Fetal/Neonatal Pericardial Effusion in Down's Syndrome: Case Report and Review of Literature

Pramod Pharande; Kiran Kumar Balegar Virupakshappa; Bhavesh Mehta; Nadia Badawi

doi:10.1055/s-0038-1675337

American Journal of Perinatology Reports, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · AJP Rep 2018; 08(04): e301-e306
DOI: 10.1055/s-0038-1675337

Case Report

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fetal/Neonatal Pericardial Effusion in Down's Syndrome: Case Report and Review of Literature

Pramod Pharande

¹Department of Neonatology, Nepean Hospital, Kingswood, New South Wales, Australia

²School of Women's and Children's Health, Sydney Medical School Nepean, University of Sydney, Kingswood, New South Wales, Australia

³Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia

,

Kiran Kumar Balegar Virupakshappa

¹Department of Neonatology, Nepean Hospital, Kingswood, New South Wales, Australia

²School of Women's and Children's Health, Sydney Medical School Nepean, University of Sydney, Kingswood, New South Wales, Australia

,

Bhavesh Mehta

⁴Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, New South Wales, Australia

⁵School of Women's and Children's Health, University of Sydney, New South Wales, Australia

,

Nadia Badawi

⁴Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, New South Wales, Australia

⁵School of Women's and Children's Health, University of Sydney, New South Wales, Australia

› Institutsangaben

Abstract

We report a preterm (35 ^4/7 weeks) male neonate with Down's syndrome (DS) diagnosed with isolated pericardial effusion (PE) at 20 weeks of gestation. He was born by precipitous delivery, needed no resuscitation and presented within first 24 hours of life with respiratory distress, anemia due to feto-maternal bleed, hypotension, hepatomegaly, and coagulopathy. Postnatal echocardiography confirmed a 5 mm rim of PE without tamponade, normal cardiac structure, and function. He was stabilized with ventilation, packed red cell, fresh frozen plasma, inotropes (dopamine, dobutamine, and adrenaline), and steroid (hydrocortisone). Subsequent evaluation confirmed hypothyroidism, transient myeloproliferative disorder (TMD), hepatic failure due to fibrosis/cirrhosis with portal hypertension, and steroid sensitive hypotension on two occasions possibly due to adrenal insufficiency. PE completely resolved over 2 weeks. In view of progressively worsening liver failure with ascites and portal hypertension, the family opted for palliation. Literature review has been discussed regarding perinatal onset of PE in DS.

Keywords

Down's syndrome - hypothyroidism - pericardial effusion - steroid - transient myeloproliferative disorder

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References
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