[Delivery after a previous cesarean in the Gyneco-Obsteric Hospital Garza Garcia, N.L]. / Parto después de cesárea en el Hospital de Ginecoobstetricia de Garza García N.L.

One hundred and four patients who delivered after a previous cesarean section, at Hospital de Ginecoobstetricia de Garza García, N.L., from February 1, 1994 to January 31, 1995, were reviewed. The objective for this study was to know materno-fetal morbi-mortality at our hospital. Age, parity weeks of gestation, cause for previous section, delivery culmination, weight and Apgar of products, as well as, materno-fetal morbi-mortality, were analyzed. Average age group was 21 to 30 years with 68.5%. As to parity nulliparae predominated with 48.1%. As to weeks of gestation, the most frequent was 37 to 40 weeks, 85.5%. Previous section indication was: 1. Pelvic presentation, 2. Fetal stress, 3. Cefalo-pelvic disproportion, 4. Premature rupture of membranes, 5. Toxemia. As to deliveries outcome, there was dystocia in 86.5%, by profilactic low forceps application in 81.7%; and mid low in 4.8%. Eutocic delivery, 13.5%. Product weight was 3,000 to 3,500 g, with 51%. Apgar in 94 products was 8 and 9 at one minute. Maternal morbidity was 15.3% being most frequent vaginal tears. There was one case of uterine atonia, and one case of dura mater adverted puncture. There were no uterine dehiscence nor rupture. Perinatal morbidity was 5.6%. There was no perinatal death.

[Adolescent primipara]. / Primigesta adolescente.

263 cases of adolescent primipara at Hospital de Ginecoobstetricia, at Garza García. N.L. from January to December, 1995, were reviewed. two groups were formed, one of 12 to 15 years with 79 (30.1%); and the other one of 16 to 18 years, with 184 (69.9%), (p < 0.05). There were significant differences in both groups, with a greater proportion in the first group (p < 0.05), as to free union and preterm pregnancy; less prenatal control in the young ones with 31.6% against 23.3% in complications during pregnancy, more frequent the first group 36.7% and 28.8%; being more frequent, in both groups premature rupture of membranes, followed by anemia, toxemia and prolonged pregnancy. In pregnancy resolution, cesarean section showed a significant difference in both groups, being more frequent in the first group with 55.7% against 34.4% (p < 0.01) and the main indication was cephalopelvic disproportion with 32.9% and 16.8%. As to weight of products only 5% and 6.5% were subnormal; in the Apgar at one minute. it was slightly low in the first group with two deaths prepartum in the group two. Maternal morbidity was greater in the youth with 5% against 1%; There were no maternal deaths. Perinatal morbidity/mortality was 8.8% and 11.4%, predominating in both groups. Retardation of intrauterine growth, and in group two, congenital malformations and two deaths, fetal, prepartum. The contraceptive method used was Intrauterine device postpartum with a frequency of 81% against 72.2%. It is concluded that the adolescent primipara should be considered as high risk, as there is an increase in maternofetal morbidity, being more intense in the younger ones, and that a prenatal control, adequate, is of a great benefit.

[Analysis of the use of the Salinas forceps at the Gynecologic-Obstetric Hospital of Garza García, N.L. (Nuevo León)]. / Análisis de aplicación de Fórceps Salinas, en el Hospital de Ginecoobstetricia de Garza García, N.L.

Six hundred and thirteen cases of Salinas forceps application at Hospital de Ginecoobstetricia de Garza García, N.L. from November 1992 to April, 1993, were reviewed. The largest patients group, 20 to 29 years of age with 54.5%; primiparae were predominant with 55.9%, the largest amount of applications in term products, 80.8%; elective forceps with 72.5%; low application with 83.0%; medium 2.5%; episiotomy, medium, right lateral in all the cases; epidural block anesthesia in all the patients, and only one complication 0.1%; most frequent position variety OIA with 50%; and the smaller OIP with 2.6%; 96.3% of products weighted more than 2,500 g; and 87.1% with Apgar 8-9 at one minute. Maternal morbidity, 30.1%; fetal morbidity, 6.1%, with one case with facial paralysis (0.1%) by medium forceps. There were no maternal deaths; 3 antepartum fetal deaths; none postpartum.

[Syndrome of amenorrhea and galactorrhea. Clinical considerations]. / Sindrome de amenorréa y galactorréa. Consideraciones clínicas.

PIP: Of 180 cases of secondary amenorrhea and 20 of primary amenorrhea, 46 patients suffered from the syndrome of amenorrhea and galactorrhea. This showed that this problem is more frequent than the literature indicates. Of the 46 cases, 13% had a pituitary tumor. Such a high percentage was found with several authors so the possibility of a tumor should always be considered. Another 24% of the cases were postpartum and 52.1% were idiopathic. The latter, suffering from primary or secondary sterility were treated with different ovulation induction medication and in 37.2% pregnancy resulted. In general, the treatment of amenorrhea and galactorrhea tries to restore normal ovulation and the menstrual cycle. Possible useful medications are clomiphene, citrate, pergonal, and levo-dopa. Also, recent studies indicate that some alkaloid derivitives of ergot are effective in treating the syndrome. It is important to realize that the syndrome may have physiopathogenic implications that substantiate careful ovulation induction medication.^ieng