Abstract

GUTIERREZ, Carmen et al. Sudden infant death syndrome. Diagnosis of the situation in Montevideo. Uruguay. Rev. bol. ped. [online]. 2003, vol.42, n.2, pp.125-134. ISSN 1024-0675.

Objectives: 1. To apply a uniform autopsy protocol to study all infants who die suddenly and unexpectedly in Montevideo. 2. To know the prevalence of the causes of death presenting initially as sudden and unexpected. 3. To identified among those, the cases of true sudden infant death syndrome (SIDS). Methods: autopsies were performed in infants dying suddenly and unexpectedly from October 1998 to March 2000. The study was conducted by a pediatric pathology (PP) and an expert in forensic science and included complete macroscopic and histologic examination, photography, radiology, toxicology, microbiology, vitreous electrolyte measurement, clinical history review and death scene investigation. Final diagnosis conferences were held with PPs, pediatricians and pediatric neurologists. Results: the number of deaths investigated was 115. The age range was extended to include infants up to 18 months, but 109 cases (95%) were younger than 1 year and 6 cases (5%) were 12 to 18 months old. 65% of the cases were non-SIDS, or explained deaths. Pulmonary infections, cardiac anomalies, dehydration and septicemia were the most important causes of death. 20% of the cases were SIDS and 15% of the cases were unexplained or undetermined (gray zone). Conclusions: the development of this program has allowed a clear understanding of the causes of death in infancy in Montevideo and it provided the means for health care improvement. It also contributed to the education of health care providers since it was possible to discuss these cases, previously seen only by forensic and legal personnel, at conferences widely attended by physicians of different specialties involved in the care of infants. The information obtained through this program will be used in preventing explained deaths as a way to lower infant mortality rate in Uruguay.

Keywords : Sudden infant death syndrome.