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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
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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 727.4 • 1-4 YEARS 32.6 • 5-14 YEARS 18.5 • 15-24 YEARS 80.7 Rates: per 100,000 population/year.
CONGENITAL ANOMALIES: DEFINITIONS • MALFORMATIONS • DISRUPTIONS • DEFORMATIONS • SECQUENCES • SYNDROMES
MALFORMATIONS PRIMARY ERROR OF MORPHOGENESIS
DISRUPTIONS SECONDARY DESTRUCTION (AMNIOTIC BANDS)
DEFORMATIONS EXTRINSIC DEFORMITY (BIOMECHANICAL CAUSES) CLUBFEET Deformation but no destruction
SYNDROMES MICROCEPHALY, CYCLOPIA, PROBOSCIS, POLYDACTILY AND ABNORMAL KARIOGRAM NOT related to a single initiating defect
CONGENITAL ANOMALIES: CAUSES • GENETIC 12-25% • ENVIRONMENTAL 10-13% • MULTIFACTORIAL 20-25% • IDIOPATIC 40-60%
POLICYSTIC KIDNEY SX.
CONGENITAL ANOMALIES: 3% 1st. CAUSE OF DEATH UNDER 1 YEAR.
BIRTH WEIGHT & GESTATIONAL AGE • AGA • SGA • LGA 37 W----------------42W PRETERM FULL-TERM POST-TERM
PREMATURITY • 2nd. IN NEONATAL MORALITY • RISK FACTORS: -PPROM -INTRAUTERINE INFECTION -STRUCTURAL ABNORMAL. -MULTIPLE GESTATIONS • COMPLICATIONS -RDS -NECROTIZING EC -SEPSIS -BRAIN HEMORRAGHE
KERNICTERUS KERNICTERUS
BIRTH INJURIES CAPUT SUCCEDANUM
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
HYDROPS FETALIS