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BAYI BARU LAHIR

ABNORMAL
Afrilia Intan Pratiwi
12176
Noor Adibah Hanum Che Hashim12299
Meita Ucche
12122
Zamrina Adilafatma
12159

Kasus

Bayi laki-laki lahir dari ibu P1A0 dengan
UK 36+1 minggu, spontan, tidak
langsung menangis, air ketuban jernih,
resusitasi sehingga langkah awal,
dengan berat badan lahir 2550 gram,
Apgar Score 6/8

Riwayat Perkembangan
Penyakit
2 jam setelah lahir:
Bernapas cepat & dalam (takipnea) >
60 x/menit
Napas cuping hidung/nasal flare
Retraksi interkostal
Mulut dan hidung sianosis
Grunting

.Diagnosis TTN memiliki gejala yang mirip dengan gangguan pernapasan lain yang berat pada bayi pneumonia  hipertensi pembuluh darah paru-paru   foto rontgen untuk menegakkan diagnosis.

Infiltrate difus di lapang paru Over inflated Perihilar streaking  retensi cairan paru .

Definisi  gangguan pernapasan pada bayi baru lahir yang berlangsung singkat short-lived (< 24 jam) self-limited  terjadi sesaat setelah / beberapa jam setelah kelahiran prematur & matur .

faktor risiko : Lahir secara secar Lahir dari ibu dengan diabetes Lahir dari ibu dengan asma Small for gestational age .Penyebab    wet lungs atau respiratory distress syndrome tipe II tidak dapat didiagnosis sebelum lahir.

Patophysiologi sisa cairan yang masih terdapat di paruparu pengeluar an cairan dari paruparu terlalu lambat bernapa s lebih cepat dan lebih dalam .

Respiratory Distress Syndrome   clinical Dx. interchanged terms Hyaline Membrane Disease (pathological diagnosis) and Surfactant Deficiency (typical appearances on radiographs of infants with RDS) Small typical radiological featuresvolume lungs of Surfactant Deficiency: Homogenous Air "ground bronchogram glass" s opacity .

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• heart is all but obscured by the diffuse. homogenous lung fields • intubated • umbilical catheters in situ .

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infection should be considered in the differential diagnosis.Transient Tachypnoea of the Newborn (TTN)  also called Retained Fetal Lung Fluid or “Wet Lung” is a diagnosis of exclusion  *Because the symptoms and radiological features are non-specific. . respiratory symptoms resolve within the first 24-hours of life. but occasionally can persist longer.  Typically.

interstitia t ("staraeration l and interloba burst" pleural r fissures appearan fluid ce) Cardiomegaly .Typical radiologic features are illdefined but include Increase d central Evidence vascular of Prominen markings Hyper.

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infection should be included on the differential diagnosis. *Because the symptoms and radiological features are non specific.Meconium Aspiration Syndrome      occurs in about 12% of deliveries defined by meconium aspirated from below the vocal cords presents as respiratory distress and cyanosis pulmonary hypertension is common. .

Radiographic Features Coarse infiltrates Widespread consolidation Pleural effusions Hyperinflation Pneumothorax and pneumomedias tinum .

.bilateral patch opacity with hyperinflatio n (although not severe).

• air leak with a prominent mediastinal lucency • free air at the bases • patchy opacity of the lung fields .

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it is most commonly associated with a patent ductus arteriosus causing haemorrhagic pulmonary oedema other causes include :     surfactant administration (perhaps from a rapid change in compliance resulting in an increase in the size of the left-to-right shunt. with a catastrophic collapse.Pulmonary Haemorrhage     relatively common in neonates dramatic in its onset. or it can be more subtle with blood-tinged endotracheal secretions in preterm infants. and haemorrhagic oedema) airway haemangiomata (rare) any cause of pulmonary congestion (for example.  The PEEP should generally be increased in an attempt to maintain high mean airway pressures so that oedema is forced back into the pulmonary vascular bed . severely reduced left ventricular function in an asphyxiated or septic term infant) Babies frequently require a significant increase in their ventilatory support.

although appearanc es can be normal .• nonspecific in appearanc e • commonly demonstra te patchy infiltrates.

and cardiomegaly (from cor pulmonale) . irregular fibrous streaks. with a bubbly appearance Stage 4 consisted of a inhomogenous appearance with hyperinflation. bleb formation.Neonatal Chronic Lung Disease   a sequel of significant lung disease in the immediate newborn period four stages :     Stage 1 was the homogenous appearance of RDS Stage 2 was a generalised opacity. frequently seen towards the end of the first week of life Stage 3 marked the onset of chronic changes.

initially more marked on the right but then more widespread a few days later .8 and 12 days in a baby born at 25 weeks  lung fields show a coarse bubbly appearance.

lung fields are generally "bubbly" and "streaky" with localised areas of hyperaeration in the right lower lobe and left lower lobe .advanced Stage 4 CLD .

and antibiotics should be given at least until cultures are proven negative .Water Aspiration   chest radiographs  not specific but frequently demonstrate pleural effusions and patchy alveolar infiltrate infection must be considered in the DDx.

.  pleural effusions and patchy alveolar infiltrate .

in this case. and oedema cause  congenital chylothorax . bilateral pleural effusions. ascites.Hydrops  fluid in at least two body cavities   with hydrops .

appearance after birth • generalised oedema • bilateral huge pleural effusions • right lung is seen as the (small) lucent area slightly crossing the midline • appearance of central gas in the abdomen. suggesting the presence of ascites .

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.appearance 3 days after birth • dramatic reduction in the subcutaneous oedema • bilateral pleural effusions remain.