[Indication for cesarean section: review of 300 cases]. / Indicación de la operación cesárea: revisión de 300 casos.

The indications of the cesarean surgery, nere determined sample of 300 cases was studied in the period form January to February 1995, of a total of 4385 patients, all of them attended in the Specialties Regional Hospital No. 23 "Dr. Ignacio Morones Prieto" of the Instituto Mexicano del Seguro Social. It was selected a non aleatory sample analyzing the variates instruction of the cesarean surgery. The first cause of surgery indication was the cephalopelvic disproportion, followed by previous cesarean, preeclampsia, severe fetal suffering and abnormal position. The cesarean surgery index was of 45.08%, which is high if it is compared with other medical publications of our country. To decrease the surgery incidence, we have to keep guard on the women with previous uterine surgery, with a good pelvic evaluation, prenatal estimate of the fetus weight, hospital and surgeons quality attention, in order to reduce the indexes of surgeries due to these causes.

[Prediction of fetal weight by the Johnson-Toshach metod]. / Predicción del peso fetal mediante la técnica de Johnson y Toshach.

Evaluation of Johnson and Toshach method to predict fetal weight. 200 patients with terminal pregnancy. The clinical method of Johnson and Toshach was used to calculate the fetal weight and it was compared with the immediate neonatal weight. Results were analyzed by the t Student test for paired data, with a certainty interval of 95%. The technique was accepted as useful in the cases without significative differences. 150 cases (75%) were in labor. The gestational ages were 38 weeks in 62 case; 39 weeks, 56 case; 40 weeks, 60 cases; 41 weeks, 22 cases. The average fetal weight vs neonatal weight was: At 38 weeks, 3,164 g (DS 289 g) vs 3,218 g (DS 364 g) (p > 0.05); 39 weeks 3,175 g (DS 301 g) vs 3,326 g (DS 391 g) (p < 0.05); 40 weeks 3,281 g (DS 404 g) vs 3,385 g (DS 461 g) (p < 0.05); 41 weeks 3,282 g (DS 308 g) vs 3,298 g (DS 267 g) (p > 0.05). From the cases with significative difference, 85% had labor. The Johnson and Toshach method is useful to predict the fetal weight in patients with terminal pregnancy and no labor.