[Prognostic importance of controlled ovarian hyperstimulation previous to therapeutic laparoscopy of infertile patients]. / Importancia pronóstica de la hiperestimulación ovárica controlada previa a laparoscopia terapéutica en pacientes infértiles.

The use of the laparoscopic approach in the initial evaluation of the infertile couple without obvious disease is controversial; for these reason some centers has been done the initial treatment with ovarian stimulation (OS). The present article analyze two groups, the first for patients with OS for 4 cycles and laparoscopic approach after that and the second group with initial laparoscopy and medical treatment if they need it. Both groups has a OS after the laparoscopic procedure. The analysis of the prognosis of the OS before the laparoscopy and the impact in the reproductive outcome is done. The results shows that the OS does not have deleterious effects of the pregnancy rates if it is used before the procedure. However, the pregnancy are present early in the second group P < 0.05. In conclusion, in infertile woman without obvious disease that indicate the laparoscopy, the initial use of OS before the laparoscopy does not have a deleterious impact on the pregnancy rates.

[Integral treatment of severe ovarian hyperstimulation syndrome by means of autotransfusion of ascitic fluid and intravenous infusion of albumin]. / "Tratamiento integral del síndrome de hiperestimulación ovárica severo mediante autotransfusión de ascitis e infusión intravenosa de albúmina".

Severe ovarian hyperstimulation syndrome (OHSS) is a potential life-threatening condition relationated with ovulation induction. It affects multiple systems. Little is known about it's pathophysiology. The treatment available consists in the correction of fluid, electrolyte and hematologic imbalances. In other hand, is mandatory the prevention of embolic phenomena. Ascitic fluid aspiration result in dramatic improvement of symptoms. The purpose of this study was to assess the effect of autotransfusion of ascitic fluid obtained by paracentesis and the intravenous infusion of albumin for the treatment of severe from of the OHSS.

[Giant mesenchymal tumor of the vulva with atypical clinical evolution]. / Tumor mesenquinmatoso gigante de la vulva con comportamiento clínico atípico.

Mixed mesenchymal tumors of the vulva are rare lesions. On other hand, aggressive angiomyxoma is a recently characterized neoplasm occurring principally in the pelvic soft-tissues and showing propensity for local recurrence. The benign soft-tissue tumors are small than malign neoplasm, mimicking and often are misdiagnosed as cysts of Bartholin's gland. In this report we describe one case of a benign, giant and atypical mixed mesenchymal tumor of the vulva and its particular clinical characteristics.

[Successful course of pregnancy in a patient with polyglandular Schmidt's syndrome treated with hormonal replacement therapy]. / Evolución exitosa del embarazo en una paciente con síndrome pluriglandular de Schmidt tratada con terapia hormonal de reemplazo.

Schmidt's syndrome is characterized by the existence of adrenal insufficiency and lymphocytic thyroiditis, yet, it can also be accompanied of some other autoimmune diseases. Addison's disease usually produces infertility due to chronic anovulation, but patient who are properly treated can still be fertile. There are few reports of pregnancy and Schmidt's syndrome, this work presents a case treated with hormonal substitution therapy and successful obstetric outcome.

[Current state of uterine tamponade with Foley catheter in intractable bleeding]. / Estado actual del taponamiento uterino con sonda de Foley en sangrado incoercible.

In obstetrics, the uterine tamponade has been used for the control of acute uterine bleeding. However, the control of the acute hemorrhage from the nonpuerperal uterus is more difficult. Four cases are presented with uterine bleeding during dilation and evacuation without response to medical treatment. They were treated with the use of the Foley catheter for 12 to 24 hrs. There were not complications. The uterine tamponade with Foley catheter is a therapeutic option before the radical surgical treatment.

[A clinical case. Diagnosis and laparoscopic treatment of ovarian pregnancy]. / Caso clínico. Diagnóstico y tratamiento laparoscópico del embarazo ovárico.

Ovarian pregnancy is an uncommon presentation of ectopic pregnancy. It's frequency is 0.3-3.0 of all ectopic gestations. Is reported the case of a 33-year old female patient without previous pathology, was admitted because of lower abdominal pain, bloody vaginal discharge, a right adnexal mass, and positive serum pregnancy test. The preoperative diagnosis was tubal ectopic pregnancy. The following case report illustrates the successful application of operative laparoscopy for to treat primary ovarian pregnancy.

[HELLP syndrome. Severe consequence of hypertensive disease induced by pregnancy]. / Síndrome de HELLP. Consecuencia severa de enfermedad hipertensiva inducida por el embarazo.

A descriptive, transversal retrospective study was performed, to determine the prevalence of HELLP syndrome among patients with Pregnancy-Induced Hypertension (PIH), who were admitted into the Gynecology and Obstetrics Service the American British Cowdray Hospital in Mexico City, since July 1992 to June 1995. We detected a total or 11 patients who had the diagnostic parameters proposed by Sibaí, those were 11.8% of all the patients with PIH. The medial gestational age was 33 weeks (range from 30 to 39) The mean tensional levels were 170/ 107 mm Hg, in base of platelet count, nine patients were classified as Class I (82%) and two in Class II (18%), the medial peak levels of transaminases and bilirubins was reached 40 hours and that of lactic deshidrogenase 60 hours after the diagnosis was established, while the minimum levels of hematocrit and platelets were at 48 and 57 respectively. The mean weight of the neonates was 1,655 g, the maternal mortality rate was 9% and the perinatal 8.3%, the diagnosis of HELLP syndrome was established before delivery in 40% of the cases and after that in 60%, puerperal HELLP may occur more frequently that is believed. Point out the importance of early detection of this clinic entity in order to establish an opportune and efficient treatment which improves maternal and fetal prognosis.