Acute fetal distress is a serious problem that occurs in about 15% of  pregnant women in labor, producing a high perinatal mortality or rreversible neurological damage if nothing is done on time. This is why pregnant women at risk of developing or carrying insufficient uteroplacental chronic degenerative diseases that alter their homeostasis should be monitored closely for signs of possible deterioration. One of the most dramatic changes in obstetrics has been the use of biophysical and biochemical assessment of fetal wellbeing parameters, allowing to identify the products of risk and guide treatment, thus achieving decrease perinatal problems. The use of electronic fetal monitoring to assess the state of the product at risk in the prenatal period through a test contraction, as well as intrapartum, because in most cases, uterine activity is the triggering factor fetal distress, when add...

La amniotomía de rutina o sistemática, practicada en gestantes con trabajo de parto de inicio espontáneo, se da en gran parte de hospitales del Perú y el mundo, documentándose su prevalencia hasta en 77%. Sin embargo, poco se conoce acerca de los beneficios y daños que puede ocasionar en el feto y en la madre. Se realizó una búsqueda de la literatura médica, con la finalidad de encontrar evidencia científica sólida que respalde o rechace esta práctica. Se llega a la conclusión que la amniotomía practicada sistemáticamente altera la evolución fisiológica del trabajo de parto, acortándolo hasta en 50 minutos en promedio; sin embargo, este acortamiento no tiene trascendencia clínica ni para el feto ni para la madre. Por el contrario, su práctica de rutina puede aumentar el número de partos disfuncionales y el puntaje Ápgar menor de siete a los cinco minutos.

Many repairs in the diagnosis of prolonged pregnancy are due to the lack of precision in the calculation of gestational age, since clinical concern does not occur until the problem arises when the background and diagnostic methods are less reliable.

A prospective, experimental clinical, was performed in 50 pregnant women in high risk obstetric Lima Maternity (INAMI) Hospital, between March and June 1990 to assess fetal conditions can stressante a different test to test oxytocin stressante (TSO) in terms of costs, resources and risks, but to produce a similar uterine response and therefore to give adequate and reliable information about fetal well-being. Gestational age in 49 cases, was between 37 and 41 weeks. A case of severe pre-eclampsia was 34 weeks. Electronic fetal monitoring (EFM) was performed with cardiotacógrafos two channels. A record will be made at baseline for 10-15 minutes, during which spontaneous and remote uterine contractions in pregnant women were registered 21 and no spontaneous contractions were recorded in 29. After breast stimulus started, one bilateral as appropriate, within 5 to 20 more minutes (latency pe...

Chewing coca leaves is a rooted habit in several localities in Latin America, especially in the Andean areas. This habit has been related to possible alterations in various components of the oral cavity. The purpose of this review is to describe the changes that oral cavity structures undergo by chewing coca leaves. Several studies will be presented where it is found that the frequency in addition to the alkaline substance used in chewing coca leaf affects the hard and soft tissues of the oral cavity. It is concluded in the review that chewing coca leaf leads to pigmentation of oral mucosa, dental wear and periodontal diseases.

La masticación de hoja de coca es un hábito arraigado en varias localidades de Latinoamérica, sobre todo en las zonas andinas. Dicho hábito se ha relacionado con posibles alteraciones en diversos componentes de la cavidad oral. El propósito de esta revisión es describir los cambios que sufren las estructuras de la cavidad bucal por la masticación de hojas de coca. Se expondrán diversos estudios donde se encuentra que la frecuencia del consumo de la hoja, además de la sustancia alcalina que se emplea en la masticación, afecta a los tejidos duros y blandos de la cavidad oral. Se concluye en la revisión que la masticación de la hoja de coca conlleva a la aparición de pigmentaciones de la mucosa oral, desgaste dental y a enfermedades periodontales.

Observational epidemiologic studies conducted during the past years in several countries reported favorable associationbetween wheat flour fortified with folic acid and reduced cases of neural tube defects (NTD). Objectives: To determine the globalincidence rate (GIR) of neuronal tube defects (NTD) and their reduction in the post-fortifying phase (2006-2010) of wheat flour withfolic acid. Design: Observational, descriptive and retrospective study. Setting: Instituto Nacional Materno Perinatal - INMP, Peru.Participants: Neonates. Interventions: We reviewed 88 236 medical histories of neonates born between 2006 and 2010 and average,standard deviations, absolute and relative frequencies were obtained. NTD trend was measured statistically by Prais Winsten. Poissontest was used to measure 95% CI for GIR of NTD. Main outcome measures: Global incidence rate (GIR) of NTD. Results: A total of 77m...

A randomized trial was carry with 40 pregnants, that were being attended, in their second trimester, in the Prenatal Clinics of the MaternoPerinatal Institute (IMAPE). The first group received ferric hidrate polimaltose non ionic compund, in amount that equals 100 mg. of elemental iron, associated to 350 mg. of folic acid. After eigth weeks of treatment, when the patients were in their third trimester of pregnancy, were evaluated. The findings at this moment showed that hematic profile, of the pregnants that received iron, was signicatively better in relation to the control group. Only 2.3% of the patients presented intolerance to the substance used. On the basis of the general knowledge and the experience obtained with this study, a risk table for the anemia in pregnancy and a scheme for its treatment based on the figures obtained, for each level, are proposed.

Acute stress is related to the energetic release of catecholamines, cytokines, and cortisol, which trigger pain perception. Chewing stimulates serotonergic neurons, these neurons modulate the neural pathways of pain; however, the relationship between these variables is still in the process of understanding. Objective. To determine the effect of acute stress and chewing stimulus on pain. Methods. an experiment that was developed in the Faculty of Medicine of the UNMSM. 40 eight-week-old male Balb/c mice were randomly assigned into 5 equal groups. A: week 1 without any stimulus and week 2 chewing stimulus + stress. B: week 1 without any stimulus and week 2 stress. C: week 1 stress and week 2 without any stimulus. D: week 1 masticatory stimulus + stress and week 2 without any stimulus. E: control, without any stimulus. Pain was assessed in the 5 groups at 7 and 14 days using the tail-withdr...

Objetivo: Evaluar la felicidad y los factores asociados en mujeres puérperas de Lima Metropolitana y Callao, Perú. Métodos: Estudio multicéntrico, analítico, y de corte transversal realizado en los cinco hospitales más representativos de atención pública del Ministerio de Salud en Lima Metropolitana y Callao: Instituto Nacional Materno Perinatal, Hospital Nacional Docente Madre Niño San Bartolomé, Hospital Nacional Arzobispo Loayza, Hospital Nacional 2 de Mayo y Hospital Nacional Daniel Alcides Carrión. La información fue obtenida mediante revisión de historias clínicas, cuestionarios de auto reporte y entrevista personal. La investigación fue aprobada por los Comités de Investigación y Ética de los hospitales en cuestión. Resultados: Se tomó una muestra total de 772 puérperas. La edad promedio fue de 26.7±5.9 años, 63.2% era conviviente, 79.8% estaba desempleada, ...

Introduction: Teenage pregnancy is a public health problem that places the status of a teenager in biomedical and social vulnerability, the stigmatization of a pregnant adolescent. Objective: To evaluate psychometrically an instrument to measure stigmatization of pregnant adolescents. Design: Cross-sectional study. Location: National Maternal Perinatal Institute, Lima, Peru. Participants: Adolescent puerperae. Interventions: To 292 postpartum adolescents attended from January through May 2010 an Adolescent Pregnant Stigma Scale (APSS) consisting in 7 items was applied. For the theoretical construction of the scale, two promoter entities of social stigma were assumed: family and social environment. To assess the predictability of APSS the following hypothesis was considered: the higher levels of stigma are associated with a lower self-concept of the adolescent mother. Main outcome measure...

Introducción: El embarazo adolescente es un problema de salud pública que representa una situación que posiciona la vida de la adolescente en una condición de particular vulnerabilidad no solo biomédica, sino también social, siendo particularmente importante la estigmatización hacia la adolescente embarazada. Objetivo: Evaluar psicométricamente un instrumento destinado a cuantificar la estigmatización de la adolescente embarazada. Diseño: Estudio transversal. Lugar: Instituto Nacional Materno Perinatal, Lima, Perú. Participantes: Adolescente puérperas. Intervenciones: Se estudió 292 adolescente puérperas atendidas durante los meses de enero a mayo del 2010.Se usó la Escala de Estigmatización de la Adolescente Embarazada (EEAA), la cual está compuesta de 7 ítems. Para la construcción teórica de la escala, se asumió dos entidades sociales promotoras de la estigmatizaci...

Introduction. Acute stress alters memory and spatial learning and the expression of interleukin 6, the chewing stimulus would prevent these effects. Objective. To determine the effect of chewing stimulation and acute stress on the expression of interleukin 6 and memory and spatial learning in mice. Methods. Experiment where 70 male albino mice of the Balb/c of age 2 month were randomly distributed into: Group A1: acute stress 1 hour; Group A2: acute stress 1 hour + chewing stimulus 1 hour; Group B1: acute stress 2 hours; Group B2: acute stress 2 hours + chewing stimulus 2 hours; Group C1: acute stress 3 hours; C2: acute stress 3 hours + chewing stimulus 3 hours; Group D: without intervention. For 3 days, spatial memory and learning were tested in the Morris water maze. Interleukin 6 (IL-6) was analyzed by ELISA test. Results. IL-6 was higher in the B2 group vs the other groups (p<0.00...