ABSTRACT
Background: A higher prevalence of congenital malformations among twins than among single has been reported in the literature. Aim: To study the incidence of congenital malformations in twins in the maternity hospital of the University of Chile in the period 1983-1997. Material and methods: As part of the Latin American Collaborative Study of Congenital Malformations, every newborn in the maternity hospital was examined by a neonatologist and congenital malformations were recorded in a special file. Results: In the study period there were 48.663 deliveries of single pregnancies and 448 deliveries of twin pregnancies, giving birth to 886 twins borns alive and 17 stillbirths (1.9 percent mortality). Of these, there were 423 twins, 17 triplets, a sextuple delivery and two siamese. Seven point one percent of twins born alive and 6.5 percent of single newborns had a congenital malformation. The prevalence of malformations in twins and single stillbirths was 35.2 and 17.2 percent respectively (p <0.04). In four pairs and siamese newborns, malformations typical of monozygotic twins were present, such as an acardiac fetus with Trap sequence, a papyraceous fetus and two with hydroanencephaly. Twelve twins had malformations attributable to uterine compression. Conclusions: This study did not find a higher frequency of malformations comparing twins with single babies born alive, but in stillbirths there was a significant difference between single and twin stillbirths (7.1 percent versus 35.2 percent, respectively, p <0.05)
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Twin Studies as Topic , Abnormalities, Multiple/epidemiology , Prevalence , Delivery Rooms/statistics & numerical data , Diseases in Twins/etiology , Diseases in Twins/epidemiology , Fetal Death/epidemiology , Abnormalities, Multiple/etiology , Twins, Dizygotic/statistics & numerical data , Twins, Monozygotic/statistics & numerical dataABSTRACT
Una de las complicaciones más serias de la celulitis facial bacterémica es la meningitis bacteriana aguda. En el presente estudio fueron revisadas retrospectivamente las fichas de 39 niños menores de 2 años ingresados con el diagnóstico de celulitis facial en la Unidad de Infecciosos del Hospital Roberto del Río entre agosto de 1992 y marzo de 1996. De los resultados destaca que de los 39 niños con celulitis facial estudiados 4 presentaron bacteremia a H. influenzae, 1 de éstos con meningitis asociada (2,5 por ciento de 39 casos). Los 4 casos tuvieron en común la ausencia de puerta de entrada. El análisis conjunto de este trabajo y otro anterior efectuado en la misma Unidad y publicado en 1993 permite concluir que la ausencia de puerta de entrada predice el riesgo de bacteremía y meningitis. Actualmente se siguen buscando criterios clínicos y de laboratorio en la celulitis facial que sugieran bacteremia y riesgo de compromiso meníngeo. Estos criterios orientarían a decidir en qué casos es necesario llevar a cabo un estudio acabado para descartar la meningitis bacteriana aguda como complicación