Case 3: Abdominal Distention and Gastrointestinal Bleeding in a Late Preterm Neonate

Abstract

A late preterm female neonate is born at 34 weeks, 6 days of gestation, with a birthweight of 2.1 kg. The mother is a gravida 2 woman and the infant is delivered via cesarean section in view of scar dehiscence. The infant cries immediately after birth and does not require any resuscitation. She develops respiratory distress in the delivery room, is transferred to the NICU, and given continuous positive airway pressure (CPAP). She is comfortable with CPAP and is gradually weaned to room air 48 hours after birth. On the third day after birth, tube feeding is commenced at 20 mL/kg per day. However, the next day she develops abdominal distention, gastrointestinal bleeding, and melena for which feeding is stopped. There is no history of treatment with steroids or nonsteroidal anti-inflammatory drugs. On the same day, she is transferred to a level IIIB NICU for further management. On admission to the institute, the infant is lethargic and tachypneic. Blood pressure and capillary refilling time are in the normal range. The …