d. Prognosis depends on the severity of the hemorrhage and the precipitating
factors. Some neonates demonstrate mild symptoms with few effects while others may
progress to seizuring and death. Survival after a severe case increases the risk of
permanent cerebral damage, hydrocephalus, mental and neurologic impairment, and
cerebral palsy. And in addition, hydrocephalus may be present. This is excessive
accumulation of cerebrospinal fluid (CSF) within the ventricular spaces of the brain-
causing enlargement of the head.
TRACHEOESOPHAGEAL FISTULA AND ESOPHAGEAL ATRESIA
a. Tracheoesophageal fistula is a developmental anomaly characterized by an
abnormal connection between the trachea and the esophagus and usually accompanies
esophageal atresia (see figure 11-3). Esophageal atresia is failure of the esophagus to
form a continuous passage from the pharynx to the stomach. There are some cases of
Tracheoesophageal fistula without esophageal atresia.
Figure 11-3. Tracheoesophageal fistula and esophageal atresia.
b. Signs and symptoms vary according to location of fistula and atresia.
(1) The infant appears to swallow normally but soon after coughs,
struggles, become cyanotic, and stops breathing.
Stomach distention may cause respiratory distress.
(3) Air and gastric contents may reflux through the fistula into the trachea
resulting in chemical pneumonitis.
(4) If there is esophageal atresia without a fistula, as secretions fill the
esophageal sac and overflow into the oropharynx, the infant develops mucus in the
oropharynx and drools excessively.