[Transcutaneous bilirubinometry and early hospital discharge in low risk newborns with jaundice]. / Bilirrubinometría transcutánea y egreso hospitalario temprano en neonatos de bajo riesgo con ictericia.

INTRODUCTION: Discharge soon after birth and beginning of therapeutic interventions in jaundiced newborns depends on the assessment of bilirubin serum levels. OBJECTIVE: The comparison between total bilirubin serum levels with transcutaneous bilirubin levels and evaluate utility of a hand held device to measure transcutaneous bilirubin as a diagnostic tool to predict early discharge. METHODOLOGY: Transversal, prolective study. Near simultaneous measurements of serum and transcutaneous bilirubin was undertaken in newborns with birth weight > 2000 grams, gestational age > 36 weeks and extrauterine life under 72 hours. RESULTS: 100 newborns were enrolled, with birth weight 3,135 +/- 499.9 grams, gestational age of 38.85 +/- 1.4 weeks and 45.46 +/- 1.75 hours of life at the time of bilirubin measurement. Correlation coefficient was 0.81 (p < 0.0001). DISCUSSION: Predischarge quantification of jaundice by transcutaneous bilirubin should be performed in all healthy newborns. Levels under 4.9 mg/dL within first 24 hours of life and values under 7.9 mg/dL between 48 to 72 hours, were considered safely to allow early discharge in newborns studied.

[Perinatal risk factors for mortality in the high-risk newborn]. / Factores de riesgo perinatal para mortalidad en el neonato de alto riesgo.

This study was to determine the risk factors for mortality in a cohort of neonates in a neonatal intensive care unit. Comparative study of the perinatal antecedents between lives and deaths, calculating risk factors for mortality by the chi square test, with Mantel and Haenzel corrected and bivariate analysis. We studied 425 neonates with, weight and age of gestation 1640 +/- 359 gr. and 32 +/- 2 weeks (X and SD), all required assisted mechanical ventilation during 10 +/- 12 days, and stayed in NICU 13 +/- 12 days. The risk factor for mortality were (p < 0.05); gesta IV, < 1 abortion previously, premature rupture of placenta, premature rupture of membranes with chorioamnionitis, pelvic delivery for vaginal via, age of gestation < 28 weeks, birth weight < 1,000 gr., septic shock, metabolic acidosis, acute renal failure, neonatal necrotizing enterocolitis and air leak. In this group of high risk neonates, for the prenatal, neonatal and postnatal antecedents, we find 12 risk factors for mortality; four attributed to the pregnancy, on to the delivery and seven for problems of the neonate.

[Perinatal risk factors and correlation with the incidence of early peri-and intraventricular hemorrhage in neonates with a birthweight under 1500 g]. / Factores de riesgo perinatal y correlación con la incidencia de hemorragia peri-intraventricular temprana en neonatos con peso menor de 1500 g.

The goal of this article is to know the incidence of early periventricular-intraventricular hemorrhage (EPIVH) and the risk factors that contribute to its development in low birth weight infants of less than 1500 g. Ultrasonographic brain scan was performed in Newborns with perinatal risk factors with birth weight less than 1500 grams, gestational age less than 34 weeks, and extrauterine age less than 24 hours at the time of the brain scan. 91 patients met inclusion criteria, 48 (52.7%) had EPIVH. 27 (29.7%) had periventricular ecodensities and 16 (17.6%) had a normal brain scan. Statistical significative differences were found between group with EPIVH and patients with normal brain scan respect to birth weight, gestational age, and Apgar score at 5 minutes. Perinatal risk factors that were significative to EIVH more than grade I were, premature rupture of membranes, vaginal delivery and Apgar score of 0-2 at 1 minute. The most relevant risk factors to EIVH grade III and cerebral infarction were twin pregnancy, vaginal delivery, breech presentation, obstetric trauma and urinary tract infection. Our incidence of EIVH is according to literature. cesarean section must be considered to diminish neonatal neurological morbidity and mortality.

[Electrolytes in toxemic fetuses]. / Electrolitos en el fetópata toxémico.

The study shows the gasometric and electrolytic features during the first five day from newborns from toxemic mothers. It is a prospective study, carried out during a four month period at the obstetrics premature ward at the Gynecological-Obstetrics Hospital of "La Raza" Medical Center. Thirty-three newborn babies with evidences of toxemia and who had not received any intravenous therapy were studied. Blood samples were taken and serum calcium, phosphorus and magnesium levels were measured at 24, 48, 72 and 120 hours after birth. The results showed that six patients (18%) were anemic, and another had polycythemia. Twelve others (36%) had plaquetopenia, one had hypercalcemia, another hypocalcemia, and eleven (33%) presented hypophosphatemia. Of the initial 33 patients, 75% presented metabolic acidosis which spontaneously corrected itself within the following 72 hours. Three showed signs of hypernatremia, four hyponatremia, and two others hyperkalemia, with a return to normal levels within the next 24 hours. No chloride alterations were found in any of the patients. Some newborn babies born from toxemic mothers can spontaneously correct their electrolytic and acid-base imbalance within 72 hours of their birth. Electrolytes; toxemia.