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Medical Diagnoses A-D

When adopting a child internationally, parents may run across terms in their medical sheets that are confusing and unfamiliar. For help, we’ve taken the following diagnoses from the Russian Adoption Medical Services site. For further details, please visit them at www.russianadoption.org.

Additional (abnormal) heart chordae (or trabeculae)

This refers to extra muscle tissue in the wall of the heart, usually left ventricle. This is found by doing an echocardiogram of the heart. This is an “incidental finding” which does not cause symptoms or disease.

Alcohol and drugs – a lack of information in the medicals

This is common because orphanage records seldom contain this information. Prenatal records and hospital records are not transmitted to the orphanage in detail at the time the child is transferred to the orphanage. A similar problem exists when trying to obtain family history. The information is simply not available at the orphanage.

Apgar score

The Apgar score is used in evaluating the neonatal status of a child internationally. It is a quick general evaluation of the baby’s overall functioning. A score (0 or 1) is given to each of the five major bodily systems (heart rate, respiratory effort, muscle tone, skin color, and reflexes in response to stimulation) and is taken 1 minute and 5 minutes after delivery and, therefore, consists of two numbers, like 7/8. The Apgar score ranges from 1 to 10. A typical healthy American infant scores from 7/8 to 9/9. The first number is the score after the first minute and the second number is the score after the fifth minute. The first score is useful mainly as an indicator of how difficult the birth was, and the second score is important as a relatively long-term prediction. If only one score is shown (as sometimes happens in medical documents from Eastern Europe) it usually means the second score (the 5 minutes check-up). From Eastern European medical reports, it is usually not known how the Apgar scores were actually obtained and what constituted “peaks” and “valleys” during the examination.

BCG vaccination

This is a vaccination against tuberculosis, which is mandatory in Eastern Europe. BCG is usually given at birth. Reported protection from BCG is zero to 80%. Young children who were recently vaccinated are more likely to have a positive PPD test, but the potential consequence of being wrong is greater and the potential benefit of Isoniazid prophylaxis is lifelong.

Cerebral insufficiency syndrome of hypoxic origin

This diagnosis means general weakness of the Central Nervous System (CNS) caused by the decreased delivery of oxygen to a fetus.

Convergent squint or strabismus

This is a failure of the two eyes to look at the same object thereby preventing binocular vision. Human binocular vision develops during the first few years of life. Interruption to the motor, sensory or CNS components, for example nerve or muscle defect, can lead to sensory or central defect. Causes of many squints are not fully understood although the majority seemed due to hereditary factors. The degree of the strabismus must be determined by a specialist on arrival.

Dysbacteriosis

This is loose or diarrhea-like stool following lack of breast-feeding, illness or use of antibiotics, due to changes in the normal bacterial flora of intestine. This condition is treated first with antibiotics to decontaminate the gastrointestinal tract and then with enzymes similar to treatment with lactase or lactobacillus.