Last Saturday was Julianna’s sched for Newborn Screening and BCG Shot. Naku parang sinusumpa ko yung Newborn Screening … susme, halos super namula talaga si Julianna nung ni-prick na yung heel niya, she was crying so hard dahil mega piniga yung blood niya sa heel para mapuno yung 4 circles sa filter ng blood sample niya. Pero strong talaga ang baby namin, umiyak lang siya during the procedure. Pero after that natulog na siya ulit, parang walang nangyari.Nung BCG shot din niya, umiyak lang siya nung tinurok na sa kanya yung needle, pero after nun natulog nanaman siya hahaha.
Our baby’s pedia did her routine check-up on Julianna. And when she looked at her back, she saw a dimple near Julianna’s butt. She asked me if I already saw this before. Sabi ko, ngayon ko lang din nakita yun. She calls it a sacral pit. Usually daw yung mga newborn babies na kulang sa timbang nagkakaroon ng sacral pit. The doctor advised us to go to another doctor, a pediatric neurologist, to clear whether the sacral pit is on the safe side or not.
After seeing my OB for my post partum check-up, we headed to the pedia neuro to check on Julianna. Based on her test, all of Julianna’s reflexes were normal. And when she saw the dimple, she said that na malayo naman pala sa spinal cord. Pero para makasiguro, she advised us to have her sacral ultrasound just to make sure na walang problema. Sabi ni Pedia, we should do it in 2 weeks time. Para sa next check up ni Julianna eh may result na ang ultrasound. Kaya we need your prayers, na sana ok naman at walang maging problema sa aming prinsesa.
Ano nga ba ang sacral pit?
A sacral dimple or sacral pit, also known as a pilonidal dimple, is an indentation or little hole in the crease between the buttocks and the base of the tailbone. This dimple generally develops as the spinal column is forming inside the mother’s womb. To put it simply, if the inner tissues of the neural tube that forms the spinal column become malformed, the outside layer of tissue including the skin may not be smooth. This could mean that the outside layer formed with some dimples in it, which have no effect on the inner layers; or there could be a malformation of the inner layers, which have no effect on the outer layers. So a dimple in the lower back along the spine may be a simple divot in the skin, causing no problems whatsoever, or it may be the sign of malformation in lower tissue layers including the spine and spinal cord.
Most sacral dimples are harmless. However, some sacral pits continue deep inside and may even connect to the spinal canal or even the colon or large intestine. In the latter case, bits of stool can leak out through the opening causing a chronic rash. This type of dimple needs to be closed. Other signs that may indicate an abnormality in the lower spine include large or deep sacral dimples or dimples that are covered by hair or a birthmark.
Most spinal cord defects signaled by a sacral dimple may be adequately investigated by doing a thorough physical exam and, if needed, an ultrasound. For those in which there is a very high suspicion of a spinal cord defect, an MRI is usually performed. If these tests detect a problem affecting the spinal cord, the child may require surgery.
If you notice a deep or an unusual-looking sacral dimple on your infant, be sure to discuss it with your pediatrician.
Some things your pediatrician will look for include:
* Can the floor of the pit or dimple be easily seen? When the bottom portion of a divot can’t be seen, this may be an indication of a neural tube that never closed completely.
* Does the pit have hair growing from it? This again makes a pit suspicious for deeper involvement.
* Is the neurologic exam normal? If there is significant involvement of the spinal column, there may be weakness in the legs.
* How high up on the back is the dimple? Most dimples very low on the back (just above the buttocks) are of little concern. The higher the dimple is, the more likely it is to be associated with defects in deeper tissues.
* Are there signs of any other defects? The brain, spinal column, kidneys, as well as other structures form at the same time the neural tube closes. Therefore, if there are any malformations in any other parts of the body, it becomes more probable that the neural tube may be involved as well.
After doing an exam, your child’s doctor will discuss what, if any, treatment is needed.
SOURCE: https://www.akronchildrens.org
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