Fetal Gallstones in a Newborn after Maternal COVID-19 Infection

Fetal gallstones are rare incidental findings on ultrasound during pregnancy. We describe a newborn girl with gallstones that was born to a mother who had COVID-19 infection during her last trimester. The baby remained asymptomatic, and the stones resolved spontaneously without any treatment or complications within six weeks of birth. Several conditions predispose to fetal gallstones, and it is unclear if the recent maternal COVID-19 infection had any role in the occurrence of these abnormalities or was merely coincidental. This is the first case describing an association of fetal gallstones with a COVID-19 infection in pregnancy.

Computed Tomography-Guided Percutaneous Drainage of Pneumomediastinum in a Newborn: A Case Report

Background: Neonatal pneumomediastinum is seen in 2.5 per 1000 live births and mostly managed conservatively. An intervention is essential in cases with tension pneumomediastinum. Ultrasonography-guided (USG-guided) relief of pneumomediastinum has been reported in newborns. There are no reported cases of computed tomography-guided (CT-guided) drainage of pneumomediastinum in neonates. Case report: A newborn girl born at 34 week of gestation was intubated due to respiratory distress and received intratracheal surfactant treatment. Pneumomediastinum was detected at the chest X-ray on the 6th postnatal hour. On the second postnatal day, the patient's oxygen needs increased, tachypnea and subcostal retractions recurred, so it was decided to intervene. USG-guided drainage of the pneumomediastinum was attempted twice but was unsuccessful. Percutaneous drainage with CT guidance was performed successfully. Conclusion: This report aims to emphasize that CT-guided intervention of pneumomediastinum can be an effective alternative in a newborn if USG-guided intervention fails.

Congenital epignathus associated with a cleft palate: a case report

Background Epignathus is a rare, benign, congenital teratoma of the hard palate with an estimated incidence of 1 in 200,000 live births. Epignathus frequently leads to a high mortality (80–100%) due to airway obstruction in the neonatal period. Case presentation We report a case of successful management of a rare oropharyngeal teratoma in a African newborn girl who was referred to our institute with a large protruding intraoral mass, combined with cleft palate, causing some respiratory compromise. The palatal mass was removed on the fifth day after birth, and a palatoplasty performed on day 30. Conclusion Epignathus is a life-threatening condition at the time of delivery. Appropriate management begins with securing the airway, followed by complete resection of the tumor.

Anal membrane: varied presentations

An anal membrane is categorized as a low anorectal malformation and is noted under rare malformations in the International classification. It is very rare and may present variedly in different age groups and only a handful of cases have been ever described. It is one of the few anorectal malformations in which the anal canal is at a normal position, thus concealing itself from an attendant who is not suspicious. We present two cases of anal membrane. A newborn girl presenting at birth was treated by primary excision of the membranes. The second case was a 2 year boy with chronic constipation with an obstructive web of a persistent ruptured anal membrane. Both were short procedures with almost no morbidity. Both the cases would have been diagnosed earlier if the primary attendant had done a rectal examination. There was good post-operative outcome in terms of continence and constipation in both the cases. Neither of them needed any anal dilatations. Anal membrane is a rare low anorectal malformation which needs keen suspicion for diagnosis. It is easy to miss it if the attendant omits a rectal examination. Therefore, it is imperative to do a rectal examination of all neonates with non-passage of meconium and as well as children with chronic constipation.

Diagnostics and treatment of Herlyn–Werner–Wunderlich syndrome in a newborn girl

Herlin-Werner-Vanderlich syndrome refers to the Müllerian duct anomalies, including uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. At the first stage of treatment, a reasonable intervention is opening the hemivaginal septum by extra-vaginal access under visual control or using vaginoscopy. We identified a rare variant of the defect identified, since the longitudinal septum of the hemivagina did not prolapse through the introinus, which required a complex diagnosis and surgical aid in the newborn. A significant volume of hydrometrocolpos was associated with the accumulation of urine from the right hypoplasmic kidney with an abnormal flow of the ectopic ureter into the cavity of the atresized vagina. It determined the need for surgical treatment for urgent indications. In this regard, a biochemical analysis of the fluid obtained after drainage of the hydrometrocolpos with the detection of the concentration of urea, creatinine, total protein, and cellular composition is mandatory.