Due to its magnitude, mortality, complications and costs, abortion constitutes a public health problem; it is necessary to banish old stigmas leading to women’s dangerous unjustified guilt feelings, making her care more humane, warranting postabortion care quality, giving a continuous person-woman care, and allowing permanent health servers’ training. We briefly review Karman’s equipment and intrauterine manual aspiration technique that modified classical and deeply rooted post abortion care concepts.

The authors study maternal morbidity and mortality in 1088 cases of septic abortion attended at the Maria Auxiliadora Hospital’s Department of Obstetrics and Gynecology, from January 1.º, 1990 through December 31, 1993. Findings were compared with those before 1990. Abortion rate in our Hospital is 299 per 1000 live newborns and septic abortion rate 18%. Endometritis complicated all the cases and other severe complications were found in 14,4% of cases. Septic abortion today is more frequent in adolescents than before 1990 and tends to ocurr earlier in pregnancy. Ten percent of patients were submitted to abdominal hysterectomy with or without adnexectomy. maternal mortality by septic abortion was 603 per 100000 live newborns. In conclusion, septic abortion is an important cause of maternal morbidity and mortality in our hospital and its frequency tends to increase.

OBJECTIVE: To determine maternal mortality during the last 10 years and establish its tendency, causes and patient characteristics. DESIGN: Epidemiologic, retrospective, descriptive and analytical study. SUBJECTS: 121 maternal deaths occurred at our Hospital between January 1988 and June 1997. RESULTS: Maternal mortality rate was 250,18/100 000 live newborns. Main characteristics were age 20 to 24 (44/36,6%), secondary education (45/48,4%), stable union (45/49%), term gestation (33/34,3%) and less than 20 weeks (28/29%). Only 28% (34) had any prenatal control. Most deaths occurred at postpartum (62/51,2%) and 31,3% (33) were primiparae; 84 (69,4) died by direct obstetrical cause and 36 (29,8%) by indirect causes. Main causes of death were preventable. Most frequent indirect cause was tuberculosis (14/11,6%); 65 (53,7%) died after 48 hours from hospitalization. CONCLUSIONS: Our maternal m...

OBJECTIVE: To determine incidence, evolution, characteristics, and complications of septic abortion in adolescents. DESIGN: Epidemiological study from 1990 through 1996. RESULTS: From 1709 abortions, 285 occurred in adolescents. General abortion rate was 274,5 per 1 000 lnb, in non-adolescents 290 and in adolescents 203. Incidence ofseptic abortion was 16,7%, distributed in 16,1% in patients over 19 years and 20,5% in adolescents (p < 0,05), especially at ages 18 and 19; 42% had pregnancy interruption above 12 weeks gestation: 27% had a previous pregnancy. Most frequent complications at hospitalization were anemia and septic shock; hysterectomy wasperformed in 8,5%. CONCLUSION: Sept abortion is tbefirst cause of maternal mortality at our Hospital, butfortunately is less frequent in adolescents.

OBJECTIVE: To determine incidence, evolution, characteristics, and complications of septic abortion in adolescents. DESIGN: Epidemiological study from 1990 through 1996. RESULTS: From 1709 abortions, 285 occurred in adolescents. General abortion rate was 274,5 per 1 000 lnb, in non-adolescents 290 and in adolescents 203. Incidence ofseptic abortion was 16,7%, distributed in 16,1% in patients over 19 years and 20,5% in adolescents (p < 0,05), especially at ages 18 and 19; 42% had pregnancy interruption above 12 weeks gestation: 27% had a previous pregnancy. Most frequent complications at hospitalization were anemia and septic shock; hysterectomy wasperformed in 8,5%. CONCLUSION: Sept abortion is tbefirst cause of maternal mortality at our Hospital, butfortunately is less frequent in adolescents.

OBJECTIVE: To determine maternal mortality during the last 10 years and establish its tendency, causes and patient characteristics. DESIGN: Epidemiologic, retrospective, descriptive and analytical study. SUBJECTS: 121 maternal deaths occurred at our Hospital between January 1988 and June 1997. RESULTS: Maternal mortality rate was 250,18/100 000 live newborns. Main characteristics were age 20 to 24 (44/36,6%), secondary education (45/48,4%), stable union (45/49%), term gestation (33/34,3%) and less than 20 weeks (28/29%). Only 28% (34) had any prenatal control. Most deaths occurred at postpartum (62/51,2%) and 31,3% (33) were primiparae; 84 (69,4) died by direct obstetrical cause and 36 (29,8%) by indirect causes. Main causes of death were preventable. Most frequent indirect cause was tuberculosis (14/11,6%); 65 (53,7%) died after 48 hours from hospitalization. CONCLUSIONS: Our maternal m...

Due to its magnitude, mortality, complications and costs, abortion constitutes a public health problem; it is necessary to banish old stigmas leading to women’s dangerous unjustified guilt feelings, making her care more humane, warranting postabortion care quality, giving a continuous person-woman care, and allowing permanent health servers’ training. We briefly review Karman’s equipment and intrauterine manual aspiration technique that modified classical and deeply rooted post abortion care concepts.

OBJECTIVE: To evaluate frequency, indications and repercusions of cesarean hysterectomy. DESIGN... Descriptive retrospective study of cases attended at Lima Maria Auxiliadora Hospital between july 1988 and june 1997. RESULTS: Of 47427 deliveries 314 ended in cesarean hysterectomy (0,7916), more frequently between 20 and 35 year-old (66,8916) and similar percentages at extreme ages (16,5910). Primiparae represented 45,2%, more frequently between 37 and 41 weeks gestation. Frequent maternal pathologies were PROM, anemia, preeclampsia, UTI, 7TH, STH, TPL. IUGR was 19,7916, prematurity 15,9%, intermediate fetal mortality 59,8 x 1000 lb, latefetal mortality 156,4, perinatal mortality 173,9 and maternal mortalit 3347x 100000 lb.

OBJECTIVE: To evaluate frequency, indications and repercusions of cesarean hysterectomy. DESIGN... Descriptive retrospective study of cases attended at Lima Maria Auxiliadora Hospital between july 1988 and june 1997. RESULTS: Of 47427 deliveries 314 ended in cesarean hysterectomy (0,7916), more frequently between 20 and 35 year-old (66,8916) and similar percentages at extreme ages (16,5910). Primiparae represented 45,2%, more frequently between 37 and 41 weeks gestation. Frequent maternal pathologies were PROM, anemia, preeclampsia, UTI, 7TH, STH, TPL. IUGR was 19,7916, prematurity 15,9%, intermediate fetal mortality 59,8 x 1000 lb, latefetal mortality 156,4, perinatal mortality 173,9 and maternal mortalit 3347x 100000 lb.

We present the case of a 39 years-old patient who had had molar pregnancy 7 years before and presented no with six-month genital blood loss, melena and severe anemia. Pathological examination revealed metastatic choriocarcinoma to lung, kidney and Jejunum.

OBJECTIVE. To identify risk factors associated to maternal mortality. DESIGN.- Cross sectional study of maternal mortality using the perinatal informatic system of the Obstetrics and Gynecology Department of Hospital Marla Auxiliadora of 21621 cases recorded from July 1, 1988 to December 31, 1992. We used a 2 x 2 table confidence interval 95% test to calculate relative risk (RR) taking social antroprometric, biologic and obstetric variables. RESULTS: The most important risk factors were: single status, no antenatal care, eclampsia, tuberculosis, puerperal infection, second trimester hemorrhage, preterm delivery, anemia, third trimester hemorrhage, septic abortion and urinary infection. CONCLUSION.- There is an association between maternal mortality and no antenatal care, single status and prevalent pathologies of pregnancy.

OBJECTIVES: To determine if the Pap smear decreases the risk of developing invasive cervical cancer and cytological features history of patients with invasive cervical cancer. DESIGN: Descriptive, transversal. LOCATION: Department of Gynecology and Obstetrics of Mary Help Support Hospital. MATERIALS AND METHODS: cytological screening of 59 patients with histologically confirmed invasive cervical carcinoma and 155 with squamous intraepithelial lesion high grade (LEI-AG), seen between January 1997 and September 1998. RESULTS: Of the patients invasive cancer, 53.4% had never had cytology and 65.5% of patients had no PAP or the last study was conducted for more than five years; 31% of patients had gynecologic evaluation and negative PAP in the last three years. Of patients with squamous intraepithelial lesions of high grade (LEI-AG), 35.2% had never done a PAP or had had for more than five y...

OBJECTIVES: To determine if the Pap smear decreases the risk of developing invasive cervical cancer and cytological features history of patients with invasive cervical cancer. DESIGN: Descriptive, transversal. LOCATION: Department of Gynecology and Obstetrics of Mary Help Support Hospital. MATERIALS AND METHODS: cytological screening of 59 patients with histologically confirmed invasive cervical carcinoma and 155 with squamous intraepithelial lesion high grade (LEI-AG), seen between January 1997 and September 1998. RESULTS: Of the patients invasive cancer, 53.4% had never had cytology and 65.5% of patients had no PAP or the last study was conducted for more than five years; 31% of patients had gynecologic evaluation and negative PAP in the last three years. Of patients with squamous intraepithelial lesions of high grade (LEI-AG), 35.2% had never done a PAP or had had for more than five y...

OBJECTIVE. To determine the influence of adolescence in maternal outcome. DESIGN. Adolescence was divided in early and late and compared with a control group 20 to 24 year-old. RESULTS. Incidence of deliveries in adolescent was 18,3%, 1,2% corresponding to early adolescence and 17,1% to late adolescence. Preeclampsia, eclampsia, threatened premature labor, anemia, and puerperal infection were significantly more frequent in early adolescence. There was lesspre-natal control, more premature labor and respiratory distress, and less infection in the newborn in early adolescence. There was no difference in results between late adolescence and control group. CONCLUSIÓN. Maternal and perinatal risks are more frequent in early adolescence.

OBJECTIVE. To evaluate distribution of intraepithelial squamous lesions (ISL) detected by citology and to determine priority age groups in cervical cancer detection. DESIGN. Retrospective descriptive study. METHODS. Study of 61846 cervical citologies obtained at DISUR II eripheric centers between january 1994 and december 1996. Statistical analysis was by frequencies, percentages and statistical validation by Epi-In/b. RESULTS. Sixty-five percent of Papanicolaou smears were obtained from women below 30 year-old and 35% from older women. Women below 30 bad low grade ISL (ISL-LG) in 0,3% and high grade ISL (ISL-HG) in 0,07%; older women bad 0,24% ISL-LG and 0,38% ISL-HG. CONCLUSION. If we consider that the woman with ISL-HG has a higher risk toprogress to cervical cancer and that ISL-HG increases after age 30, we recommend to start studying cervical citology at this age.

OBJECTIVE To examine the need for blood transfusion in cases of obstetric hemorrhagic shock origin in Maria Auxiliadora Hospital patients and determine the frequency of some adverse effects. METHODS: descriptive cross-sectional epidemiological investigation, to which the files of the departments of obstetrics and gynecology and clinical and Blood Bank January 1, 1994 to December 31, 1998. It was pointed Laboratory examined the total of births attended, the frequency hemorrhagic disease in obstetric patients and the frequency of hemorrhagic shock according to the pathology encountered. Also the number of blood transfusions performed and complications were determined it said. RESULTS: A total of 28 151 births, 6537 abortions, ectopic pregnancies and 111 186 hydatidiform moles, 136 cases of hemorrhagic shock (0.48% of all births) was found. The main causes of hemorrhagic shock were the cond...

OBJECTIVE. To evaluate distribution of intraepithelial squamous lesions (ISL) detected by citology and to determine priority age groups in cervical cancer detection. DESIGN. Retrospective descriptive study. METHODS. Study of 61846 cervical citologies obtained at DISUR II eripheric centers between january 1994 and december 1996. Statistical analysis was by frequencies, percentages and statistical validation by Epi-In/b. RESULTS. Sixty-five percent of Papanicolaou smears were obtained from women below 30 year-old and 35% from older women. Women below 30 bad low grade ISL (ISL-LG) in 0,3% and high grade ISL (ISL-HG) in 0,07%; older women bad 0,24% ISL-LG and 0,38% ISL-HG. CONCLUSION. If we consider that the woman with ISL-HG has a higher risk toprogress to cervical cancer and that ISL-HG increases after age 30, we recommend to start studying cervical citology at this age.

OBJECTIVE. To determine the influence of adolescence in maternal outcome. DESIGN. Adolescence was divided in early and late and compared with a control group 20 to 24 year-old. RESULTS. Incidence of deliveries in adolescent was 18,3%, 1,2% corresponding to early adolescence and 17,1% to late adolescence. Preeclampsia, eclampsia, threatened premature labor, anemia, and puerperal infection were significantly more frequent in early adolescence. There was lesspre-natal control, more premature labor and respiratory distress, and less infection in the newborn in early adolescence. There was no difference in results between late adolescence and control group. CONCLUSIÓN. Maternal and perinatal risks are more frequent in early adolescence.

We report the case of a patient who underwent 15 years ago to removal of right ovarian tumor at another institution, admitted to the gynecology by a tumor apparently dependent gynecological sphere. Exploratory laparotomy showed a tumor in the bladder and other retroperitoneal surface attached to the vena cava. The pathological study reported that both were metastatic ovarian TCS-TA. The pathology Iáminas surgery performed 15 years earlier was revised, confirming that corresponded to the same entity.

We report the case of a patient who underwent 15 years ago to removal of right ovarian tumor at another institution, admitted to the gynecology by a tumor apparently dependent gynecological sphere. Exploratory laparotomy showed a tumor in the bladder and other retroperitoneal surface attached to the vena cava. The pathological study reported that both were metastatic ovarian TCS-TA. The pathology Iáminas surgery performed 15 years earlier was revised, confirming that corresponded to the same entity.