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Introduction: Nasal continuous positive airway pressure (nCPAP) is one of the most commonly used non-invasive ventilation modes in neonates with transient tachypnea of the newborn (TTN). Non-invasive high frequency oscillatory ventilation (nHFOV) is an non-invasive ventilation mode that has been increasingly used in neonatal respiratory disorders. Based on the unique physiologic advantages that nHFOV offers, we hypothesized that nHFOV might result in a decrease in the duration of non-invasive positive pressure ventilation in neonates with TTN. Methods: Late preterm and term infants > 34 weeks’ gestation were included in the study. Infants were randomized into nHFOV or nCPAP groups. Treatment was started with standard settings in both groups. Infants who met treatment failure criteria were switched to nasal intermittent mandatory ventilation for further positive-pressure support. Results: Total of 60 infants were included in the study. Thirty of these infants were included in the nHFOV group and 30 were included in the nCPAP group. There was no difference between the groups in terms of duration of positive-pressure ventilation; however, it showed a decreasing trend in the nHFOV group (21 hours, IQR [16-68] vs 15 hours, IQR [11-33]; p=0.09). After adjusting for confounders, the nHFOV group had a shorter duration of positive-pressure ventilation compared with the nCPAP group (mean difference: 16.3 hours; 95% confidence interval [CI], 0.7 to 31.9; p=0.04). Conclusion: Non-invasive high frequency oscillatory ventilation can shorten the duration of positive-pressure ventilation and supplemental oxygen in TTN.

Objectives: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly of the diaphragm with pulmonary hypoplasia and persistent pulmonary hypertension and has serious consequences. Despite recent diagnosis and treatment strategies, CDH is still a challenging condition. We aim to present our clinical experiences of CDH, and review of the literature. Methods: Data of CDH patients who were operated in our clinic between January 2010 and September 2018 were obtained from the patient's chart. The clinical course and results of the patients with Bochdalek type CDH were reviewed. Results: We performed diaphragmatic closure in 16 patients with Bochdalek CDH during study period. Fourteen (82%) cases were diagnosed antenatally. In 5 (29%) patients, preoperative pulmonary hypertension developed and nitric oxide was administered. Twelve of the sixteen patients (75%) underwent primary repair and 4 of them underwent prosthetic patch. Three patients were repaired thoracoscopically. Five (31%) patients died due to severe persistent pulmonary hypertension on postoperative period. There was no recurrence in our patients who were followed-up for a mean of 27 months. Conclusion: In the management of Bochdalek CDH, the clinical success has been increasing in parallel with the important developments with the application of new treatment modalities in the neonatal intensive care units and new surgical techniques in recent years.

Late-onset sepsis (LOS) remains an important cause of morbidity and mortality in preterm infants. In this study, our aim was to investigate the red-cell distribution width (RDW) levels during a LOS episode, and its association with the type of growing microorganism and mortality.Preterm infants with culture-proven sepsis during their neonatal intensive care unit stay were enrolled. Red-cell distribution width levels were obtained in the first 4 h of postnatal life and at the onset of the LOS episode, and compared for these time frames. The study cohort was divided into two groups according to the type of the growing microorganism. The RDW levels were then assessed in intra- and inter-group analyses.Eighty-six infants were included in the final analysis. RDW levels were increased in the study cohort after a LOS attack (P0.001). Infants with Gram-negative sepsis showed a significant increase in their RDW levels, but they remained unchanged in infants with Gram-positive sepsis (P0.001 and P = 0.4, respectively). An RDW cut-off of19.50% was related with a sensitivity of 87% and a specificity of 81% for predicting late-onset Gram-negative sepsis (P0.001). Logistic regression analysis showed a positive association of RDW with mortality when adjusted for covariants (adjusted odds ratio: 1.40; 95% confidence interval: 1.02-1.80; P = 0.03).Our findings show that RDW levels increased during a LOS episode in preterm infants, which was especially evident in Gram-negative infections. We believe that these findings may be of importance in the early diagnosis and prognosis of LOS in preterm infants.

Introduction: This study aimed to determine the association between serum mannose-binding lectin (MBL) levels, gene polymorphisms and late-onset sepsis (LOS) in preterm infants. Methods: Infants with

Introduction: Glutathione synthetase (GSS) deficiency is an autosomal recessive disorder (frequency < 1/1,000,000) with different varyingly severe clinical manifestations that include metabolic aci...

Achondrogenesis is a group of rare and fatal disorders occurring in approximately one in every 40,000-60,000 newborns. Achondrogenesis is classified in three groups, as Achondrogenesis type 1A (Houston-Harris type or AC-G1A), Achondrogenesis type 1B (Parenti-Fraccaro type or ACG1B) and Achondrogenesis type 2 (Langer-Saldino type or ACG2), depending on clinical and radiological findings. Achondrogenesis Type 2 is a lethal skeletal dysplasia that is typically characterized by short arms and legs, a small chest with short ribs, lung hypoplasia, a prominent forehead, a small chin, and an enlarged abdomen that may accompanied by polydramnios and hydrops. This study contributes to the literature by presenting a patient who was admitted to the Level ΙΙΙ Neonatal Intensive Care Unit (NICU), Bursa, Turkey), with extremely short extremities, a small chest, abdominal distention and respiratory distress, who was diagnosed with ACG2. On the COL2A1 gene, genetic analysis with next generation sequencing (NGS), was revealed to have a heterozygous missense variation, c.2546G>A, p.Gly849Asp mutation, which is a different genetic variant that has not been previously described in the literature.

Objective: Preterm infants are prone to increased bilirubin burden and display adverse outcomes if left unmonitored; therefore, predicting an increased bilirubin production is of paramount ...

Purpose: We evaluated biochemical analysis results with the aim of discovering serum levels that have possible effects on the development of retinopathy of prematurity (ROP). Methods: A retrospective study was conducted between January 2017 and January 2018 on a total of 110 infants with 35 or less gestational weeks. The sample included 78 infants who had been diagnosed with different stages of ROP and 32 infants without ROP. Results from routine serum biochemical analyses, performed at birth and at one month after birth, were evaluated. The Independent Sample t-test and Mann-Whitney U test were performed to compare the data. Results: The infants with ROP were born at a mean of 28.0 (±2.1) weeks of gestation, weighing a mean of 1066 (±314) g, and the mean duration of stay in the incubator was 38.2 (±19) days. The infants without ROP were born at a mean of 29.6 (±2.6) weeks of gestation, weighing a mean of 1265 (±372) g. 59 infants (53.6%) were females, and 51 (46.4%) were males. Between infants with and without ROP, differences in the following levels were not statistically significant: glucose, blood urine nitrogen, creatinine, alanine aminotransferase, aspartate aminotransferase, albumin, total protein, direct bilirubin, indirect bilirubin, uric acid, and phosphorus. Serum magnesium (Mg) levels at birth in infants with ROP were significantly higher than infants without ROP (p = 0.014). Conclusions: Serum Mg levels at birth were found to be higher in infants with ROP than in those without ROP. The levels may be dependent on the mothers’ treatment of Mg for different medical reasons.

Aim: To measure serum leptin, homocysteine concentrations and insulin resistance in active and remission stages of children with nephrotic syndrome (NS) and to investigate their role in NS pathogenesis. Methods: A total of 70 children were included in the study, 40 patients who had been diagnosed with NS and 30 healthy patients were control. Changes in plasma concentration of the serum homocysteine, leptin, and insulin were measured and compared with the other parameters in the groups. Results: Serum leptin concentrations in active phase were lower than the remission phase (1.48 ± 0.09 ng/dl, 1.84 ± 1.64 ng/ml, p

A case of posterior urethral valve is described with multiple urethroperineal fistulas. This association is extremely rare. The crucial point in the diagnosis is to distinguish these fistulas from the urethral duplications that actually guide the treatment. The presence of these fistulas in patients with posterior urethral valve may have a beneficial effect on renal function as it reduces the pressure on the bladder. On the other hand, incomplete valve ablation may contribute to the recurrence of the fistula.

Introduction: We investigated the association between low 25-hydroxyvitamin D (25-OHD) levels and late-onset sepsis (LOS) in preterm infants (

Background Various non-pharmacologic methods are used to alleviate pain in preterm infants who spend their first days in neonatal intensive care units (NICU) because they are exposed to numerous painful interventions. Objective To determine the effects of Yakson and Gentle Human Touch (GHT) methods on pain and physiologic parameters during heel lancing procedures in preterm infants. Design and methods This was a randomised controlled trial. The study was conducted in a NICU between June 2018 and June 2019. A total of 90 preterm infants were divided into three groups: 30 infants in the Yakson group, 30 infants in the GHT group, and 30 infants in the control group. All preterm infants were randomly divided into groups. Pain responses were evaluated using the Neonatal Infant Pain Scale. Results It was found that pain scores and heart rates were significantly lower during and after heel lancing in preterm infants in the Yakson and GHT groups than in the control group, the difference was statistically significant (p Practical implications Yakson and GHT applied to preterm infants during heel lancing has positive effects on pain and physiologic parameters.

Purpose: Retinopathy of prematurity (ROP), an abnormal proliferation of retinal vessels in premature infants with low birth weight, develops due to many factors. This study investigated a possible correlation between haematological parameters and ROP development. Method: This study included 189 infants without ROP and 128 with ROP. All were born at 35 weeks’ gestation or earlier, had a CBC drawn within 72 hours of birth, and had haemogram data for the first month. Haemoglobin (Hb), haematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), red cell distribution width (RDW), platelet counts (PLT), mean platelet volume (MPV) and platelet distribution width (PDW) values were obtained from hospital data and retrospectively analysed. Results: The mean gestational age was 31 weeks and 29 weeks for the control and ROP groups, respectively; the mean birth weights were 1757 g and 1332 g, respectively. The ROP group’s birth Hb, MCV and RDW were significantly lower than the control group (p p p p

Objective: This study aimed at assessing the serial carboxyhemoglobin (COHb) levels in preterm infants during the first week of life and their variation with late-onset sepsis (LOS). Study Design: ...

Objective: Mannose-binding lectin, which belongs to the collectin family, is an acute-phase reactant that activates the complement system. This study aimed to investigate the effect of MBL2 gene polymorphism on short-term outcomes in preterm infants. Method: Infants of

Giriş: Prematüre bebeklerde tiroid fonksiyon testlerindeki TFT bozukluğun sıklığı, etiyolojisi ve morbiditelerle ilişkisinin belirlenmesi.Gereç ve Yöntem: Bu çalışmaya Ocak 2009 ve Ocak 2012 yılları arasında Uludağ Üniversitesi yenidoğan yoğun bakım ünitesinde yatarak tedavi görmüş olan toplam 139 prematüre bebek alındı. Hastaların prenatal, natal ve postnatal özellikleri ve alınmış olan TFT değerleri kaydedildi. Tüm hastaların yaşamın 1. ve 3. haftasında TFT çalışıldı. Tiroid stimülan hormon TSH düzeyi 10 IU/L üzerindeki değerler yüksek kabul edildi. Serbest T3 ve T4 değerleri laboratuvar sınırları göz önüne alınarak değerlendirildi. Hipotiroidi tanısı olan ve olmayan tüm hastaların poliklinik izlemlerinden 6, 12 ve 18. aylardaki tartı, boy ve baş çevresi ölçümleri değerlendirmeleri kaydedildi.Bulgular: Çalışmamızda 41 hastanın %24 TFT’sinde anormallik tespit edilmiş olup olguların 22’sinde %53,6 geçici TSH yüksekliği, 9’unda %22 primer hipotiroidi, 9’unda %22 nontiroidal hastalık ve 1’inde %2,4 geçici hipotiroksinemi izlendi. Tiroid fonksiyon bozukluğu olan hastalarda respiratuvar distres sendromu sıklığı anlamlı derecede yüksek saptandı p=0,007 . Annesinde hipotiroidi olan bebeklerde tiroid fonksiyon bozukluğu oranı maternal hipotiroidi olmayan bebeklere göre anlamlı derecede yüksek saptandı p=0,049 . TFT’de bozukluk olan grupta 18. aydaki baş çevresi ortalaması TFT normal gruba kıyasla anlamlı olarak düşüktü p=0,047 .Sonuç: Prematürelerde tiroid fonksiyon bozukluğu sık görülen bir morbiditedir ve nöromotor gelişim açısından önemlidir. Maternal tiroid fonksiyon bozukluğu bebeklerde tiroid testlerinde bozulmaya yol açabilir. Tüm prematüre bebeklerde TFT’lerinde çalışılmalı ve hipotiroidi tedavi edilmelidir. Prematürelerde iyot maruziyetinin azaltılması TFT bozukluğu ve geçici hipotiroidi oranını azaltabilir, Introduction: To determine the rate, etiology and morbidity association of disorders of thyroid function tests TFTs in premature babies.Materials and Methods: A total of 139 premature babies who were admitted to Uludag University Faculty of Medicine Hospital Neonatal Intensive Care Unit between January 2009 and January 2012 were included in this study. Prenatal, natal and postnatal characteristics along with TFTs results were recorded. TFTs were performed for all patients in the first and third weeks of life. Thyroid stimulation hormone TSH values of >10 IU/L was considered elevated. Free T3 and T4 levels were evaluated according to laboratory cut-off values. Weight, height and head circumference values of all individuals with and without the diagnosis of hypothyroidism on the 6th, 12th, and 18th months of their polyclinic follow-ups Results: Abnormal TFTs were detected in 41 24% patients. Twenty two patients 53% had transient TSH elevation, 9 22% had primary hypothyroidism, 9 22% had non-thyroidal disease and 1 2.4% had transient hypothyroxinemia. Among morbidities, respiratory distress syndrome rate was found to be significantly higher in patients with thyroid function disorders p=0.007 . The rate of thyroid function disorders in patients with mothers with hypothyroidism was significantly more frequent compared to patients without maternal hypothyroidism p=0.049 . The mean head circumference in 18 month was significantly lower in patients with abnormal TFTs p=0.047 . Conclusions: Thyroid function disorders are common morbidities in premature babies and are important for neuromotor development. Maternal thyroid function disorder can lead to impairment of TFTs in infants. Thyroid function tests should be performed in all premature babies and hypotyhroidism should be treated. Avoidance of iodine exposure in premature infants can reduce the rate of abnormal TFTs and transient hypothyroidism.

Aim: Late-onset sepsis (LOS) persists to be a crucial reason of morbidity and mortality in preterm infants. Studying the effect of neutrophil-lymphocyte ratio (NLR) value in predicting the LOS episode and relation with the type of the growing microorganism were the aim of this study.Material and Methods: Preterm infants were classified as two groups in accordance with having culture proven LOS during the stay in neonatal intensive care unit. Premature infants with culture proven LOS was defined as study group and infants with no-LOS as control group. Study group is consisting of two subgroups in terms of the growing microorganism type. NLR values were compared within and between the groups.Results: Overall, final analysis were applied to 116 infants. NLR values were raised in the study group during LOS episode (p0.001). NLR value of the Gram-positive sepsis group (Subgroup 1) was significantly higher in comparison to Gram-negative sepsis group (Subgroup 2) (median: 2.4 and 1.8, respectively, p = 0.02). ROC analysis showed that area under the curve (AUC) of NLR was 0.723 (p0.001) and cut-off point optimized for sensitivity of 68% and a specificity of 82% was stated as NLR ≥1.57 for conforming LOS.Conclusions: These findings demonstrated that in preterm infants, NLR values rise for the duration of a LOS episode. We believe that NLR value may be a helpful for the prediction of LOS in preterm infants.

Background & objective Preterm infants need nutritional and medical requirements in accordance with the physiologic maturity at birth and maintaining optimal postnatal corporal and cerebral growth is one of the main targets of medical caregivers. However, only a few strategies exist to improve the outcomes of infants in a pathogen-rich and nutrient-poor neonatal intensive care unit environment. In this pilot study, we hypothesize that synbiotics may enhance brain growth, which is reflected indirectly by an increase in head circumference through several signalling molecules. Methods A pilot study was conducted in preterm infants with a gestational age of ≤32 weeks and a birth weight of ≤1500 grams at neonatal intensive care unit of Uludag Univeristy Medical Faculty (NICU) for one-year period. Following the randomization of the infants, a prepared commercial synbiotic solution containing multi-combined probiotics and prebiotics was administered enterally to the study group. Results The odds of a patient having a lower body weight and head circumference below the 10th percentile were significantly lower in the probiotic group (p=0.001, p=0.03, respectively). Moreover, the infants in the synbiotics group had a more optimal head circumference (between the 50th and 90th percentiles, p=0.001). Conclusions Our results show that if we can maintain optimal gut microbiota, we might achieve better neuro-development via the beneficial effects of synbiotics on cytokines, neurotransmitters, and the cellular immunity of the nervous system. Further investigational models are needed to demonstrate the beneficial effects of synbiotics on the central nervous system.

Hanhart syndrome is a congenital disorder that causes an undeveloped tongue and malformed extremities and fingers. Small mouth, short or incompletely developed tongue (hypoglossia), absent or shortened fingers and/or toes, jaw abnormalities such as micrognathia, retrognathia or partially missing mandible (lower jaw), high-arched, narrow, palate, absent or unusually formed arms and/or legs. If the tongue and/or mouth are affected, this can worsen feeding difficulties that are already present due to the craniofacial abnormalities. A diagnosis of Hanhart syndrome is typically made based on the presence of characteristic signs and symptoms. To date, no specific disease-causing genes have been identified. We present the case of a 3000 g male infant who was born at 39 weeks' gestation to a 42-year-old gravida 2 para 2 mother via cesarean section. At the physical examination he was noted to have adactyly at two hands, micrognathia, incompletely developed tongue and high-arched palate. Tongue movements were inadequate because of the small size. When we looked at the pregnancy history the mother took thyroid drugs cause of hypothyroidism after thyroid surgery and there was no family history of congenital anomalies or consanguinity. Due to feeding difficulties he stayed at neonatal intensive care unit. Cranial and abdominal ultrasonographyic examination of the infant was otherwise normal. The infant was discharged home on full oral feedings on day 6.

Parenteral nutrition (PN) has been widely used in preterm infants. The lipid solutions used for PN, however, are associated with oxidative stress and morbidity. The aim of this study was to compare the effectiveness of a new-generation lipid emulsion (SMOFLipid) and olive-oil based lipid emulsion for prevention of PN-associated oxidative damage.Preterm infants 32 weeks of gestational age were included in this prospective randomized study. All infants were randomized to SMOFlipid or olive-oil based lipid emulsion (ClinOleic). Lipid peroxidation products were evaluated in all infants. In addition, total antioxidant capacity (TAC), and both pro- and anti-inflammatory cytokines were studied at days 0, 7 and 14.A total of 89 infants (SMOFlipid, n = 42; ClinOleic, n = 47) were enrolled. TAC was higher in the SMOFlipid group compared with the ClinOleic group at all time points, and the difference on day 7 was statistically significant. Although the anti-inflammatory cytokine interleukin-10 was higher in the SMOFlipid group, this difference was not significant. Bronchopulmonary dysplasia (BPD) was lower in the SMOFlipid group (14.1%) than in the ClinOleic group (31.2%), but this finding was non-significant p 0.05. The rate of severe BPD was significantly lower in the SMOFlipid group.To our best of knowledge, this is the first study to suggest that SMOFlipid might decrease oxidative damage and oxidative-stress-associated morbidity compared with olive oil-based emulsion in preterm infants.

A 2590 g female infant was born at 39 weeks' gestation to a 34-year-old gravida 4 para 4 mother via cesarean section. Upon delivery she was noted to have an absence of skin on the huge part of the trunk. Lesion was unilateral, gelatinous and covered by a thin membrane. The pregnancy history was unremarkable, the mother denied having taken any drugs and there was no family history of congenital anomalies or consanguinity. The physical examination of the infant was otherwise unremarkable. Conservative treatment was recommended by dermatologist with gentle cleansing and application of local antibiotics. Ultrasonographic evaluation of abdomen and kranium, echocardiographic evaluation and detailed genetic assessment were normal. The patient was discharged home on full oral feedings on day 6 and recommended follow up at the outpatient dermatology clinic. Definition of aplasia cutis congenita (ACC) is, complete or partial absence or scarcity of skin at birth. ACC can occur anywhere in the body but majority of cases occur on the scalp. In most cases ACC is an isolated skin defect but some cases might be seen with congenital malformations involving the cardiovascular, gastrointestinal and central nervous systems. ACC is a rare condition with an incidence of 1/10,000 to 3/10,000 births and the exact mechanism is still unknown. Several factors like genetics, teratogens, intrauterin infections can lead to this condition. Most cases occur sporadically but rare familial cases have been reported. Physicians should remember the possible co-occurrence of other congenital anomalies in these infants.

Subglosso-palatal membrane (SPM) is an extremely rare entity and only a few neonatal cases have been reported in the literature. Anatomically, SPM is a fibrous tissue, extending from the floor of the mouth to the palate. Majority of the cases are recognized during the first feeding with the inability of opening the mouth and latching, thus feeding difficulty is the major sign that prompt the physician to consider the diagnosis. Simple surgical resection of the fibrous band is sufficient for the treatment; however, the practical importance of this entity is that physicians should keep in mind the possible co-occurrence of other congenital anomalies such as cleft lip and palate, micrognathia, microglossia and temporomandibular joint disorders in these infants. We present the case of a 3230g male infant was born at 40 weeks gestation to a 30-year-old gravida 2 para 1 mother via cesarean section. Upon delivery he was noted to have severely restricted oral opening due to a mucous intra-oral band vertically connecting the floor of the mouth to the midline of the hard palate. Tongue movements were intact. The pregnancy history was unremarkable, the mother denied having taken any drugs, there was no family history of congenital anomalies or consanguinity. Immediate surgical resection of the aberrant tissue was performed in the operating room with minimal hemorrhage following excision. The physical examination of the infant was otherwise unremarkable and detailed genetic assessment was also normal. The infant was discharged home on full oral feedings on day 5.

Meconium peritonitis is a sterile chemical peritonitis caused by intestinal perforation in-utero or shortly after birth and perforation usually occurs due to intrauterine obstruction. Its incidence is approximately 1 in 35,000 births and the mortality was reported to be 60-80%. The radiographic findings of meconium peritonitis are pneumoperitoneum, intestinal obstruction and abdominal calcifications. The classic eggshell calcification occurs owing to the defensive mechanism of the body against the inflammation in an effort to surround the meconium in the abdominal cavity. In a newborn with abdominal distension, meconium peritonitis should be kept in mind, especially if calcified foci are seen on plain abdominal radiographs, since timely diagnosis and surgery improves the survival rates. We present the case of a female newborn of 34 weeks' gestational age was admitted to the neonatal intensive care unit (NICU) with marked abdominal distension. The pregnancy was complicated by maternal polyhydramnios and a cesarean section was performed due to fetal distress. The infant was noted to have a grossly distended abdomen; however, the physical examination was otherwise unremarkable. The abdominal radiograph revealed distension of the bowel loops and free air with multiple peritoneal calcifications (Figure 1). Surgery, performed on day 1 of life, demonstrated ileal atresia and perforation in the distal part of the ileum. Solid meconium, which leaked into the abdominal cavity was removed and the atresic bowel was resected and anastomosed. The infant regained bowel function on postoperative day 7 and discharged home on the third week after gradual advancement to full enteral feeding.

Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce Dr. Ipek Guney Varal, Uludag Universitesi Tip Fakultesi, Cocuk Sagligi ve Hastaliklari Anabilim Dali, Neonatoloji Bilim Dali, Bursa, Turkiye Tel.: +90 532 341 33 89 E-posta: ibettyg@yahoo.com Ge lis ta ri hi/Re cei ved: 07.01.2014 Ka bul ta ri hi/ Ac cep ted: 22.03.2014 1Uludag Universitesi Tip Fakultesi, Cocuk Sagligi ve Hastaliklari Anabilim Dali, Neonatoloji Bilim Dali, Bursa, Turkiye 2Uludag Universitesi Tip Fakultesi, Cocuk Sagligi ve Hastaliklari Anabilim Dali, Pediatrik Kardiyoloji Bilim Dali, Bursa, Turkiye 3Uludag Universitesi Tip Fakultesi, Radyoloji Anabilim Dali, Pediatrik Radyoloji Bilim Dali, Bursa, Turkiye Ipek Guney Varal1, Nilgun Koksal1, Hilal Ozkan1, Ozlem Bostan2, Onur Bagci1, Fahrettin Uysal2, Zeynep Yazici3, Pelin Dogan1

Bartter’s syndrome (BS) is an inherited renal tubular disorder characterized by hypokalemia, hypochloremic metabolic alkalosis, and hyperaldosteronism with normal blood pressure. A 22-year-old woman was referred at 23 week of gestation. Polyhydramnios was detected and the chloride level of the amniotic fluid was high. The mother was treated with indomethacin from 26 to 31 week of gestation. The newborn was delivered at 34 week of gestation. At 8th day of life, indomethacin was also started for the baby. After three days, a colonic perforation developed. Indomethacin-induced colon perforation is uncommon in antenatal Bartter’s syndrome. This patient indicates that administration of indomethacin in both antenatal and/or early postnatal period may be associated with colonic perforation.