Breech presentations in a sample of Colombian hospitals.

All the breech presentations that occurred in a large sample of data on obstetric deliveries from a random sample of urban hospitals in Colombia are examined. The 463 breeches are analyzed by age and parity of the mother, type of breech presentation (frank or footling) and type of delivery (vaginal or abdominal). The data suggest that abdominal delivery reduces perinatal mortality although cell values are too small to adequately control for birth weight.

[Assistance to delivery according to hospital classification]. / Atencion del parto segun clasificacion hospitalaria.

PIP: Between March and October 1977 40 urban Colombian hospitals participated in an evaluation of services given to women with high risk pregnancies. The purpose of the study was to find out whether high risk cases go to the more appropriate and better equipped hospitals. A total of 13,450 deliveries were observed at random, i.e. 8.3% of all deliveries in all 40 hospitals during the same time. Social, cultural, and clinical characteristics of mothers and infants were carefully recorded. It was found that Social Security hospitals had the lowest number of high risk patients, a moderate number of surgical interventions, and the lowest maternal and perinatal mortality rate. On the other hand, average size hospitals serviced a larger number of high risk patients, had the highest rate of surgical intervention and of perinatal mortality, and a moderate maternal mortality rate. University hospitals, with the highest concentration of high risk patients and with a moderate incidence of surgical interventions, had a moderate rate of perinatal mortality, and a high rate of maternal mortality. Obviously not all high risk patients were serviced by the best equipped hospitals and by the best prepared personnel, which resulted in a high rate of maternal-infant morbidity and mortality. It would be necessary to reorganize all available services in a more functional way, so that high risk patients can be assisted and treated in the most appropriate environment.^ieng

Maternity record: initial report on a national experience (Colombia).

The International Fertility Research Program, in cooperation with the Government of Colombia, drew a random sample of urban hospitals in which obstetric deliveries take place. Data were collected on a sample of the deliveries. Hospitals were divided into six types: university, university maternity, social security and three sizes of general hospitals. These groups of hospitals are compared with respect to the proportion of high-risk patients admitted, intervention rates and perinatal mortality rates.

[Endometrial study made during the continuous administration of microdoses of 30 micrograms of d-norgestrel]. / Estudio endometrial en la administraction continua de microdosis de 30 microgramos de d-Norgestrel.

PIP: 171 endometrium biopsies taken from 61 patients before and during treatment with daily doses of 30 mcg of d-norgestrel were studied. It was found that continuous treatment with this drug produces a number of changes in the endometrial mucus membrane, although they are less marked than those found during treatment with oral contraceptives of the combination type. The progestational effect appeared to take place earlier, and secretion began earlier, as shown by the appearance of subnuclear vacuoles. An atrophied endometrium was found in only 1 case, but this may be due to the fact that biopsies were not taken from patients showing amenorrhea. Considerable edema was frequently found in biopsies taken at all stages in the cycle. Despite the earlier appearance of the progestational effect, the development of the endometrium appeared to be less complete than in the case of normal patients without treatment. These changes may be related to the contraceptive action of d-norgestrel.^ieng