Neonatal pseudo-Bartter syndrome caused by maternal hyperemesis gravidarum: analysis of a twins
10.3760/cma.j.cn113903-20230827-00157
- VernacularTitle:妊娠剧吐致双胎新生儿假性巴特综合征
- Author:
Junchen FANG
1
;
Lili FAN
;
Yaofang XIA
;
Xin CHEN
;
Yudong ZHANG
;
Li MA
Author Information
1. 河北省儿童医院新生儿科，石家庄 050031
- Keywords:
Hyperemesis gravidarum;
Bartter syndrome;
Twins;
Infant, newborn;
Alkalosis
- From:
Chinese Journal of Perinatal Medicine
2023;26(11):946-949
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical manifestations, treatment and outcome of neonatal pseudo-Bartter syndrome caused by maternal hyperemesis gravidarum.Methods:This retrospective study collected the clinical data of a set of premature twins with pseudo-Bartter syndrome who were admitted to Hebei Children's Hospital in September 2022. Clinical features of the cases were summarized with descriptive analysis.Results:The twins born with a gestational age of 30 +3 weeks required tracheal intubation and mechanical ventilation due to premature birth and respiratory distress. They were transferred to our hospital 2 h after birth. The mother suffered from hyperemesis gravidarum and even had severe vomiting complicated by hypokalemia 3 d before delivery. The blood gas analysis of the twins at 2 h after birth showed severe metabolic alkalosis, hyponatremia, hypokalemia, hypochloremia and hyperlactatemia. Hyperglycemia appeared at 6 h after birth, and scleredema neonatorum at 24 h after birth. No significant abnormalities were found in the tandem mass spectrometer analysis of blood or urine samples. Whole-exome sequencing showed no abnormalities in the genes related to the phenotype. The twins were diagnosed with neonatal pseudo-Bartter syndrome. After symptomatic and supportive treatment, metabolic alkalosis and electrolyte disorders in the twins were completely resolved 4 d after birth. They were cured and discharged 51 d after birth without recurrence. Follow-up revealed no abnormalities in the physical or neurological development of the twins at 11 months after birth. Conclusions:Maternal hyperemesis gravidarum can lead to neonatal pseudo-Bartter syndrome, characterized by severe metabolic disorders as well as respiratory and circulatory dysfunction at the early stage after birth. Timely diagnosis and treatment are conducive to good prognosis in the affected neonates.
