Aim To study the influence of cystic fibrosis (CF) on intrauterine growth of the fetus, newborn and infant child with CF, from CF mother.
Methods We used tests such as sweat test and the molecular diagnostic tests, spirometry, sputum bacteriological examination, HRCT, to assess the pulmonary distress and faecal elastase, for determining the degree of exocrine pancreatic insufficiency to a CF pregnant and her child to confirm CF and health assessment. For monitoring the evolution of pregnancy was performed simple and Doppler ultrasound examination.
Results We report a case of CF female, born in 1992, with CFTR genotype F508del/F508del. She got pregnant at 22 years old, being on a CF stage associated with COPD (from 11 years old), bilateral saccular bronchiectasis, multiple air cysts of the right upper lobe, pulmonary fibrosis, chronic pulmonary infection with Ps.aeruginosa, B.cepacia, St.maltophilia, II degree chronic respiratory failure, exocrine pancreatic insufficiency associated with growth severe disorders (weight – 43 kg, height – 158 cm, BMI – 17,22).
During pregnancy the fetus suffered intrauterine chronic hypoxia, chronic placental insufficiency and intrauterine growth retardation (IUGR), induced by severe chronic respiratory failure of pregnant women, due to uncontrolled pulmonary complications.
At the term of 35 gestation weeks, by planned caesarean section, was born a boy, with a body mass of 1470 g, height 40 cm, head circumference 29 cm, thoracic circumference 23 cm, Apgar score 7/8.
The clinical examination of the newborn found IUGR, with a weight and stature deficiency. In the first month of life, a newborn was diagnosed with CF, by determining the mutation F508del/F508del, faecal elastase-1<200 µg/g. The imaging examination of the child showed no pulmonary and abdominal organ pathologic changes. In the neonatal period the child administrates treatment with Creon 1,000 IU/kg, with gradual increase up to 5000–8000 IU/kg/24 hour. During the first 3 weeks the child has gained 210 g, at the age of 3 months his body mass was 2600 g, and at the age of 1 year – 10 kg, 2 years – 12 kg, 3 years – 14 kg.
Conclusion The pregnancy in the patient with a severe form of CF, with chronic pulmonary destructive changes, height and weight severe deficiencies passes with complications and negative impacts upon the child with chronic intrauterine hypoxia, IUGR, highly marked morphological and functional immaturity, which was caused from impact by CF of the child too.
- Cystic Fibrosis
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