[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.

[Laparoscopic findings in patients with pelvic pain, dysmenorrhea and sterility]. / Hallazgos laparoscópicos en pacientes con dolor pélvico, dismenorrea y esterilidad.

Endometriosis is a frequent gynecologic disease and is associated with dysmenorrhea, pelvic pain and infertility. We evaluated 71 patients who had any of these entities and were treated with laparoscopic procedures. We found a higher frequency of endometriosis in these groups in comparation with the reports of the literature but, there was no direct relation between the severity of endometriosis and the three groups (Revised Classification of the American Fertility Society). The organic pathology was the principal factor associated with the pelvic pain in most cases. Finally, we established the utility of laparoscopy in the diagnosis stading and treatment of endometriosis.

[Acute myocardial infarct and pregnancy. Report of a case and review of the literature]. / Infarto agudo del miocardio y embarazo. Presentación de un caso y revisión de la literatura.

We present the case of a 39 year old woman with 36 weeks pregnancy and acute myocardial infarction seen at the Hospital ABC. Acute myocardial infarction during pregnancy is not very common and it's incidence has been calculated in 1:10,000 pregnancies it takes place more often during the third trimester, so we have to keep it in mind for early diagnosis. Mortality increases when it occurs during the third trimester close to delivery, during labor or in the first 7 days post delivery. Initial management of this high risk patients has to be done in a intensive care unit and requires of the intervention of multiple specialists, to decrease maternal and fetal mortality.

[Hypertrophic cardiomyopathy and pregnancy. Presentation of a case and review of the literature]. / Cardiomiopatía hipertrófica y embarazo. Presentación de un caso y revisión de la literatura.

We present the case of a 31 year old woman with primary hypertrophic myocardiopathy associated with term pregnancy seen in the Department of Gynecology and Obstetrics at the Hospital ABC. Pregnancy, labor and delivery coursed without obstetric and perinatal complications. We comment the classification, etiology, diagnosis and treatment of this cardiopathy that has been reported in pregnancy in few publications.