Hamdanul Haque

Group – 7637M2a
Case № 5
A girl from the 1th pregnancy, first delivery, high level of perinatal risk (low placentation, ARVI
with fever, St aureus carrier since the 28th week, colpitis, chronic tonsillitis, preeclampsia since
the 37th week, fetal dystress) was delivered by caesarean section with body weight 3160 g, body
length 52 cm.
The child`s condition at birth is severe: total cyanosis, no vagitus, no breathing, atonia, arreflexia,
sporadic heart beats.
Reanimation measures were given: upper respiratory ways sanation, intubation, ALV, cardiac
compressions, adrenaline and normal saline introduction. On the 10th minute HR grew to
110/minute. The child was transported to the intensive care department, peripheral venous access
was provided and infusion therapy was began.
In 6 hours after birth child manifested with extremities jerking. CBC: WBC - 30х 109/l,
PLT - 160 х 109/l, HGB – 160 g/l. NSG: cerebral edema. X-ray of the lungs: Pneumonia right-
sided focal. Lumbar puncture: neutrophilic cytosis.
What are the reasons of seizures?
1. Infectious damage of CNS due to intranatal infections
2. Hypoxic damage could also be there
Doctor`s tactic
Adequate lung ventilation
adequate brain circulation support trough preventing of systemic hypo- or hypertension,
polycythemia
Anticonvulsant therapy (Phenobarbital is used in the initial dose of 20 mg/kg (within 20-30 min),
with supporting dose of 3-5 mg/kg for 2 input)
Osmotic diuretics for cerebral edema (Mannitol 0.25-1 g/kg IV initially; maintenance dose of
0.25-0.5 g/kg IV q4-6hr)
Antibiotics (amoxicillin with clavulante)