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Intrauterine premature aging with congenital proptosis -dr Shaugi Adugory
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- 1. ALFASHER EYE HOSPITAL Case presentation by:- Dr Shawgi Adugory 9.2011
- 2. CASE PRESENTATION DR SHAWGI MB BS 01 June 2011, a new-born male baby was referred to the eye dept, from the obstetric unit In Alfashir Hospital. neonate born with bilateral proptosis after long labor & difficult forceps delivery .
- 3. Abgar score was done to this neonate and is (8 10) >(Activity (muscle tone)= Active motion=2 >Pulse (heart rate)=88 beats per minute=2 >Grimace (reflex response)= Grimace during suctioning=1 >Appearance (color)= Good color in body with bluish hands & feet=1 >Respiration (breathing) =Good& cry=2
- 4. It was noted that the baby was born with severe proptosis.
- 5. On Examination : full term pregnancy. Weight 2 kg. Bilateral Severe echymosis. Bilateral severe proptosis . Bilateral dry cornea.
- 7. Other Findings: 1. full set of teeth. 2. Rinkled dry skin. 3. Circumcised penis. 4. descended testicles.
- 8. abnormal deviation of gross teeth the fingers
- 9. skin folds circumcised penis
- 10. Presumed Diagnosis: Intrauterine premature aging with congenital proptosis .
- 11. MOTHER’S STORY A 42 years old female. Iliterate housewife from Alfasher. Para 13. All her deliveries at home with midwife with no complications There was no history of similar condition (baby born like her last baby )but have 2 babies died aged 9/12, 3/12 , respectively.
- 13. MANAGEMENT both eyes were washed with ringer lactate drip and then covered by Sterile gauze. patient was admitted & put hypo tear drops & ointment. gentamycin and benzyl penciling injections. intravenous fluids were administered
- 14. Liboratory investigation ; Hb%(2 days after admission is 17 gdl and 22 days later be 12.6 gdl. Hematological finding platelet increase (600 10 /μl)=thrombocytosis.
- 16. First patient suffering from lost breast feeding due to his mother is afraid of him she think that his baby may bite her with his teeth and then he also suffering from difficulty sucking. During course of admission the patient condition has Improved.
- 18. Patient discharge on 12th of July with improve health condition ;his eyes in the orbit but if crying the eyes be outside the orbit and come 2 times for follow up.
- 19. Unfortunately one month later from discharge the baby dead because of dehydration (2 day diarrhea & vomiting) on 12th of august 2011.
Editor's Notes
- Activity (muscle tone)0 — Limp; no movement1 — Some flexion of arms and legs2 — Active motionNewborn APGAR test Watch a newborn APGAR test and find out what the scores mean.Pulse (heart rate)0 — No heart rate1 — Fewer than 100 beats per minute2 — At least 100 beats per minuteGrimace (reflex response)0 — No response to airways being suctioned1 — Grimace during suctioning2 — Grimace and pull away, cough,or sneeze during suctioningAppearance (color)0 — The baby's whole body is completely bluish-gray or pale1 — Good color in body with bluish hands or feet2 — Good color all overRespiration (breathing)0 — Not breathing1 — Weak cry; may sound like whimpering, slow or irregular breathing2 — Good, strong cry; normal rate and effort of breathing