[Chorioamnionitis as a cause of jaundice during pregnancy]. / Corioamnioitis como causa de ictericia durante el embarazo.

A clinical case of a pregnant patient with chorioamniotis and E. coli sepsis during the third trimester, whose principal clinical symptom was an icteric syndrome, is presented. Jaundice during pregnancy represents many etiologic possibilities, nevertheless the most frequent causes are hepatic or biliary tract diseases, some systemic illness like infections or eclampsia can be associated to this syndrome. It is proposed that, although is not a common cause, chorioamniotis must be considered between the causes of jaundice during pregnancy.

Curva de crecimiento cefalico fetal normal, por medicion seriada del diametro biparietal con ultraecosonografia. / Normal fetal cephalic growth curve, by serial measurement of biparietal diameter by ultrasound echography

Se presenta el resultado de las mediciones seriadas del diametro biparietal del feto (DBP), por medio de ultrasonido con tecnica de A-scan, en 70 casos seleccionados de embarazo normal, con fetos que llegaron al termino y cuyo peso al nacimiento fue mayor de 2,500 g. Se establecen los valores promedio y la variabilidad de las mediciones en razon de la edad gestacional, anotando leves diferencias con los encontrados por otros autores. Asi mismo, las tendencias de crecimiento del DBP entre las semanas 15 y 39 de gestacion. La medicion seriada iniciada alrededor de la semana 20, permite definir la tendencia de crecimiento fetal. La evaluacion aislada es poco confiable en terminos de prediccion del peso al nacimiento

[Obstetrics and perinatal medicine]. / Obstetricia y medicina perinatal.

PIP: Perinatal medicine concerns the period from delivery to the 1st 28 days of life; it includes maternal-fetal and neonatal medicine and the intervention of the specialist in internal medicine, obstetrics, and pediatrics. Currently, factors related to increased obstetrical, fetal or neonatal risk have been used to establish indices to aid the identification of the population more at risk of perinatal morbidity/mortality. A high risk newborn has been defined as presenting possible physical, intellecteual, or social problems which can negatively influence his or her normal development and/or learning abilities. Retrospective analyses conducted in Great Britain and in the U.S. showed that about 19% of the population falls into this category; the percentage is much higher in less industrialized countries. Modern technology can detect 70-80% of cases at risk of perintatal morbidity and mortality, and can intervene, even before delivery, with fetal intrauterine transfusion, fetal monitoring of the heart, and amniocentesis. Perinatology cannot exist without proper equipment and highly specialized personnel, which have been the major cause for the spectacular decrease in neonatal mortality experienced in many countries; still, neonatal mortality is about 4 times higher than general mortality. Many physicians consider family planning an integral part of any neonatal medical program. Several statistics show that 75% of anatomical or functional alterations are due to factors present before birth; such alterations can be epilepsy, mental retardation, deafness, blindness, or cerebral paralysis. Statistics for Mexico show the presence of about 600,000 individuals with serious and permanent problems due to sequelae of perinatal morbidity. Cause-effect relationships are extremely difficult to establish; the influence of socioeconomic factors, low birth weight, or reduced gestational age can be of paramount importance in influencing perinatal morbidity/mortality.^ieng

[Socioeconomic conditions and perinatal development]. / Condición socioeconómica y evolución perinatal.

PIP: It is a well proven fact that socio-cultural and medico-biological factors have a great influence in perinatal morbidity and mortality. The wide differences in fetal and neonatal mortality rates between developed and underdeveloped countries show that socioeconomic and cultural conditions are determining factors. Moreover differences in infant morbidity and mortality vary according to the different socioeconomic levels inside a single country. Birth weight is, for example, strictly associated to parity and education of the mother, and to the status of the family. The one factor which mostly influences perinatal mortality is, however, prenatal care. For example according to a survey conducted in Mexico in 1977, a high economic status but poor prenatal care entail a higher risk of perinatal death than a low socioeconomic status but good prenatal care. Prenatal care is also related to a good intellectual development and, apparently, to a higher I.Q. in later years.^ieng