[Ovarian volume as a predictive factor of ovarian reserve in response to exogenous stimulation with gonadotropins and its correlation with ovum/embryo development in FIVTE/ICSI results]. / Estudio del volumen ovárico como factor predictivo de reserva ovular en respuesta a la estimulación exógena con gonadotropinas y su correlación con el desarrollo óvulo/embrionario en los resultados de FIVTE/ICSI.

UNLABELLED: The evaluation of ovarian reserve in regard to the exogenous response elicited by gonadotropines is directly related to the interconnection of diverse intrafollicular factors involved in ovum components, and thus, to a better embryonic development, which will be reflected in the pregnancy ratios of assisted reproduction programs. A series of markers have been proposed in order to dynamically evaluate the ovarian response: hormone determinations (FSH, E2, FSH:LH index), biochemical factors (inhibine-B), intrafolicular (cytokines, leptin), neuromodulators (GNRH test), and so forth. However, none has shown a specific sensitivity in order to accurately determine the best treatment depending on the values they provide. OBJECTIVE: To evaluate the capacity of ovarian response on the basis of ovarian volume determination. Two groups of patients were studied: group 1 (n = 19) with a basal ovarian volume smaller than 3 cm3, and group 2 (n = 21), those with a volume greater than 3 cm3. Patients in group 2 showed a better response to ovarian stimulation, as well as the collection of better quality ovarian, increased fertilization, segmentation and pregnancy ratios and a lower cancellation index as compared to group 1. It can be concluded that patients with an ovarian volume lower than 3 cm3 on the day before the stimulation will present a poor response to exogenous gonadotropins, thus, this variable must be considered as a marker of ovarian follicular response.

[Vaginal hysterectomy assisted by laparoscopy. Critical and comparative study if vaginal and abdominal hysterectomy at the A.B.C. Hospital of Mexico]. / Histerectomía vaginal asistida por laparoscopia. Estudio crítico y comparativo con histerectomía vaginal y abdominal en el Hospital A.B.C. de la Ciudad de México.

The laparoscopically assisted vaginal hysterectomy offers the possibility to convert abdominal to vaginal approach give to the patient the benefits of ti. The analysis of the first 20 cases in our institution is done and are compared with abdominal and vaginal approaches in some parameters including costs, indications and hospitalization days. The laparoscopically assisted vaginal hysterectomy offers to the patient the benefits of the vaginal approach with hospital stay similar and cost and operative time higher than those for either vaginal and abdominal hysterectomy. The exact role of the laparoscopically assisted vaginal hysterectomy on daily practice still is pending.

[New perspectives for an old problem: premature labor]. / Nuevas perspectivas para un problema antiguo: el trabajo de parto pretérmino.

Preterm birth has been and continues to be one of the most serious problems in Obstetrics. It is the most common cause of neonatal death, and morbidity in surviving infants. The presence of bacterial vaginosis, and other genital infections is associated with increased risk of preterm labor. Cytokines promote the release of prostaglandin, and have been implicated as cause of uterina activity. Recently, new methods of detection as transvaginal ultrasonography, and measures of cervical fetal fibronectin have been acclaimed as useful to detect the problem. Atosiban, cytokines, glyceril trinitrate, and many others agents have been proposed as treatments and are under investigation. Such drugs, will allow an effective management of preterm labor with lower side effects. Antenatal TRH administration cannot be recommended for widespread clinical use. However, the antenatal administration of corticosteroids to fetuses at risk of preterm delivery include not only a reduction in the risk of respiratory distress syndrome but also a significative reduction in intraventricular hemorrhage mortality.

[Endometriosis. Analysis of laparoscopic findings at the A.B.C. (American-British Cowdray) Hospital]. / Endometriosis. Análisis del hallazgo laparoscópico en el Hospital A.B.C.

Endometriosis approximately affects 10 to 15% of premenopausic women. Diagnosis mainly is made by laparoscopy. We revised all the laparoscopies which were made in labor service at the American British Cowdray Hospital from July 1st 1989 to June 30th 1994 in order to evaluate the incidence of endometriosis in the institution. They were made from 882 laparoscopies done, in 447 cases (50.68%) endometriosis was the main finding, this was similar to the reports published by other authors. The group of age mainly affected was from 20 to 29 years-old. Sterility was found in 53% of these patients, slightly above the results in other series. The 85% of the cases were in hospital for less than 24 hours. Complications were in 7% of them, none required a laparotomy, however.