Pulmonary artery thrombosis in preterm infants born to a diabetic mother: a case report

Abstract

Background: Pulmonary artery thrombosis in neonates is a rare entity. We describe a neonate with this diagnosis as well as his presentation, evaluation, and management. This case highlights the importance of cardiac ultrasound screening for neonates with high risk factors for pulmonary artery thrombosis without clinical symptoms, as it is not easily detected.

Case presentation: Here, we present an unusual case of a Chinese premature infant, born to a diabetic mother, in whom thrombosis developed in the main pulmonary artery 12 days after an exploratory laparotomy. The preterm infant had no clinical manifestations of pulmonary artery thrombosis, which was found by reexamination of cardiac ultrasound before discharge; after treatment with low-molecular-weight heparin sodium, the embolus became smaller, and follow-up examination was conducted after discharge, and the baby is now developing well.

Conclusion: Pulmonary artery thrombosis is rare in newborns, and asymptomatic manifestations are even rarer in this age group. For newborns with high risk factors, early cardiac ultrasound screening is very important.

Keywords: Diabetic mother; Premature infant; Pulmonary artery thrombosis.

Fig. 1

A Echocardiogram showing abnormal echo of the main pulmonary artery, normal internal diameter of the main pulmonary artery, and a hyperecho mass with size of 1.3 cm × 0.9 cm at the distal bifurcation of the main pulmonary artery. B Echocardiogram showing that the thromboembolus was smaller than before (0.9 cm × 0.6 cm). C Echocardiogram conducted 5 weeks after the identification of a thrombus revealing a main pulmonary artery thromboembolus (red arrow). The external dimensions of the aberrant echogenic mass located at the distal bifurcation measured approximately 1.1 cm × 0.6 cm. The core, characterized by hyperechogenicity, had dimensions of roughly 0.5 cm × 0.4 cm. D The computed tomography angiogram showed no dilation or filling defect in the pulmonary aortic trunk and pulmonary arteries after 4.5 months