Estudo sobre hidrocefalias congenitas em um hospital universitario brasileiro

AUTOR(ES)
DATA DE PUBLICAÇÃO

2000

RESUMO

Since the early 1990 s there has been an increase in the number of children born with hydrocephalus at CAISM - UNICAMP. This observation has motivated the current study which airns to investigate this higher incidence, looking for the possible causes, as well as to analyse those cases of hydrocephalus associated with other congenital defects(CD). It has been registered the hydrocephalus cases which were born at CAISM ITom September, 1987 to December, 1998. Data were collected ITom the Program ofPerinatal Genetics (ECLAMC and Perinatal Genetics Arnbulatory) as welI as Tom medical registers, according to a protocol containing information about family history, prenatal data, physical examination and laboratory exams of alI the cases of hydrocephalus. Other data were colIected as shown: information about the whole population of newborn children contained in the data of ECLAMC as well as information about 77 control cases paired up by sex, registered since 1992. From the 35.112 newborns, 111 cases of hydrocephalus were registered. These cases were clinically divided in: isolated hydrocephalus - 38 cases, hydrocephalus associated with congenital infection - ~3 cases, hydrocephalus associated with syndromes - 16 cases and hydrocephalus associated with other CD with no clinical-etiological diagnosis or children with malformations - 34 cases. The incidence of CD during the period was 5,74% and the incidence of hydrocephalus was 3,1611000 newborns. Considering the total amount of 111 cases, 92 cases (91,1%) started the prenatal folIow up in other hospitals and were sent to CAISM by maternal or fetal indication or by the ocasion of delivery. From those cases sent to CA):SM during the prenatal folIow up and by the ocasion of delivery, 68 had previous diagnosis ofhydrocephalus and 35 cases were sent for other reasons (other fetal malformations, maternal diseases or to give birth). The incidence, within this period, showed an statistically significant increase in the general group ofhydrocephalus (p=O,OOI), in the group sent to CAISM with previous diagnosis of hydrocephalus (p=O,OOl), in the group sent to CAISM for other reasons (p=0,043) and in the group of isolated hydrocephalus (p=O,ool) The differences found between the hydrocephalus group and the general population were: lower (birth) weight, higher cephalic perimeter, lower gestation age, higher incidence of cesarean section and higher incidence of other hydrocephalus cases in the farnily. The subgroup of syndromes consisted of 9 cases at first. After this current investigation and study, 7 cases were reclassified as syndromes and changed ITom the multimalformed subgroup to the svndrornic SUb!!roUD. Data show that the increased incidence of hydrocephalus is strongly in the period studied, related to an increase in the prenatal diagnosis (by ultrasound method) and the consequent concentration of these cases in a specialized center (CAISM) of the region. In 45% of the cases, hydrocephalus was associated with other CD and this fiequent association shows the importance of making a complete investigation every time a case of hydrocephalus is detected

ASSUNTO(S)

hidrocefalia diagnostico pre-natal ultra-sonografia

ACESSO AO ARTIGO

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