Hernia Diafragmática Congénita Derecha

Abstract

Congenital diaphragmatic hernia is an anomaly that has its origin in the absence or default of the pleuroperitoneal membrane posterolateral and dorsal transverse septum. The defect in the left is usually eliminated by the pericardium, so the majority of hernias have right location. Viscera contained usually are: Columbus, omentum, ileocecal angle, liver and stomach. Has a high morbidity and mortality and is presented in 1 of every 2 000 to 4 000 newly born, usually presented serious complications respiratory by hypoplasia e hypertension pulmonary.

It's a baby of 24 hours of life, male sex, the fourth epic product. Background prenatal: date of last menstruation: 07 / 10 / 2015 (not reliable) mother is performed 4 controls and 1 eco normal, ingested iron more acid folic during all the pregnancy, is placed them 2 doses of vaccine tetanus and not concerns complications during the pregnancy.

Mother of newly born refers output of liquid transvaginal transparent of 12 hours of evolution, cause apparent, aggression on the part of the partner which apparently punched hits level of abdomen, starting from which presents pain abdominal type contraction of moderate intensity. Valuation is performed by OB / GYN which reported pregnant uterus, fetus, transverse, with FCF: 140 x', Vaginal touch: expansion: 3 cm, Borramieto:50%, in addition to an ultrasound scan: in which is observed at the level of fetal abdomen cystic dilatation with the stomach. Index of fluid amniotic: 25. DBP: 41, 5 mm. CC: 338 mm. Abdominal girth: 362 mm Femur length: 72, 5 mm. Approximate weight: 3600g for 40 weeks, positive crystallography. It was decided to terminate pregnancy by Cesarean section receiving newly born male, alive, not vigorous, amniotic fluid abundant 1500cc approximately, based upon previous placenta, is cradle of radiant heat where we proceed to dry, stimulate and aspiring secretions, not observing response starts with good response positive pressure ventilation, rear 5 minutes newborn begins with shortness of breath so it is placed oxygen by Hood closed , there is increase of distress respiratory, but with autonomy respiratory is decides your income to the service of Neonatology with CPAP nasal.

Newborn to stay 24 hours in the area of Neonatology presenting without any improvement respiratory distress, cardiac arrest box is carried out resuscitation advanced neonatal lung cardio that extends for approximately 30 minutes but without reversal of picture is declared the death of the newborn.