* A. Hawal1, **S. El Deib2; 1Amina Hospital, Pediatrics & Neonatology, Ajman, United Arab Emirates, 2NMC Royal Hospital, Pediatrics & Neonatology, Abu Dhabi,

United Arab Emirates

Abstract

Background and Aims:

Our Study is a clinical case review that aims to state the evidence-based effect of surgical PDA ligation on the stormy neonatal course with perforated gut in extreme very low birth weight neonates & the strategies guidelines for choosing the preferable & best management for such cases.

Methods:

The study is a clinical case review of a male Preterm(+28 wks), EVLBW (690grams) who was delivered & transferred to NICU because of Prematurity, EVLBW, sever IUGR,RDS & need for respiratory support. Baby presented with large PDA with huge volume overload which medically failed to close, then baby shortly undergo a stormy course of multisystem complications of NEC, multiple sites perforated GUT, periventricular leukomalacia, bacterial & fungal neonatal sepsis, metabolic acidosis, abnormal hematological & coagulation profile. Baby was deteriorated clinically, So, Abdominal exploration surgery with intestinal resections & end–end anastomosis was done urgently & surgical PDA ligation done, after that baby was improved significantly & early feedings was started & gradually increased up to full feedings with a significant clinical improvement in baby’s condition.

Results:

The Study stated the evidence-based effect of the surgical PDA ligation on the stormy neonatal course with perforated gut & multisystem complications in extreme very low birth weight neonates & the strategies guidelines for choosing the preferable & best management for such cases as the surgical PDA ligation is the preferable choice in the management of PDA with big volume overload in EVLBW neonates with multiple complicated course than the medical management with a significant clinical, laboratory & radiological improvement of such cases.

Conclusions:

Prematurity is the single greatest risk factor for multisystem complications & avoidance ofpremature birth is the best way to prevent such problems.2)The role of surgical PDA ligation & its preference than medical management with its significant effect on stormy neonatal course.

Biography

* Dr. Amr I.M. Hawal has his expertise in evaluation and passion in improving the health and wellbeing. His open and contextual evaluation model based on responsive constructivists creates new pathways for improving health care specially in Neonatology field. He has built this model after years of experience in research, evaluation, teaching and administration both in hospital and education institutions. Our case presentation was done in one of the biggest & modern of art & advanced NICU based on tertiary generation level in the region (Latifa Hospital, DHA, Dubai, UAE).