[Congenital absence of the vagina. Mayer-Rokitansky-Kuster-Hauser syndrome. Presentation of a case and review of the literature]. / Ausencia congénita de vagina. Síndrome Mayer-Rokitansky-Kuster-Hauser. Presentación de un caso y revisión de la literatura.

The normal development of the feminine reproductive tract depends on complete interaction between genetic, hormonal and environmental factors to produce the differentiation of the Müellerian, Wolff and urogenital sinus. The alteration in this balance result in a wide spectrum of the reproductive tract anomalies including imperforated hymen, vaginal septum, vaginal atresia, incomplete fusion of the Müellerian conducts and Müellerian aplasia. In order to evaluate the feminine genital tract disorders, we studied a feminine with amenorrhea and primary sterility. Ultrasonography and diagnosis laparoscopy where performed. Incomplete fusion of Müellerian conducts was observed. Blood genetics tests plus biopsy of ovarian tissue were taken which reported 46 XX karyotype with no structural anomalies. Conservative evaluation and management.

[Analytic study of amniocentesis in prenatal genetic diagnosis. Transversal study of cases]. / Estudio analítico de la amniocentesis en el diagnóstico genético prenatal. Estudio transversal de casos.

The experience obtained in 44 cases, in which amniocentesis was practiced for genetic diagnostic purpose in the private center in México City is presented. Indications, morbility and results are similar to those reported in the literature, is considered that this method should be offered to the couples who receive information about it and have maternal age 35 or older, antecedent of family chromosomal disease, alteration in maternal serum screening or family anguish. This is a safe method and easy to perform with a high sensibility and specificity, this is the first report in a private center in México that analyzes technique.

[Uterine sarcoma. Analytic study of 37 cases]. / Sarcoma uterino. Estudio analítico de 37 casos.

The lack of uniformity in the nomenclature of the uterine sarcomas, it have contributed to a variety and variability of classifications. Fortunately the sarcomas of uterus are rare. The incidence of this tumor is of 3-5% of all the uterine cancers or of 1.7/100,000 women of 20 years or more. The clinical presentation of these tumors is diverse could come bleed uterine abnormal, abdominal pain, pelvic mass, discharge or cervix prominent mass. Clinical discoveries associated with exist the sarcomas how they are the obesity and high blood pressure in a 30% of the patients it are also observed antecedents of pelvic radiation in a 5-10% of the cases. The genomic alterations that is reported the chromosomes in the literature is associated with 1, 7 11 playing an important paper in the initiation or progression of the sarcomas. We was carried out a retrospective analysis of 37 cases of uterine sarcoma managed in the National Institute of Cancerology at one time of 5 years. Being that the leiomiosarcomas comes in the 51.3% of the cases, followed by the stromal sarcoma, bleed uterine abnormal it was the clinical fact of high importance, detecting these patients in Ia and IIa stadiums predominantly. We observed an increment in the incidence of the uterine sarcoma in patients of 40 years or more. 17 patients were managed exclusively with surgery, 17 patients with surgery and radiotherapy and 5 patients with surgery and chemotherapy (2 patients were managed with surgery + radiotherapy + chemotherapy). The index of failure was from the 45.1% to two years in general form, coming metastasic illness in lung, liver and breast mainly. In conclusion, the adjuvant radiotherapy and chemotherapy to the hysterectomy doesn't increase the index of survivor in the several subtype of uterine sarcomas.

[HELLP syndrome. Severe consequence of hypertensive disease induced by pregnancy]. / Síndrome de HELLP. Consecuencia severa de enfermedad hipertensiva inducida por el embarazo.

A descriptive, transversal retrospective study was performed, to determine the prevalence of HELLP syndrome among patients with Pregnancy-Induced Hypertension (PIH), who were admitted into the Gynecology and Obstetrics Service the American British Cowdray Hospital in Mexico City, since July 1992 to June 1995. We detected a total or 11 patients who had the diagnostic parameters proposed by Sibaí, those were 11.8% of all the patients with PIH. The medial gestational age was 33 weeks (range from 30 to 39) The mean tensional levels were 170/ 107 mm Hg, in base of platelet count, nine patients were classified as Class I (82%) and two in Class II (18%), the medial peak levels of transaminases and bilirubins was reached 40 hours and that of lactic deshidrogenase 60 hours after the diagnosis was established, while the minimum levels of hematocrit and platelets were at 48 and 57 respectively. The mean weight of the neonates was 1,655 g, the maternal mortality rate was 9% and the perinatal 8.3%, the diagnosis of HELLP syndrome was established before delivery in 40% of the cases and after that in 60%, puerperal HELLP may occur more frequently that is believed. Point out the importance of early detection of this clinic entity in order to establish an opportune and efficient treatment which improves maternal and fetal prognosis.

[Laparoscopic treatment of dermoid cyst. First report in Mexico]. / Tratamiento laparoscópico de quiste dermoide. Primer informe en México.

The laparoscopic treatment of adnexal masses has been controversial; however, the study of the case with the judicious use of the laboratory and ultrasound permit the laparoscopic approach of the most of the adnexal masses, including the dermoid cyst or mature cystic teratomas, and offer to the patient the benefits of the laparoscopic surgery with low morbidity. However, it should be do it in medical centers with the human and technics recourse need it for the performance. It present the first report in Mexico of laparoscopic treatment in contrast with a group of patients with laparotomy. The results of this study, are in conformity with the reports on the literature and suggest the initial laparoscopic approach of the dermoid cyst.