Jorge Catalán M

Incidencia de labio leporino y paladar hendido en la Maternidad del Hospital Clínico de la Universidad de Chile y en las maternidades chilenas participantes en el Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC) período 1991-1999

Background: ECLAMC is a registry, aimed to assess the incidence of congenital malformations, that started in 1967 and Chile incorporated to it in 1969. Aim: To report the incidence of cleft lip/palate, updated to 1999 in the University of Chile Maternity Hospital and other Chilean hospitals participating in the ECLAMC. Patients and methods: A review of the ECLAMC database that registers all births or stillbirths of more than 500 g. Results: The incidence of orofacial cleft, at the University of Chile Maternity Hospital, in the period 1991-1999 was 17.8 per 10000 (12.6 for cleft lip and 5.2 for cleft palate). The incidence in the rest of participating hospitals was 12.04 and 4.6 respectively. Males had a higher incidence of cleft lip and 80% of children with cleft palate, had other malformations, most of them as part of a syndrome (13 and 18 trisomy, holoproscencephalia, Pierre Robin, Apert en EE syndromes, anencephaly etc). In three of 12 children with cleft lip but without cleft palate, there was a relative with the same malformation. Conclusions: It is proposed that both entities, cleft lip with or without cleft palate and cleft palate without cleft lip, are two etiopathogenically different conditions (Rev Med Chile 2001; 129: 285-93).

Efectos sobre la función renal fetal y neonatal del tratamiento con antagonista del receptor de angiotensina II en el embarazo: Caso clínico

Fetal renal structure and function can be altered by medications prescribed to pregnant women. We report a chronic hypertensive pregnant woman treated with losartan before and throughout pregnancy. At 30 weeks the patient was referred to our Fetal Medicine Unit due to absent amniotic fluid with normal uterine artery Doppler and fetal growth. During her hospitalization a new scan was performed showing that both fetal kidneys were enlarged and slightly hyperechogenic and placental and fetal artery Doppler showed signs of hypovolemia or increased resistance to feto-placental blood flow. Ductus venosous was normal. The fetus was delivered after three days by caesarean section at 30+4 weeks of gestation due to abnormal fetal heart rate tracing. Following delivery, the preterm newborn was treated for a transient renal failure characterized by anuria-oliguria and high plasma creatinine levels (from 3.8 mg/dL at day 5 to 0.8 mg/dL at 16 days). At 30 days of age, ultrasound showed kidneys of normal form and size. The adverse effects of Angiotensin II receptor antagonists in fetal nephrogenesis and function are discussed.

IMPACTO ECONÓMICO DE LA PREMATUREZ Y LAS MALFORMACIONES CONGÉNITAS SOBRE EL COSTO DE LA ATENCIÓN NEONATAL

RESUMENObjetivos: Calcular los costos de la atencion neonatal de recien nacidos prematuros y en portadores demalformaciones congenitas mayores compatibles con la vida. Pacientes y Metodo: Estudio retrospectivoefectuado en el Departamento de Ginecologia y Obstetricia del Hospital Clinico de la Universidad de Chile,en 82 recien nacidos menores de 34 semanas de gestacion y en 14 con malformaciones congenitasmayores, de mas de 37 semanas de gestacion, compatibles con la vida, atendidos entre enero y diciembrede 2004. Resultados evaluados son los costos de la atencion neonatal subdivididos en componentes.Resultados: El costo promedio de la atencion neonatal en recien nacidos menores de 34 semanas fue iguala

Morbilidad neonatal de los prematuros tardíos en embarazos únicos: estudio de caso-control

2.519.508, en menores de 32 semanas igual a

Distrofia miotónica tipo I (Enfermedad de Steinert) y embarazo: Descripción de un caso clínico

3.766.999, en menores de 1500 gramos igual a

Impacto de las malformaciones congénitas en una unidad de cuidados especiales neonatales

12.017.650 y en portadores de malformaciones congenitas mayores compatibles con la vida de

PREVALENCIA DE COLONIZACION POR STREPTOCOCCUS AGALACTIAE (GRUPO B) EN EL TERCER TRIMESTRE DEL EMBARAZO PESQUISADO EN MEDIO DE CULTIVO NO SELECTIVO

30.967.180. El dia cama representa el componente mas significativo dentro cada paquete con mas del60% del costo promedio. Conclusiones: El costo de la atencion neonatal de prematuros menores de 34semanas o portadores de malformaciones congenitas mayores compatibles con la vida es mayor alcontemplado en los paquetes de prestaciones a todo evento, representando el dia cama su componentemas significativo.PALABRAS CLAVES: Atencion neonatal, costo de salud, prematurez, malformacionescongenitas mayoresSUMMARYObjective: To calculate the cost involved in the neonatal care of premature or live born babies carriersof mayor congenital abnormalities compatible with life. Patients and method: Retrospective study whoanalyzed 82 premature live born of less than 34 weeks and 14 live born carriers of mayor congenitalabnormalities compatible with life, from January to December 2004, at the Maternity Ward from theUniversity of Chile Clinical Hospital. The outcome measures were the neonatal care average cost packagesubdivided by components. The cost was expressed in chilean currency. Results: Neonatal care averagecost was

Aumento de la incidencia del síndrome de Down y su posible relación con el incremento de la edad materna

2.519.508 in live born of less than 34 weeks,

Malformaciones congénitas: un modelo predictivo basado en factores de riesgo

3.766.999 in less than 32 weeks,

Impacto de las malformaciones congnitas en una Unidad de uidados Especiales Neonatales

12.017.650 inless than 1500 grams babies and