A new born baby has been delivered through SVD (SIMPLE VAGINAL DELIVERY) on 23/09/11.
APGAR SCORE was 9.10.10.
Body Weight was 2700 g.
The child has developed vomiting after breastfeeding since 24th September, and he has developed neonatal jaundice.
Bl sugar has been followed up and dextrose 50% given whne there was tendency to hypoglycaemia.
X-Pen and Gentamycin have been given i.v., because of chest congestion (inhalation of liquor?).
The child has been put on Hydrocortison 25 mg TID, and Phenobarbitone 15 mg OD because of jaundice.
Sun bathing has been performed in hospital.
Total bilirubine has reached 18.2 mg/dl, with 6.1 of direct bilirubine.
No anemia was detected, but severe leukocytosis with WBCs about 55000/ml, and piastrinosis with PLTs at 301,000/ml.
The child has been passing little meconium only when stimulated per anus with a thermometer.
On September 25th the new born has developed abdominal distension. We have inserted NGT and we have recovered a huge quantity of meconium-like material.
Fearing intestinal obstruction or aganglionic megacolon, we have referred the patient for barium meal and follow through.
The radiologist says: reflux oesophagitis and partial gastric outlet obstruction.
Because our theatre and our expertize are not enough to ensure a good operation and a proper post op follow up, we have decided to refer the child to the University Hospital of Nairobi.
We sincerely hope he will survive.
Bro Dr Giuseppe Gaido
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