[Diagnostic and therapeutic usefulness of laparoscopic surgery in acute abdomen of gynecologic origin]. / "Utilidad diagnóstica y terapéutica de la cirugía laparoscópica en el abdomen agudo de origen ginecológico".

The objective was to determine the usefulness of laparoscopy for treatment of gynecological emergencies. In this work were studied 78 cases of patients which were treated in the Emergency Room of ABC Hospital, with symptomatology associated to reproductive organs. The age of patients was 27.7 +/- 6.3 years. The more frequent diagnosis before surgery were ectopic pregnancy and ovarian cysts, the remainder patients were operated to determine pain etiology. Ectopic pregnancy antecedent was determinant to have same problem (X2, p < 0.05), other determinative factors were infertility and pelvic inflammatory disease. Abdominal pathology was detected in 97.4% of patients; 98.6% with gynecological pathology. The predictive positive value of preoperative diagnosis was 83.3% and 91.3% for ectopic pregnancy and ovarian cysts, respectively. In 25.6% of the cases endoscopy turned in laparotomy; massive hemoperitoneum in tubal rupture in cases of ectopic pregnancy was the most frequent indication of this conduct. As conclusion, laparoscopy is useful in most of cases of gynecological emergencies. Fast detection or abdominal pathology, in special ectopic pregnancy can be to lower conversion of laparoscopy to open surgery.

[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.

[Epidemiologic evaluation of the diagnosis and treatment of extrauterine pregnancy at the ABC Hospital]. / Evaluación epidemiológica del diagnóstico y tratamiento del embarazo extrauterino en el Hospital ABC.

The objective of this study was to determine the frequency, risk factors, treatment and morbility of the ectopic pregnancy (EP) at the ABC Hospital. EP cases occurring between January 1992 and May 1995 were studied retrospectively analyzing the next variables: Number of live births and EP's, the patients age, obstetric history, previous EP, sterility, previous pelvic surgeries, gestational age at diagnosis, treatment and complications. The results showed that the frequency of EP was 2.06% There was a positive correlation between EP and infertility, nuliparity, and previous tubal surgery secondary to EP. We concluded that even though EP tends to be diagnosed and treated in early stages, the majority of the surgical procedures lower patients fertility.

[HELLP syndrome as manifestation of pre-eclampsia decompensation during puerperium. 2 case reports]. / Síndrome de Hellp como manifestación de descompensación de la preeclampsia durante el puerperio. Presentación de dos casos.

Two extreme cases of pregnancy-induced hypertension with puerperal HELLP syndrome are presented and the literature is review. HELLP is an English acronym, for describing the preeclamptic or eclamptic patient, who also has hemolysis, elevated hepatic enzymes and low platelets. Its etiology has not been elucidated, but it has been accepted the theory of dysequilibrium in prostanoid metabolism. It has an incidence of 5 to 15% among patients with pregnancy-induced hypertension. Maternal mortality is about 10 to 28% and neonatal of 40%. Owing to fatal complications, treatment consist of interrupting pregnancy. Point out the importance of early detection of this clinic entity, which improves maternal-fetal prognosis.