Incidence of congenital hydrocephalus and the role of the prenatal diagnosis

Abstract

Artigo submetido em 07.06.02, aceito em 03.12.02. ResumoObjetivo: analisar criticamente o aumento da incidência de hidrocefalia na Maternidade do CAISM -UNICAMP, identificando o(s) fator(es) que podem explicar esse aumento.Casuística e métodos: estudou-se os portadores de hidrocefalia nascidos no CAISM, no período de setembro de 1987 a dezembro de 1998, exceto as hidrocefalias secundárias a defeito de fechamento de tubo neural. Os dados foram coletados a partir dos arquivos do Programa de Genética Perinatal-CAISM, incluindo as fichas ECLAMC e as do Ambulatório de Genética Perinatal, além de prontuários médicos hospitalares dos recém-nascidos e/ou de suas mães. As hidrocefalias foram classificadas em quatro grupos clinicamente distintos. As incidências das hidrocefalias e suas tendênci-as foram estudadas a partir do teste de tendência de CochranArmitage.Resultados: foram registrados 111 recém-nascidos portadores de hidrocefalia (3,16/1.000 nascimentos). A incidência anual das hidrocefalias mostra uma tendência em aumento significativa (p=0,001), que se acentuou após 1992. Dos 4 subgrupos de hidrocefalias (isoladas, associadas a infecção, associadas a síndromes dismórficas e associadas a defeitos múltiplos), apenas entre as isoladas foi observada tendência em aumento significativa (p=0,001). A maioria, 85% (94/111), das hidrocefalias registradas no período tinha diagnóstico pré-natal, e dessas, em 66% identificou-se um encaminhamento para o CAISM devido a tal diagnóstico.Conclusões: o presente estudo sugere fortemente que a tendên-cia em aumento das hidrocefalias no CAISM está associada ao diagnóstico ultra-sonográfico pré-natal e conseqüente encaminhamento preferencial desses casos para o CAISM, dada a sua condição de hospital de referência na região. Dentre os grupos clínicos de hidrocefalia, a tendência em aumento se verifica especialmente no grupo, etiologicamente heterogêneo, das hidrocefalias isoladas.J Pediatr (Rio J) 2003;79(2):135-40: hidrocefalia congênita, diagnóstico pré-natal, incidência, ultra-sonografia. AbstractObjective: to investigate the increasing incidence of hydrocephaly at the Hospital CAISM-UNICAMP and to identify its probable causes.Methods: all children with hydrocephaly delivered at CAISM from September 1987 to December 1998 were studied. Those children presenting hydrocephaly due to neural tube defects were excluded. Data were collected from medical records of the Perinatal Genetics Sector (CAISM). Hydrocephaly incidence and statistical trend were analyzed using the Cochran-Armitage test.Results: during the study, 111 infants with hydrocephaly (3.16/ 1,000 births) were identified. The annual incidence shows a significant increasing trend of hydrocephaly cases (p = 0.001). This phenomenon has been more evident since 1992. After classifying hydrocephaly in four subgroups (i.e., isolated hydrocephaly, hydrocephaly associated with congenital infection, syndromic hydrocephaly, and hydrocephaly associated with multiple defects), only isolated hydrocephaly cases show a significant increasing t...

Regional analysis on the occurrence of oral clefts in South America

“…Furthermore, this hospital in Campinas is also known to terminate pregnancies with a fetus diagnosed with malformations [Cavalcanti and Salomão, 2003]. Moreover, we failed to evaluate to what extent this bias of selective ascertainment is also affecting other detected clusters in our study, with Campinas representing an extreme situation.…”

Non‐immune hydrops fetalis: A prospective study of 53 cases

“…The second group more frequent was the syndromic cases (10-18.9%), and this could be associated with the high frequency of birth defects in our hospital that is around 6-7% (unpublished data). In addition, the role of the prenatal ultrasonography specially involved in the high frequency of structural defects easily diagnosed at prenatal have been showed since the early 2000's [Cavalcanti and Salomão, 2003]. High frequency of the syndromic group was also reported [Heinonen et al, 2000;Has, 2001].…”

Preservation of functional architecture in visual cortex of cats with experimentally induced hydrocephalus

“…Congenital hydrocephalus is a major neurological disorder in children, with an incidence of three to four cases per 1000 births (Cavalcanti & Salomão, 2003). Some visual functions are retained despite gross anatomical abnormalities in the brain of hydrocephalic subjects (Chen et al.…”

“…Congenital hydrocephalus is a major neurological disorder in children, with an incidence of three to four cases per 1000 births (Cavalcanti & Salomão, 2003). Some visual functions are retained despite gross anatomical abnormalities in the brain of hydrocephalic subjects (Chen et al, 1992;Richardson et al, 1998;Ptito et al, 1999; for an extreme case, see Kansu et al, 2001), whereas some abnormalities of the eyes and vision are often found in children with hydrocephalus (Ehle & Sklar, 1979;Gaston, 1985;Houliston et al, 1999).…”