الفهرس 
Sudden Infant Death SyndromeOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
Sudden Infant death Syndrome (SIDS) is defined as a natural, un expected fatal event that occur within one hour of the beginning of symptoms in an apparently healthy infant or in one whose disease was not so severe that such an abrupt outcome could have been predicted.
SIDS accounts for 35-55% of infant death and it continue to be the most common cause of post neonatal infant death ,it usually occurs in infants under one year of age (usually between two weeks & eight months old).
The risk is higher in males, low birth weight infants, in low socio-economic levels, during cold months and for babies who sleep facedown.
Other contributing factors are: myocardial conduction system defect, or defective autonomic cardiorespiratory control, viral infection, some nutritional and metabolic disturbances or overheating.
Current evidence suggests that SIDS involves a convergence of stressors that probably results in the asphyxia of a vulnerable infant who has defective cardiorespiratory or arousal defense systems during a critical developmental period when immature defense mechanisms are not fully integrated. Thus, our current understanding of the pathogenesis of SIDS reflects the simultaneous juxtaposition of multiple events that, when taken individually, are far less powerful than the result of their chance combination. SIDS remains a major problem that mandates continued interdisciplinary efforts for its ultimate resolution.
The direct cause of SIDS is still unknown. Near-miss SIDS is a synonymous to apnea of infancy, where the risk for SIDS is raised.
It represent a frightening episode of cessation of breathing for 20 seconds or longer, or a shorter respiratory pause associated with bradycardia, cyanosis or pallor.
Near-miss terminology is undesirable since it implies a more definite relationship between apnea and SIDS than may be warranted for a given patient, it may contribute to some un necessary confusion and concern in the parents.
Several causes were blamed for the occurrence of apnea. Some investigators proposed that GER is an important etiologic mechanism for SIDS. While others rejected the possibility that GER causally related to SIDS. Cardiac causes as fallot tetralogy, mitral valve prolapse, aortic stenosis, were also blamed for occurrence of SIDS.
In order to establish the diagnosis of SIDS, and autopsy must be performed. Other causes of sudden infant death must be excluded such as meningitis, myocarditis, intracranial hemorrhage, child abuse, infanticide, and cardiac causes.
Hospitalization and initial evaluation for all near-miss SIDS infants supposed to be at increasing risk for SIDS should be insured for at least 24 hours. Initial screening evaluation of the infant is directed towards identifying any specific and treatable disease process that could have caused the frightening spell.