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Congenital conditions are some of the main concerns during a childbirth. There are various issues experienced during a childbirth both by the mother and the baby. This raises the need for a research on the conditions which are experienced, their causes, prevention, and effects. Sacral dimples are among such conditions, and they occur for unknown reasons. Although the condition does not pose complications in most cases, there are a few cases where it leads to clinical concerns. Considering the rate of children born with sacral dimples, it is important to address this condition along with its symptoms, causes, diagnosis, and treatment through a specific case.
Sacral dimples consist of small as well as shallow indentations. They are found at the back or above the buttock’s crease. They are usually discovered once the doctor carries out an examination of the infant. Since a person is born with it, it is a congenital condition. Normally, there are no signals raised when a child is born with this condition. Although the causes of sacral dimples are not known, 2-4% of the total newborns have the condition (Donna, Alessandro, and Michael Alessandro, 2009). In most occasions, the sacral dimples are regarded as a sign of minor abnormality during the development of the fetus in the womb. Although rare, they may lead to certain problems in the future.
There are various symptoms which can be attributed to sacral dimples. One of the symptoms is swelling in the region as well as skin tags. Usually, this is observed in the lower back, and it indicates the presence of a sacral dimple. A birthmark may be present in the area. At times, it appears as a patch of hair on a dimple. Such cases show the involvement of a sacral dimple. Other symptoms include the presence of a fatty lamp, a more than 5mm deep dimple, tenderness as well as discoloration in the lower back (Zywicke & Rozzelle, 2011). It is also possible to discover these symptoms in children and adults. The cause of sacral dimple development is unknown, but it is believed to result from pushed loose hairs to the skin.
Various sacral dimples do not contain any problematic issues. Moreover, the risk issues of the condition are also unknown. There is no specific treatment, which is required for the sacral dimple condition. However, the pits may continue to deepen linking the spinal cord or at times the colon to the condition (Chauhan, Moghal, Guessoum, Fraser, & Shenoy, 2017). As an outcome, the patient can obtain chronic rash. When such situation has appeared, it is necessary to close the dimple to prevent further complications. The spinal canal is the initial part to test after about four months of childbirth (Donna, Alessandro, and Michael Alessandro, 2009).
At times, a very large or deep dimple can be a sign of congenital disability. The defect includes spinal cord or even the spinal bone (Chauhan et al., 2017). Some of the issues that should raise the alarm in the condition are drainage of pus, tenderness, redness as well as swelling in the sacral dimple region. Before taking any actions with a patient affected by a sacral dimple, it is crucial to investigate the medical situation of the patient by the doctor. The reason for such analysis implies the potential influence the sacral dimple on the health condition.
In the given case study, Alex is a newborn who has the condition of a sacral dimple. His birth came without any complications. Alex’s mother should know about the sacral dimple. However, it is necessary to tell her that the condition occurs to various newborns and in most cases it does not have any complications. At the same time, it is possible to have a health condition associated with the sacral dimple, consequently, she should check the baby regularly. The sacral pit can also require examination and evaluation to be sure that it does not have medical health conditions (Donna, Alessandro, and Michael Alessandro, 2009). After the test, in case of a health concern it is necessary to take a treatment, and if there are no health concerns, it is important to ensure that the sacral dimple conditions do not entail any complications in the future. Some of the symptoms that Alex’s mother needs to keep checking on the sacral dimple include swelling and redness. Drainage of pus as well as tenderness in the sacral dimple region may provoke a health concern.
The examination on Alex should focus on ultrasound or the MRI evaluation. This can help to determine any health concerns associated with the condition. The doctor should examine Alex based on various conditions. For instance, it is necessary to assess the length of the condition. Usually, a dimple, which is more than 5mm deep, demands more precise examination (Beh, Rowland, Reynolds, & Bennett, 2015). The significant depth of the dimple may indicate abnormality or other health complications. Furthermore, it is important to evaluate the accompanying dimples if there any. In this case, the health professional evaluates whether other sacral dimples are present apart from the main dimple in the lower back region. If more dimples are present, then more evaluation of the baby’s health is required. It is necessary to determine the length of the sacral dimple and anus opening (Christiano, 2017).
Since the birth of Alex did not involve any complications, it is crucial to hold a few tests in regard to the sacral dimple. His mother did not get the necessary prenatal care before 4 months of pregnancy, and this also calls for more investigation. Although sacral dimples are unproblematic in most occasions, parents and doctors should take a caution to avoid future complications. Therefore, it is important to make both MRI and ultrasound testing on the child. Alex may have clinical complications resulting from the dimple, thus making it of highly importance to follow up them after testing. Although it is rare, the sacral dimple in Alex may be a sign of spinal cord defect. Moreover, spina bifida occulta is one of the possible conditions as well, though it is a rare issue (Christiano, 2017). The type of the future follow-up on Alex should include checking the condition of the dimple from time to time. It is possible that the condition does not have any effects as in the majority of cases. However, a follow-up is still necessary to ensure the baby remains in good health without further complications by the dimple.
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Cecilia needs counseling regarding the condition of her child. Most parents start worrying after the discovery of a sacral dimple on their children. However, the dimple does not have complications in most instances. It is important for Cecilia to get a consultation on prenatal care. According to the case, her first care was administered when she was four months pregnant. This contradicts the rules since the care should start at approximately eight weeks of pregnancy (Beh et al., 2015). A prenatal visit needs to be applied once a person notices her pregnancy. This care is important for the health of the child during their development in the womb.
Differential diagnosis applied to sacral dimples are spina bifida as well as tethered cord syndrome. Spina bifida is a mild form, which is possible to attribute to this condition. It takes place once the spine fails to close well around the spinal cord and remains with spinal canal instead (Chauhan et al., 2017). In most occasions, there are no symptoms confirming the spina bifida. Therefore, an examination is necessary to determine this condition. Tethered cord syndrome involves situations in which the spinal cord is found along spinal canal. It occurs once the spinal cord tissues consist of reduced movement. It has various signs and symptoms including legs numbness, bowel as well as bladder incontinence.
Pharmacologic Treatment Modalities
Some sacral dimples may require further treatment. For instance, OSDs may be observed in the child requiring a surgery action. When the location of the dimple is more than 2.5mm from the anus, neurosurgical intervention is necessary since the condition might involve occult spinal dysraphism (Zywicke & Rozzelle, 2011). Skin dimples need to be identified to determine whether they require further evaluation and treatment. Although most dimples do not reveal the presence of dermal sinus tracts, some of them have this condition. Therefore, diagnostic acumen is necessary when a sacral dimple is observed, especially when it has any abnormalities. Two treatment modalities that can be considered in cases of further evaluations requirements include ultrasound and MRI.
Although most sacral dimples are harmless thus requiring no treatment plan, some may have clinical complications that might require a treatment. When a sacral dimple is observed in a newborn, it is crucial to start the treatment plan immediately. It is important to carry out observations and tests to determine whether the dimple is a simple sacral dimple. In most occasions, the latter does not require further evaluation or treatment since it has no effects on the health of the child (Somers et al., 2016). In the cases where abnormalities such as a deep dimple, tenderness, and presence of accompanying dimples are present, the treatment plan should continue. A specialist should carry out a test to investigate the condition. MRI or even ultrasound can be used for testing a sacral dimple showing suspicious characteristics such as skin discoloration. After the identification of the cause of the dimple, the specialist can go ahead to recommend the best treatment based on the condition of the dimple (D'Alessandro & D'Alessandro, 2009). Once the doctor initiates the treatment plan, it is necessary to follow up with the patient to ensure that the baby remains in good health.
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Patient Education Plan
Teaching patients on sacral dimples requires a plan. The latter is important considering the unknown causes of sacral dimples. Thus, any child can be born with the dimple. Being a congenital condition, it is crucial to give the prior education. Doctors should inform the patients concerning various possible complications. The first step is creating awareness that sacral dimples are mostly non-problematic. Simple sacral dimples do not contribute to any clinical conditions of a patient (Beh et al., 2015). However, there are few cases of complications that may result from the condition. When a child is born with the dimple, it is necessary to do the examination to determine whether further evaluations are required. If the doctor observes any abnormalities, he or she should recommend a treatment plan for a baby. Follow-up and check-up are also of highly importantance for a child with sacral dimples to ensure that complications do not take place in the future.
Sacral dimples do not lead to adverse health effects except when clinical complications are involved. Just like in the case of Alex, they may occur without any complications and in such instances treatment is not necessary. To prevent adverse effects in the future, it is crucial to check the babies with this condition to determine signs of swelling, pus, and rashes. If such cases appear, the doctors should carry out medical examinations and treatment to prevent complications arising from sacral dimples.
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