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International Journal of Trend in Scientific Research and Development (IJTSRD)
Volume 7 Issue 1, January-February 2023 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470
@ IJTSRD | Unique Paper ID – IJTSRD52699 | Volume – 7 | Issue – 1 | January-February 2023 Page 375
Pierre Robin Syndrome: A Case Report
Parimala L1
, Kathiravan N2
1
Professor cum Vice Principal, Saveetha College of Nursing,
2
M.Sc (N) – NPCC II Year, Saveetha College of Nursing,
1,2
SIMATS, Saveetha University, Thandalam, Chennai, Tamil Nadu, India
ABSTRACT
Pierre-Robin syndrome (PRS) is characterized by micrognathia,
ptosis, and palatal malformations. Infants often have immature
mandibles and difficulty breathing. A small lower jaw pushes the
tongue backward, leading to PRS. A wide, U-shaped cleft palate is
also commonly associated with this abnormality. PRS is not just a
syndrome, it is a range of disorders, one abnormality leading to
another. We report the case of a 10-day- old neonate who complained
of malnutrition and dyspnea and was later diagnosed with Pierre-
Robin syndrome (PRS).
KEYWORDS: Cleft palate, Micrognathia, Glossoptosis, Pierre Robin
Syndrome
How to cite this paper: Parimala L |
Kathiravan N "Pierre Robin Syndrome:
A Case Report" Published in
International
Journal of Trend in
Scientific Research
and Development
(ijtsrd), ISSN:
2456-6470,
Volume-7 | Issue-1,
February 2023,
pp.375-376, URL:
www.ijtsrd.com/papers/ijtsrd52699.pdf
Copyright © 2023 by author (s) and
International Journal of Trend in
Scientific Research and Development
Journal. This is an
Open Access article
distributed under the
terms of the Creative Commons
Attribution License (CC BY 4.0)
(http://creativecommons.org/licenses/by/4.0)
INTRODUCTION
Pierre Robin Syndrome (PRS) is characterised with
the aid of using triad of micrognathia, glossoptosis
and cleft palate. Pierre Robin Sequence is taken into
consideration to be a nonspecific anomalad which can
also additionally arise both as an remoted disorder or
as a broader organization of malformations. In 1923
French medical doctor Pierre Robin brought the term
`glossoptosis`in affiliation with micrognathia. In 1934
he suggested an affiliation with cleft palate and this
constellation of findings changedinto later termed as
syndrome. The Pierre-Robin Syndrome (PRS) is a
unprecedented malformating pathology and its
anticipated frequency is about 1/30000. Some familial
instances have additionally been suggested, which can
also additionally suggest that a few instances have an
inherited basis.
Case Description
We report the case of a 10-day-old neonate of AGA
(of childbearing age) of35 ± 2 weeks' gestation/(2.35
kg) LBW (low birth weight), born to a 27-year-old
mother. The patient presented to the Department of
Pediatrics, Saveetha Medical College and Hospital,
Chennai, Tamil Nadu, with symptoms of feeding and
breathing difficulties.
About collecting exhaustive and detailed histories, It
turned out that the mother had complained of
hyperemesis gravidarum early in her pregnancy. Her
prenatal ultrasound revealed oligohydramnios with an
amniotic fluid index (AFI) of 6. Upon careful
examination of the patient, micrognathia, a “U”-
shaped cleft palate, and ptosis were observed (Figure
1, Figure 2, Figure 3). With a head circumference of
32 cm, a length of44 cm, and a chest circumference of
29 cm, she had a new Ballard score of 32.
Respiratory examination observed mild intercoastal
and substernal recession. On examination of the
central nervous system, the newborn's reflexes were
blunted. No murmurs were detected on cardiovascular
examination. Sepsis screening was normal.
Two-dimensional echocardiography was found to be
normal. Ophthalmologic examination was normal.
Breastfeeding in a prone or lateral position provides
comfort to the patient. In our case, noartificial airway
was required. No family history was reported and was
the first birth orderwithout siblings.
IJTSRD52699
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD52699 | Volume – 7 | Issue – 1 | January-February 2023 Page 376
Figure 1: Showing U shaped claft palate Figure 2: Showing micrognathia Figure 3: Showing
glossoptosis
Discussion
Pierre Robin syndrome, also known as Pierre Robin
chain, or Robin anomaly, is characterized by varying
degrees of severity of micrognathia, bullous disease,
and palatal deformity. In this malformation, the size of
the tongue remains normal but bilateral asymmetry
due to microbiology, increased opacity is often
observed.
The word "sequence" suggests that one abnormality
leads to the next, and micrognathia is considered to be
the cause abnormality in PRS patients. Airway
obstruction and feeding difficulties occur and the
severity of problems varies.
PRS can occur alone or in combination with other
syndromes such as Stickler syndrome, myocardial
syndrome. Therefore, a geneticist should be consulted
to find out the likelihood of this occurring in future
children. In about 30% of cases, PRS may be a single
event, while in the next 30%, it is associated with
other malformations and in thelast third of cases it is
part of a complex syndrome. more complex (usually
Stickler syndrome). This diversityof manifestations is
the result of a mixed genetic origin: in 40% of cases,
PRS is genetically isolated, otherwise it is autosomal
recessive or autosomal dominant. In our case, no
association with other abnormalities was observed.
Whatever the cause, infants and infants with Pierre
Robin sequence can have varying degrees of airway
obstruction and feeding difficulty. PRS can be life-
threatening in the neonatal period with the onset of
airway obstruction, which can occur any time soon
after birth. If left untreated, persistent airway
obstruction can lead to acute or chronic hypoxia,
cyanosis, apnea, aspiration, respiratory infection,
difficulty feeding, malnutrition, and growth
retardation. . Later complications of chronic hypoxia
are chronic carbon dioxide retention, increased
pulmonary vascular resistance, arrhythmias, right-
sided heart failure, and cerebral hypoxia.
Most patients with PRS are in remission with
conservative measures, but those with marked
micrognathia, growth retardation, prolonged
nasopharyngeal use, or prolonged intubation require
surgical correction. As in our case, conservative
measures were sufficient to control the infant's
symptoms.
Conclusion
All cases of PRS should be thoroughly investigated to
diagnose association with other syndromes and to
determine further treatment strategies. Each individual
case of PRS is unique and should be evaluated
individually. It is our responsibility as physicians to
recognize this disorder in a timely manner and to
provide closefollow-up and appropriate treatment and
advice.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: Not required
References
[1] Gupta R, Patel M, Bajaj N. Pierre Robin
syndrome: a case report. Int J Res Med Sci
2015; 3:3432-4.
[2] Cristiano C. Oliveira; Maria Aparecida C.
Domingues. Pierre Robin sequence: case report,
the relevance ofautopsy J Bras Patol Med Lab
2015, v. 51, n. 5, p. 335-338.
[3] Pramod Sharma, Kanishka Navin Guru, Kapil
Malviya. Pierre Robin syndrome: A case report
and review of literature and multidisciplinary
approach in management updates. International
Journal of Medical and Dental Case Reports
(2018), Article ID 220818, 6 Pages.
[4] Thakkar NV, Bhatt MJ. Pierre robin syndrome:
Rehabilitation of a neonate for nursing with a
palatal obturator. J Indian Prosthodont Soc.
2005; 5:208-10.
[5] Hsieh Y, Chang C, Tsai H, Yang TC, Lee CC,
Tsai CH. The prenatal diagnosis of Pierre-
Robin sequence.Prenat Diagn. 1999; 19:567-9.

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Pierre Robin Syndrome A Case Report

  • 1. International Journal of Trend in Scientific Research and Development (IJTSRD) Volume 7 Issue 1, January-February 2023 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470 @ IJTSRD | Unique Paper ID – IJTSRD52699 | Volume – 7 | Issue – 1 | January-February 2023 Page 375 Pierre Robin Syndrome: A Case Report Parimala L1 , Kathiravan N2 1 Professor cum Vice Principal, Saveetha College of Nursing, 2 M.Sc (N) – NPCC II Year, Saveetha College of Nursing, 1,2 SIMATS, Saveetha University, Thandalam, Chennai, Tamil Nadu, India ABSTRACT Pierre-Robin syndrome (PRS) is characterized by micrognathia, ptosis, and palatal malformations. Infants often have immature mandibles and difficulty breathing. A small lower jaw pushes the tongue backward, leading to PRS. A wide, U-shaped cleft palate is also commonly associated with this abnormality. PRS is not just a syndrome, it is a range of disorders, one abnormality leading to another. We report the case of a 10-day- old neonate who complained of malnutrition and dyspnea and was later diagnosed with Pierre- Robin syndrome (PRS). KEYWORDS: Cleft palate, Micrognathia, Glossoptosis, Pierre Robin Syndrome How to cite this paper: Parimala L | Kathiravan N "Pierre Robin Syndrome: A Case Report" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-1, February 2023, pp.375-376, URL: www.ijtsrd.com/papers/ijtsrd52699.pdf Copyright © 2023 by author (s) and International Journal of Trend in Scientific Research and Development Journal. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (http://creativecommons.org/licenses/by/4.0) INTRODUCTION Pierre Robin Syndrome (PRS) is characterised with the aid of using triad of micrognathia, glossoptosis and cleft palate. Pierre Robin Sequence is taken into consideration to be a nonspecific anomalad which can also additionally arise both as an remoted disorder or as a broader organization of malformations. In 1923 French medical doctor Pierre Robin brought the term `glossoptosis`in affiliation with micrognathia. In 1934 he suggested an affiliation with cleft palate and this constellation of findings changedinto later termed as syndrome. The Pierre-Robin Syndrome (PRS) is a unprecedented malformating pathology and its anticipated frequency is about 1/30000. Some familial instances have additionally been suggested, which can also additionally suggest that a few instances have an inherited basis. Case Description We report the case of a 10-day-old neonate of AGA (of childbearing age) of35 ± 2 weeks' gestation/(2.35 kg) LBW (low birth weight), born to a 27-year-old mother. The patient presented to the Department of Pediatrics, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, with symptoms of feeding and breathing difficulties. About collecting exhaustive and detailed histories, It turned out that the mother had complained of hyperemesis gravidarum early in her pregnancy. Her prenatal ultrasound revealed oligohydramnios with an amniotic fluid index (AFI) of 6. Upon careful examination of the patient, micrognathia, a “U”- shaped cleft palate, and ptosis were observed (Figure 1, Figure 2, Figure 3). With a head circumference of 32 cm, a length of44 cm, and a chest circumference of 29 cm, she had a new Ballard score of 32. Respiratory examination observed mild intercoastal and substernal recession. On examination of the central nervous system, the newborn's reflexes were blunted. No murmurs were detected on cardiovascular examination. Sepsis screening was normal. Two-dimensional echocardiography was found to be normal. Ophthalmologic examination was normal. Breastfeeding in a prone or lateral position provides comfort to the patient. In our case, noartificial airway was required. No family history was reported and was the first birth orderwithout siblings. IJTSRD52699
  • 2. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD52699 | Volume – 7 | Issue – 1 | January-February 2023 Page 376 Figure 1: Showing U shaped claft palate Figure 2: Showing micrognathia Figure 3: Showing glossoptosis Discussion Pierre Robin syndrome, also known as Pierre Robin chain, or Robin anomaly, is characterized by varying degrees of severity of micrognathia, bullous disease, and palatal deformity. In this malformation, the size of the tongue remains normal but bilateral asymmetry due to microbiology, increased opacity is often observed. The word "sequence" suggests that one abnormality leads to the next, and micrognathia is considered to be the cause abnormality in PRS patients. Airway obstruction and feeding difficulties occur and the severity of problems varies. PRS can occur alone or in combination with other syndromes such as Stickler syndrome, myocardial syndrome. Therefore, a geneticist should be consulted to find out the likelihood of this occurring in future children. In about 30% of cases, PRS may be a single event, while in the next 30%, it is associated with other malformations and in thelast third of cases it is part of a complex syndrome. more complex (usually Stickler syndrome). This diversityof manifestations is the result of a mixed genetic origin: in 40% of cases, PRS is genetically isolated, otherwise it is autosomal recessive or autosomal dominant. In our case, no association with other abnormalities was observed. Whatever the cause, infants and infants with Pierre Robin sequence can have varying degrees of airway obstruction and feeding difficulty. PRS can be life- threatening in the neonatal period with the onset of airway obstruction, which can occur any time soon after birth. If left untreated, persistent airway obstruction can lead to acute or chronic hypoxia, cyanosis, apnea, aspiration, respiratory infection, difficulty feeding, malnutrition, and growth retardation. . Later complications of chronic hypoxia are chronic carbon dioxide retention, increased pulmonary vascular resistance, arrhythmias, right- sided heart failure, and cerebral hypoxia. Most patients with PRS are in remission with conservative measures, but those with marked micrognathia, growth retardation, prolonged nasopharyngeal use, or prolonged intubation require surgical correction. As in our case, conservative measures were sufficient to control the infant's symptoms. Conclusion All cases of PRS should be thoroughly investigated to diagnose association with other syndromes and to determine further treatment strategies. Each individual case of PRS is unique and should be evaluated individually. It is our responsibility as physicians to recognize this disorder in a timely manner and to provide closefollow-up and appropriate treatment and advice. Funding: No funding sources Conflict of interest: None declared Ethical approval: Not required References [1] Gupta R, Patel M, Bajaj N. Pierre Robin syndrome: a case report. Int J Res Med Sci 2015; 3:3432-4. [2] Cristiano C. Oliveira; Maria Aparecida C. Domingues. Pierre Robin sequence: case report, the relevance ofautopsy J Bras Patol Med Lab 2015, v. 51, n. 5, p. 335-338. [3] Pramod Sharma, Kanishka Navin Guru, Kapil Malviya. Pierre Robin syndrome: A case report and review of literature and multidisciplinary approach in management updates. International Journal of Medical and Dental Case Reports (2018), Article ID 220818, 6 Pages. [4] Thakkar NV, Bhatt MJ. Pierre robin syndrome: Rehabilitation of a neonate for nursing with a palatal obturator. J Indian Prosthodont Soc. 2005; 5:208-10. [5] Hsieh Y, Chang C, Tsai H, Yang TC, Lee CC, Tsai CH. The prenatal diagnosis of Pierre- Robin sequence.Prenat Diagn. 1999; 19:567-9.