Abstract Ref Number = APCP1018
THE USE NIFEDIPINE FOR TREATING PERSISTENT HYPOGLYCEMIA IN NEONATE BORN FROM DIABETIC MOTHER IN RURAL HOSPITAL OF EAST NUSA TENGGARA
Erick Kristianto Adityatama,Stevia Ariella Pasande,Sondang Herikson Panjaitan
Umbu Rara Meha General Hospital
Background : Hypoglycemia is a common metabolic issue in neonates. Several factors related to higher risk of hypoglycemia are prematurity, perinatal stress, small or large size for gestational age, and diabetic mothers. The goal of treating hypoglycemia is to prevent poor neurodevelopmental outcome in order to provide better quality of life. Unfortunately, treatment can be challenging if hypoglycemia persists beyond the first few days of life.
Case Presentation Summary : A vigorous baby was born term from a multiparous diabetic mother. His birth weight was 2980 gram. Blood was drawn from the baby to check blood glucose level. Blood glucose level was 28 mg/dl. Therefore, he was given 6 ml of D10% bolus. An hour later, blood glucose level was rechecked. The result was 31 mg/dl so 6 ml D10% was given and glucose infusion rate (GIR) was targeted to be 6 by giving D10% 10 cc/hour. An hour later, blood glucose was still 36 mg/dl. GIR was uptitrated to be 9 by giving D12,5% 13 cc/hour for 3 hours. Yet, blood glucose level was still 38 mg/dl. GIR was once again uptitrated to be 12 by giving D15% 14 cc/hour. Targeted blood glucose level was still not achieved. It was concluded that the patient suffered from neonatal persistent hypoglycemia. Instead of uptitrating GIR, nifedipine 0,3 mg/kg three times daily were given and blood glucose level was monitored every 3 hours. The blood glucose level after the first dose of nifedipine was 45 mg/dl. Three hours later, blood glucose level was 54 mg/dl. The blood glucose monitoring was done every 12 hours twice. The results were 62 mg/dl and 71 mg/dl.
Learning Points/Discussion : In rural areas where diazoxide, octreotide and hydrocortisone are not always available, nifedipine can be chosen as a treatment for persistent hypoglycemia.
Keywords: Persistent Hypoglycemia Nifedipine Neonates