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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
1   Department of Neonatology, Nepean Hospital, Kingswood, New South Wales, Australia
2   School of Women's and Children's Health, Sydney Medical School Nepean, University of Sydney, Kingswood, New South Wales, Australia
3   Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia
,
Kiran Kumar Balegar Virupakshappa
1   Department of Neonatology, Nepean Hospital, Kingswood, New South Wales, Australia
2   School of Women's and Children's Health, Sydney Medical School Nepean, University of Sydney, Kingswood, New South Wales, Australia
,
Bhavesh Mehta
4   Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
5   School of Women's and Children's Health, University of Sydney, New South Wales, Australia
,
Nadia Badawi
4   Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
5   School of Women's and Children's Health, University of Sydney, New South Wales, Australia
› Author Affiliations
Further Information

Publication History

26 July 2018

05 September 2018

Publication Date:
29 October 2018 (online)

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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

Ethical Approval

The article is a case report and does not contain any studies with human or animal participants performed by any of the authors. The scientific report does not reveal patient identity anywhere.


 

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