Retardo grave en el crecimiento intrauterino en un neonato de 480 g al nacer / Intrauterine growth retardation in a 480 g neonate at birth

RESUMEN

Introducción. Existen pocos reportes de neonatos vivos de <500g con retardo en el crecimiento intrauterino (RCIU). Caso clínico. Se reporta el caso de un recién nacido con RCIU grave, madre de 30 años, primera gesta, 31 semanas de gestación y oligohidramnios grave, obtenido por cesárea, femenino, de 480 g, talla 30 cm, Apgar de 7-7, recibió oxígeno al 80% por 48 horas y, a partir de entonces, se inicia vía oral y nutrición parenteral. Las IgG e IgM para citomegalovirus y cuerpos de inclusión citomegálica fueron negativos. A los 20 días de vida pesó 500 g, cursó asintomático y toleró bien su fórmula, aumentando hasta los 1 700 g antes de su egreso a los 5 meses. A los 12 meses, con peso de 2.8 kg y retraso en el desarrollo psicomotor de 6 meses para la edad cronológica, no desarrolló retinopatía del prematuro, leucomalacia periventricular ni hemorragia intrancraneal. Conclusión. Se reporta el caso de un neonato de 480 g al nacer, de 31 semanas de gestación, que presenta RCIU grave y retraso en el desarrollo psicomotor. Sin embargo, no presenta leucomacia paraventricular ni hemorragia paraventricular.

ABSTRACT

Background. There are few cases of live neonates with intrauterine growth retardation (IGR) <500 g with a satisfactory outcome, including apparent normal neurodevelopment. Clinical case. We report the case of a female 480 g neonate diagnosed with severe IGR who was the product of a 30-year-old mother. This was the first gestation and delivery was at 31 gestation weeks. The neonate demonstrated severe oligoamnios and was delivered by Cesarean section. Apgar score was 7-7, oxygen was administered at 48 h, and parenteral nutrition and formula for premature infants was initiated. Serum cytomegalovirus IgG and IgM and cytomegalic urine inclusion were all negative. The infant accepted formula and was asymptomatic. She reached 500 g at 20 days of life. At 5 months old, her weight increased to 1 700 g before hospital discharge. Patient was followed-up until 1 year of age. She weighed 2.8 kg and demonstrated a 6-month delay in psychomotor neurodevelopment. It is important to mention that she did not develop retinopathy of prematurity, periventricular leukomalacia or intracranial hemorrhage. Conclusion. The patient presented here was born after 31 weeks gestation with a birth weight of 480 g. She showed severe IGR with neurodevelopmental delay; however, no retinopathy of prematurity, periventricular leukomalacia or intracranial hemorrage was demonstrated.