Le tétanos néonatal : aspects épidémiologiques, cliniques et thérapeutiques. À propos de 34 cas

Background: In spite of progress in science of medicine, the tetanus neonatal still exists in third world countries. Objective: to describe epidemiological, clinical features, treatment and evolution of the tetanus at new-borns in our experience. Materials and Methods: retrospective survey of 34 cases of tetanus neonatal in neonate intensive care of the children's hospital in Rabat (Morocco) between 1990 and 2003. We analysed: the progress of pregnancy and the mother's antitetanus vaccination, the conditions of delivery and the newborn's contamination, the clinical picture, the treatment and the evolution. Results: pregnancies are not controlled in 70%. Nine percent of the women received two injections of antitetanus vaccination. The delivery produced at home in 56% of the cases. The septic section of the cord has been observed in 56% of the cases and the application of substances on the cord in 35% of the cases. The delay of consultation was on average of three days (1-10 days). The mean score of “Rhéa” was 4,3 and the mean score of “Patel and Jocq” was 3,5. The treatment was essentially sedation and mechanical ventilation. The main complication was the nosocomial pneumopathy (53%). The rate of death was 62%. Conclusion: the sanitary education lack increases the tetanus neonatal. This affection remains fatal. Currently, only the prevention is efficient.