RESUMEN
Child abuse has been the leading cause of death in pediatric patients for a long time. The subject is complex in its etiology, appearance, consequences and prognosis. To be confronted with the patient is emotional. Inpatient treatment at a pediatric centre should be performed in any suspicious cases of non-accidental injury. The child protection group consists of one pediatric specialist as well as four ward physicians, one psychotherapist, two staff nurses and one graduated social worker. The team's aims are the early detection of violence towards children, the safeguarding of child protection policies and the provision of family centred, interdisciplinary treatment. During a 6-year period (2001-2006) 476 children were treated at our department. Cruelty was found in 47%, sexual abuse in 28% and willful neglect in 25%. Only 12% of the patients presented obvious injuries. In 88% secondary symptoms resulted in the correct diagnosis. Child protection groups are important institutions for dealing with the complex matter of child abuse. The burden and responsibility for the single person can be reduced within the team. Medical practitioners outside the hospital may give a referral without a loss of confidence.
Asunto(s)
Maltrato a los Niños/diagnóstico , Heridas y Lesiones/diagnóstico , Heridas y Lesiones/cirugía , Austria , Niño , Maltrato a los Niños/legislación & jurisprudencia , Maltrato a los Niños/estadística & datos numéricos , Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/legislación & jurisprudencia , Abuso Sexual Infantil/estadística & datos numéricos , Protección a la Infancia/legislación & jurisprudencia , Estudios Transversales , Hospitales Pediátricos , Humanos , Notificación Obligatoria , Grupo de Atención al Paciente/legislación & jurisprudencia , Pronóstico , Derivación y Consulta/legislación & jurisprudencia , Heridas y Lesiones/epidemiologíaRESUMEN
INTRODUCTION: Twin pregnancy may be a burden both during pregnancy and delivery, thus it is necessary, apart from special supervision and determination of Apgar scores, to perform testing of fetal blood. The purpose of this investigation was to determine the incidence of twin pregnancies during the three-year period, associated pathologies during pregnancy and delivery, as well as acid-base status of the twins. METHODS: The investigation included a group of women with twin pregnancy who underwent either vaginal or cesarean delivery during the three-year period (1994-1996) with special attention paid to acid-base status. RESULTS: During 1994, there were 80 pairs of twins (1.31%) delivered at the Department of Obstetrics and Gynecology in Novi Sad, in 1995--81 twins (1.22%) and in 1996, there were 70 pairs of twins (1.15%). The following associated pathologies have been recorded: PIH--7.98%, incompetent cervices--6.75%, cystitis--6.52%, pyelonephritis--0.61%. In 1994 term delivery was recorded in 60.71%, whereas preterm in 39.29%. In 1995 there were 61.67% term and 38.33% preterm deliveries and in 1996, there were 57.45% term and 42.55% preterm deliveries. Apgar score values were estimated at 1 and 5 minute and pH levels estimated for both twins as well as the values of PaCO2 (kPa), BE (mEq/l), BB (mEq/l), HCO3 (mEq/l), PaO2 (kPa). Satyr. O2 (%)-acid-base status. CONCLUSION: Twin pregnancy being a high risk pregnancy, requires intensive monitoring: of the course of pregnancy and labor, proper choice of completion of the delivery, particularly in cases of preterm labor in order to avoid hypoxia, trauma and metabolic disorders and consequent damage of organs and systems.