Infant Journal
for neonatal and paediatric healthcare professionals

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,

Udoka Asoh
ST7 Paediatric Trainee, Neonatal Unit, Hull University Teaching Hospitals NHS Trust,

Full text available by subscription ...
The full text of this article is available to subscribers in text, and in Tablet/iPad format and as a PDF file.

Please subscribe and log in to see the full article.

clinical practice guidelines; neonatal death; coroner referral;
Key points
  1. Following the death of a baby there can be uncertainty over whether referral to a coroner is appropriate. Furthermore, there is inconsistency in practice between settings.
  2. A guideline has been developed to aid decision making for referral to the coroner in different neonatal scenarios.

Also published in Infant:

Comparing international survival rates of extremely preterm infants: the impact of variation in reporting signs of life
There is wide international variation in reported survival rates of extremely preterm infants. However, some of this variation might be related to local differences in decisions about whether a baby born at the threshold of survival is considered to be live-born and consequently whether the death is reported as a stillbirth or neonatal death. This variation results in biased comparisons of survival rates.