Fetal ultrasound biometry: normative charts for a Puerto Rican population

PURPOSE: To evaluate fetal growth parameters throughout gestation in Puerto Rican women and compare them to other mixed U.S. populations. METHODS: Cross-sectional study of 548 patients who met inclusion criteria of Puerto Rican ancestry, no history of drug, alcohol or tobacco use, no identifiable fetal anomalies, normal amniotic fluid and certainty of last menstrual period. Standard sonographic biometric data (biparietal diameter, occipito-frontal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight) was obtained for each gestational age between 13 and 38 weeks and the 10th, 50th, and 90th percentile determined for each one. Results were compared to those of other mixed U.S. populations. RESULTS: Biometric data on fetal growth throughout gestation among Puerto Ricans is presented. Comparison with other mixed populations did not show any significant differences in fetal biometric measurements throughout pregnancy. CONCLUSIONS: Different to other ethnic groups, Puerto Ricans show similar fetal growth patterns as those reported from mixed U.S. populations. This information validates the use of these reference values in the evaluation of fetuses in Puerto Rico.

Seasonal variation in the incidence of cleft lip and palate based on the age of conception

BACKGROUND: The purpose of this study is to identify seasonal changes in the incidence of Cleft lip and Palate (CL/P) in our population. METHODS: All cases of isolated CL/P born in Puerto Rico from January 1998 through December 2002 were identified through the Puerto Rican birth defect registry. Conception dates were estimated based on the reported last menstrual period. All deliveries during this same period were recorded and their conception dates estimated in the same manner. The data was separated into 4 groups for each year studied corresponding approximately to the four seasons. RESULTS: 484 cases of CL/P were identified among 308,968 live births (incidence 1.57/1000 live births. The lowest incidence of CL/P was seen during fall and winter (1.24 and 1.38/1000 live births respectively) and the highest during spring and summer (1.77 and 1.97/1000 live births respectively) (p = 0.002). The seasons with the highest incidence correspond to the period when the least number of conceptions are occurring. Estimation of relative risks using winter as a reference point (relative risk of 1.0) showed a decrease in the risk of CL/P in fall to .89 (95th confidence interval 0.88 - 1.57), an increase in the risk to 1.28 (CI 1.16 - 2.03) during spring and 1.42 (CI 1.16 - 2.03) during summer. CONCLUSIONS: The reported seasonal variation in incidence may be secondary to the action of yet to be identified teratogens acting on the population at large, or more likely, changes in activity and diet patterns of the population.

Prenatal diagnosis of renal disease

INTRODUCTION: The purpose of this study is to report the range of renal congenital anomalies identified by ultrasonography and to analyze the indications for the ultrasound study that lead to their diagnosis. MATERIALS AND METHODS: All cases of renal malformations diagnosed at our institution from June 2001 through May 2004 were evaluated retrospectively. The indications for sonographic evaluation were reviewed. Cases were divided into those referred for routine ultrasound screening and those referred with other indications. Results were expressed as percents of total. RESULTS: A total of 117 cases of renal congenital anomalies were identified, in 14 cases (11.9), other congenital anomalies were also present. Hydronephrosis was the most common diagnosis detected in 64 cases (54.7). There were 21 lethal renal anomalies identified (17.9). Multicystic dysplastic kidneys were present in 21 cases (17.9). Renal agenesis was identified in 15 cases (12.8). Other detected anomalies were: bladder outlet obstruction 15 (12.8), echogenic kidneys 13 (11.1), ectopic ureteral implantation 2 (1.7), renal cysts 1 (0.8), pelvic kidney 3 (2.6), double collecting system 1 (0.8), and unilateral atrophic kidney 1 (0.8). A total of 94 cases (80.3) had no indications for sonographic evaluation other than routine screening. CONCLUSIONS: Relying on risk factors as indications for ultrasound studies will not detect the majority of congenital anomalies, especially those associated to the urogenital system, a group of conditions that may particularly benefit form prenatal detection.

Incidence of fetal echogenic intracardiac foci in a Hispanic population

Echogenic intracardiac foci (EIF) are small areas of increased echogenicity inside the fetal ventricles. When isolated, they are considered to be a normal finding with prevalence differing among ethnic groups. It has been described as a weak marker for trisomy 21 and other chromosomal anomalies. Little information exists regarding the incidence of these foci among Hispanic fetuses. We examined prospectively 485 normal fetuses between 14 and 32 weeks of gestation from January through March 2001. Nine cases of isolated intracardiac foci were identified (incidence of 1.8 per cent). None of these cases had a chromosomal anomaly. Our data shows a frequency in our population similar to that reported among Caucasians.

Determinacion de inmunoglobulina E (IgE) en pacientes asmaticos. / Determination of immunoglobulin E (IgE) in asthmatic patients

Se presentan los valores de IgE encontrados en pacientes de asma bronquial en Cuba utilizando el metodo de Phadebas IgE PRIST Se constato una alta cifra de IgE en suero (mas de 1.000 U/ml) en la mayoria de los pacientes atipicos. Se pudo constatar que la buena evolucion clinica no va seguida de una disminucion de los valores de IgE en el suero y que por lo tanto no tiene valor como parametro evolutivo en el tratamiento. Se presentan los cuadros con los resultados obtenidos y las referencias bibliograficas consultadas