[Uterine arteriovenous malformation as cause of uterine bleeding of sudden onset. Doppler ultrasound utility, other imaging methods and the minimally invasive treatment]. / Malformación arteriovenosa uterina como causa de hemorragia uterina súbita. Utilidad del ultrasonido Doppler de consultorio, otros métodos de imagen y tratamiento de mínima invasion.

Background: Uterine arteriovenous malformation is a rare disorder that can cause sudden life-threatening vaginal bleeding. Objetive: To present the clinical features in addition to the use of office gynecologic ultrasound and other imaging techniques in the diagnosis and minimally-invasive treatment of a patient with sudden vaginal bleeding resulting from a uterine arteriovenous malformation. Case report: A 31 year old woman presented sudden onset vaginal bleeding requiring the transfusion of 3 units of red blood cells. An initial diagnosis of uterine arteriovenous malformation was made using an office gynecological ultrasound and Color Doppler sonography. The patient was referred to interventional radiology for confirmation of the diagnosis and patient care. The diagnosis and localization of the uterine arteriovenous malformation was confirmed using magnetic resonance imaging. Therapeutic management proceeded with superselective angiography and embolization of the supplying arteries resulting in immediate symptomatic resolution. Conclusion: The use of office gynecologic ultrasound in combination with other imaging techniques is an important tool in the diagnosis and localization of uterine arteriovenous malformation. Embolization of supplying arteries is considered a safe and effective therapeutic option due to advances in radiologic intervention techniques. Advantages of this procedure include a minimally-invasive technique, low morbidity and preservation of uterine function.

Evidence of multi-walled carbon nanotube fragmentation induced by sonication during nanotube encapsulation via bulk-suspension polymerization.

The synthesis of multi-walled carbon nanotube/polystyrene composites, with nanotube concentrations of 0.04, 0.08 and 0.16 wt%, was carried out by in situ bulk-suspension polymerization with the assistance of sonication. By using this method both encapsulation and exfoliation of the nanotubes into the polymer host were achieved. Evidence of significant nanotube fragmentation was found by scanning electron microscopy; the cause of such fragmentation was attributed to the induction of strong cavitation due to the application of ultrasound during the synthesis. Infrared spectroscopy showed no evidence of the formation of covalent bonds between the nanotubes and the polystyrene during the process of synthesis. The thermal stability was not improved by the inclusion of the nanotubes, it was attributed to the low nanotube concentrations; however, composites glass transition temperature showed improvements.

[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.