. UniverThere is some data to suggest that amniotic fluid (AF) Three infants with congenital chylothorax have recently presented. Two of these were full-term females and the third was a 36 week male. Each pregnancy was uncomplicated and had spontaneous vertex vaginal deliveries.Immediately after birth each infant had severe respiratory distress requiring intubation and ventilation. Each showed significant edema limited to the chest wall and trunk with no other physical anomalies.The chest x-ray in each case revealed large bilateral pleural effusions. Chest tubes were inserted and >200 cc of serous fluid containing >3,000 W B C (~~% lymphs) was drained from each thorax.With the removal of the fluid, 2 of the 3 infants improved markedly with both edema and respiratory distress resolving within 5 days. There was no recurrence of fluid even after feedings were begun. The premature male continued to require maximal respiratory support and died of respiratory failure at 12 days. The histopathology of his lung revealed changes consistent with bronchopulmonary dysplasia.In summary, congenital chylothorax must be considered in a newborn with respiratory distress, pleural effusions and edema limited to the thorax and abdomen. In order to assess the effect ot place of'birth'on the survival of the VLBW infant the population of an entire county was studied. All premature infants born during the 1977-79 calendar years and whose birth weights were between 500 and 1250 gms. were included. These babies were delivered at either the Ohio State Regional Pednatal Center(0SU-RPC)or the maternity services of the five general hospitals located in the county. Labor and delivery room records and data from the Dept.of Vital Statistics were reviewed and compared. Mortality rates were studied in relation to place of birth and source of ultimate neonatal care (nennatal tranannrt).
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