, Ru X, Huang X, Sang T, Li S, Wang Y, et al. A prospective cohort study on lactation status and breastfeeding challenges in mothers giving birth to preterm infants. Int Breastfeed J [Internet]. 2022 [citado 06 Mar 2022];17:6. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751123/
Published
How to Cite
Issue
Section
License
Copyright: Camagüey Medical Archive Magazine, offers immediately after being indexed in the SciELO Project; Open access to the full text of the articles under the principle of making available and free the research to promote the exchange of global knowledge and contribute to a greater extension, publication, evaluation and extensive use of the articles that can be used without purpose As long as reference is made to the primary source.
Conflicts of interest: authors must declare in a mandatory manner the presence or not of conflicts of interest in relation to the investigation presented.
(Download Statement of potential conflicts of interest)
The Revista Archivo Médico de Camagüey is under a License Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 International (CC BY 4.0).
This license allows others to distribute, to mix, to adjust and to build from its work, even for commercial purposes, as long as it is recognized the authorship of the original creation. This is the most helpful license offered. Recommended for maximum dissemination and use of licensed materials. The full license can be found at: https://creativecommons.org/licenses/
22 julio 2025