[Perinatal death in a multiple pregnancy associated with placental chorangiosis].
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Biomedical subjects
Publications and source records attributed to B Jiménez Cobo.
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BACKGROUND: The addition of somatostatin to the conventional treatment of neonatal chylothorax has been described in isolated cases. OBJECTIVE: To describe the results obtained in a series of five patients with neonatal chylothorax treated with somatostatin. PATIENTS: Five neonates (gestational age range: 29-39 weeks) diagnosed with chylothorax of various etiologies were included. Chylothorax was congenital in two neonates, secondary to congenital diaphragmatic hernia repair in two neonates and secondary to thrombosis in the superior vein cava in one neonate. All the neonates were started on conservative therapy and intravenous somatostatin in distinct doses ranging from a bolus of 2 microg/kg/12 h to continuous perfusion at 10 microg/kg/h. RESULTS: In all patients the chylous drainage was stopped. No adverse effects were observed. CONCLUSIONS: Somatostatin can be a safe and effective option in the treatment of both primary and secondary neonatal chylothorax refractory to conservative treatment.
AIM: To study the relationship between the delay of herniotomy in the extremely premature infant and the rate of complications in comparison with full-term children. METHODS: A follow-up study of three groups of neonates operated on for inguinal hernia was performed. The groups were defined as: a) the short-waiting group (SWG): prematures (mean gestational age: 32.56 +/- 0.62; n = 9) operated on within 2 wk of diagnosis (median: 5 d); b) the long-waiting group (LWG): prematures (mean gestational age: 28.38 +/- 1; n = 21) operated on after more than 2 wk (median: 39 d); and c) control group of full-term children (FTG); (mean gestational age: 38.18 +/- 0.29; median of timing: 3 d; n = 11). Several variables (gestational age, weight at birth and at surgery, side of the inguinal herrnia, timing, duration of surgery, type of anaesthesia, length of hospitalization), as well as the occurrence of apnoea, incarceration and testicular atrophy were compared between groups. RESULTS: Timing was the only variable that was different between the LWG and the other two groups (p < 0.001, ANOVA). Seven preoperative episodes of incarceration occurred: one in the SWG, two in the LWG and four in the FTG (p = 0.138, chi2). In the follow-up study two testicular atrophies, related to previous episodes of incarceration, were found: one in the FTG and the other in the SWG (p = 0.221, chi2). CONCLUSION: The deferral of herniotomy in the extremely premature infant, until the child is ready to be discharged from the neonatal unit, does not seem to increase the risk of incarceration episodes or testicular atrophy.
OBJECTIVE: We report the results of survival and incidence of neurodevelopmental sequelae in a group of 249 infants treated in our hospital between 1986-91, whose birth weight was under 1,500 grams. METHOD: We perform a follow-up at corrected ages of 3, 6, 10, 18, 36 months and 5 years thought results only included children followed until 18. Sequelae were classified in three groups, according to the disability degree. RESULTS: Survival resulted to be 69.87% (174), 38.7% for the group under 1,000 grams and 84.7% for those over 1,000 grams. Sequelae were present in 22.6% (11.6% moderate and 10.9% severe). The incidence of severe sequelae was very different on basis of the birth weight, 25.8% for children under 1,000 grams, 13.9% for 1,000-1,249 grams and 1.6% for 1,250-1,500 grams. CONCLUSIONS: Intracranial haemorrhage, hyperbilirubinemia, assisted ventilation and persistence of ductus arteriosus were significantly associated sequelae. We didn't find differences with respect to multiple pregnancy, seizures, sepsis or neonatal hypoxia.
The cases of 131 newborns with positive blood cultures have been reviewed. These children were born in our hospital between 1985 and 1990. We found that the incidence of sepsis was 4.3/1000 newborns. Early neonatal sepsis was the most frequent, representing 58% of the cases. Late sepsis in hospitalized infants represented 1.34% of the cases. Streptococcus B was the microorganism most frequently isolated (26.7%), followed by S. epidermidis (19.8%), E. coli (13.7%) and S. aureus (10.68%). In over 50% of the cases of early sepsis, maternal-fetal risk factors were present. Mortality was 7.6%, with half of these cases due to Streptococcus B.
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Three cases of congenital dwarfism are presented. All of them are lethal and represent the three better known nonviable nosologic entities: Achondrogenesis I, Achondrogesis II and Thanatophoric dwarfism. According to clinical features and radiologic data it is possible to approach the diagnosis accurately. We comment genetic, clinic, radiologic and histologic aspects of these processes. It is important to establish a differential diagnosis as these entities have different genetic basis, what influences genetic counsel.