Intrahepatic cholestasis of pregnancy (ICP) complicates among 0.2-2% of pregnancies and has been associated with adverse perinatal outcomes, including sudden stillbirth, meconium strained fluid, preterm birth, perinatal asphyxia, and transient tachypnea of the newborn. The diagnosis of "bile acids pneumonia" was previously proposed and a causative role of bile acids (BA) was supposed with a possible mechanism of action including surfactant dysfunction, inflammation, and chemical pneumonia. In the last few years, the role of lung ultrasound (LUS) in the diagnosis and management of neonatal respiratory distress syndrome has grown, and LUS scores have been introduced in the literature, as an effective predictor of the need for surfactant treatment among neonates with respiratory distress syndrome. We present four cases of infants born from pregnancies complicated by ICP, who developed respiratory distress syndrome early after birth. Lung ultrasound showed the same pattern for all infants, corresponding to a homogeneous alveolar-interstitial syndrome characterized by a diffuse coalescing B-line pattern (white lung). All infants evaluated require non-invasive respiratory support and in three cases surfactant administration, despite the near-term gestational age, with rapid improvement of respiratory disease and a good clinical outcome.

Perri, A., Patti, M. L., Velardi, M., Sbordone, A., Prontera, G., Fattore, S., D'Andrea, V., Tana, M., Vento, G., Bile Acids Pneumonia: A Respiratory Distress Syndrome in Early-Term Neonates, <<JOURNAL OF CLINICAL MEDICINE>>, 2023; 12 (20): N/A-N/A. [doi:10.3390/jcm12206565] [https://hdl.handle.net/10807/261198]

Bile Acids Pneumonia: A Respiratory Distress Syndrome in Early-Term Neonates

Perri, Alessandro;Prontera, Giorgia;Fattore, Simona;D'Andrea, Vito;Tana, Milena;Vento, Giovanni
2023

Abstract

Intrahepatic cholestasis of pregnancy (ICP) complicates among 0.2-2% of pregnancies and has been associated with adverse perinatal outcomes, including sudden stillbirth, meconium strained fluid, preterm birth, perinatal asphyxia, and transient tachypnea of the newborn. The diagnosis of "bile acids pneumonia" was previously proposed and a causative role of bile acids (BA) was supposed with a possible mechanism of action including surfactant dysfunction, inflammation, and chemical pneumonia. In the last few years, the role of lung ultrasound (LUS) in the diagnosis and management of neonatal respiratory distress syndrome has grown, and LUS scores have been introduced in the literature, as an effective predictor of the need for surfactant treatment among neonates with respiratory distress syndrome. We present four cases of infants born from pregnancies complicated by ICP, who developed respiratory distress syndrome early after birth. Lung ultrasound showed the same pattern for all infants, corresponding to a homogeneous alveolar-interstitial syndrome characterized by a diffuse coalescing B-line pattern (white lung). All infants evaluated require non-invasive respiratory support and in three cases surfactant administration, despite the near-term gestational age, with rapid improvement of respiratory disease and a good clinical outcome.
2023
Inglese
Perri, A., Patti, M. L., Velardi, M., Sbordone, A., Prontera, G., Fattore, S., D'Andrea, V., Tana, M., Vento, G., Bile Acids Pneumonia: A Respiratory Distress Syndrome in Early-Term Neonates, <<JOURNAL OF CLINICAL MEDICINE>>, 2023; 12 (20): N/A-N/A. [doi:10.3390/jcm12206565] [https://hdl.handle.net/10807/261198]
File in questo prodotto:
File Dimensione Formato  
jcm-12-06565.pdf

accesso aperto

Tipologia file ?: Versione Editoriale (PDF)
Licenza: Creative commons
Dimensione 912 kB
Formato Adobe PDF
912 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/261198
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 0
social impact