[Maternal mortality at the Gynecologic-Obstetric Hospital of the Western National Medical Center, Mexico. A 12-year review]. / Mortalidad materna en el Hospital de Gineco-Obstetricia del Centro Médico Nacional de Occidente. Revisión de 12 años.

The aim of this study is to present the analysis of the leading causes of mortality found in all the cases of maternal death at the Hospital de Ginecobstetricia (HGO) and Hospital de Especialidades (HE) del Centro Médico Nacional de Occidente (CMNO), during a period of 12 years, to achieve a winder view and to find a solution to reduce maternal mortality (MM). We reviewed files and reports of the maternal mortality committee of 151 women who were hospitalized and died at the HGO and HE del CMNO in Gudalajara, Jalismo, México, between January first, 1985 and December 31, 1996. During this period the maternal death ratio was 64 per 100,000 live births. The main cause of maternal death was toxemia 25%, follow by hemorrhage 23%, pulmonary thromboembolism 16%, infection 13%, and anesthetic complications 6%. 73% were foreseen deaths and 23% were unforeseen deaths. At the patients arrival to the hospital 37% were avoidable deaths. 66% were direct obstetric deaths and 34% were avoidable deaths. 66% were direct obstetric deaths and 34% were indirects. In 50% of the cases the end of pregnancy was done by cesarean section. The professional responsibility existed in the 72% and the hospitalary in the 23%. We made an analysis related factors and we propose strategies to diminish the maternal mortality.

[Maternal mortality at the Hospital de Ginecobstetricia del Centro Médico de Occidente, IMSS. Review of 5 years]. / Mortalidad materna en el Hospital de Ginecobstetricia del Centro Médico de Occidente, IMSS. Revisión de 5 años.

This study was carried out in order to know the mortality rate and related factors at Hospital de Ginecobstetricia, Centro Médico de Occidente, and to analyze the problem and to propose solutions. The files and reports of the Maternal Mortality Committee, regarding 74 deaths in a five year period, were reviewed. The definitions and classification criteria proposed by tha International Federation of Gynecology and Obstetrics, were used. The average maternal death rate was 8.01 per 10,000 births. The main death causes were: hemorrhage, systemic hypertension, probable pulmonary thromboembolism and sepsis. Direct obstetrical deaths, were 82.4%; predictable deaths, 66.2%, and deaths on hospital arrival, 39.1%. There was professional liability in 66.2%, and hospital liability in 25.6%. These and other data, were analyzed and possible strategies to diminish maternal mortality, were proposed.

[Subcapsular hepatic hematoma in severe postpartum pre-eclampsia. Presentation of a case]. / Hematoma hepático subcapsular en preclampsia severa postparto. Presentación de un caso.

One of the known complications of the patient with preeclamptic or eclamptic disease is the subcapsular hepatic hematoma, caused mainly by the development of disseminated intravascular coagulation. When such hematoma ruptures to the abdominal cavity mortality is high. Nevertheless, there are reports of survival, depending on a prompt and accurate diagnosis and a prompt surgical approach. In this article, a case of a patient with a postpartum severe pre-eclampsia is presented. She was diagnosed as a HELLP syndrome complicated by a disseminated intravascular coagulation and a subcapsular hepatic hematoma by clinic and supported by lab and confirmed by ultrasound, who had a satisfactory outcome.

[Acute fatty liver in pregnancy. Presentation of a case]. / Hígado graso agudo del embarazo. Presentación de un caso.

Acute fatty liver of pregnancy (AFLP) is not a very frequent disease, of unknown etiology mainly present in the 3rd trimester of the pregnancy. Early diagnosis and treatment including interruption of pregnancy (delivery or caesarean section) had been the key for decreasing fetal-maternal morbidity-mortality in recent years. This paper analyzes a clinical report of a 30 years old woman suffering AFLP histologically confirmed admitted to our hospital two weeks after illness started and who died because of secondary complications which did not respond to management probably because it was too late.