PERINATOLOGIYA I PEDIATRIYA.2015.4(64):29-32; doi 10.15574/PP.2015.64.29 
 

Case of prenatal diagnosis and successful treatment of bilateral chylothorax complicated by compression of hypoplastic lungs and asphyxia in neonate 
 

Slepov O. K., Davydova Yu. V., Lukyanova I. S., Ponomarenko O. P., Gladyshko O. P., Kurinnyi S. I., Shypot O. G.

SE «Institute of pediatrics, obstetrics, gynecology of NAMS Ukraine», Kyiv 
 

We described clinical case of successful treatment of congenital bilateral chylothorax complicated by compression of hypoplastic lungs and asphyxia in neonate. Due prenatal diagnosis, before birth, we developed tactics and strategy of treatment of chylothorax, C-section on elective basis, with presence of pediatric surgeons and intesivists. Resuscitation began on the first minute of life, including pleural puncture and chest drain placement bilaterally. Followed by conservative treatment: octreotide, TPN, chest drainage, antibacterial treatment. Proposed tactics and strategy of treatment turned out effective, child discharged on the 54th day of life. During follow-up with pediatric surgeon and pediatrician on SE «IPOG NAMS Ukraine» at the age of 8 month — good treatment effect. 
 

Key words: bilateral chylothorax, prenatal diagnosis, tactics and strategy of treatment, neonate. 
 

REFERENCES

1. Au M, Weber T, Fleming R. 2003. Successful use of somatostatin in a case of neonatal chylothorax. Journal of Pediatric Surgery. 38(7): 1106—1107. http://dx.doi.org/10.1016/S0022-3468(03)00205-7

2. Buttiker V, Fanconi S, Burger R. 1999. Chylothorax in children: guidelines for diagnosis and management. Chest. 116(3): 682—687. http://dx.doi.org/10.1378/chest.116.3.682

3. Wasmuth-Pietzuch A, Hansmann M, Bartmann P et al. 2004. Congenital chylothorax: lymphopenia and high risk of infections. Acta Paediatrica. 93(2): 220—224. http://dx.doi.org/10.1111/j.1651-2227.2004.tb00710.x; PMid:15046278

4. Brissaud O, Desfrere L, Mohsen R et al. 2003. Congenital idiopathic chylothorax in neonates: chemical pleurodesis with povidone iodine (Betadine). Archives of Disease in Childhood Fetal and Neonatal Edition. 88(6): 531—533. http://dx.doi.org/10.1136/fn.88.6.F531; PMCid:PMC1763240

5. Das A, Shah P. 2010. Octreotide for the treatment of chylothorax in neonates. Cochrane Database of Systematic Reviews. Is 9; Art no: CD006388.

6. Sousa P, Leitao H, Camacho M et al. 2010. Idiopathic congenital chylothorax treated with octreotide. BMJ Case Reports. 6: 1136—1140. http://dx.doi.org/10.1136/bcr.06.2009.1950

7. Rasiah S, Oei J, Lui K. 2004. Octreotide in the treatment of congenital chylothorax / S. Rasiah, // Journal of Paediatrics and Child Health. 40(9-10): 585—588. http://dx.doi.org/10.1111/j.1440-1754.2004.00471.x; PMid:15367160

8. Rennie J, Roberton N. 1999. Textbook of Neonatology. 3rd Ed. London: Churchill Livingstone.

9. Estoff JA, Parad RB, Frigoletto FD et al. 1992. The natural history of isolated fetal hydrothorax. Ultrasound Obstet Gynecol. 2: 162—165. http://dx.doi.org/10.1046/j.1469-0705.1992.02030162.x; PMid:12796967