[Morbimortality at a second-level neonatology unit]. / Morbimortalidad en una sala de neonatología de segundo nivel.

In order to detect existing problems and opportunely pinpoint failures, an evaluation was conducted to determine the most frequent causes of morbidity and mortality in a neonatal ward. A retrospective analysis was carried out on the total number of births attended per year (1,003) at the hospital and of those newborns, those transferred to the neonatal ward (213, 21.2%). Of the 213 newborns placed in the neonatal ward, 30 of them (14.08%) were transferred to a Third Level Hospital (Neonatal Intensive Care Unit) while the rest remained in the neonatal ward. The five most frequent pathologies seen at the ward were reviewed. A high percentage (28.1%) of the patients were considered as potentially infected, while the remaining pathologies encountered were found to be similar to others reported elsewhere in the literature. Of the 183 babies looked after in the neonatal ward, 176 (96.17%) were cured and later discharged from the ward while the other seven died (3.8%) due to hyaline membrane disease, intracranial hemorrhaging, ischemic hypoxic encephalopathy and hospital-acquired septicemia. We conclude that specialized prenatal care and the early detection of high risk pregnancy decreases morbidity and mortality in second level hospital wards. Recommendations are given on the management of neonatal ward.

[Diagnostic problems in neonatal hypocalcemia]. / Problemas de diagnóstico en hipocalcemia neonatal.

Fifteen newborns were studied in the neonatal ICU of the Infantile Hospital of Tamaulipas in whom ICH, neural infection, tetanus, HIE++ and electrolyte disturbances were ruled out, with clinical data highly suggestive of hypocalcemia. Determination of both QTc and QoTc intervals by ECG and measurement of levels of total serum calcium and calcium in CSF and calculation of ionic calcium by means of the McLean Hastings nomogram were made in each patient. Calcium gluconate was administered IV as a therapeutic test. Presence and disappearance of clinical manifestations were correlated with laboratory tests during the suspicious period, 8 and 24 hours after treatment was begun. There was no correlation between clinical features and QTc or QoTc, nor between total serum, CSF or ionic calculated calcium. We conclude that the diagnosis of hypocalcemia in centers that do not have the specific electrode for direct Ca +/- measurement, should be sustained basically when after IV administration of Ca, symptomatology disappears and that the real usefulness of laboratory determination of total C, of ionic calcium, of QTc and QoTc is very limited.