komplikasi dan prognosis

18
KOMPLIKASI DAN PROGNOSIS

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komplikasi dan prognosis

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Page 1: Komplikasi Dan Prognosis

KOMPLIKASI DAN PROGNOSIS

Page 2: Komplikasi Dan Prognosis

NECROTIZING ENTEROCOLITIS

Page 3: Komplikasi Dan Prognosis

• Typically occurs in the second to third week of life in premature, formula-fed infants

• 60-80 % terjadi pada bayi prematur• The use of an all human milk diet can lower

the risk of necrotizing enterocolitis (NEC) by 79%.(NECsociety)

Page 4: Komplikasi Dan Prognosis

• NEC most commonly affects the terminal ileum and the proximal ascending colon.

Page 5: Komplikasi Dan Prognosis

An acute inflammatory disease with a multifactorial and controversial etiology

ETIOLOGY

ABNORMAL FLORA

INTESTINAL MUCOSA

IMMATURITY

INNATE GENETIC

PREDISPOTITON

MEDICATION

Page 6: Komplikasi Dan Prognosis

ABNORMAL INTESTINAL FLORA

• Bifidobacteria oligofructose dari ASI. • Susu formula tanpa oligofructose

predominan Clostridial

Page 7: Komplikasi Dan Prognosis
Page 8: Komplikasi Dan Prognosis

• Indomethacin patent ductus arteriosus dapat -- splanchnic vasoconstriction --- impaired intestinal integrity.

• Vitamin E, used to treat retinopathy of prematurity, is known to impair leukocyte function and has been associated with NEC

• The results from a multicenter, prospective, observational study suggest that ranitidine treatment in very low birth weight infants is associated with an increased risk of infections, a 6.6-fold higher risk of NEC, and a significantly higher mortality rate.

Page 9: Komplikasi Dan Prognosis

Bayi preterm

• in the preterm infant, mucosal cellular immaturity and the absence of mature antioxidative mechanisms may render the mucosal barrier more susceptible to injury. Intestinal regulatory T-cell aggregates are a first-line defense against luminal pathogens and may be induced by collections of small lymphoid aggregates, which are absent or deficient in the premature infant.

Page 10: Komplikasi Dan Prognosis

• the classic clinical triad consists of abdominal distension, bloody stools, and pneumatosis intestinalis (train-track lucency configuration).

Page 11: Komplikasi Dan Prognosis

CEREBRAL PALSY&

PERIVENTRICULAR LEUKOMALACIA

Page 12: Komplikasi Dan Prognosis

CEREBRAL PALSY

• Absolute risk of CP was 8.5% among children born at 23 to 27 weeks' gestation, 5.6% at 28 to 30 weeks, 2.0% at 31 to 33 weeks, 0.4% at 34 to 36 weeks, and 0.1% thereafter

Page 13: Komplikasi Dan Prognosis
Page 14: Komplikasi Dan Prognosis

• Imaturitas otak dan vaskuler cerebral palsy• Before term, the distribution of fetal circulation

to the brain results in the tendency for hypoperfusion to the periventricular white matter. Hypoperfusion can result in germinal matrix hemorrhages or periventricular leukomalacia.

Page 15: Komplikasi Dan Prognosis
Page 16: Komplikasi Dan Prognosis
Page 17: Komplikasi Dan Prognosis

• Between weeks 26 and 34 of gestation, the periventricular white matter areas near the lateral ventricles are most susceptible to injury. Because these areas carry fibers responsible for the motor control and muscle tone of the legs, injury can result in spastic diplegia (ie, predominant spasticity and weakness of the legs, with or without arm involvement of a lesser degree).

Page 18: Komplikasi Dan Prognosis