[Social-economic and obstetric factors associated to premature rupture of membranes]. / Factores sociodemográficos y obstétricos asociados con rotura prematura de membranas.

BACKGROUND: The premature rupture of membranes is the delivery of amniotic liquid after 20 weeks of gestation and before the beginning of labour. OBJECTIVE: To evaluate the association between premature rupture of membranes and sociodemographics and obstetrics antecedents. MATERIAL AND METHODS: Unmatched case-control study carried out in patients from Hospital Civil de Culiacan, Sinaloa (Mexico), from January 2003 to December 2006. Risk factors frequency was compared in women with and without premature rupture of membranes (cases: 1,399; controls: 1,379). Most important variables were: socio-economic level, smoking, and gyneco-obstetric history (sexual partners, pregnancies, newborns, abortions, prenatal control and intergenesic interval). Odds ratio, crude and adjusted, and interval of confidence (IC 95%) were obtained by means of non-conditional logistic regression models. RESULTS: Prevalence of premature rupture of membranes was 8.9%. Socio-economic level was similar in both groups. Premature rupture of membranes was associated with smoking, beginning of sexual activity, and intergenesic interval. History of two or more cesarean sections was considered a protective factor of premature rupture of membranes. Number of sexual partners was marginally meaningful (p = 0.053). Preterm birth frequency was higher in cases group. Resolution of pregnancy was the same for both groups (p = 0.233). CONCLUSIONS: Premature rupture of membranes was significantly associated with smoking, beginning of sexual activiti, intergenesic interval and a preterm birth history. Two or more previous caesarean sections were considered as protective factor.

[Total laparoscopic hysterectomy: complications and clinical evolution in an 87 cases series]. / Histerectomia total laparoscópica: complicaciones y evolución clinica en una serie de 87 casos.

BACKGROUND: Laparoscopic hysterectomy is a frequent non-obstetrical surgical technique. Its main benefits are less hospital stay and complications, and better surgical results. OBJECTIVE: To describe complications and clinical evolution of patients underwent to total laparoscopic hysterectomy. MATERIAL AND METHOD: Retrospective study. We review files of 87 patients with total laparoscopic hysterectomy since 2003 to 2006. General characteristics, indications, anesthetic technique, pneumoperitoneum means, trans- and post-operatory complications, procedure length, uterine size and weight, and conversion rate were examined. RESULTS: Average length of the procedure was 123.01 minutes, uterine size: 14.54 cm, uterine weight: 387 g (DE: 57.43). Trans-operatory bleeding was 151.01 mL, and hospital stay was 19.45 h (DE: 3.21). Trans-operatory complications were: bladder (1.14%), ureter (1.14%), small bowel (1.14%) and epigastric vessels (1.14%) injuries. Three patients had post-operatory complications: fever syndrome (3.4%) and sacral region burn injury (1.14%). Conversion rate to abdominal hysterectomy was 2.29%. CONCLUSION: Total laparoscopic hysterectomy is a feasible and safe procedure with complications rate similar to that reported in literature, and it in an option for candidates to abdominal hysterectomy.