It is disconcerting to note that these deaths occur each year, for inadequate control, prenatal, not to use family planning methods, by technical failures in care (dependent on inadequate training of serving) or by illegal abortion.

Past, Present and Future of medical residency in Peru.

Given the rarity of this type of neoplasms, little can be seen in the literature, that expresses enough experience in one hospital. There are a number of discrepancies regarding the classification, morphological details, histogenesis, diagnosis and treatment.

Despite continuing advances in the interpretation and treatment of shock, this clinical syndrome is still responsible for many deaths: the shock is a complex in which there is the presence of micro-circulatory and biochemical imbalances.

A 0.23% incidence of benign Hydatidiform Mole, comparable with similar groups of patients is found at the Hospital Materno Infantil de San Bartolomé in Lima. Most of the 13 cases reported occurred in young to middle-age women, parous three or more, although 30% were first pregnancies. The most common symptoms were vaginal bleeding (100%), vomiting, softness (46.1 %) and excessive growth of the uterus (61.5%). Toxemic symptoms were present in only 23% of the women. Evacuation was accomplish by oxytocin followed by curettage in 53.7% of the cases. In the remaining ones hysterotomy was necessary and a 30.7% incidence of lutein cysts was detected. A low incidence of complications, absence of malign transformation and of maternal death are reported.

The Peruvian Society of Obstetrics and Gynecology through its standing committee proposes training leaders in this project in order to deepen and broaden knowledge and skills in the specialty of ginecoobtetricia especially in the fields of perinatology, obstetrics and gynecology Human Reproduction and Oncology gynecological. It is proposed to develop an annual program that offers the opportunity to young doctors who have completed their residentado of obstetrics and gynecology or ginecoobstetras doctors who are practicing in a hospital MOH and IPSS, who through a selection process to obtain grants to develop knowledge , skills, and leadership responsibilities in the fields of human reproduction, perinatology and oncology, for which they must be assigned to a teaching hospital prequalified for a year.

As presentation work we wanted to raise in general canons, the use of two diagnostic methods: colposcopy and colpocytology, which at the time occupied a place of privilege in the specialty undisputed we grow. We are sure that these methods are well known by all of you, but it is possible that certain aspects, based on our experience and presented consistently, can serve clarifying concepts and refreshing ideas what our intention will be fulfilled. It is only the Colposcopía.- stereoscopic visualization of the cervix under magnification with direct lighting. It was Hinselman in 1925 which originally described the technique and has since been used with increasing frequency. Our learning and experience with the colposcope, we have obtained in Philadelphia. Dr. Warren Lang (disciple of Hinselman) with whom we conducted work in relation to vaginitis. The study is Colpocitología.- exfoliated...

The problem of vaginal vault, is a rare problem, but annoying, complicating a previous abdominal hysterectomy or Vaginal, conditioning upset the surgeon and the patient. What is questionable is the way of correction whether it should be abdominal or vaginal or a combination of both. We believe that the solution depends on each professional, according to the experience you have, and the conditions of the particular case; the gynecologist must be familiar with 1 or 2 techniques accepted vaginal or abdominal level; vaginal, is the natural technique, since the vagina is not retained in position by intraabdominal suspension only from above but for ligament support from below; but surgical repair is one of the most difficult problems in gynecological surgery; Although different techniques have appeared through the years, yet not completely satisfactory methods are reported.

In the last 30 years, we have witnessed countless exception symposia, panels, roundtables, forums, etc. etc. held to discuss the how to reduce maternal and perinatal mortality in our country, not chords figures advancing medical knowledge. In parallel we have had the opportunity to enjoy a pleasant experience: that even with structural constraints, poor implementation and facing the same type of patients with low economic level, it is feasible, and would say that reducing mortality quite significantly.

Se evalúa 639 adolescentes que acudieron al Hospital San Bartolomé y al Instituto San Marcelino entre los años 1977 y 1982, constituyendo el 4,22% del total de usuarias. El 12.67% de los casos tenía menos de 16 años de edad; sólo el 5.45 o/o no tuvo embarazo previo. La mayoría de los casos -64.32%-prefirieron el D.I.U. como método y, en segundo lugar- 18.16% -, la tableta anticonceptiva. En 13.93% se administró progestinas de depósito.  El método más eficaz y con menor porcentaje de fallas -0.74/100 años mujer- fue la tableta anticonceptiva, contra el 3.6 de fallas con el D.I.U. Se observó más complicaciones con el D.I.U -28%- y con la amenaza adicional de complicaciones potenciales. 

Se evalúa 639 adolescentes que acudieron al Hospital San Bartolomé y al Instituto San Marcelino entre los años 1977 y 1982, constituyendo el 4,22% del total de usuarias. El 12.67% de los casos tenía menos de 16 años de edad; sólo el 5.45 o/o no tuvo embarazo previo. La mayoría de los casos -64.32%-prefirieron el D.I.U. como método y, en segundo lugar- 18.16% -, la tableta anticonceptiva. En 13.93% se administró progestinas de depósito.  El método más eficaz y con menor porcentaje de fallas -0.74/100 años mujer- fue la tableta anticonceptiva, contra el 3.6 de fallas con el D.I.U. Se observó más complicaciones con el D.I.U -28%- y con la amenaza adicional de complicaciones potenciales. 

As presentation work we wanted to raise in general canons, the use of two diagnostic methods: colposcopy and colpocytology, which at the time occupied a place of privilege in the specialty undisputed we grow. We are sure that these methods are well known by all of you, but it is possible that certain aspects, based on our experience and presented consistently, can serve clarifying concepts and refreshing ideas what our intention will be fulfilled. It is only the Colposcopía.- stereoscopic visualization of the cervix under magnification with direct lighting. It was Hinselman in 1925 which originally described the technique and has since been used with increasing frequency. Our learning and experience with the colposcope, we have obtained in Philadelphia. Dr. Warren Lang (disciple of Hinselman) with whom we conducted work in relation to vaginitis. The study is Colpocitología.- exfoliated...

A 0.23% incidence of benign Hydatidiform Mole, comparable with similar groups of patients is found at the Hospital Materno Infantil de San Bartolomé in Lima. Most of the 13 cases reported occurred in young to middle-age women, parous three or more, although 30% were first pregnancies. The most common symptoms were vaginal bleeding (100%), vomiting, softness (46.1 %) and excessive growth of the uterus (61.5%). Toxemic symptoms were present in only 23% of the women. Evacuation was accomplish by oxytocin followed by curettage in 53.7% of the cases. In the remaining ones hysterotomy was necessary and a 30.7% incidence of lutein cysts was detected. A low incidence of complications, absence of malign transformation and of maternal death are reported.

The problem of vaginal vault, is a rare problem, but annoying, complicating a previous abdominal hysterectomy or Vaginal, conditioning upset the surgeon and the patient. What is questionable is the way of correction whether it should be abdominal or vaginal or a combination of both. We believe that the solution depends on each professional, according to the experience you have, and the conditions of the particular case; the gynecologist must be familiar with 1 or 2 techniques accepted vaginal or abdominal level; vaginal, is the natural technique, since the vagina is not retained in position by intraabdominal suspension only from above but for ligament support from below; but surgical repair is one of the most difficult problems in gynecological surgery; Although different techniques have appeared through the years, yet not completely satisfactory methods are reported.

Hormonal variations that characterize the normal menstrual cycle, noting that depends on adequate hypothalamic-pituitary-ovarian interaction are reviewed. He realizes the daily changes of the gonadotropins, estrogens and progesterone, as measured by radioimmunoassay blood analysis, gained over 7 normal menstrual cycles. It was found that the concentrations of FSH and LH are slightly higher in the follicular phase than in the luteal, displaying all mesocíclica them a matching rise in the ovulatory phase of both LH and FSH. Estradiol showed a significant elevation pre-ovulatory surge of gonadotropins and another in the luteal phase. Progesterone remained at a low level during the follicular phase increase substantially since the onset of the ovulatory peak of gonadotropins. The meaning of these hormonal changes is discussed.

50 cases of patients who had preterm labor is studied. Careful not to include cases where the cause of prematurity was evident (twins, polyhydramnios, hemorrhagic cases) were reported. Urine culture sample was taken by bladder catheterization in the first 48 hours postpartum. Parallel monitoring 50 cases of patients whose delivery was at term, and also was made urine culture is studied. It was obtained obvious differences in both groups. In the group studied was 20% positive urine cultures, against 10% in the control group. The predominant germ was E. coli. The perinatal mortality in the study group was 20%, ten times higher than the control group. It is recommended that urine cultures routinely performed in all cases of preterm labor.

50 cases of patients who had preterm labor is studied. Careful not to include cases where the cause of prematurity was evident (twins, polyhydramnios, hemorrhagic cases) were reported. Urine culture sample was taken by bladder catheterization in the first 48 hours postpartum. Parallel monitoring 50 cases of patients whose delivery was at term, and also was made urine culture is studied. It was obtained obvious differences in both groups. In the group studied was 20% positive urine cultures, against 10% in the control group. The predominant germ was E. coli. The perinatal mortality in the study group was 20%, ten times higher than the control group. It is recommended that urine cultures routinely performed in all cases of preterm labor.