[Incidence of clinically apparent ductus arteriosus in premature infants less than 2 000 g]. / Incidencia del ductus arterioso persistente clínicamente aparente en prematuros de menos de 2,000 gramos.

We have studied the incidence of patent ductus arteriosus (PDA), its clinical features and hemodynamic significance in 715 newborns < 2,000 g admitted to our nursery between 1978-1988. Among 566 in borns, 100 (18%) met clinical diagnostic criteria for PDA. Incidence of PDA by birth weight (BW) was: 17/88 (20%) for BW < 1,000 g; 57/179 (32%) for BW 1,000-1,499 g; and 26/299 (9%) for BW 1,500-1,999 g. PDA was considered hemodynamically significant (HS PDA) in 57 of the 100 babies with PDA, this was found to happen more frequently in smaller babies: 17/17 (100%) with BW < 1,000 g; 30/57 (52.6%) when BW was 1,000-1,499 g; and 10/26 (38.5%) for BW 1,500-1,999 g. Both incidence of PDA and percentage of HS PDA were significantly higher in preterms < 1,500 g (p < 0.01 and < 0.001 respectively). Among 149 outborns, 45 (30%) had PDA, the incidence by birth weight was: 7/17 (41%) in < 1,000 g; 27/70 (39%) in 1,000-1,499 g; and 11/62 (18%) for 1,500-1,999 g. The clinical findings and conditions more frequently found associated with HS PDA were: tachycardia (72%), bounding pulses (67%) and need of ventilatory support (64%), and 89% of these patients had some evidence of pulmonary disease, usually hyaline membrane disease (60%).

[Indomethacin in the treatment of patent ductus arteriosus in premature newborn infants]. / Indometacina en el tratamiento del ductus arterioso persistente en recién nacidos prematuros.

The effectiveness of indomethacin versus usual medical treatment with fluid restriction to 75% of the volume given in the previous days, with or without frusemide (UMT), for the closure of hemodynamically significant patent ductus arteriosus (HSPDA) was retrospectively studied in 87 premature infants under 2,000 g admitted to our nursery from year 1978 throughout 1988. Among 16 babies, treated from the beginning with indomethacin and UMT, HSPDA was closed 72 h later in 14 (87.5%), versus only 14 closures in 71 babies (19.7%) treated by UMT alone (p < 0.01). Of the 57 babies whose HSPDA failed to close with UMT alone, 23 were given indomethacin and successful closure was seen in 16 (69.6%), while among 34 babies remaining on UMT alone, closure resulted in only 7 (20.6%) (p < 0.01). Intravenous route for administration and early use of indomethacin (before age 7 days) proved to have significantly higher success rates than oral route and use of the drug after age 7 days.

[Intrauterine growth in Chilean middle class newborn infants]. / Crecimiento intrauterino en recién nacidos chilenos de clase media.

Intrauterine growth of 11,543 newborn infants, liveborn between 1978 to 1987 that met prospective selection conditions (without intrauterine growth retardation risk) and their data are reported. MBW and weight percentiles 10, 25, 50, 75, 90 from 26 throughout 42 week of gestational age are reported. Selection of cases was important in obtaining adequate percentiles of birth-weight vs gestational age. The intrauterine growth pattern herein reported is recommended for evaluation of chilean newborns, because it is different to that of some foreign countries and the studied sample seems representative of chilean babies.

[Intrauterine growth according to fetal sex and maternal parity]. / Crecimiento intrauterino según sexo fetal y paridad materna.

Influence of fetal sex on intrauterine growth (by birth weight) was studied in 8,533 newborn infants (4,199 females and 4,334 males) without known risk factors. Similar effects of maternal parity were also evaluated in infants of the same cohorts (648 infants from multigestae women were excluded because of antecedent abortion, 3,291 were first born to primigravidae and 4,594 were born to multiparae mothers). Male infants mean birth weights were 180-228 g greater than those of female infants. Male infants weighed 3,340 g +/- 390 (mean +/- SD) and 3,643 g +/- 414 (mean +/- SD) and female babies: 3,210 g +/- 376 and 3,502 g +/- 393 (mean +/- SD) at 38 and 41 weeks of gestational age respectively. Mean birth weights of newborn from multiparae were 85-140 g higher than those from primigravidae. Babies from multiparae weighed 3,337 g +/- 393 (mean +/- SD) and 3,608 g +/- 418 (mean +/- SD) and babies from primigravidae: 3,202 g +/- 372 mean +/- SD) and 3,523 g +/- 384 (mean +/- SD) at 38 and 41 weeks of gestational age in each case. All of these data were statistically different at 38 throughout 41 weeks of gestational age. A correction is suggested for birth weight according to a graph of differences between general mean birth weight and those for multiparae, primigravidae, males and females.

Sindrome de la cimitarra. / Scimitar syndrome

Se presenta un caso clinico de drenaje venoso pulmonar anomalo derecho a la vena cava inferior (Sidrome de la Cimitarra).El cuadro clinico se caracterizo por ausencia de sintomas los primeros cinco dias de vida comenzando luego con polipnea, discreta retraccion y requerimientos de oxigeno variable. El diagnostico inicial fue de atelectasia de lobulo superior derecho, sin embargo la evolucion radiologica descarto esta posibilidad. Se envio al Hospital Calvo Mackenna para completar su estudio efectuandose un cateterismo cardiaco que confirmo el diagnostico de Sindrome de la Cimitarra