Treatment

The best means of controlling the disease are those that prevent the organism from entering - namely ensuring sterile conditions for the birth. The umbilicus should be treated conservatively and cleaned with hydrogen peroxide; foreign objects should be removed, and thimerosal (Merthiolate) applied.

Most medical observers conclude that in order to lessen the incidence of neonatal tetanus in Third World nations, obstetrical procedures must be improved by teaching traditional birth attendants about sepsis. The transfer of maternal tetanus antibodies across the placenta has been found to be effective in conferring passive immunity to the neonate for several months, though it is better if the mother is immunized before, rather than during, pregnancy. Nevertheless, researchers have recently discovered that injections of absorbed tetanus toxoid given to pregnant women who have not been inoculated previously for tetanus (at least 2 injections spaced about 6 weeks apart) can successfully prevent infant infection.

Babies who do develop neonatal tetanus are often sedated with phenobarbital and chlorpromazine given intramuscularly, although diazepam is frequently used now because it works quickly. Antibiotics are also administered. The infant should be kept quiet, fed through a tube, and, if having difficulty breathing, given mouth-to-mouth resuscitation. The aim is first to control muscle spasms with sedatives and then to keep the baby breathing with a tracheotomy and a respirator if available. Medical attendants in hospitals or clinics commonly place the infant in intensive care, give an antitoxin, apply antibacterial therapy, and ensure airway clearance.

Pregnancy And Childbirth

Pregnancy And Childbirth

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