By ULY CLINIC

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Neonatal Tetanus

 

Introduction

Usually occurs through introduction of tetanus spores via the umbilical cord during delivery through the use of an unclean instrument to cut the cord, or after delivery by “dressing” the umbilical stump with substances heavily contaminated with tetanus spores.

 

Diagnostic Criteria

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• Sudden inability of a newborn to suck/feed between 2nd and 28th day after birth

• Generalized stiffness

• Convulsions

Prevention

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• Immunize women of reproductive age with TTCV, either during pregnancy or outside of pregnancy. This protects the mother and also her baby through the transfer of tetanus antibodies to the fetus.

• Good hygienic practices when the mother is delivering a child are also important to prevent neonatal and maternal tetanus.

• To be protected throughout life, WHO recommends that an individual receives 6 doses (3 primary plus 3 booster doses) of TTCV through routine immunization.

 

Management

 

Rigorously cleanse the umbilical stump to stop the production of toxin at the site of infection

 

Antibiotic therapy:

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• Amoxycillin via Nasal Gastric Tube 20–30 mg/kg/day every 8 hours

AND

• Metronidazole 7.5 mg/kg For postnatal age ≤7 days: 1200–2000 g: 7.5 mg/kg/day given every 24 hours >2000 g: 15 mg/kg/day in divided doses every 12 hours.

• Postnatal age & gt; 7 days: 1200-2000 g: 15 mg/kg/day in divided doses every 12 hours >2000 g: 30 mg/kg/day in divided doses every 12 hours

 

Immunotherapy

 

To neutralise circulating toxin B: Administer human antitetanus immunoglobulin (TIG), 100–300 IU/kg intramuscularly stat, with the dose divided into two different muscle masses.

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To provide effective management of muscle spasm, give a sedative cocktail of ALL the following via NGT: B: Diazepam 0.5 mg/kg every 6 hours

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AND

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• Chlorpromazine 2 mg/kg every 6 hours

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AND

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• Phenobarbitone 6 mg/kg every 12 hours

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Guidelines for Dosage Administration**