descargas-supresión. Desarrolla infección asociada a cuidados de la salud con foco respiratorio, presenta mal manejo de secreciones y evolución tórpida, falleciendo a los 110 días. El caso se destaca por presentarse síndrome epiléptico en un paciente con fenotipo correspondiente al síndrome de Pierre Robin; pero que además tiene micropene. La presencia de las tres características citadas no pudo ser englobada dentro de un síndrome descripto con anterioridad. En recién nacidos con dismorfia y síndrome convulsivo es importante descartar la presencia de alteración estructural en el sistema nervioso como responsable del síndrome.

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The incidence of newborns (NB) with intrauterine growth restriction (IUGR) in Latin America and the Caribbean is 10%. Objectives: To determine the causes and characteristics of IUGR in children born at the Hospital Nacional in Paraguay from January 1999 to December 2001 and establish which factors are associated with symptomatic polycythemia. Materials and Methods: An observational and descriptive retrospective cohort study with nested case-controls including 259 NB with birth-weight below the 3d percentile. Results: 165 (64%) of NBs were premature, with a mean age of 33.1 ± 3.1 weeks. 220 NB (84.9%) showed symmetrical IUGR and 37 (14.2%) perinatal asphyxia. The most frequent causes of IUGR were maternal hypertension 87 (33.5%), adolescent mother 67 (25.9%), older mothers 44 (17%), twin pregnancy 34 (13%), and STORCH group infections 17 (6.5%). The dominant pathologies in NBs were hyperbilirubinemia 119 (47%), transitory tachypnea 76 (30%), hyaline membrane disease 49 (19%), nosocomial sepsis 43 (17%), and hypoglycaemia 14 (36%). Of the 195 NB with hematocrit (HCT), 53 (27%) developed polycythemia, and of those, 14 (26%) were symptomatic. Symptoms included hypoglycemia 6 (43%), weak suck 6 (43%), apneas 4 (18%), respiratory distress and hypotonia 3 (21%). The NB with symptomatic polycythemia had mostly suffered asphyxia (OR = 2.92), had asymmetric IUGR (OR = 2.39), or been children of preeclamptic mothers (OR=1.73). NB with thrombocytopenia were least frequently symptomatic. No signifi cant difference was shown in mean HCT between symptomatic and asymptomatic NB. Conclusions: The most common cause of IUGR was maternal arterial hypertension (AHT). More than half of NB with IUGR were premature, with the symmetrical form being more common. Factors associated with evolution of polycythemia were NB who were asphyxiated or with preeclamptic mothers. (Key words: Fetal growth retardation, etiology, risk factors, symptomatic polycythemia). Pediatr. (Asunción), 2008; 35(2): 77-87 CONO SUR SOUTH CONE OF AMERICA Rev Chil Pediatr 2010; 81 (4): 366-367Esta sección contiene los artículos originales de las Revistas de Pediatría de las Sociedades de Pediatría del Cono Sur seleccionados en el XIV encuentro de Editores, Brasilia, Brasil 2009, para ser publicados por los países integrantes durante el año 2010.

Background: In the context of a worldwide syphilis increment, the worst scenario is during pregnancy: if the correct treatment is not realized on time, the conception's product will be affected, amplifying this infection dimension.General Objective: Determine why pregnant women with syphilis did not receive the correct therapy.Specific Objectives: Determine absolute and relative frequency of pregnant women without treatment, inadequate one, or with reinfections, and their reasons.Stablish conception products (abortion, stillbirth, newborn) frequencies and describe the lastone's clinical situation.Methods & Materials: Methodology: observational retrospective study, based on clinical files revision.Period: Between January 1st 2015 and September 30th 2017 Inclusion Criteria: Pregnant women who finalize pregnancy in our hospital with acute syphilis.Results: During the study, 224 gestational syphilis were diagnosed, 165(73%) had the delivery in our hospital, hence were included in the study.Seroprevalence among pregnant women in our hospital during 2015 and 2016 was 1.27% and 2.24% respectively. The median age each year was 24 years in 2015 and 22 in 2016 and 2017 (p: 0.164). 76 (46%) out of 165 gestational syphilis included did not receive treatment, or it was inadequate, hence their children were assumed as congenital syphilis: 66 as suspicious (20 dead fetuses or abortion) and 10 as confirmed. The reasons why this situation could not be avoided are described below: