Suggest Treatment For Recurrent Chest Infection

Posted on Tue, 28 Apr 2015

Question: Thank you baby induced into delivery without any medical reason to do so at 37 wks.. Delivered after twelve labor; nuchal cord 1x loosely around neck; immobile; cynotic (blue) and in respiratory distress. resuscitated by pediatrician after 5 minutes after birth to 20 mins. returns to pink status and transferred to NICU (natal intensive care unit) respiratory distress disappears but due to jaundice baby not discharged with mother. After one day released. When home lips turn blue baby having breathing problems returned to hospital on emergency admission. Remains in hospital (12 days) where symptoms re occur on several occasions. discharged. Apena and respiratory distress continues to present day with hospitalizations and operations to relieve condition" Adenoid operation, oxygen tents; monitors ets. Baby born XXXXXXX 28 2012. Question: Is there a medical connection between pre mature delivery and persistent respiratory distress as described thank you for any help you can provide

Answered by Dr. Deepti Verma (41 minutes later)

Brief Answer:
No chance of preterm delivery complications

Detailed Answer:
Hi XXXX, I have gone through your question and understand your concerns. Delivery at or after 37 weeks of gestation is a term delivery, and the baby's lungs have matured by then, so there are no chances of complications of a preterm neonate like respiratory distress or patent ductus arteriosus which can cause respiratory distress and cyanosis in lower limbs.

Repeated respiratory distress with cyanosis ( turning blue) is the most common presentation of the cyanotic heart disease like tetralogy of Fallot, trivialize atresia, transposition of great arteries, and many others.These diseases become symptomatic once the baby is born.

However, respiratory problems including recurrent chest infection can also be present which need to be evaluated.

I would suggest that the child should be evaluated by a paediatric cardiologist so that he can be properly examined, investigated( including echocardiography) and appropriate treatment can be done.

Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Deepti Verma (10 hours later)

Thank you really appreciate your prompt response. We recognize the lung issue but could not the immaturity of the muscles necessary to aid in breathing be caused by the pre mature birth. Baby born XXXXXXX 2012. has had apnea and breathing distress ever since.

Answered by Dr. Deepti Verma (3 hours later)

Brief Answer:
Neurological causes should be ruled out

Detailed Answer:
Hi XXXX, thanks for responding. As I said earlier, birth of a baby at or after37 weeks is not a preterm birth.
Moreover, weakness of the muscles helping in respiration( eg intercostal muscles) is not due to preterm birth, rather the cause of weakness may be genetic causes like spinal muscular atrophy and congenital muscular dystrophy, which can be diagnosed after a proper neurological evaluation.
I would suggest a proper neurological evaluation of the cardiac evaluation of the child is normal.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Raju A.T