[Preventive program of birth defects: incidence of anencephaly in Maracaibo, Venezuela. 1993-1996 period]. / Programa preventivo de defectos del nacimiento: incidencia de anencefalia en Maracaibo, Venezuela. Período 1993-96.

Incidence of anencephaly in the State of Zulia, and specifically in the Eastern Coast of Lake Maracaibo, an oil exploitation area, has been declared high since the beginning of the 80's, coincident with the generalized use of ultrasound as a diagnostic tool for fetal evaluation. Through the Birth Defects Preventive Program, established at the Hospital Chiquinquirá in Maracaibo, we have developed a fourfold strategy for the study of birth defects: i) analysis of more than 32,332 ultrasound evaluations within the Ultrasound Service, between 1993 and 1996, ii) a case-control malformation registry beginning in 1995, iii) a study of malformed stillbirths at the Pathology Service, observed after 4232 deliveries within this hospital, and iv) a registry of over 638 mothers with high risk pregnancy for fetal defects detected at the prenatal clinic and carried out at the Perinatal Medical Genetics Service. As a reference population we study 345 medical histories obtained from the Medical Genetics and Prenatal Diagnostic Service at Hospital Coromoto, and oil companies related medical facility. This approach has led us to conclude that the incidence of anencephaly in the State of Zulia is 0.75/1000, significantly similar to that expected for most populations.

Hipertension inducida por el embarazo Estudio de aminas biogenicas, hierro y funcion plaquetaria. / Pregnancy inducing hypertension. Study of biogenic amines, iron and platelet function

Se compararon los parametros hematologicos funcion plaquetaria y catabolitos urinarios de aminas biogenicas, en 27 embarazadas con Hipertension Inducida por el Embarazo (HIE) y en 27 embarazadas normales con la misma edad gestacional. Se observo un aumento significativo de los niveles de hemoglobina, hematocrito y hierro serico en el grupo con HIE, el cual se atribuye principalmente a hemoconcetracion, ya que no se modifican los valores de saturacion de transferrina. Los estudios de coagulacion mostraron resultados similares en ambos grupos, con excepcion de las concentraciones de fibrinogeno plasmatico, que fueron significativamente mas altos en HIE severa, apoyando la hipotesis de hemoconcentracion. La agregacion plaquetaria maxima, inducida por ADP, se encontro disminuida en las pacientes con HIE, sin embargo, estas pacientes mostraron mayor captacion plaquetaria de serotonina, sugiriendo que una deficiencia de esta amina en la plaqueta, sea la responsable de la deficiente agregacion. Las concentraciones urinarias de los acidos 5-hidroxindolacetico y hemovanilico se encontraron disminuidas en el grupo con HIE, lo cual pudiera indicar una menor actividad adrenal secundaria a los cambios microvasculares