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Urinary tract infections (UTIs) are common in kids. it occurs when bacteria (germs) get into the bladder or kidneys.Up to 8% of girls and 2% of boys will get a UTI by age 5.

Sometimes the symptoms of this infection can be hard to spot in kids,that is why Prompt diagnosis and appropriate treatment are very important to reduce the morbidity associated with this condition.PMID: 30592257

A baby with a UTI may have a fever, throw up, or be fussy. Older kids may have a fever, have pain when peeing, need to pee a lot, or have lower belly pain

causesPMID: 20514772

10.1586/14787210.2015.986097 dio

• fire: UTI in children is of concern because it can be associated with acute mortality (i.e. urosepsis) and/or chronic medical problems like renal scarring, hypertension, and chronic renal insufficiency [7].PMID: 25421102

In the age of “ALARA” (as low as reasonably achievable), physicians must judiciously utilize imaging to decrease the adverse events associated with radiation exposure. In 1999, the AAP recommendations for imaging after an initial febrile UTI were extensive and included renal and bladder ultrasound, voiding cystourethrography (VCUG) or radionuclide cystography in all children younger than two years of age [43]. This approach became widely known as the “bottom-up” algorithm because it begins with the diagnosis of VUR. In these guidelines, the AAP was vague concerning the use of 99mTc-DMSA. However, the American Academy of Family Physicians advised this test after treatment of UTI to determine if permanent renal scarring occurred. This approach exposed children to many invasive radiologic examinations [44]. Since 1999, a vast amount of research has been done to demonstrate that the amount of imaging performed in these children can be safely reduced, and that the children most at risk for renal scarring can still be identified.

In the latest AAP UTI guidelines, VCUG is no longer recommended after the initial UTI. However, renal and bladder ultrasound is still recommended. Ultrasound is non-invasive and poses no radiation risk to the child. Moreover, a renal ultrasound is useful to screen for renal abnormalities like as hydronephrosis. If the child does have hydronephrosis, the underlying cause may need to be determined by utilizing further imaging modalities such as VCUG or MAG-3 renal imaging [42]. The AAP modified its stance on VCUG imaging after first febrile UTI because only a small number of children ultimately require surgical or medical treatment for VUR. Delaying a VCUG until UTI recurrence avoids VCUG in approximately 90% of children with a first febrile UTI. Thus, if a VCUG is performed, the likelihood that a child has high-grade VUR is greater as children at highest risk of febrile UTI recurrence are those with clinically significant VUR.

The NICE guidelines also recommend that all children younger than 6 months undergo an ultrasound within 6 weeks of the infection. However, the NICE guidelines differ in that ultrasonography is not recommend in children older than 6 months with an uncomplicated febrile UTI [42]. To add to the confusing aspect of UTI imaging, subsequent studies have both disputed and upheld these guidelines. For example, Ristola and Hurme conducted a retrospective review of a cohort of 672 patients younger than 3 years of age with UTI. According to their data, if the NICE guidelines had been applied to their cohort, 59 patients with VUR would have been missed and 13 of these eventually underwent surgical anti-reflux surgery [45]. In contrast, Deader et al demonstrated that the vast majority of renal anomalies demonstrated on what they deemed “inappropriate” ultrasounds were of little significance, thereby concluding the NICE imaging guidelines are safe and appropriate [46].

Gunecology contentFemale Reproductive Anatomy

• Gynecologic Procedures
• Pelvic Organ Prolapse
• Vaginal Prolapse
• Urinary Incontinence
• Vaginal Discharge
• Vulvar Diseases
• Cervical Lesions
• Cervical Neoplasia
• Müllerian Anomalies
• Enlarged Uterus
• Endometrial Neoplasia
• Physiologic Enlargement
• Prepubertal Pelvic Mass
• STDs with Ulcers
• STDs without Ulcers
• Hepatitis B Virus (HBV)
• Human Immunodeficiency Virus (HIV)
• Pelvic Inflammatory Disease
• Intrauterine Contraception
• Long-Acting Reversible Contraception
• Natural Family Planning
• Periodic Abstinence
• Coitus Interruptus
• Vaginal Douche
• Lactation
• Sterilization
• Sexual Dysfunction
• Sexual Assault
• Menstrual Physiology
• Premenarchal Vaginal Bleeding
• Abnormal Vaginal Bleeding
• Primary Amenorrhea
• Secondary Amenorrhea
• Precocious Puberty
• Premenstrual Disorders
• Hirsutism
• Polycystic Ovarian Syndrome
• Infertility
• Menopause
• Normal Breast Development
• Benign Breast Disorders
• Breast Cancer

Obstetric content

• Placental Hormones
• Physiologic Changes in Pregnancy
• Physiology of Lactation
• Embryology and Fetology
• Perinatal Statistics and Terminology
• Genetic Disorders
• Induced Abortion
• Early Pregnancy Bleeding
• Fetal Demise
• Ectopic Pregnancy
• Obstetrical Ultrasound
• Invasive Procedures
• Prenatal Diagnostic Testing
• Diagnosing Pregnancy
• Establishing Gestational Age
• Identifying Prenatal Risk Factors
• Normal Pregnancy Events
• Normal Pregnancy Complaints
• Safe and Unsafe Immunizations
• Prenatal Laboratory Testing
• Late Pregnancy Bleeding
• Perinatal Infections
• Obstetric Complications
• Cervical Insufficiency
• Multiple Gestation
• Alloimmunization
• Preterm Labor
• Premature Rupture of Membranes
• Post-term Pregnancy
• Hypertension in Pregnancy
• Gestational Hypertension
• Preeclampsia
• Preeclampsia with Severe Features
• Eclampsia
• Chronic Hypertension with or without Superimposed
• Preeclampsia
• HELLP Syndrome
• Cardiac Disease
• Thyroid Disease
• Seizure Disorders
• Diabetes
• Anemia
• Liver Disease
• Urinary Tract Infections
• Thrombophilias
• Antiphospholipid Syndrome
• Intrauterine Growth Restriction
• Macrosomia
• Antepartum Fetal Testing
• Nonstress Test
• Amniotic Fluid Assessment
• Biophysical Profile (BPP)
• Contraction Stress Test
• Umbilical Artery Doppler
• Fetal Orientation in Utero
• Normal and Abnormal Labor
• Obstetric Anesthesia
• Intrapartum Fetal Monitoring
• Operative Obstetrics
• Postpartum Physiologic
• Postpartum Contraception and Immunizations
• Postpartum Hemorrhage
• Postpartum Fever

Causes

• The exact cause of a placental abruption may be hard to determine,But some factors may raise a woman's risk for it:

1. History of placental abruption in previous pregnancy
2. Long-term high blood pressure
3. Sudden high blood pressure in pregnant women who had normal blood pressure in the past
4. Heart disease
5. Smoking
6. drugs like Alcohol or cocaine use
7. twins pregnancy or more
8. Being older than 35

• Direct causes are rare, but include:

1. Injury to the belly area (abdomen) from a fall, hit to the abdomen, or automobile accident
2. Sudden loss of uterine volume (can occur with rapid loss of amniotic fluid or after a first twin is delivered)

Placental abruption is an important cause of antenatal haemorrhage; but it is not the most common. Differential diagnoses to consider include:

• Placenta praevia : where the placenta is fully or partially attached to the lower uterine segment.
• Subchorionic Hemorrhage: is bleeding between the amniotic sac (membranes) and the uterine wall.This can occur by the placenta disconnecting from the original site of implantation, resulting in bleeding of the chorionic membranes, the outer layer of the amniotic sac.
• Vasa praevia: which is extremely rare but devastating condition in which fetal umbilical cord blood vessels cross or run in close to the inner cervical os.
• Uterine rupture : This usually occurs in labour with a history of previous caesarean section or previous uterine surgery such as myomectomy, where the full-thickness disruption of the uterine muscle and overlying serosa.
• Local genital causes:
  • Benign or malignant lesions :e.g. polyps, carcinoma. cervical ectropion (common).
  • Infections : e.g. candida, bacterial vaginosis and chlamydia.

history and examination

• the pregnant comes with vaginal bleeding associated with abdominal pain and contractions ,in the second half of pregnancy.