[Seven-year experience with microsurgery]. / Experiencia de siete años de microcirugía.

From 700 laparoscopies performed, in 600 of them (85.7%) the tuboperitoneal factor was altered. Surgery included: termino-terminal plastia 70 cases (36%), (3 patients had previous plastia); adhensiolysis 62 (31%), salpingostomy 48 (24%), neoimplantation 10 (5%), and mixed surgery 9 (4%). After surgery, desertion was present in 78 patients. Of the 121 remaining, 34 (28.1%) had primary sterility and 87 (71.9%) secondary sterility. 74 patients (61.2%) obtained pregnancy, 62 (83.8%) reached term, seven were abortions of first trimester (9.5%) and were five ectopic pregnancies (6.7%). The interval between surgery and pregnancy achievement was 1 to 48 months, 12.8 months average. We emphasize the 47 patients analysis who didn't has pregnancy, through: remark time after surgery, histerosalpingography, new laparoscopy and reevaluation of sterility factors; the results were: 19 cases (40.5%) have a 5 to 60 months time after surgery, 19.5 months average, 18 (38.3%) had new tubary obstruction, three (6.4%) with endometriosis treatment, three (6.4%) have tuberculosis genital treatment, two (4.2%) with falling again endocrine-ovarian factor, and two (4.2%) with masculine relapse. A decease was present because anesthetic complication. We underline selection surgery criterion and a strictly evaluation, such as an antiadhesion pre, trans and postoperative regime, ligamentopexya of rounds ligaments and a conscious education of the patients in their strictly pursuit.

[The use of prostaglandins for labor conduction in its latent phase]. / Empleo de prostaglandinas para la conducción del trabajo de parto en su fase latente.

We wanted to know enprostil efficacy, an E2 prostaglandin analogous as a labor conductor in it's latent phase in term pregnancies. 188 patients were included, 52% received intracervical enprostil and 48% were treated with oxytocin. The labor evolution, resolution and complications were watch over. 15 patients (15.6%) of the study group required labor conduction with oxytocin because it was inhibited after peridural anesthesia. The main pregnancy resolution was vaginal via; only 6.3% of the study group subjected cesarean section against 10.3% of the witness group and the most frecuent indication was stationary dilation (1 and 8 cases respectively). The time of the latent phase and total labor was lower statistically in the study group. The observed complications were post-labor hemorrhage (3.1%), polysystolia (4.1%) and vomiting (5.2%), without significant difference with the witness group. We conclude that intracervical enprostil help cervical mature. shortenning latent phase and total labor, disminish oxytocin requeriment and cesarean incidence by cervical alterations without compromise maternal-fetal morbi-mortality.

[Tumor of the ovarian juvenile granulose cells. Presentation of a case with an immunohistochemical and ultrastructural study]. / Tumor de células de la granulosa juvenil del ovario. Presentación de un caso con estudio inmunohistoquímico y ultraestructural.

Female, 5 years old; first pregnancy of term, eutocic, weight 3,100 g; breast fed, complete vaccination program. A bronchial pathology that was present seven months later, yielded with medical treatment. Her illness started on September, 1984 after sever trauma by horse kick, presenting with a tumor in left illiac fossa; there was pain, improved by analgesics; the tumor continued to grow up to 5 x 6 cm in diameter, painful on palpation, causing hospital admission. Thirty days later an ultrasonographic study reported an ovoid echogenic and echolucid mass of 6.5 cm in left ovary; an infra-umbilical laparotomy was performed, finding a left ovarian tumarration, ovoid, pink white, with vascular areas, 24 x 18 x 15 cm at maximal diameters, solid, smooth and bright; at section there was gray-white, nodular tissue, with cystic cavities, 0.5 cm. Electronic microscopy an immunochemistry study were carried out in order to confirm the diagnosis of juvenile granulosa cell tumor. The patient died seven months later.