Introduction. Neonatal sepsis is a set of clinical signs and symptoms caused by a systemic infection, associated with maternal, neonatal or hospital risk factors. Objective. Provide informed recommendations for the best available evidence for the prevention, diagnosis and treatment of neonatal sepsis. Methods an Evidence-based Clinical Practice Guide (CPG) was developed through an adaptation process, in charge of a team of methodologists and neonatologists who are experts in the clinical management of neonatal sepsis. The search and pre-selection of CPGs that respond to the scope and objectives set were carried out, using the AGREE-II instrument, the methodological quality of the guides was evaluated and their adaptation decided. To identify the evidence that answers the questions in the guideline, a systematic search was carried out in multiple databases: M...

Environmental Microbiota of the Neonatology Department at the National Maternal Perinatal Perinatal, Lima, Perú

Introduction. Healthcare-associated infections (IAAS) increase neonatal morbidity and mortality. Identifying the microbiological profile and sensitivity of the microbiota allows us to reduce infection rates, rationalize the use of antibiotics and improve neonatal survival. Objectives. To know the environmental microbiota and antimicrobial sensitivity in the Department of Neonatology (DN). Methods. Observational, descriptive, cross-sectional study, carried out between April and May 2021, in the Intensive Care, Intermediate and Immediate Care services of the DN of the Instituto Nacional Materno Perinatal, a reference center for maternal and neonatal care. 144 surfaces were selected from the hospitalized patient environment. Using swabbing technique, samples were obtained and then seeded in common and selective culture media. Sensitivity was determined using Kirby-Bauer diffusion disks, the...

La preeclampsia severa repercute en la morbimortalidad neonatal, afecta la mayoría de los aparatos y sistemas. Objetivo: Elaborar un modelo predictivo de mortalidad con factores maternos y neonatales en recién nacidos hijos de madres con preeclampsia severa en el Instituto Nacional Materno Perinatal, atendidos entre el 2016 y 2022. Método: Estudio retrospectivo, observacional, analítico, tipo casos y controles. La muestra fue seleccionada aleatoriamente, conformando 185 casos (fallecidos) y 367 controles. Se investigaron 42 variables independientes y una dependiente (muerte neonatal). Se desarrolló análisis descriptivo, categórico bivariado y ejecutaron 07 algoritmos matemáticos para elaboración del modelo predictivo de mortalidad neonatal con 80% de la muestra y se realizó la validación con el 20% restante. Resultados: El grupo de casos desarrolló múltiple morbilidad neonat...

Background: Prematurity is a serious public health problem, due to its high morbidity and mortality, with 15 million premature births and one million deaths annually worldwide. The main causes of neonatal mortality in premature infants are necrotizing enterocolitis and late sepsis. In Peru, the percentage of premature births increased from 6.4% in 2020 to 7.5% in 2023, with an average of 30,000 premature newborns annually. In 2023, 70% of neonatal deaths corresponded to premature babies. The National Maternal Perinatal Institute reported high rates of neonatal mortality, especially in premature babies weighing less than 1500 grams. It is worth mentioning that of all neonatal deaths by 2023, 70% corresponded to premature babies and 46.5% to those less than 1500g. Objective: Determine the protective effect of colostrotherapy in premature newborns with birth weight less than 1500g in the IN...

Preeclampsia is a condition that affects pregnant women and is one of the leading causes of maternal death in Peru and the world, causing morbidity in both the mother and her newbom, in the most common problems in the neonatal age that associated with this pathology in neonates are: intrauterine growth restriction, small for gestational age, low birth weight, prematurity, metabolic disorders, clotting disorders, intraventricular hemorrhage, hyperbilirubinemia, respiratory distress, patent ductus arteriosus, necrotizing enterocolitis, hypotension, retinopathy , erosive gastritis, predisposition to infectious processes, including sepsis due to deficit in the activity of granulocyte chemotaxis and cytokines, etc. The impact of this disease continues throughout the life associating risk of diabetes mellitus, hyperlipidemia, hypertension, coronary artery disease, among others.

Objective: To determine the causes of neonatal mortality and its epidemiological characteristics in our institution, 2015and 2016. Materials and methods: Retrospective, descriptive and observational study, we reviewed the clinical records ofpatients who died in the neonatal department of the INMP during 2015 and 2016.

The best food for the newborn is breast milk, given the evidence of short and long-term medical and neurodevelopmentalbenefits. It should be considered a public health strategy to reduce neonatal morbidity and mortality, improve quality of lifein short and long term. Breast milk, also known as white blood, consists of approximately 258 components, from living cells,macro and micronutrients, hormones, defense system molecules, immunoglobulins, bacterias, etc; has great variability inrelation to the moment within the breastfeeding, time of day, age of the baby, according to the needs of the baby amongothers. The advantages extend to the mother and are multiple. For those cases where it is impossible to get breast milk, wemust be able to offer the option of receiving pasteurized milk from a milk bank. Currently the Ministry of Health and healthinstitutions have been working to accredit as a...

Childhood anemia is a public health problem in Peru. Physiologically, its main effect is the decrease of oxygen supply to tissues, which can have acute and chronic consequences in the infant, ranging from physical and transient deterioration to severe and permanent deterioration of physical and mental (cognitive) development. The diagnosis of anemia in the infant is not an easy task but by consensus a hemoglobin or hematocrit equal to or lower than the 5th percentile is used as the diagnostic threshold for the age, race and sex of the patient. Hemoglobin levels are usually high (> 14 g/dL) at birth to hemoglobin decrease rapidly, reaching a nadir of ~ 11 g/dL at 6-9 weeks of age due to the "physiological anemia of childhood". The causes of anemia according to the age of presentation. In neonates, immune haemolytic disease, infectious diseases, inherited disorders, delayed umbilical co...

Se describe el caso de una lactante con microcefalia, retraso en el crecimiento pondoestatural y de lenguaje, nacida en el Instituto Materno Perinatal en quien se halló un cariotipo 46, XX, r(7) (p22q36) [25]. Los hallazgos fenotípicos observados en el propositus fueron compatibles con los pocos casos reportados en el mundo con cromosoma 7 en anillo.

The frontal encephalocele represents a rare congenital anomaly of the anterior neuroporous closure, with herniation of the cranial content. We present the clinical case of a newborn born at the Maternal Perinatal Institute, who presented at birth, a frontal bilobed encephalocele, without associated commitment, even in our setting we lack multidisciplinary management guidelines that allow a favorable prognosis and evolution.

La COVID-19 fue declarada pandemia mundial por la OMS el 11 de marzo del 2020, en la actualidad hay más de 34 millones de personas infectadas en el mundo y más de un millón han fallecido1,2. Dong reportó de un total de 2,135 niños afectados solo el 1.5% en edad neonatal3. En el Perú, al 30 de setiembre del 2020, se han reportado 818,290 infectados y 32,535 fallecidos. Según el registro de NOTI-CDC-MINSA Perú hasta el 20 de setiembre del presente año, 6183 recién nacidos sospechosos a COVID-19, representa una incidencia acumulada de 17.93 x 1000 nacimientos. Por otro lado, notificaron 313 casos positivos con PCRrt, de ellos fallecieron   24 recién nacidos4. Los niños de todas las edades pueden enfermar con COVID-19, la mayoría no se enferman con tanta gravedad como los adultos, y algunos quizás no presenten síntomas. Los índices de hospitalización para niños ha...

Introduction: Adherence to clinical practice guidelines (CPG) improves the management of neonatal sepsis, reducing complications and mortality in newborns. Objective: To identify factors associated with adherence to CPG for neonatal sepsis at the Instituto Nacional Materno Perinatal (INMP). Material and Methods: A retrospective case-control study was conducted at the INMP, analyzing 988 neonatal sepsis hospitalizations between May and December 2021. Maternal and neonatal variables were evaluated using a mixed-effects logistic regression model to estimate adjusted prevalence ratios with 95% confidence intervals (CI95%). Results: Overall adherence to CPG was 75%, higher in early-onset sepsis (81,4%) than in late-onset sepsis (66,9%). Late-onset sepsis was associated with lower adherence (adjusted OR=1.37; CI95 %=1.05-1.78; p<0.01). Care provided by non-neonatologist pediatricians reduce...

Objective: The objective of this research is to describe adherence to the neonatal sepsis clinical practice guideline according to the type of sepsis in a perinatal maternal institute in Lima, Peru. Method: A descriptive study was carried out between the months of June to December 2021 at the Instituto Nacional Maternal Perinatal (INMP). The adherence of care to the CPG for the prevention, diagnosis and treatment of neonatal sepsis based on the INMP evidence was evaluated. Medical care was evaluated by two physicians who reviewed compliance or not with the 16 CPG recommendations. Adequate adherence was considered to be compliance of 80% or more of the recommendations established by the guideline in one care. Global adherence was calculated in percentages, by dimensions, by item and according to maternal and perinatal characteristics of care. Results: A total of 968 medical attentions wer...

Myelomeningocele is the most frequent form of spinal dysraphism, it represents a congenital anomaly of posterior neuropore closure and its cervical location is rare. The clinical case of a newborn born at the Perinatal Maternal Institute, who presented cervical myelomeningocele with neurological deterioration from birth and a karyotype with Robertsonian translocation, is presented.

  Objective. Determine the factors associated with congenital syphilis in newborns from the INMP between 2018-2021. Materials and methods. Quantitative, observational, analytical, case-control, cross-sectional and retrospective study, the group of cases were 214 neonates with congenital syphilis and 214 controls; A data collection sheet was used and to determine the degree of association, the Chi-square test and the calculation of the Odds ratio (OR) with a confidence interval (CI) at 95% and later a bivariate and multivariate logistic regression analysis were applied. Results. 64.02% of the mothers were between 20 and 35 years old, 82.71% educational level up to secondary school, 99.1% had no complete treatment, 59.3% less than 6 prenatal check-ups, 51.4% were born vaginally; 6.07% hypertensive disorder of pregnancy, 3.74% urinary tract infection, 3.74% chorioamnionitis, 2.34% positive...

Objective. Determine the factors associated with congenital syphilis in newborns from the INMP between 2018-2021.Materials and methods. Quantitative, observational, analytical, case-control, cross-sectional and retrospective study,the group of cases were 214 neonates with congenital syphilis and 214 controls; A data collection sheet was used and todetermine the degree of association, the Chi-square test and the calculation of the Odds ratio (OR) with a confidence interval (CI) at 95% and later a bivariate and multivariate logistic regression analysis were applied. Results. 64.02% of themothers were between 20 and 35 years old, 82.71% educational level up to secondary school, 99.1% had no completetreatment, 59.3% less than 6 prenatal check-ups, 51.4% were born vaginally; 6.07% hypertensive disorder of pregnancy,3.74% urinary tract infection, 3.74% chorioamnionitis, 2.34% positive HIV test...

The National Maternal Perinatal Institute (INMP), within the strategies implemented with the objective of reducing the morbidity andmortality rate with the technical advice of Brazil, inaugurated in 2010 the first Human Milk Bank of the country, with the purpose offeeding With mother’s milk from her own mother or with breast milk donated pasteurized, totally or partially to the preterm born inour institution, primarily to those born with a weight ≤ 1500 grams, as well as to post-surgical newborns. The BLH Responsible foractions of promotion, protection and support to breastfeeding, performs the processes of procuring (donor recruitment, lactationcounseling, etc); Processing or pasteurization of human milk (from this process comes safe milk) and fractionation and distributionaccording to medical indication. In order to carry out our work, we have the support of our collection centers,...

Since the efficacy of phototherapy has been demonstrated, it has become the main method for the prevention and treatmentof hyperbilirubinemia in the neonate with neonatal jaundice. Therefore, the objective of this project is to decrease the abnormallevel of bilirubin in the blood with innovation tools and to place it at low risk levels. For this, the proposed design consists ofa blue light source, which offers a uniform light distribution throughout the neonate’s surface; A control system that ensuresthe level of constant irradiance throughout the treatment, a noninvasive predictive method to determine the level of bilirubinin the neonate and a programmable interface that allows to suggest the most effective type of treatment. Electrical hazardsaccording to IEC 60601-1 standard for medical equipment are included.

We present the first case of application of therapeutic hypothermia in a newborn with a diagnosis of moderate ischemic hypoxic encephalopathy with the inclusion criterias. Risk factors, diagnostic criteria, evolution and monitoring during hypothermia and the followed-up post-discharge, are reported in our institution.