[Obstetric hysterectomy. Review of 675 cases at the Instituto Nacional de Perinatología]. / Histerectomía obstétrica. Revisión de 675 casos en el Instituto Nacional de Perinatología.

A retrospective study of 675 patients subject to obstetric hysterectomy from January 1st, 1985 to December 31st, 1995 at the Instituto Nacional de Perinatología was carried out. The incidence of this procedure reached its highest level in patients from 26 to 40 years, which represented 60.5% (409 cases) of the studied population. Patients with one previous cesarean section comprised 34.8% of total obstetric hysterectomies, followed by women with two to three previous cesarean sections (24.5% and 22.2%, respectively). As for gestational age, it reached term in 51.1% (345 cases), pre-term in 38% (257), post-term in 1.4% (10), and less than 20 weeks in 9.3% (63 cases). Main indications for obstetric hysterectomy included placenta accreta in 34.07% (230 cases), uterine atony in 32.4% (219), deciduomyometritis in 6.3% (43 cases), and uterine rupture in 4.5% (31). Most frequent complications included hypovolemia (12.1%), bladder injury (5.4%), and ureteral injury (0.7%). Postoperative complications included anemia (61.6%), febrile syndrome (7.5%), mechanic ileum (7.5%), wall abscess (3.4%), and vesicovaginal fistula (1.6%). A total of eight maternal deaths (1.1%) was reported.

[Therapeutic efficacy of vaginal administration of bromocryptin in patients with hyperprolactinemia]. / Efectividad terapéutica de la bromocriptina (BEC) administrada por vía vaginal en pacientes con hiperprolactinemia.

Oral bromoergocriptine (BEC) is currently the treatment of choice in women with hyperprolactinemia secondary to a prolactinoma. However, undesirable side effects (of variable type and intensity) are frequently present in these women due to both local irritation and to a direct effect upon the central nervous system. The present work was undertaken as a pilot study to assess the therapeutic effectiveness of vaginally administered BEC and to corroborate if the side effects are less frequent and of minor intensity when compared to oral BEC. Initially, 16 women were included, but two of them did not accept to continue in the study; thus, a total of 14 women with hyperprolactinemia (> or = 40 ng/ml) were divided in two groups: Group A encompassed five women, aged 27 to 36 years old, two with normal menstrual cycles and three with oligomenorrhea; all had primary or secondary sterility during 3 to 12 years and galactorrhea from 6 months to 3 years; in only one patient a brain computerized axial tomography (CAT) was performed which showed the existence of a macroprolactinoma. All received oral BEC (2.5-5 mg/day, except one patient with 10 mg/day). Group B included nine women, aged 26 to 36 years old, four had normal menstrual cycles and five had oligomenorrhea; all had primary or secondary sterility during the last 2 to 7 years and eight out of nine, also had galactorrhea during 1 to 8 years; in four of them a CAT was performed showing a pituitary microadenoma.(ABSTRACT TRUNCATED AT 250 WORDS)