Evaluation of pneumothorax in the first month of life.

Abstract

Pneumothorax is relatively more frequent in the first month of life than in other times of life. We aim to analyze the demographics, characteristics, incidence, factors associated, seasonality, treatment modality and mortality of pneumothorax of newborns. The methods that we used were a cross-sectional study of 97 newborns with pneumothorax over a period of 24 months January 2017 and December 2018. The patient's demography and characteristics of delivery were studied. Additional analyses of the incidence, severity, risk factors associated it, monthly and seasonal variation, diagnostic workup, treatment modality and mortality of pneumothorax. Our results show that the pneumothorax was diagnosed in 97newborns with an incidence of 7.1%. 57 were males and 40 were females. 43% were preterm and 57% was the term. The birth weight was normal in 60 newborns. 64% were born inside the hospital. 61% were delivered by cesarean section. Of these, 57% right side, 40% left side and 3% bilateral. Pneumothorax was mild in 11%, 48% moderate and 41% tension. A slight spring and summer preponderance, 19(20%) ,19(20%) occurred in spring (2017,2018 )respectively and 17(18%),18(19%) in summer (2017,2018)respectively . Active resuscitation was the predominant associated factor that occurred in 39%. 97% of pneumothorax required drainage. 21% of newborns died. The highest mortality was observed in severe pneumothorax. We concluded that the incidence of newborns pneumothorax was relatively frequent. Newborns resuscitation should be done very carefully. More studies are needed to investigate the seasonal factors of pneumothorax in the 1st month of life.

Primary spontaneous pneumothorax in a term neonate

“… 5 It is mostly unilateral and commoner on the right side of the lung. 6 Our patient was term male neonate that required no intrapartum resuscitation but developed SP in his right lung at the 1 st day of life. He had no underlying lung pathology and no known risk factor aside male gender.…”

“…However, it results from alveoli rupture either secondary to high pressure needed to expand previously uninflated lungs or from uneven distribution of inflating pressures among the alveoli. 6 Neonatal SP is commoner in premature, postmature and male infants. 5 It is mostly unilateral and commoner on the right side of the lung.…”