[Value of the Linton-Nachlas balloon for the management of post-partum hemorrhage: a series of 25 cases]. / Intérêt de la sonde de Linton-Nachlas dans la prise en charge des hémorragies du post-partum : une série de 25 cas.

OBJECTIVES: Post-partum hemorrhage (PPH) is the first cause of maternal mortality in France. Uterine tamponade is an alternative in the management of PPH. We investigated the efficiency of the Linton-Nachlas balloon in treating severe PPH in a French Guiana center where interventional radiology is not available. MATERIALS AND METHODS: In this retrospective study, 25 women with severe PPH were included. Severe PPH is defined by the persistence of PPH despite sulprostone treatment. All women included in the study gave birth by vaginal delivery. The Linton-Nachlas balloon (Coloplast(®), France) used for digestive hemorrhage was inserted transvaginally. The primary endpoint for the efficiency was stopping PPH. RESULTS: The use of this balloon stopped the bleeding for 24 out of 25 patients (96 %). There was one case in which the treatment by the balloon was a failure. In that case, vaginal packing stopped the hemorrhage. No patient needed any complementary surgical treatment. CONCLUSION: This technique is a non-invasive, inexpensive, easy and efficient treatment. Most of the time, its use can stop hemorrhage and preserve fertility of young women wishing further pregnancies.

[Prevalence of anemia in pregnancy, Pucallpa Regional Hospital, Perú]. / Prevalencia de anemia en gestantes, Hospital Regional de Pucallpa, Perú.

Population based health surveys in Peru show that the general fertility rates, proportion of pregnant adolescents, and maternal and child morbidity are higher in the jungle regions than in other parts of the country. Endemic intestinal parasitic diseases increase the risk of anemia in pregnant women already suffering from iron, folic acid, and other nutritional deficiencies. This is the most common complication of pregnancy in many Latin American countries and is often associated with premature labor, low birthweight, and perinatal mortality. There are very few studies on this subject based on jungle populations and no reliable estimates of the prevalence of anemia in local pregnant women. The present study was designed to determine the prevalence of anemia in pregnant women attending the Regional Hospital in Pucallpa, located in the Peruvian jungle, from January 1993 to June 1995. This cross-sectional study, which was based on the registries of prenatal and childbirth services encompassing 1,015 pregnant women, looked into the potential association between anemia and such variables as the mother's chronological age, schooling, previous pregnancies, and weight at the beginning of pregnancy. Maternal hemoglobin levels were compared with the newborns' weight at birth. The prevalence of anemia in this population sample was 70.1%. This value was not modified when adjusted for maternal age, schooling, or interval between births. Anemia prevalence was directly related to the number of previous pregnancies and inversely related to weight gain during pregnancy. The perinatal mortality rate was 37.7 per 1,000 births. Neither this rate nor the birthweights were associated with the mother's degree of anemia. A multivariate regression analysis showed that maternal body weight at the start of pregnancy (P = 0.0001), weight gain during pregnancy (P = 0.0001), and the number of pregnancies (P = 0.008) are predictors of birthweight. Results showed that the high prevalence of anemia in Pucallpa's pregnant women is not associated with low birthweight or a high perinatal mortality rate. Future studies should investigate the principal causes of anemia in the pregnant women of Pucallpa and how the disease affects the psychomotor development of their offspring.

[Obesity as a risk factor in surgery for urinary incontinence]. / La obesidad como factor de riesgo en la cirugía anti-incontinencia.

There is controversy in the literature related with the prognosis of incontinent obese patient. The objective of this study was to demonstrate if obesity has influence on the relapse of postsurgical incontinence in genuine urinary incontinence. 148 patients were included measuring their Body Mass Index and divided in two groups: Group "A" 74 patients without relapse and Group "B" 74 patients with relapse. The results showed in the obese patients the double of surgical failures than in those with our it (P < 0.05). In conclusion obesity is a adverse prognostic factor in the postsurgical evolution in these patients.