Fatal malformations in Jamaica

Babies with major malformations were identified during the Jamaica Perinatal Morbidity and Mortality Survey. They were in 96 (8.6 percent) of 1112 perinatal and neonatal deaths coming to necropsy and in 25 (2.35 percent) of 1085 other deaths. The central nervous system was not most commonly affected, followed by the renal, gastro-intestinal and cardiovascular system in decreasing order of frequency. Many infants had abnormalities in more than one system and 10 malfomation syndromes/sequences were identified. Although at the present time, major malformations make only a small contribution to perinatal and neonatal mortality in Jamaica, its importance will increase as there is a fall in deaths related to perinatal asphyxia, currently the major cause of perinatal mortality in Jamaica. Although many malformations are currently untreatable, it is important to take account of gastro-intestinal defects when planning surgical services for the newborn, since these are the most easily remediable (AU)

Fatal malformations in Jamaica

Babies with major malformations were identified during the Jamaica Perinatal Morbidity and Mortality Survey. They were in 96 (8.6 por ciento ) of 1112 perinatal and neonatal deaths coming to necropsy and in 25 (2.35 por ciento ) of 1085 other deaths. The central nervous system was not most commonly affected, followed by the renal, gastro-intestinal and cardiovascular system in decreasing order of frequency. Many infants had abnormalities in more than one system and 10 malfomation syndromes/sequences were identified. Although at the present time, major malformations make only a small contribution to perinatal and neonatal mortality in Jamaica, its importance will increase as there is a fall in deaths related to perinatal asphyxia, currently the major cause of perinatal mortality in Jamaica. Although many malformations are currently untreatable, it is important to take account of gastro-intestinal defects when planning surgical services for the newborn, since these are the most easily remediable.

[Congenital malignant neoplasms]. / Neoplasias malignas congénitas.

In order to determine the proportion of congenital neoplasias, a study of 1 076 malignant neoplasias was carried out at the Pathology Department of the Hospital Infantil de Mexico. As unquestionably congenital malignant neoplasias were considered those detected since birth and as possibly congenital, those identified during the first year of life of the patient. As a whole, in this series of neoplasias, approximately one case was found of the sum of the congenital group and the possibly congenital, to 4.5 of the total series. However the proportion of the group of congenital malignant neoplasias and that of possibly congenital varied for each type of neoplasias in particular. Excluding malignant neoplasias of hematopoietic tissues, retinoblastoma, nephroblastoma and neuroblastoma were the malignant neoplasias most frequently found.

[Congenital urethral diverticulum]. / Divertículo uretral congénito.

It is a rare condition; cases seen more frequently are usually secondary to other diseases or to surgical procedures. In this paper, a case of sacular diverticulum of urethra is reported in a newborn and was made evident by urinary obstruction. Treatment is discussed and review is made of the literature.

[Hyperthrophic congenital pyloric stenosis]. / Estenosis hipertrófica congénita del píloro.

An analysis is made of 18 cases with congenital pyloric stenosis, attended at the Hospital General de México S.S.A. The discussion is focused toward: age, sex, clinical, laboratory data and radiological features. Literature to this respect is reviewed finding historical data, surgical techniques employed and etiological hypothesis. We conclude, that every physician who attends children must keep in mind that infants under four months of age, with a history of vomiting immediately after feeding, without biliar contents, progressive in frequency and intensity, accompanied by pyloric stenosis must be suspected. The clinical examination must be directed to finding peristalic waves and pyloric tumor. Pyloromyotomy is the treatment in all cases. The prognosis should be favorable if the diagnosis and correction are properly and promptly made.

[Neonatal screening for hypothyroidism. Preliminary results from different methods (author's transl)]. / Neugeborenen-Hypothyreosescreening. Möglichkeiten und erste Erfahrungen.

In a regional study 2062 newborns were screened for congenital hypothyroidism by determination of TSH in plasma or dried blood spots on the fifth day of life. Three newborns with congenital hypothyroidism were detected. All of them showed high TSH-levels between 462 and 2192 micromicron/ml. One newborn with a congenital goiter had a TSH-level of 143 micromicron/ml. Additionally, in a follow-up study of 50 newborns with jaundice TSH, T4, T3 and reverse T3 during the first 120 h of life were measured. Efficiency of the different methods concerning their applicability to mass screening is discussed.

[Prognosis of prenatal varicella-zoster-infections in relation to their onset during pregnancy (author's transl)]. / Zur prognostischen Bedeutung des Zeitpunktes einer pränatalen Infection mit dem Varizella-Zoster-Virus.

7 children were observed, whose mothers had Varicella-Zoster-Virus-infection. 3 of these children developed postnatal Herpes Zoster without Varicella in their history; 1 child had Varicella in the neonatal period. There are indications that primary infection with Varicella-Zoster-Virus during the first four months of pregnancy may cause deformities in the child; the same during the last five days of pregnancy increases the risk of varicella with a complicated course in the newborn. Independent of the time of infection during pregnancy the prognosis of a secondary Varicella-Zoster-Virus-infection in the mother seems always to be good for the child. Aspects of the child's immunological maturation, still incomplete at birth, are discussed and can help to understand the different prognoses during pregnancy. The importance of serological diagnosis has been emphasized.