[Cervical ectopic pregnancy of 16 weeks gestation. Block with preventive hysterectomy surgical technique for massive pelvic hemorrhage. Case report]. / Embarazo ectópico cervical de 16 semanas de gestación. Histerectomía en bloque con técnica quirúrgica preventiva para hemorragia pélvica masiva. Reporte de un caso.

Obstetric hemorrhage remains the leading cause of maternal death, we continue to insist on preventive management of patients at high risk of massive pelvic bleeding, uterine dearterialization selective, significantly reduces the morbidity and mortality of the patient, on this ocassion we report the case of a 33-year-old with a diagnosis of cervical ectopic pregnancy of 13 gestational weeks, treated with selective dearterialization of hypogastric arteries with excellent results, without postoperative complications.

[Hypogastric arteries ligation: an experience in gynecological and obstetric patients at Hospital Universitario de Saltillo]. / Experiencia en la ligadura de arterias hipogástricas a pacientes ginecológicas y obstétricas del Hospital Universitario de Saltillo.

BACKGROUND: Pelvic hemorrhage is a potential complication that occurs performing an obstetric or gynecological surgery, it is essential to know the distribution of pelvic vascular supplement, and implement preventive measures, can significantly reduce morbidity and mortality. OBJECTIVE: To describe the experience of hypogastric artery ligation, as a preventive and therapeutic measure of pelvic hemorrhage, this will give us new prospective lines for future investigation. METHODS: Retrospective observational study, in which all patient who were performed a surgical procedure and report hypogastric artery ligation at the Saltillo University Hospital, from January 2008 to July 2014 was studied. RESULTS: 41 patients were obtained with hypogastric artery ligation, 28 gynecological and 13 obstetric patients. Among gynecological indications, cancer surgery represents 67.85%, benign lesions 25% and pelvic abscess 7.12%. Obstetric indications were uterine hypotonia with 46%, placenta previa with 23.07% and uterine fibroids, broad ligament hematoma and abruptio placenta a total of 30.7%. There was one complication in relation with technique that was a laceration of internal iliac artery without any consequence linked to this. And uterine preserving of 62% was observed in obstetric patients. CONCLUSIONS: This technique is a feasible and safe for preventive and therapeutic management of pelvic surgery, with a low incidence of complications 3.5% in gynecological patients and 0% in obstetric, with a mortality of 0%.

[Anterior pelvic exenteration. Report of a case]. / Exenteración pelvica anterior. Reporte de un caso.

Anterior pelvic exenteration is the last opportunity to control disease in a patient with cervical cancer in an advanced stage with a vesico-vaginal fistula, or in a patient with persistence of the disease and the need of improving the quality of life. In this case we present the cause of a 62 year old patient, with IVa stage cervical cancer, with bladder spread and a vesico-vaginal fistula treated with an anterior pelvic exenteration with Bricker technique and adjuvant treatment with radiotherapy.

[Histologic chorioamnionitis prevalence in patients with premature rupture membranes]. / Frecuencia de corioamnionitis histológica en pacientes con ruptura prematura de membranas.

OBJECTIVE: Search Histologic Chorioamnionitis frequency in patients in week 28 (+/-) and pregnancy with premature rupture of membranes. PATIENTS AND METHOD: Retrospective and observational study in which we studied all patients who came between June 28, 2011 and November 15, 2011 to receive obstetric care in the service of Tocochirurgical of the University Hospital of Saltillo, with greater than or equal 28 weeks of pregnancy. RESULTS: 598 patients were studied, and the frequency of premature rupture of membranes with histologic chorioamnionitis at term patients was, respectively, 1.7 and 5.3% in preterm labor. In the total sample frequency of histologic chorioamnionitis was 0.6% (4 patients) and, of these, 25% were term and 75% with preterm rupture. In patients with premature rupture of membranes the clinical chorioamnionitis was 0% valued by the criteria of Gibbs. CONCLUSIONS: The premature rupture of membranes is a risk factor important for histological chorioamnionitis. To decrease risk factors and possible complications, an established protocol must be taken.