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Clinical Review of Neonatal Tetanus(54 Cases and Review of Literature)

Journal of the Korean Pediatric Society 1971;14(7):449-455.
Published online July 31, 1971.
Clinical Review of Neonatal Tetanus(54 Cases and Review of Literature)
Ki Sub Chung, Han Ky Hwang, Dong Shik Chin
Department of Pediatrics, Yonsei University College of Medicine Seoul,Korea
新生兒 破傷風에 關한 臨床的 考察
鄭 親 變, 黃 激 芮, 陳 東 植
延世大學技 醫科大學 小兒科學敎室
Abstract
Neonatal tetanus is still one of the serious problem in Korea because of its high incidence. The incidence of neonatal tetanus is not changed since past 10 years rather than decreased. Prevention is most important although therapeutic regimen advances recently. As Schofield et al.25 and Mac-Lennan et al.3) studied, active immunization of pregnant women with plain toxoids or AIPO4 toxoids is recommended to prevent neonatal tetanus. Authors observed clinically total 54 cases of neonatal tetanus who were admitted to the Department of Pediatrics, Severance Hospital from Jan. 1960 to Sept. 1970, and reviewed the literatures. The following results were obtained. 1.The annual incidence of neonatal tetanus was 5 cases as mean, and 39 of the total 54patients were died and over all mortality rate was 72.2%. 2.Sex incidence showed that males predominated in a proportion of 3. 5:1. 3.Average incubation period was 5. 3 days, and peak incidence was noted between 4 and 6days. The more incubation period was short, the more patients were tended to die within 24 hours of hosptalization. 4. Fourty eight of 54 patients (88. 9%) were delivered at home, and the umbilical cord was cutted by home scissors in 44 cases. 5.There was no nspecific relation between the duration from onset to admission and mortality. 6.The typical symptoms such as sucking failure, convulsion, trismus, irritability and rigidity were observed in all patients. 7. There was no different therapeutic effect among the value of 10,000 I.U. ~50,000 I.U. of tetanus antitoxin, of 60,000 LU.~100, 0001.U. and of 110, 000 I.U.~150, 000I.U. in the treatment of neonatal tetanus. 8.Steroids had no specific therapeutic effect in the treatment of neonatal tetanus. 9.Most common complication was asphyxia (16 of 21 patients).


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