Sección de Perinatología. Servicio de Pediatría del Hospital Universitario Cruces / Perinatology section: pediatrics department of the Hospital Universitario Cruces

En este artículo se presenta la organización, la actividad asistencial, docente y de investigación y los índices de calidad de la Sección de Perinarología del Hospital Universitario Cruces (HU Cruces). Se trata de un proceso multidisciplinar que tiene como principal objetívo contribuir a mantener y, si es posible, mejorar la calidad de la atención sanitaria del recién nacido (RN) y su madre, contando con la implicación y participación de todo e! personal sanitario de la Sección y en coordinación con otras áreas asistenciales (Unidad de Medicina Perinatal, Unidad de Medicina Fetal y Unidad Neonatal) y especialistas. Se describirá nuestra actual Cartera de Servicios y las estrategias de mejora para favorecer la información prenatal, la asistencia especializada a partos de riesgo y e! control posnatal, tanto de los RN aparentemente sanos, como de los que requieran una adaptación especial o un control multidisciplinar postnatal, promocionando y favoreciendo la inseparabilidad de la madre y su hijo de manera segura y la lactancia materna (LM) (AU)

This paper presents the Organization, the Quality Indexes and the Health Care, Teaching and Research activities of the Perinatology Section at Cruces University Hospital. The paper holds a multidisciplinary perspective and its main objective is to help to maintain and, if possible, improve newborns and mothers' health care quality, relying on the participation of all the health care workers in the Section and on the coordination with other care areas (Unit of Perinatal Medicine, Fetal Medicine Unit and Neonatal Unit) and specialists. Our current service portfolio will be presented together with suggestions of improvement strategies leading to the following objectives: prenatal information improvement, specialized care for risk births, postnatal control, related both to apparently healthy newborns and to those requiring special adaptation or a multidisciplinary postnatal control, and the encouragement of safe mother-child inseparability and breastfeeding (AU)

Newborn genetic identification: a protocol using microsatellite DNA as an alternative to footprinting.

Newborn identification by foot- or finger-printing presents serious drawbacks. This study proposes an alternative method based on DNA analysis of blood-spots taken from the newborn child. CSF1PO, TPOX and TH01 microsatellite loci were chosen to develop a fast and reliable protocol to be applied in cases where it is suspected that newborn children have been exchanged. The advantage of these loci is that one can simultaneously amplify them by PCR multiplex reaction and determine their alleles, thereby reducing the time needed for identification tests. Moreover, the amplification products of these loci are very small (< 350 bp) and so can be analyzed in samples with degraded DNA. We have been able to prove that it is possible to obtain results in blood-spots taken from newborns up to 13 years before and kept at room temperature. Thus the protocol proposed here can be applied in long-term post-natal identification cases.

[DNA prints instead of plantar prints in neonatal identification]. / La "huella ADN" en lugar de la "huella plantar" en la identificación neonatal.

BACKGROUND: To check the possible usefulness in studying DNA in dried blood spots taken on filter paper blotters for newborn identification. It set out to establish: 1. The validity of the method for analysis; 2. The validity of all stored samples (such as those kept in clinical records); 3. Guarantee of non-intrusion in the genetic code; 4. Acceptable price and execution time. MATERIAL AND METHODS: Forty (40) anonymous 13-year-old samples of 20 subjects (2 per subject) were studied. DNA was extracted using Chelex resin and the STR ("small tandem repeat") of microsatellite DNA was studies using the "polimerase chain reaction method" (PCR). Three non coding DNA loci (CSF1PO, TPOX and THO1) were analyzed by Multiplex amplification. RESULTS: It was possible to type 39 samples, making it possible to match the 20 cases (one by exclusion). The complete procedure yielded the results within 24 hours in all cases. The estimated final cost was found to be a fifth of that conventional maternity/paternity tests. CONCLUSIONS: The study carried out made matching possible in all 20 cases (directly in 19 cases). It was not necessary to study DNA coding areas. The validity of the method for analyzing samples stored for 13 years without any special care was also demonstrated. The technic was fast, producing the results within 24 hours, and at reasonable cost.

[The fetal development curves of newborn infants in the Hospital de Cruces (Vizcaya). I. Weight]. / Curvas de desarrollo fetal de los recién nacidos en el Hospital de Cruces (Vizcaya). I. Peso.

Taking a 33,753 live birth sample, without congenital or genetical malformations and from single pregnancies, delivered at Cruces Hospital (Vizcaya) from January 1st. 1987 to December 31st. 1992. Fetal growth curves of weight, have been developed. For every gestational week, percentile distribution, mean and standard deviation and 95% confidence interval of the mean have been calculated. The later calculation allowed us to compare our means with those of national and international studies, finding significance differences with the great majority of them. Since the sample used was of large size, we believe that the resulting norms adjusted to our population. Being useful clinical, public health and investigational purposes.

[The fetal development curves of newborn infants in the Hospital de Cruces (Vizcaya). II. Length, head circumference and ponderal index]. / Curvas de desarrollo fetal de los recién nacidos en el Hospital de Cruces (Vizcaya). II. Longitud, perímetro cefálico e indice ponderal.

Taking a 27,641 live birth sample, without congenital or genetical malformations and from single pregnancies, delivered at Cruces Hospital (Vizcaya) from February 17 1987 to December 31st 1992, fetal growth curves of length, head circumference and ponderal index, have been developed. For every variable and in every gestational week, percentile distribution, mean and standard deviation and 95% confidence interval of the mean have been calculated. Charts of intrauterine growth in length, head circumference and weight-length ratio must be use in conjunction with intrauterine weight charts allowing the identification of infants with unusual prenatal growth patterns.

[C-peptide in cord blood from macrosomatic and low birth weight for gestational age newborns]. / Péptido C en sangre de cordón en recién nacidos macrosomáticos y de bajo peso para la edad gestacional.

Forty-six newborn babies (11 macrosomic, 11 small-for-dates and 24 of normal weight) have been prospectively studied. The levels of C-peptide in the umbilical blood were determined and the results were statistically analyzed for relationships to several perinatal variables of the mother, newborn and placenta. A positive correlation between C-peptide levels and neonatal weight, newborn ponderal index and maternal weight-gain during gestation were observed. Some other variables strongly related to neonatal infant weight (maternal weight, net placental weight and placental volume) were independent of C-peptide levels.