Características clínicas de recién nacidos internados por mielomeningocele en el Hospital del Niño "Dr. Ovidio Aliaga Uría". 1993 2002
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Rev. bol. ped.
Abstract
Objetivos: determinar las características clínicas de los recién nacidos (RN) con mielomeningocele (MMC) en el Hospital del Niño "Dr. Ovidio Aliaga Uría". Diseño: estudio retrospectivo y descriptivo (serie de casos). Lugar: Hospital pediátrico institucional de tercer nivel. Pacientes: 55 RN hospitalizados por MMC en la sala de neonatología del Hospital del Niño, entre enero del 1993 y diciembre del 2002. Método de muestreo: consecutivo no probabilístico. Mediciones de los resultados principales: los casos clínicos se ubicaron revisando los archivos de alta, con el nombre o número de historia clínica se encontraron las fichas en el servicio de estadística. En un formulario preestablecido se registraron las variables y para el análisis se emplearon estadísticas descriptivas. Resultados: los RN con MMC representaron 2.1% de los ingresos neonatales. 73% provinieron del área urbana. La mediana de edad materna fue 25 años y fueron multíparas 73% de ellas. 55% realizó control prenatal. 45% nacieron en sus domicilios. 75% de los pacientes fueron derivados de un centro asistencial. 33% de los RN ingresaron con menos de 24 horas de vida. 71% tuvieron el MMC roto a su ingreso. Los MMC se ubicaron en la región lumbar en 47.28% y en la región lumbosacro en 38.18%; de los casos. 71% de los RN con MMC desarrollaron hidrocefalia. Fallecieron 27% durante el período neonatal. Solo el 12.5% concurrió a controles por neurólogo o pediatra. Conclusiones: el diagnostico prenatal del defecto fue ocasional. La derivación al hospital de los RN con MMC fue tardía. La mayoría de los MMC estuvieron ubicados en la región lumbar y lumbosacro, muchos pacientes ingresaron con el MMC roto y un alto porcentaje desarrollaron hidrocefalia. La mortalidad fue mayor a la reportada en la literatura y un mínimo porcentaje realizó controles posteriores al alta.
Objectives: to determine the clinical characteristics, of newborns with myelomeningocele (MMC), in the Hospital del Niño "Dr. Ovidio Aliaga Uría". Design: retrospective and descriptive study (case series). Setting: institutional pediatric hospital of third level. Patients: 55 newborns hospitalized between January 1993 to December 2002. Sampling method: consecutive not probabilistic. Measurements of the main results: the clinical cases were located checking the clinical histories of patients discharged from the hospital or revising the charts from the statistic department. We registered the variables and for the analysis we employed descriptive statistics. Results: we found 2.1% of MMC. 73% are originated from urban area. The median maternal age was 25 years, being multiparae 73% of them. 45% born in home. 75% were derived from medical facilities. 71% had the MMC broken and 33% were admitted under 24 hours of life. The MMC was situated in the lumbar region in 47.28% and lumbosacral region in 38.18%, of case. 71% heaved hydrocephalus. 27% of patients died and only 12.5% came back for a follow-up visit. Conclusions: the prenatal diagnosis was infrequent and patients were send late to the hospital. The most frequents sites for the defects were the lumbar and lumbosacral areas and most of them were open defects and a high percentage develop hydrocephalus. The mortality was high and very few of the patients returned for the follow up.
Objectives: to determine the clinical characteristics, of newborns with myelomeningocele (MMC), in the Hospital del Niño "Dr. Ovidio Aliaga Uría". Design: retrospective and descriptive study (case series). Setting: institutional pediatric hospital of third level. Patients: 55 newborns hospitalized between January 1993 to December 2002. Sampling method: consecutive not probabilistic. Measurements of the main results: the clinical cases were located checking the clinical histories of patients discharged from the hospital or revising the charts from the statistic department. We registered the variables and for the analysis we employed descriptive statistics. Results: we found 2.1% of MMC. 73% are originated from urban area. The median maternal age was 25 years, being multiparae 73% of them. 45% born in home. 75% were derived from medical facilities. 71% had the MMC broken and 33% were admitted under 24 hours of life. The MMC was situated in the lumbar region in 47.28% and lumbosacral region in 38.18%, of case. 71% heaved hydrocephalus. 27% of patients died and only 12.5% came back for a follow-up visit. Conclusions: the prenatal diagnosis was infrequent and patients were send late to the hospital. The most frequents sites for the defects were the lumbar and lumbosacral areas and most of them were open defects and a high percentage develop hydrocephalus. The mortality was high and very few of the patients returned for the follow up.
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Vol. 42, No. 3