[Risk factors in cesarean section]. / Factores de riesgo en la operación cesárea.

BACKGROUND: Improvement of surgical techniques, innovation, and technological development have increased the frequency of cesarean section. OBJECTIVE: To identify the sociodemographics, obstetrical, attention and medical practice factors of risk most frequently associated to cesarean section. PATIENTS AND METHOD: From January to June 2007, we carried out a study of cases and controls with 222 cases of cesarean section and 358 controls of vaginal childbirth in Hospital General no. 6 of Ciudad Juárez. We compared frequency of sociodemographics, obstetrical, attention, and medical practice variables, by means of chi2 and Fisher exact tests; association among these variables and cesarean section was considered with odds ratio. In all cases chosen confidence interval was 95%. RESULTS: Risk factors associated with cesarean section were: maternal age over 28 years, previous cesarean section, complicated pregnancy, fetal suffering, cephalopelvic disproportion, deficient prenatal care; fetal podalic version, oxytocin administration, abnormal amniotic fluid, double- or triple-circle umbilical cord; patient attended by a gynecologist with more than 16 years of experience and by a resident; and medical care in evening shift. There was no association with age, menarche, beginning of sexual relationships, body mass index, smoking, or addictions. CONCLUSIONS: Risk factors associated with cesarean section were: previous cesarean section and patient attended by a gynecologist with more than 16 years of experience and by a resident.

[Violence against women and family medicine]. / Violencia contra la mujer y medicina familiar.

BACKGROUND: prevalence of violence against women in Mexico fluctuate within 30 to 60%, but health and court administration institutions' numbers are under real ones, they only include extreme violence or pressed charges against them aggressor. OBJECTIVE: To asses the level of knowledge on the norms and procedures for the attention of domestic violence in family practitioners workers of the Instituto Mexicano del Seguro Social in Colima, México. MATERIAL AND METHOD: A cross-sectional study was conducted during the September-December 2005 period. The indicator was obtained of a self-administered questionnaire. The data collection instrument was design to asses the level of knowledge in five areas: definition, norms, classification, risk factors and domestic violence indicators. An knowledge index was constructed and analyzed using frequencies distribution and percentages. RESULTS: The age average was 41 years; medical practice 20 years. 72% men, 28% women; 91% had sentimental couple; 53% was family medicine specialist and 2% mastery; 53% worked in the morning shift and 47% in the evening one. The 91% didn't know the Mexican official norm; 91% without training on domestic violence, 74% ignored the types that exist; 76% ignored the cycles; 63% didn't register it as diagnostic in the clinical file; 52% know that the integral attention health registration leaf has a specific item for this problem. The average of guessed right answers was of 19 (range 15-24). CONCLUSIONS: The level of knowledge on the norms and procedures for the attention of domestic violence in family practitioners workers of the Instituto Mexicano del Seguro Social in Colima, México; was low degree in 0%, moderate in 81% and highly in 19%.