# Very rare combination of Pierre Robin sequence with patent ductus arteriosus, severe persistent pulmonary hypertension, and sepsis in an Afghan neonate: a case report and literature review

## TL;DR

A rare case of a neonate with Pierre Robin sequence and multiple severe health complications is reported, highlighting the challenges in treating such complex conditions.

## Contribution

This case report documents a very rare combination of Pierre Robin sequence with PDA, PPHN, and sepsis in an Afghan neonate.

## Key findings

- The neonate had Pierre Robin sequence along with patent ductus arteriosus and severe pulmonary hypertension.
- The infant's death was attributed to respiratory failure from airway obstruction and comorbidities.
- The case emphasizes the importance of managing coexisting conditions in resource-limited settings.

## Abstract

Pierre Robin sequence (PRS) is a rare congenital abnormality that may complicate serious circumstances in infants. We report a very rare case of PRS in a five-day-old Afghan girl, accompanied by patent ductus arteriosus (PDA), severe persistent pulmonary hypertension of the newborn (PPHN), perinatal asphyxia, sepsis, and low birth weight. The integration of these comorbidities with PRS makes the case noteworthy. The infant was initially admitted due to perinatal asphyxia and hypothermia and, was discharged in stable condition the next day. On the fifth day of life, she was readmitted with a diagnosis of PDA, severe PPHN, and sepsis, and received treatment for these conditions. Finally, the newborn died from cardiopulmonary arrest resulting from respiratory failure caused by severe airway obstruction and comorbidities. PRS may predispose the neonate to PDA, PPHN, perinatal asphyxia and infection. Consequently, it is important to treat coexisting morbidities that worsen prognosis, especially in resource-limited settings.