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Case report--a neonate with nonimmune hydrops fetalis
S P Ram1, W A Ariffin, Z Kassim
1Department of Paediatrics, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan.
Singapore Medical Journal
|October 1, 1993
Summary
A neonate presented with severe congenital syphilis, leading to fetal hydrops, anemia, and bone abnormalities. Despite resuscitation, the infant succumbed to overwhelming sepsis within hours of birth.
Area of Science:
- Neonatal Medicine
- Pediatric Infectious Diseases
- Medical Genetics
Background:
- Congenital syphilis poses significant risks to newborns, including intrauterine growth retardation and stillbirth.
- Early diagnosis and intervention are crucial for managing congenital syphilis and its complications.
Observation:
- A male infant born via Caesarean section exhibited severe asphyxia, hydrops fetalis (anasarca), anemia, purpura, and massive hepatosplenomegaly.
- Radiographic findings included ascites and bilateral metaphysitis of the long bones.
- Laboratory results revealed profound anemia (Hb 5.0 gm/dl), prolonged prothrombin time (PT) and partial thromboplastin time (PTT), and a negative Coombs' test.
Findings:
- Both the neonate and mother tested positive for Venereal Disease Research Laboratory (VDRL) and Treponema pallidum hemagglutination assay (TPHA) tests, confirming congenital syphilis.
- The infant's condition rapidly deteriorated due to overwhelming sepsis, severe anemia, and disseminated intravascular coagulation (DIC).
Implications:
- This case highlights the severe manifestations and high mortality associated with untreated or advanced congenital syphilis.
- It underscores the importance of maternal syphilis screening and timely neonatal management to prevent fatal outcomes.