Fatal sclerosing mesenteritis: a 7-year-old male autopsy case report.

Sclerosing Mesenteritis (SM) is a rare diagnosis, particularly in pediatric patients, and is typically non-fatal when appropriately treated. Although molecular and immunohistochemical alterations have been described, no pathognomonic signature has been identified for this entity. This report presents a case of a seven-year-old boy who suffered sudden cardiorespiratory arrest. Upon autopsy, he was found to have multicentric SM on the upper mesentery, which led to bowel wall thinning and abdominal bleeding with bacterial translocation. We performed comprehensive morphological, immunohistochemical, and molecular analyses. SM is an atypical disorder with diverse clinical manifestations, including a rare but potentially fatal course. Early diagnosis is critical, given its potential severity. To our knowledge, this is the first case report of pediatric mortality linked to SM. Our findings emphasize the importance of increased awareness and early detection of SM in pediatric patients.

Nutritional Assessment and Support in Children with Chronic Kidney Disease: The Benefits of Working with a Registered Dietitian.

BACKGROUND: An unbalanced dietary pattern, characterized by high animal protein content: may worsen metabolic control, accelerate renal deterioration and consequently aggravate the stage of the chronic kidney disease (CKD) in pediatric patients with this condition. AIM: to assess the effect of a registered dietitian (RD) intervention on the CKD children's eating habits. METHODS: Anthropometric and dietetic parameters, obtained at baseline and 12 months after implementing healthy eating and nutrition education sessions, were compared in 16 patients (50% girls) of 8.1 (1-15) years. On each occasion, anthropometry, 3-day food records and a food consumption frequency questionnaire were carried out. The corresponding relative intake of macro- and micronutrients was contrasted with the current advice by the European Food Safety Authority (EFSA) and with consumption data obtained using the Spanish dietary guidelines. Student's paired t-test, Wilcoxon test and Mc Nemar test were used. RESULTS: At Baseline 6% were overweight, 69% were of normal weight and 25% were underweight. Their diets were imbalanced in macronutrient composition. Following nutritional education and dietary intervention 63%, 75% and 56% met the Dietary Reference Values requirements for fats, carbohydrates and fiber, respectively, but not significantly. CKD children decreased protein intake (p < 0.001), increased dietary fiber intake at the expense of plant-based foods consumption (p < 0.001) and a corresponding reduction in meat, dairy and processed food intake was noticed. There were no changes in the medical treatment followed or in the progression of the stages. CONCLUSIONS: RD-led nutrition intervention focused on good dieting is a compelling helpful therapeutic tool to improve diet quality in pediatric CKD patients.

Fatal sclerosing mesenteritis: a 7-year-old male autopsy case report

ABSTRACT Sclerosing Mesenteritis (SM) is a rare diagnosis, particularly in pediatric patients, and is typically non-fatal when appropriately treated. Although molecular and immunohistochemical alterations have been described, no pathognomonic signature has been identified for this entity. This report presents a case of a seven-year-old boy who suffered sudden cardiorespiratory arrest. Upon autopsy, he was found to have multicentric SM on the upper mesentery, which led to bowel wall thinning and abdominal bleeding with bacterial translocation. We performed comprehensive morphological, immunohistochemical, and molecular analyses. SM is an atypical disorder with diverse clinical manifestations, including a rare but potentially fatal course. Early diagnosis is critical, given its potential severity. To our knowledge, this is the first case report of pediatric mortality linked to SM. Our findings emphasize the importance of increased awareness and early detection of SM in pediatric patients.

[Experience with Denosumab in central giant-cell granuloma]. / Experiencia con Denosumab en granuloma central de células gigantes.

INTRODUCTION: Central Giant Cell Granuloma is an infrequent bone lesion located mainly in the maxillary bone. The main treatment is surgery with wide margins, so it sometimes causes great morbidity and esthetic al terations. Denosumab, a RANK-ligand inhibitor monoclonal antibody, has been presented as a valid therapeutic alternative in the treatment of these lesions. OBJECTIVE: to describe the clinical and radio logical response after treatment with Denosumab in a patient with unresected giant cell granuloma. CLINICAL CASE: 12-year-old boy who consulted due to a 24-hour maxillary swelling, without other associated symptoms. Examination revealed a tumor in the upper left maxilla with bulging of the ip- silateral gingiva. A CT scan was performed which showed a large expansive intraosseous lesion in the maxillary alveolar ridge. The biopsy of the lesion was compatible with Central Giant Cell Granuloma. Due to the size and location of the lesion, initial treatment with Denosumab, a human monoclonal antibody with action on RANK-ligand, was indicated. After 10 months of treatment, the patient showed a favorable clinical and radiological response, with a size decrease of the lesion and metabolic activity. As an adverse effect, the boy presented mild hypocalcemia, resolved after supplementation with calcium. CONCLUSION: the use of Denosumab as the first line of treatment in Giant Cell Granu loma may be an adequate therapeutic option in adolescents with lesions that are difficult to resect.

Multiparameter flow cytometry analysis of leukocyte markers for diagnosis in preterm neonatal sepsis.

PURPOSE: Neonatal sepsis is an important public health concern worldwide due to its immediate lethality and long-term morbidity rates, Clinical evaluation and laboratory analyses are indispensable for diagnosis of neonatal sepsis. However, assessing multiple biomarkers in neonates is difficult due to limited blood availability. The aim is to investigate if the neonatal sepsis in preterm could be identified by multiparameter analysis with flow cytometry. MATERIALS AND METHODS: The expression of activation-related molecules was evaluated by flow cytometry in newborn with or without risk factors for sepsis. RESULTS: Our analysis revealed that several markers could be useful for sepsis diagnosis, such as CD45RA, CD45RO, or CD71 on T cells; HLA-DR on NKT or classic monocytes, and TREM-1 on non-classic monocytes or neutrophils. However, ROC analysis shows that the expression of CD45RO on T lymphocytes is the only useful biomarker for diagnosis of neonatal late-onset sepsis. Also, decision tree analyses showed that CD45RO plus CD27 could help differentiate the preterm septic neonates from those with risk factors. CONCLUSIONS: Our study shows a complementary and practical strategy for biomarker assessment in neonatal sepsis.

SARS-CoV2 en pediatría: más allá de la infección / SARS-CoV2 in pediatrics: Beyond the infection

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Characterization of CD127- CD25++ Treg from human colostrum.

PROBLEM: Breastfeeding's influence on the tolerance to environmental antigens is essential for short- and long-term homeostasis for children. Colostrum is rich in leucocytes, but it is unknown whether regulatory T cells (Treg) account for part of this cell population. METHOD OF STUDY: Frequencies of CD127-  CD25++ Treg and levels of immunoregulatory-associated cell markers were determined in colostrum and were compared with autologous blood cells. In addition, we evaluated whether the birth conditions can affect these features. RESULTS: Higher frequencies of CD127 - CD25++ Treg cells expressing Foxp3 and CD45RO were observed in the colostrum. The cells' CD25, CD152, CD279, and TGF-ß expression levels were greater than those in autologous blood cells. In addition, the CD279 and TGF-ß expressions of colostrum CD127-  CD25++ Treg cells were influenced by gestational age and delivery mode. CONCLUSION: The higher proportion of these cells with a function-associated phenotype may reflect certain tolerogenic effects of breastmilk on newborns and infants, contributing to immune system homeostasis.

Retinopatía del prematuro: controversias en el uso de antiangiogénicos intraoculares / Retinopathy of prematurity: controversies in the usage of intraocular antiangiogenics

El aumento en la sobrevida de los recién nacidos prematuros, las características del cuidado neonatal y la escasez de programas para la prevención, detección y tratamiento de la retinopatía del prematuro provocan que esta enfermedad sea la principal causa de ceguera infantil prevenible en México. El advenimiento de agentes antiangiogénicos de uso oncológico, y su uso -no autorizado, aunque con buenos resultados- en el tratamiento de enfermedades vaso proliferativas en la retina del paciente adulto, así como la presencia de reportes anecdóticos en la literatura y series de casos con serias fallas metodológicas han sugerido su utilización en el tratamiento de la retinopatía del prematuro. Desafortunadamente, estos agentes, utilizados indiscriminadamente, presentan absorción sistémica y causan efectos secundarios en el organismo del paciente prematuro. Además, no existen estudios de seguimiento a largo plazo que garanticen la seguridad de su uso en esta población. El presente artículo describe la situación en nuestro país y advierte sobre los riesgos de estos medicamentos en la población de pacientes prematuros.

The increase in survival rates among preterm infants, characteristics of neonatal care for such infants and a lack of suitable programs for preventing, detecting and treating retinopathy of prematurity (ROP) are factors that have made this disease the main cause of preventable blindness among children in Mexico. The advent of antiangiogenic agents in cancer treatment and their off-label use with favorable results in the treatment of proliferative vessel disease of the retina among adult patients, as well as anecdotal reports in the literature and a series of cases showing serious methodological flaws, have prompted their use in the treatment of retinopathy of prematurity. Unfortunately, these agents used indiscriminately in our country have a systemic absorption and secondary effects on the preterm patient's body. There are no long-term monitoring studies that guarantee their safe use in this segment of the population. This article describes the situation in our country and warns of the risks posed by the use of this type of drug on the preterm infant population.

Hemorragia intraventricular en recién nacidos pretérmino en una Unidad de Tercer Nivel en la Ciudad de México / Intraventricular hemorrhage in premature infants in a third level unit at México City

Introducción: La hemorragia intraventricular (HIV) es una complicación en el recién nacido prematuro y su incidencia aumenta inversamente en relación a la edad gestacional y peso al nacer. Las medidas de cuidado y tratamiento en los recién nacidos con HIV van cambiando con el tiempo, el objetivo del estudio fue conocer los principales factores asociados a la HIV en la población de estudio, y considerar las medidas tendientes a disminuir esta patología. Material y métodos: Estudio observacional retrospectivo de casos de recién nacidos prematuros, con diagnóstico de HIV egresados de las terapias neonatales durante el año 2009. Se analizaron variables maternas y neonatales mediante estadística descriptiva y se determinaron factores asociados a la gravedad de la HIV por medio del cálculo de razón de momios (OR) con intervalo de confianza al 95% (IC95%). Resultados: La frecuencia de HIV fue de 6.1% y de acuerdo a la gravedad de la HIV, el grado I ocurrió en el 62%, grado II en 22%, grado III en el 13% y en 3% grado IV. Los factores asociados a hemorragia grado III y IV, fueron peso < 1,000 g con OR 5.75 (1.35, 24.49), Apgar menor de 6 a los cinco minutos con OR de 22.71 (2.06, 249.5) y enterocolitis necrosante con OR de 8 (1.78, 35.93). Conclusiones: El neonato pretérmino es de riesgo para el desarrollo de hemorragia intraventricular. En la población estudiada, los factores asociados a HIV grado III y IV fueron el peso menor a 1,000 g, Apgar bajo y ECN.

Introduction: The intraventricular hemorrhage (IVH) is a complication of the preterm infants and the incidence is inversely related to gestational age and birth weight. The care and treatment of those babies with IVH has been changing over time. Objective: determine the factors associated in the development of IVH in the study group and also consider measures to reduce this pathology. Material and methods: A cross-sectional retrospective study was designed to assess premature infants with IVH, at the time of discharge from the neonatal therapy during 2009. Maternal and neonatal conditions were analyzed using descriptive statistics and factors associated with the severity of the IVH with odds ratio and (CI 95%). Results: The overall rate of IVH was 6.1%. Grade I occurred in 62%, grade II in 22%, grade III in 13% and grade IV, 3%. Birth weight less 1000 g (5.75, 1.35-24.49), Apgar score 4-6 at five minutes (22.71, 2.06-249.5) and necrotizing enterocolitis (8, 1.78-35.93), were associated with IVH grade III and IV. Conclusion: Preterm infants are of risk for developing intraventricular hemorrhage. In this study, birth weight less 1,000 g, low Apgar score and necrotizing enterocolitis were associated with IVH grade III and IV.

Mortalidad neonatal en 2007 y 2008 en un centro de tercer nivel de atención / Newborn mortality in 2007 and 2008 in a tertiary level care center

Introducción. La mortalidad neonatal es un indicador sensible y específico que nos permite conocer el estado de salud de un país y plantear estrategias para mejorarlo. Resulta de una cadena compleja de determinantes como los biológicos, los socioeconómicos y los de salud. El objetivo de este trabajo fue conocer la tasa de mortalidad neonatal general, por peso y edad gestacional, en un instituto de tercer nivel de atención durante 2007 y 2008. Métodos. Se analizaron todos los casos provenientes del comité de mortalidad perinatal y neonatal, de 2007 y 2008, desde 22 semanas de gestación en adelante. El análisis estadístico se realizó mediante medidas de tendencia central y dispersión para las variables cuantitativas y para las variables cualitativas frecuencia, porcentaje, χ² y razón de momios con nivel de significación estadística < 0.05. Resultados. La tasa de mortalidad para el año 2007 fue de 17.7 × 1000 nacidos vivos y para el 2008 de 19.7 × 1000 nacidos vivos. En relación con el peso y con la edad gestacional no se encontró aumento de riesgo al comparar los resultados de ambos años. Las malformaciones ocuparon el mayor porcentaje entre las causas de defunción. Conclusiones. Las tasas de mortalidad en 2007 y 2008 fueron de 17.7 y 19.7 × 1000 nacidos vivos, respectivamente. Las principales causas de defunción fueron las malformaciones cardiacas.

Background. Mortality is a sensitive and specific indicator for determining the health status of a country in order to implement improvement strategies. It is the result of biological, social, economic and health factors. The aim of this study was to determine neonatal general mortality and its relationship with weight and gestational age at a third-level health institution from 2007 to 2008. Methods. We analyzed all patients >22 weeks of gestational age from the perinatal mortality service. Statistical analysis was done using measures of central tendency and dispersion for quantitative variables and χ2, percentage and frequency for qualitative variables; odds ratios were calculated with significance level <0.05. Results. The mortality rate for 2007 was 17.7 per 1000 live births, and for 2008 it was 19.7 per 1000 live births. When we compared both years, we did not find an increased risk for weight and gestational age. Malformations occupied the largest causes of death. Conclusions. For years 2007 and 2008, mortality rates were 17.7 and 19.7 per 1000 live births, respectively, and the main cause of deaths were cardiac malformations.

Ventilación nasofaríngea con presión positiva intermitente como método de extubación en recién nacidos pretérmino menores de 1,500 g / Nasopharyngeal ventilation with intermittent positive pressure like extubation method on preterm new born smallest than 1,500 g

Introducción: La ventilación nasofaríngea (VNF) no invasiva es un método que se ha utilizado para poder extubar a pacientes con ventilación mecánica, con lo cual se busca reducir el número de complicaciones; sin embargo, en el campo de la neonatología no se ha establecido como método rutinario. Objetivo: Evaluar la eficacia de la ventilación nasofaríngea con presión positiva intermitente (VNF/PPI) como método ventilatorio, posterior al proceso de extubación en recién nacidos (RN) < de 1,500 g, en comparación con RN sometidos a presión positiva continua de la vía aérea nasal (CPAPN) y cámara cefálica (CC). Material y métodos: Se llevó a cabo un ensayo clínico aleatorizado conformado por 90 neonatos estables clínica y gasométricamente durante su primer evento de extubación. Los pacientes fueron asignados en forma aleatoria en tres grupos: el grupo I con VNF/ PPI (n = 30) el grupo II con CPAPN (n = 30) y el grupo III con CC (n = 30). Las variables de interés incluyeron: éxito en la extubación, parámetros gasométricos y clínicos durante 72 h posteriores a la extubación, diagnóstico de ingreso, uso de surfactante, aminofilina, esteroides, tiempo de ventilación, edad gestacional y peso. Resultados: No hubo diferencias en cuanto a variables como peso, edad gestacional, uso de surfactante, esteroides y diagnóstico de ingreso en los tres grupos. El grupo I tuvo éxito (permanecer en la VNF o CC al menos 24 h o no necesitar ser intubado nuevamente) en 93.4%, el grupo II: 60% y el III: 80% (p = 0.009). Las complicaciones se presentaron en 20%, 73.3% y 63.3%, respectivamente. Conclusión: La VNF/PPI mostró ser un método efectivo y seguro, en comparación con los otros métodos de extubación, por lo que es posible proponerlo como una estrategia útil de extubación, en recién nacidos prematuros estables, menores de 1,500 g.

Introduction: The non invasive nasopharyngeal ventilation (NPV) is a method that has been used to extubate patient with mechanical ventilation, to reduce the number of complications, however, in neonatology it is not used as routinary method. Objective: To evaluate the effectiveness of nasopharyngeal ventilation with intermittent positive pressure (NPV/IPP) as ventilatory method, after extubation process in preterm new born smaller than < 1,500 g, in comparison with new born with continuous positive pressure of air nasal via (CPAPN) and cephalic camera (CC). Material and methods: It was carried out a randomized clinical trial conformed by 90 NB on clinic and gasometric stable state, during their first extubation event. The patients were randomly assigned to one of in three groups: group I with NPV/IPP (n = 30); group II with CPAPN (n = 30); and the group III with CC (n = 30). The variables of interest included: successfully extubation, gasometrics and clinical parameters during 72 h after the extubation, initial diagnosis, surfactant, aminophylline and steroids use, time of ventilation, gestational age and weight. Results: There were not differences in as weight, gestational age, surfactant use, steroids and initial diagnosis among the 3 groups. Group I, was successful (to remain in the NPV or CC at least 24 h or not do need intubation again in 93.4%, group II: 60% and the III: 80% (p = 0.009). The complications were presented in 20%, 73.3% and 63.3%, respectively. Conclusion: The (NPV/IPP) showed to be an effective and safe method, in comparison with the other extubation methods, for allowing to propose it like as useful extubation strategy, in stable premature new born smaller than 1,500 g.

Análisis de la mortalidad neonatal precoz en el Instituto Nacional de Perinatología (1999-2001) / Early neonatal mortality analysis at the Instituto Nacional de Perinatología, 1999-2001

Objetivo: Analizar la mortalidad neonatal precoz en el Instituto Nacional de Perinatología de acuerdo con características perinatales y tiempo de vida. Material y métodos: Análisis de casos en donde se estudiaron las variables: peso, edad gestacional al nacer, causa de muerte y tiempo de vida. Se reportan frecuencias, tasas de mortalidad, tasa de incidencia (por 1,000 nacidos vivos), probabilidad de supervivencia y tablas de sobrevida. Resultados: La tasa de mortalidad fue de 17.13 y la tasa de incidencia de 2.48 muertes/día. Las principales causas de muerte fueron: defectos al nacimiento (34%) e inmadurez (27.8%). De acuerdo con el tiempo de vida, 34.4% de las muertes ocurrieron de 1-59 minutos, 32.4% de 1-23 horas y 33.2% de 1-7 días. Se reporta una relación inversa entre las tasas con el peso y la edad gestacional. La probabilidad de supervivencia fue menor en los menores de 1,000 g y en los menores de 25 semanas de gestación. Conclusiones: La menor mortalidad se reportó en neonatos mayores de 750 g y 26 semanas. Las principales causas de muerte fueron los defectos al nacimiento y la inmadurez.

Objective: The early neonatal mortality was analyzed based on perinatal characteristics and time of neonatal death at the Insituto Nacional de Perinatología. Material and methods: To analyze the cases, we considered birth weight, gestational age, primary causes of death, and time of neonatal death. Rate of neonatal mortality and incidence (per 1,000 live births) and survival tables were reported. Results: The neonatal mortality rate was 17.13; the incidence was 2.48 deaths/day. Congenital birth defects (34%) and immaturity (27%) were the principal causes of death. According to the time of death, 34.4% of the deaths happened in the first 59 minutes, 32.4% from one to 23 hours, and 33.2% from one to seven days. There was an inverse relationship between rates, related with birth weight and gestational age. The probability of survival was less in neonates with a weight less than 1,000 g and below 25 weeks. Conclusions: Those neonates whose birth weight was above 750 g and gestational age above 26 weeks had a low mortality rate. The main causes of death were congenital birth defects and immaturity.

Uso de surfactante pulmonar exógeno en el neonato pretérmino con síndrome de dificultad respiratoria, estrategia de rescate: experiencia del Instituto Nacional de Perinatología 1997-1998 / Use of exogenous surfactant in pretem infants with respiratory distress syndrome. Rescue strategy

Objetivo. Evaluar la utilidad del surfactante exógeno sintético en el manejo del neonato pretérmino con síndrome de dificultad respiratoria en la Unidad de Cuidados Intensivos Neonatales del Instituto Nacionalde Perinatología (INPer). Material y métodos. Se realizó un estudio prospectivo, de cohorte, en la Unidad de Cuidados Intensivos del INPer, México. En el periodo de un año, comprendido entre 1997 y 1998. Ingresaron al estudio un total de 72 pacientes, neonatos pretérmino, menores de 1,750 gramos de peso al nacer, con sospecha clínica y gasométrica de enfermedad de membrana hialina, confirmada con estudio radiográfico. Estos neonatos fueron sometidos a ventilación mecánica, poniendo especial interés en el uso de esteroides prenatales, condición al nacer, FiO2, PIP, MAP, PaO2, PaCO2, relación a/A O2, morbilidad y mortalidad. Resultados. El 88.9 por ciento de los casos nacieron vía abdominal. El peso promedio fue de 1,204 ñ 246 g. En el grupo de los que fallecieron fue de 1,073 ñ 258 g. El 79.6 por ciento presentaron Apgar menor de 6 al minuto de vida, persistiendo a los cinco minutos el 27.8 por ciento. En los pacientes que murieron predominó el Apgaró3 al minuto. Sólo un 16 por ciento de los casos recibieron esteroides prenatales. Se aplicaron un total de 142 dosis de surfactante. La edad promedio de administración fue a las 5.3 hrs de vida. El 69.4 por ciento recibieron dos dosis o menos y el tiempo de intubación promedio fue de 155 horas. El 55.5 por ciento de los pacientes presentaron enfermedad pulmonar severa. Las patologías asociadas más frecuentes fueron: sepsis en el 68 por ciento, conducto arterioso en el 47 por ciento y 41 por ciento, respectivamente; la enfermedad pulmonar crónica (DBP) se presentó en el 18 por ciento de los casos. En relación con las variables ventilatorias y gasométricas, encontramos para la primera dosis, con media de 96 y 80, respectivamente. La PIP, al igual que la MAP, no disminuyó significativamente. En todos los casos los valores postdosis de PaO2 se incrementaron (primera dosis p<0.05). Los sobrevivientes el valor predosis fue siempre mayor a 50 Torr. En el caso de PaCO2 no se observaron cambios. La relación a/AO2 mostró incrementós en todos los valores postdosis (media inicial 0.11)(trunco a 2500 palabras)

Use of prenatal phenobarbital in the prevention of subependymal/intraventricular hemorrhage in premature infants.

BACKGROUND: Subependymal/intraventricular hemorrhage (SE/IVH) is a frequent cause of disability and mortality. METHODS: This is a prospective, randomized, double-blind study which included 100 pregnant Mexican women who need to interrupt their pregnancy within 28-32 weeks of gestation. One group was given a single dose of intravenous (IV) phenobarbital 10 micrograms/kg (phenobarbital group, n = 50), and the other was provided with diluted distilled water (control group). Measurements of phenobarbital serum concentrations were taken by both mother and newborn, and head sonograms were applied during the first 24 hours, at the 3rd and 7th days of life. RESULTS: The sample was made up of 42 newborns in the phenobarbital group, and 46 in the control group; the newborns had phenobarbital levels of 11.5 5.7 g/microliter at birth, and of 9.5 +/- 5.9 g/microliter 24 hours later. SE/IVH was found in 12 patients from the phenobarbital group and in 29 from the control group (p < 0.005), the first group were 11 mild SE/IVH (2 grade I, and 9 grade II), and 26 in the control group (4 grade I, and 22 grade II), p < 0.005. Severe hemorrhages were similar between groups. A larger frequency of SE/IVH was found in the newborn group which received mechanical ventilation (p = 0.0008). CONCLUSIONS: Prenatal phenobarbital can reduce the SE/IVH frequency in premature infants younger than 32 weeks at birth. Its main effect could be shown in patients with mechanical ventilation.

Use of prenatal phenobarbital in the prevention of subependymal/intraventricular hemorrhage in premature infants

Background. Subependymal/intraventricular hemorrhage (SE/IVH) is a frequent cause of disability and mortality. Methods. This is a prospective, randomized, double-blind study which included 100 pergnant Mexican women who need to interrupt their pregnancy within 28-32 weeks of gestation. One group was given a single dose of intravenous (IV) phenobarbital 10 µg/kg (phenobarbital group, n=50), and the other was provided with diluted distilled water (control group). Measurements of phenobarbital serum concentrations were taken by both mother and newborn, and head sonograms were applied during the first 24 hours, at the 3rd and 7 th days of life. Results. The sample was made up of 42 newborns in the phenobarbital group, and 46 in the control group; the newborns had phenobarbital levels of 11.5 5.7 g/µl at birth, and of 9.5 ñ 5.9 g/µl 24 hours later. SE/IVH was found in 12 patients from the phenobarbital group and in 29 from the control group (p<0.005), the first group were 11 mild SE/IVH (2 grade I, and 9 grade II), and 26 in the control group (4 grade I, and 22 grade II), p <0.005. Severe hemorrhages were similar between groups. A larger frequency of SE/IVH was found in the newborns group which received mechanical ventilation (p=0.0008). Conclusions. Prenatal phenobarbital can reduce the SE/IVH frequency in premature infants younger than 32 weeks at birth. Its main effect could be shown in patients with mechanical ventilation