[Management of severe pre-eclampsia/eclampsia. Comparison between nifedipine and hydralazine as antihypertensive agents]. / Manejo de la preeclampsia severa/eclampsia. Comparación entre Nifedipina e Hidralazina como medicamentos antihipertensivos.

The objective was to compare the fetal and maternal effects between parenteral hydralazine and sublingual nifedipine used like antihypertensive drugs in the management of severe preeclampsia. Study design was prospective, comparative, longitudinal, randomized clinical trial. It was carried out at Centro Medico Nacional IMSS Torreon, Coah. Gynecology and Obstetrics Department. The patients were women in the last trimester of pregnancy with severe preeclampsia were randomized to receive parenteral hydralazine or sublingual nifedipine as antihypertensive drugs. The only difference observed in this study was the Apgar of neonates whose mothers received hydralazine, that was significatively lesser than the Apgar of neonates whose mothers received nifedipine. Both medicaments are a good alternative as antihypertensive drugs in severe preeclampsia. Neonates whose mothers received Nifedipine had a higher Apgar.

[Anticonvulsant treatment in severe preeclampsia. Comparison between diazepam and magnesium sulfate]. / Tratamiento anticonvulsivante de la preeclampsia severa. Comparación entre diazepam y sulfato de magnesio.

The objective was to compare the materno-fetal effects between Diazepam and Magnesium sulfate used as anticonvulsivant therapy in cases of severe pre-eclampsia. The study was prospective, comparative, longitudinal, randomized clinical trial. The study was done at Centro Medico Nacional Instituto Mexicano del Seguro Social. Division of Obstetrics and Gynecology, Torreon, Coah, Mexico. The patients were all the women admitted to the labor and delivery ward with diagnosis of severe pre-eclampsia and viable conceptus were assigned at random to receive either Diazepam (Group A, n = 19) or Magnesium sulfate (group B, n = 19). There were no significant differences between both groups. All of the patients remained alert, conscious and well oriented. None of the newborns showed hiporreflexia, flaccidity or neonatal respiratory distress that could be implicated to the anticonvulsivant therapy. It is concluded that Diazepam and Magnesium sulfate are good alternatives as anticonvulsivant therapy in cases of severe pre-eclampsia.

[Management of severe pre-eclampsia in the puerperium. Comparative study of sublingual nifedipine and hydralazine]. / Manejo de preeclampsia severa en el puerperio. Estudio comparativo entre nifedipina sublingual e hidralazina.

At random, two therapeutic schemes for severe preeclampsia during the puerperium, were evaluated. Group A (n = 20) was left without antihypertensive medication and sublingual nifedipine was used only in case of diastolic pressure of 110 mmHg or more. Group B (n = 18) receive Hydralazine 40 mlg. per os, every 6 hrs.; in this group also, nifedipine was administered in case of diastolic pressure of 110 mmHg or more. The only differences were that in group B the intervals for the administration of nifedipine were much shorter than in group A; also, in the same group the need for another antihypertensive was more frequent (5 of 18 vs 1 of 20 patients).

[Gestational trophoblastic disease. Prevalence and epidemiologic features at the IMSS Torreón Medical Center]. / Enfermedad trofoblástica gestacional. Prevalencia y características epidemiológicas en el Centro Médico IMSS Torreón.

From August 1st, 1987, to August 31 1989, there were 18 patients with trophoblastic gestational disease (TGD). In that time there 12,263 births for a frequency of TGD of 1:681, the prevalence was 14.6 X 10,000 births. The most frequent symptom was nausea and the most frequent sign, abnormal uterine bleeding; uterine growth not accord to gestational age was not a constant sign. Ultrasound was the method of diagnosis and in all of the cases there were confirmation of diagnosis by tissue exam. The follow-up of the patients was done by standard protocol; oral contraceptives were used for family planning. Our findings are discussed and compared with those in the literature.

[Effect of nifedipine on fetal heart rate in pre-eclamptic patients]. / Efecto de la nifedipina sobre la frecuencia cardiaca fetal en pacientes preeclámpticas.

From March 1st to October 31, 1989, we studied 23 women with diagnosis of severe preeclampsia, the gestational age in all of them was at least 34 weeks. A tococardiograph registry was obtained during 20 minutes prior to any management, after that a standardized management was started; nifedipine 10 mg sublingual was administered, and 20 minutes later, a new registry was obtained. In spite of a significative descent of arterial pressure, we did not find any significative change in the fetal heart rate, accelerations, variability, or in the fetal motility.

[Inductoconduction with unfavorable cervix. PGE2 plus oxytocin for the induction of labor in complicated pregnancies]. / Inductoconducción con cervix desfavorable. PGE2 más oxitocina para inducir trabajo de parto en embarazos complicados.

To evaluate intracervical PGE2 plus low dose oxytocin in the induction of cervical changes and labor, we studied 36 pregnant patients who had one of the following complications: Intrauterine death, anencephaly, gestational trophoblastic disease, missed abortion and PRM with pregnancy less than 28 weeks of gestational age. 200 mcgs of PGE2 were applied in the cervix, and immediately an oxytocin infusion was started at 2 mlU, the dose of oxytocin was increased in the arithmetic fashion until labor was started. The latency between the application of PGE2 and the beginning of labor was 3.57 +/- 3.29 h., between the beginning of labor and birth was 5.59 +/- 3.39 h. The cervix changed from a Bishop score of 2.1 +/- 1.5 to 6.2 +/- 1.8 (p less than 0.0001). The hospital stay was of 1.6 +/- 0.6 days. The secondary affects were minimal, and the births were all vaginal.

[Pseudo-obstruction of the colon (Ogilvie syndrome) associated wtih Cesarean operations. Report of 2 cases and review of the literature]. / Pseudobstrucción de colon (síndrome de Ogilvie), asociado a operación cesárea. Informe del dos casos y revisión de la literatura.

We inform of two cases of pseudoobstruction of the colon (Ogilvie's Syndrome) secondary to cesarean section. The clinical picture, the diagnostic method and alternatives of treatment are analyzed. The importance of the knowledge of the syndrome and prompt diagnosis is emphasized.

[Colonic pseudo-obstruction (Ogilvie syndrome), associated with cesarean section. Report of 2 cases and review of the literature]. / Pseudobstrucción del colon (síndrome de Ogilvie), asociado a operación cesárea. Informe de dos casos y revisión de la literatura.

We inform of two cases of pseudoobstruction of the colon (Ogilvie's Syndrome) secondary to cesarean section. The clinical picture, the diagnostic method and alternatives of treatment are analyzed. The importance of the knowledge of the syndrome and prompt diagnosis is emphasized.

[Puerperal deciduometritis. Importance of mechanical cervical dilatation]. / Deciduometritis puerperal. Importancia de la dilatación cervical mecánica.

A prospective, longitudinal, comparative, experimental design, was carried out at CMN T HGZ No. 16, from Dec 5, 1988 to July 5, 1989, in order to evaluate the importance of cervical dilatation in puerperal endometritis management. Two groups of thirty patients each, were formed at random. Cervical dilatation was performed in Group A, and it was not done in Group B. Signs and symptoms as uterine pain, uterine sub-involution, fever, fetid and/or purulent lochia remitted in two to three days average, and hospital stay was six days for both groups. During the study two patients of each group showed complications (6.66%). Therefore, these results show that cervical dilatation, performed as a part of puerperal deciduometritis management, has little or none therapeutic value.