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MINISTRY OF HEALTH OF UKRAINELUGANSK STATE MEDICAL UNIVERSITY
DEPARTMENT OF PEDIATRICSREPORT PRESENTED BY RUBEN
GOMBALANDI .SUPERVISED BY ASST.PROF. OKSANA
BABINOVA. ON
Lool at this cute being!!!!!
The next morning ,you find this!!!!!!!!!!!!!!!!!!
INTRODUCTION
Sudden infant death syndrome continues to be the most common cause of post neonatal death, account for 25% of all death between 1month of age and 1 year of Age.SIDS Goes , by different names ‘’COT Death , Cribs.Some environmental risk factors are modifiable
Reducing exposure to modifiable risk factors has lowered the incidence of SIDS
New research indicates genetic risk factors Actual risk of SIDS may depend on interaction of environmental and genetic risk factors
DEFINITIONSudden Infant Death Syndrome (SIDS) is a medical term that describes the sudden death of an infant which remains unexplained after all known and possible causes have been carefully ruled out through autopsy, death scene investigation, and review of the medical history
EPIDEMIOLOGY
SIDS is responsible for more deaths than any other cause in childhood for babies one month to one year of age, claiming - 7,000 babies each year -nearly one baby every hour of every day
EPIDEMIOLOGICAL FACTS
Strikes families of all races, ethnic and socioeconomic origins without warning; neither parent nor physician can predict that something is going wrong. In fact, most SIDS victims appear healthy prior to death
DEMOGRAPHY
1.Sids is less frequent in the 1st month of life
2.Peak month of occurance is between 2-4 month
3.Boys are more likely to be affected than girls
4.Low socioeconomic stance enhances SIDS Occurance
What Causes SIDS?No adequate medical explanations for SIDS
deaths, current theories include: *Tobacco, cocaine and heroin use by mothers during pregnancy
puts the infant at a higher risk for SIDS.*Infants who sleep on their sides and stomachs have a higher risk
of SIDS than babies who sleep on their backs. (Remember to lay the baby BACK to bed)
*Babies born to teenage mothers have a higher risk of SIDS than babies who are born to older mothers.
PATHOPHYSIOLOGY
Multifactorial in origin
Triple Risk HypothesisVulnerable infantCritical developmental period in homeostatic controlExogenous stressors
Final pathway believed to involve immature cardiorespiratory and autonomic control along with failure of arousal responsiveness from sleep
SIDS FINDINGSExternal Appearance:*Normal state of hydration & nutrition*Normal state of hydration & nutrition*Small amount of frothy fluid in or about mouth & nose*Small amount of frothy fluid in or about mouth & nose*Vomitus present*Vomitus present*Postmortem lividity &/or rigors*Postmortem lividity &/or rigors*Livormortis *Livormortis *Disfiguration/Unusual position - dependant blood pooling/pressure *Disfiguration/Unusual position - dependant blood pooling/pressure marksmarks
Internal Appearances On Autopsy:Pulmonary congestion & edemaIntrathoracic petechiae 90% of timeStomach contents in trachea
RISKS FACTORS DIVIDED INTO:
SOCIAL FACTORS
Increased risk with:Lower socioeconomic statusYounger maternal ageLower maternal education
MOTHER RELATED FACTORSMothers of SIDS infants:
Less prenatal careLow birth weightPreterm birthIUGRShorter intervals between pregnancies (< 18 mo)
SMOKING
OVER HEATING
PRONE SLEEPING
WHEN THE CHILD IS IN PRONE POSITION
SUBSTANCE USE AS A PREDISPOSING FACTOR
GENETICS RISK FACTORS
Sodium and Potassium channel polymorphisms associated with long QT syndrome
Polymorphisms in serotonin transporter (5-HTT) gene
DIAGNOSIS
By definition, SIDS is a diagnosis of exclusion declaration of Sids is made after: Complete autopsy, Investigation of child’s death scene.
RISK REDUCTION
POSSIBLE MEASURES TO BE TAKEN INCLUDE:
BACK TO SLEEP IS PARAMOUNT
HARD Surface
Sleeping clothes
PROTECTIVE GUARD
DO NOT SMOKE DURING PREGNANCY AND AROUND THE INFANT
AVIOD OVERHEATING THE BABY’S SURROUNDING
BREAST FEED THE INFANT
GET A SEPARATE BED FOR THE INFANT
CONCLUSIONSSIDS is:
Major cause of death in infants after 1st Major cause of death in infants after 1st month of lifemonth of life
Sudden & silent in an apparently healthy Sudden & silent in an apparently healthy infantinfant
Unpredictable & unpreventableUnpredictable & unpreventable Quick death with no signs of suffering - Quick death with no signs of suffering -
usually during sleepusually during sleep
REFERENCE Hunt CE, Hauck FR. Sudden infant death syndrome. Cmaj. Jun 20 2006;174(13):1861-1869.Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome. Lancet. Nov 3 2007;370(9598):1578-1587.Weese-Mayer DE, Ackerman MJ, Marazita ML, Berry-Kravis EM. Sudden Infant Death Syndrome: review of implicated genetic factors. Am J Med Genet A. Apr 15 2007;143A(8):771-788.Gurbutt D, Gurbutt R. Risk reduction and sudden infant death syndrome. Community Pract. Jan 2007;80(1):24-27.Fleming P, Blair PS. Sudden Infant Death Syndrome and parental smoking. Early Hum Dev. Nov 2007;83(11):721-725.Damato EG. Safe sleep: can pacifiers reduce SIDS risk? Nurs Womens Health. Feb 2007;11(1):72-76.
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