[A descriptive study of perinatal asphyxia and its sequelae]. / Estudio descriptivo de la asfixia perinatal y sus secuelas.

INTRODUCTION: Perinatal asphyxia is a potential cause of brain injury that can produce some alterations on the neurologic development of the newborn. On the last years most part of the investigation have been focused on the physiopathology of the perinatal asphyxia, but correlation between asphyxia and brain damage is not well defined. PATIENTS AND METHODS: A retrospective study was made of the patients with the diagnosis of perinatal asphyxia born at the General Hospital of Segovia during a period of ten years (1992-2001). We took data about gestation, birth, neonatal period and follow-up period from their clinical histories. RESULTS: Over this period of ten years 703 cases of perinatal asphyxia have been diagnosed, supposing this an incidence of 7,2 cases of each 100 newborns. 116 of these newborns present risk factors of brain damage and were followed at least two years. 53 of the 116 newborns (45%) present evidence of hypoxic-ischemic encephalopathy on neonatal period. During the period of two years, 42 of the asphyxiated infants follow up (36%) present neurologic sequelae, being psychomotor retardation the most common. CONCLUSION: For a correct interpretation of the relationship between perinatal asphyxia and neurologic sequelae we have to analyze all of the perinatal data and discard any other possible aetiology or pathogenic mechanism.

[Perineal bag versus urethral catheterization of suprapubic aspiration for the diagnosis of urinary tract infections in infants in emergency units]. / Bolsa perineal versus sondaje uretral o punción suprapúbica para el diagnóstico de infección urinaria en el lactante en las unidades de urgencias.

OBJECTIVE: Our objective was to determine the utility of urine cultures collected by sterile perineal bags as a method of diagnosis of urinary tract infection in infants. PATIENTS AND METHODS: Forty-two patients, aged 0 to 27 months, were diagnosed with urinary tract infections based on the growth of more than 100,000 colonies/ml in two urine cultures collected by sterile bags. Confirmation of the infection was done by urine cultures obtained by suprapubic aspiration or urethral catheterization. A urinalysis was simultaneously performed. RESULTS: Urinary tract infection was confirmed in only 6 out of 42 patients. The positive predictive value of the sterile bag was 14%, increasing to 42% combined with an abnormal urinalysis. CONCLUSIONS: The sterile perineal bag is not an accurate method to collect urine for diagnosis of urinary tract infections in febrile infants or those who need prompt diagnosis and treatment.

[Early discharge of low-birth-weight neonates. 5-year experience]. / Alta precoz en recién nacidos de bajo peso. Experiencia de 5 años.

The object of this study was to determine whether the hospital stay could be reduced in low birth weight infants without any risk. A prospective, controlled and randomized study has been made with 80 newborn infants with birth weights < or = 2.000 gm. The infants of the experimental group (n = 40) were discharged with weights < or = 2.000 gm and the control group (n = 40) were discharged with weights > or = 2.000 gm. Both groups showed similar social, economic, perinatal and postnatal conditions. We have found significant advantages in the experimental group such as: reducing the period of hospitalization (p = 0.005), greater weight increase (p < 0.001), a longer breast feeding period (p = 0.02) and a 29% reduction in expenditures. The follow-up shows that there are no significant differences between the groups regarding morbidity, mortality, growth or psychomotor development. We conclude that there are no disadvantages, but considerable advantages, in early discharge of low birth weight infants.

[Transcutaneous bilirubin measurement in neonates]. / Bilirrubina transcutánea en neonatos.

A study was performed to determine, in our population, the relationship between transcutaneous, visual and serum bilirubin values. This was done in attempts to reduce the number of serum bilirubin determinations to be performed in the future. We did a correlation coefficient between serum bilirubin and five measurements of transcutaneous bilirubin levels in a group of 60 term newborns and 60 preterm newborns, obtaining a value of 0.84 in both groups. The results were also considered from an analytical point of view where the ability of the test to predict an alteration in serum bilirubin levels, for example > or = 12 mg/dl in preterm and > or = 13 mg/dl in term newborns, was assessed. For values of 18 in preterm and 17 in term infants, the transcutaneous method was found to be both sensitive and specific. If Kramer's test is also evaluated the results improve.

[Spontaneous chylothorax: seven cases of prenatal diagnosis]. / Quilotórax espontáneo: siete casos de diagnóstico prenatal.

Authors present 7 cases of spontaneous congenital chylothorax, all of them diagnosed antepartum echographycally. Six of them needed cardiopulmonary resucitation but none presented fetal anoxia. Three cases had associated malformations. Treatment included thoracocenthesis, pleural drainage, assisted ventilation and appropriate nutrition. Pleural effusion lasted from 14 days to 6 months. Complications were: pneumothorax, metabolic acidosis and bacterial infections. Three patients died by respiratory failure. Pulmonary hypoplasia was present in two of them, and suspected in the third one. Survivors are free of symptoms.

Fetal subdural hematoma: diagnosis in utero. Case report.

A subdural hematoma was diagnosed antepartum in an infant by means of sonography. An elective caesarean section was performed because cephalopelvic disproportion, and later the hematoma was drained with a poor evolution due to basal ganglia and intraventricular hemorrhage. No etiological factor of bleeding was found. This is the third published case of fetal subdural hematoma diagnosed antepartum.