Maternal history should be reviewed thoroughly to identify the risk factors associated with congenital pneumonia and for other pathogens, say doctors.

Congenital Pneumonia generally refers to pneumonia that is already established at birth or occurs during the first week of life. It is an inflammatory disease of the lungs which is usually seen in a small proportion of infants. A complication during the labour or delivery process can increase the risk for an infant to have respiratory distress or conditions that mimic congenital pneumonia. To prevent congenital pneumonia, an appropriate management of maternal conditions that can result in an increased risk of infection in neonates should be taken, highlighted doctors at Yashoda Hospitals. Keep reading to understand the causes of pneumonia in newborns, its treatment and prevention.

Cause of Congenital pneumonia

According to doctors at Yashoda Hospitals in Hyderabad, congenital pneumonia is mostly caused by bacterial pathogens associated with early onset sepsis. Any past maternal history of bacterial or viral diseases such as hepatitis viruses, herpes, gonorrhea or syphilis can get transmitted to the infant. So, maternal history should be reviewed thoroughly to identify the maternal risk factors associated with congenital pneumonia and for other pathogens.

The maternal risk factors associated with the perinatal phase includes the premature onset of labour under 37 weeks of gestation, prolonged or premature rupture of membranes, maternal fever and maternal chorioamnionitis. A complication during the labour or delivery process can also increase the risk for an infant to have respiratory distress or conditions that mimic congenital pneumonia.

Prevention of Congenital pneumonia

Doctors at Yashoda Hospitals suggest that a universal screening for all pregnant women with presentation of threatened delivery should be done to prevent congenital pneumonia. In addition, appropriate management of maternal conditions that can result in an increased risk of infection in neonates should be taken.

“The incidence of congenital GBS (Group B streptococcus) associated pneumonia will decrease when the early onset GBS can be identified and prevented. A proper identification of the colonized mother should be done and peripartum antibiotic prophylaxis prior to the delivery should be started,” they said.

Expectant mothers who have had a previous child infected with invasive GBS disease should be counseled about the importance of sharing this information in the medical history in all the subsequent pregnancies as the newborn or infant should be kept under observation, screened and treated for at least 48 hours after the delivery. All prenatal lab screenings should be conducted in order to screen for maternal infection, which is one of the most important prevention strategies, they added.

Treatment of Congenital pneumonia

The doctors explained – The immediate management of a neonate with congenital pneumonia is focused to provide respiratory support to optimize the blood gas exchange, since adequate oxygenation is vital. CPAP may be used for infants with more severe blood gas abnormalities. Empiric antibiotic therapies should be started as soon as possible when congenital pneumonia is suspected. And the culture results are available. Inotropes should be used as clinically indicated. Tracheostomy is required for those infants with long term ventilation. Multi organ dysfunction is seen in infants and should be treated with appropriate choice of antibiotics based on the underlying pathogen.

Case study: A pre-term baby boy with congenital pneumonia

After 7 years of marital bliss, a couple from the Ranga Reddy district in Telangana (Navaneetha and Narender) was blessed with a baby boy, but was born premature. On day 1 of life, the neonate underwent treatment with supplemental oxygen at a local hospital due to severe difficulty in breathing and respiratory distress. As the parents were counseled to receive treatment from a higher centre, the preterm baby was transported to Yashoda Hospital Somajiguda within 30 minutes for advanced treatment.

Thanks to the quick response by a team of 6 consultants led by Dr. Sudha. B, a Senior Consultant Neonatologist from the Pediatric department of the hospital, the baby was revived in a timely manner.

Recounting the diagnosis, Dr. Suresh Kumar, Lead Consultant – Pediatric Critical Care and Pediatrics at Yashoda Hospitals Somajiguda said, “The baby had congenital pneumonia. The baby was put on ventilator support in view of severe difficulty in breathing and was treated with Intravenous (IV) antibiotics and supportive therapy with continuous monitoring by our expert team of nurses. The baby was on invasive ventilation with mechanical ventilator support for 3 days, after which the baby was extubated and supported with CPAP therapy (Continuous positive airway pressure), a non-invasive mode of ventilation and was later put on supplemental oxygen. The baby was on the mother’s feed throughout the stay after which he recovered and was discharged after 7 days of hospital stay.”

A week later after the successful treatment, the infant was found to be doing well having gained weight with regular intake of feed.

This post first appeared on The Health Site

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