A floppy baby with elevated right hemidiaphragm and large stomach bubble on chest radiograph: what’s the diagnosis?

A preterm neonate of 36 weeks’ gestation was born via emergency lower segment caesarean section, requiring respiratory support soon after birth. She was hypotonic from birth and was found to have a large gastric bubble and a raised right hemidiaphragm on X-ray. She reached full feeds through a nasogastric tube on day 3 of life but later developed severe gastro-oesophageal reflux with pulmonary aspiration. What is the likely diagnosis?

Fatimah Aliyu
ST6 Paediatric Trainee, York Teaching Hospital, NHS Foundation Trust, f.aliyu@nhs.net

Udoka Asoh
ST7 Paediatric Trainee, Neonatal Unit, Hull University Teaching Hospitals NHS Trust, u.asoh@nhs.net

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Keywords

retrieval; transport; transfer; COVID-19; SARS-CoV-2;

Key points

Neonatal transport teams and units may be involved in moving suspected or confirmed neonatal COVID-19 cases.
Guidance on managing such transfers has already been published by the NTG and ESPNIC. ANTS has compiled additional practical recommendations from its experiences.
Together these recommendations will minimise horizontal SARS-CoV-2 spread during neonatal transfer.

Also published in Infant:

VOLUME 16/ISSUE 5, SEPTEMBER 2020

A structured approach to facilitate the reintroduction of parents in transport during the SARS-CoV-2 pandemic

In response to the COVID-19 pandemic, transport teams ceased taking parents with them on neonatal transfers except in exceptional circumstances. With the easing of lockdown, the Acute Neonatal Transfer Service of the East of England (ANTS) recognises how important it is for parents to be involved in their baby’s journey and has developed a set of recommendations to mitigate the risk of horizontal transmission of SARS-CoV-2 in transport.