Diseases Of Infancy & Childhood I

DISEASES OF INFANCY & CHILDHOOD I R. HUGO MARTÍNEZ LOZANO, M.D. Aug-28-2009.

LEARNING OBJECTIVES: K & U GENERAL FEATURES  CONGENITAL ANOMALIES  BIRTH WEIGHT & GESTATIONAL AGE  BIRTH INJURIES  PERINATAL INFECTIONS  NEONATAL RDS  NECROTIZING ENTEROCOLITIS  GM-VENTRICULAR HEMORRHAGES  HYDROPS FETALIS Ref: pp. 470-486 & lecture’s information 

GENERAL FEATURES: MORTALITY RATES    

< 1 YEAR 1-4 YEARS 5-14 YEARS 15-24 YEARS

Rates: per 100,000 population/year.

727.4 32.6 18.5 80.7

CONGENITAL ANOMALIES: DEFINITIONS     

MALFORMATIONS DISRUPTIONS DEFORMATIONS SECQUENCES SYNDROMES

MALFORMATIONS PRIMARY ERROR OF MORPHOGENESIS

DISRUPTIONS

IDEM

DEFORMATIONS EXTRINSIC DEFORMITY (BIOMECHANICAL CAUSES) CLUBFEET Deformation but no destruction

SEQUENCES

POTTER’S FACIES (OLIGOHIYDRAMNIOS)

SEVERE PULMONARY HYPOPLASIA (OLIGOHYDRAMNIOS)

NORMAL

SYNDROMES

MICROCEPHALY, CYCLOPIA, PROBOSCIS, POLYDACTILY AND ABNORMAL NOT related to a single initiating defect KARIOGRAM

CONGENITAL ANOMALIES: CAUSES    

GENETIC ENVIRONMENTAL MULTIFACTORIAL IDIOPATIC

12-25% 10-13% 20-25% 40-60%

POLICYSTIC KIDNEY SX.

FAS

NEUROAXIS DEFECT: Most likely environmental deficiency?

ANENCEPHALY

CONGENITAL ANOMALIES: 3% 1st. CAUSE OF DEATH UNDER 1 YEAR.

Malformation

Frequency per 10,000 Total Births

Clubfoot without central nervous system anomalies

25.7

Patent ductus arteriosus

16.9

Ventricular septal defect

10.9

Cleft lip with or without cleft palate

9.1

Spina bifida without anencephalus

5.5

Congenital hydrocephalus without anencephalus

4.8

Anencephalus

3.9

Reduction deformity (musculoskeletal)

3.5

Rectal and intestinal atresia

3.4

BIRTH WEIGHT & GESTATIONAL AGE   

AGA SGA LGA

37 W----------------42W PRETERM FULL-TERM POST-TERM

APGAR SCORE Sign

0

1

2

Heart rate

Absent Below 100

Over 100

Respiratory effort

Absent Slow, irregular

Good, crying

Muscle tone

Limp

Active motion

Response to catheter in nostril (tested after oropharynx is clear)

No Grimace respons e

Color

Blue, pale

Some flexion of extremities

Cough or sneeze

Body pink, Completely extremities blue pink

PREMATURITY  



2nd. IN NEONATAL MORALITY RISK FACTORS: -PPROM -INTRAUTERINE INFECTION -STRUCTURAL ABNORMAL. -MULTIPLE GESTATIONS COMPLICATIONS -RDS -NECROTIZING EC -SEPSIS -BRAIN HEMORRAGHE

BIRTH INJURIES

PERINATAL INFECTIONS 

TRANSCERVICAL (ASCENDING): - CHORIOAMNIONITIS - HVS-II - PAPILLOMATOSIS - CHLAMYDIASIS

PERINATAL INFECTIONS 

TRANSPLACENTAL: - TOXOPLASMOSIS - MALARIA - RUBELLA - CMV - HEPATITIS B - PARVOVIRUS B19 - BACTERIA (TREPONEMA, LISTERIA)

CONGENITAL TOXOPLASMOSIS

TOMOGRAPHY

MR

TOMOGRAPHY: DIAGNOSIS?

EARLY STAGE

N.E.

HYDROPS FETALIS