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XVII Annual Conference of IAP Maharashtra State (Mahapedicon 2006, Solapur, 3-5th November 2006)
Dr. Atul Kulkarni, M.D.(Paed), Dr. Anwar Patel, Resident,
Department of Pediatrics, Ashwini Sahakari Rugnalaya & Research Centre, Solapur.
A full term, normal vaginally delivered neonate brought to NICU was born to a 24 years primigravida. The baby had history of delayed cry after birth and presented with gasping respiration.
Baby had oxygen saturation 70%, HR-172/min, with systolic BP 50 mm of Hg, Mean BP 30 mm of Hg. The birth weight was 2.8 kg, peripheral pulses poorly felt, heart sounds were muffled, poor perfusion.
The abdomen was soft with 3 cm palpable liver. Patient had to be put on ventilator. On investigating, Blood counts normal CRP Negative, the Chest X-ray showed huge cardiomegaly. The echocardiography revealed an isolated pericardial effusion, without any other cardiac anomalies. The blood counts were within normal limits, USG had no evidence of ascites, pleural effusion and both kidneys were normal LFT normal.
The blood gas analysis showed mix metabolic and respiratory acidosis. Emergency pericardial tapping was done, draining about 120cc of clear fluid. After cytological and biochemical analysis fluid was found to be of transudative in nature. The TORCH titre was negative, nor any evidence of chylous fluid seen.
Patient was ventilated for 4 days, he developed pneumothorax during pericardiocentesis, for which ICD was put. A child survived well without any recurrence, now the child is 5 years old and doing well.
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