Yenidoğan döneminde çocuk istismarı olgusu
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Date
2010-04-15
Authors
Dallar, Yıldız
Tıraş, Ülkü
Yalaki, Zahide
Özkan, İlknur
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Giriş: Çocuk istismarı ve ihmali dünyada olduğu kadar ülkemizde de çok önemli bir sorundur. Doğum sonrası depresyona giren annelerin çocuklarına karşı istismarda bulunma olasılığı fazladır. Burada annesinde doğum sonrası depresyon saptanan ve anne tarafından fiziksel istismara uğrayan yenidoğan sunulmuştur. Olgu Sunumu: Onsekiz günlük kız hasta, vücutta morluk şikayeti ile getirildi. Anne tarafından verilen anamnezde hastanın kanapeden düştüğü belirtildi. Prenatal öyküsünde otuz bir yaşındaki annenin yaklaşık on yıldır infertilite tedavisi gördüğü ve invitro fertilizasyon ile gebe kaldığı öğrenildi. Muayenesinde; genel durumu orta, cildi soluk görünümdeydi. Sol yanakta yaygın ekimoz, sol göz kapağı ödemli, hiperemik, üst dudakta hemorajik krut, sol servikalde ekimotik alanlar mevcuttu. Ailenin çelişkili anamnez vermesi üzerine öykü derinleştirildiğinde annenin bebeğe fiziksel istismar uyguladığı, kanapeden düşmediği annenin bebeği yere attığı öğrenildi. Çocuk istismarı açısından ileri tetkikleri yapıldı ve Sosyal Hizmetler Kurumu'na bilgi verildi. Kranial tomografisinde; Sağ oksipitalde hemoraji, her iki parietalde subaraknoid kanama saptandı. Göz muayenesinde solda retinal hemoraji görüldü. Yapılan değerlendirme sonucunda annenin postpartum depresyon bipolar bozukluk tanısı ile psikiyatride takibine başlandı. Sosyal Hizmetler Kurumu'nun değerlendirmesi sonucunda bebeğin anneanne ve dedenin bakımına verilmesi kararlaştırıldı. Tartışma: Olgumuz, invitro fertilizasyonla gerçekleşen gebelik sonrası gelişen ilk neonatisid vakası olması dolayısıyla önemlidir. Yenidoğan döneminde çocuk istismarının nadir görüldüğü düşünülse de annede gelişebilecek depresyon nedeniyle bebeklerin istismara maruz kalabilecekleri unutulmamalıdır.
Introduction: Child abuse and neglect is a very important problem in our country as it also is in the world. There is a high possibility of child abuse by mothers who suffer depression after birth. Here, a newborn that was physically abused by a mother diagnosed with depression after birth is presented. Case Report: An eighteen-day old female patient was brought to our clinic with complaints of purple spots on the body. Her history given by the mother stated that the patient had fallen from a couch. The prenatal history of the 31-year-old mother revealed that the mother received infertility treatment for 10 years and became pregnant with invitro fertilization. During examination, the general condition of the patient was modearately serious. Her skin was pale. Widespread ecchymosis on left cheek, left eye lid edema, hyperemic, hemorrhagic crust on upper lip, ecchymotic areas on left cervical were present. As a result of conflicting history given by the family, further questioning revealed that the baby did not fell from a couch but she was thrown on the floor by the mother. Further examination of the patient related to a child abuse case was performed and Social Services was informed. Cranial tomography revealed hemorrhage on the right occipital region and subarachnoid bleeding on both parietal regions. During eye examination, on the retina, hemorrhage was observed. The mother was diagnosed as postpartum depression and bipolar disorder and she was admitted in the psychiatry clinic. As a result of the Social Services’ evaluation, the baby’s custody was given to the grandparents. Conclusion: Being the first neonaticide case developed after invitro fertilization makes this case important. Even though child abuse during infancy period is thought to be rare, because of postpartum depression, it should not be forgotten that babies may be exposed to abuse.
Introduction: Child abuse and neglect is a very important problem in our country as it also is in the world. There is a high possibility of child abuse by mothers who suffer depression after birth. Here, a newborn that was physically abused by a mother diagnosed with depression after birth is presented. Case Report: An eighteen-day old female patient was brought to our clinic with complaints of purple spots on the body. Her history given by the mother stated that the patient had fallen from a couch. The prenatal history of the 31-year-old mother revealed that the mother received infertility treatment for 10 years and became pregnant with invitro fertilization. During examination, the general condition of the patient was modearately serious. Her skin was pale. Widespread ecchymosis on left cheek, left eye lid edema, hyperemic, hemorrhagic crust on upper lip, ecchymotic areas on left cervical were present. As a result of conflicting history given by the family, further questioning revealed that the baby did not fell from a couch but she was thrown on the floor by the mother. Further examination of the patient related to a child abuse case was performed and Social Services was informed. Cranial tomography revealed hemorrhage on the right occipital region and subarachnoid bleeding on both parietal regions. During eye examination, on the retina, hemorrhage was observed. The mother was diagnosed as postpartum depression and bipolar disorder and she was admitted in the psychiatry clinic. As a result of the Social Services’ evaluation, the baby’s custody was given to the grandparents. Conclusion: Being the first neonaticide case developed after invitro fertilization makes this case important. Even though child abuse during infancy period is thought to be rare, because of postpartum depression, it should not be forgotten that babies may be exposed to abuse.
Description
Keywords
Çocuk istismarı, Doğum sonrası depresyon, Yenidoğan, Child abuse, Postpartum depression, Newborn
Citation
Dallar, Y. vd. (2010). "Yenidoğan döneminde çocuk istismarı olgusu". Güncel Pediatri, 8(2), 81-85.