Editorial

Sexually transmitted infections are a group of diseases whose transmission is performed at the time of intercourse. We describe them according to their etiology, or those caused by viruses, bacteria, chlamydia, spirochetes, protozoa and fungi. There are parasites that are transmitted through body contact during sex, such as produced by pubic lice or pubic Phithirus acarosis by Sarcoptes scabiei variety hominis, which will not be described in this paper.

The author defines abortion as a controverted pathology due to the various non-biologic components. It has been used since remote times as a resource to regulate fecundity. But the serious complications are still important causes of maternal death, generally as a consequence of severe infection. More than 400 000 induced abortions have been indirectly estimated in Peru, responsible for an important number of deaths due to this cause. Main non-mortal complications of induced abortion are chronic pelvic pain, ectopic pregnancy, sterility and premature menopause due to oophorectomy. The severity of infection in induced abortion done in adverse conditions frequently causes multiple organic compromise, its therapy depending in the pregnant woman’s health and in the severity of the bacteria or bacteriae involved. Once septic abortion is diagnosed treatment should be in a hospital with resolu...

Cervical ectopic pregnancy is one of the rarest forms of ectopic pregnancy. Fahmy reported that the frequency is 1 in 9,575 births -152.219, however, some authors report that is much more frequent since there are cases that are not reported or are not diagnosed.

OBJECTIVE: To determine the maternal perinatal morbility and mortality in the first pregnancy of the older women. MATERIAL AND METHODS: Retrospective and transversal study of 133 older women 35 years old or more who had their first pregnancy attended at Cayetano Heredia National Hospital between january 1st and december 31th 1996. They were compared with 5,006 women who had their first pregnancy at of 20 to 29 years old and attended in the same period of time. RESULTS: The incidence of maternal pathology is more frequent in the first pregnancy of older women with a relative risk (RR) 8,55 for previous arterial hypertension, 2,49 for eclampsia, 1,39 for pre eclampsia, 2,18 for cephalopelvic disproportion and 2,03 for hemorragia of third trimester of pregnancy. Cesarean section has a relative risk of 2,55. For the newborn the relative risk is highter for hyalina membrane (4,09), neonatal a...

Abortion as a health problem - Abortion Epidemiology, role of abortion in the demographic transition, attention techniques of incomplete abortion, abortion Prophylaxis.

The author defines abortion as a controverted pathology due to the various non-biologic components. It has been used since remote times as a resource to regulate fecundity. But the serious complications are still important causes of maternal death, generally as a consequence of severe infection. More than 400 000 induced abortions have been indirectly estimated in Peru, responsible for an important number of deaths due to this cause. Main non-mortal complications of induced abortion are chronic pelvic pain, ectopic pregnancy, sterility and premature menopause due to oophorectomy. The severity of infection in induced abortion done in adverse conditions frequently causes multiple organic compromise, its therapy depending in the pregnant woman’s health and in the severity of the bacteria or bacteriae involved. Once septic abortion is diagnosed treatment should be in a hospital with resolu...

OBJECTIVE: To determine the maternal perinatal morbility and mortality in the first pregnancy of the older women. MATERIAL AND METHODS: Retrospective and transversal study of 133 older women 35 years old or more who had their first pregnancy attended at Cayetano Heredia National Hospital between january 1st and december 31th 1996. They were compared with 5,006 women who had their first pregnancy at of 20 to 29 years old and attended in the same period of time. RESULTS: The incidence of maternal pathology is more frequent in the first pregnancy of older women with a relative risk (RR) 8,55 for previous arterial hypertension, 2,49 for eclampsia, 1,39 for pre eclampsia, 2,18 for cephalopelvic disproportion and 2,03 for hemorragia of third trimester of pregnancy. Cesarean section has a relative risk of 2,55. For the newborn the relative risk is highter for hyalina membrane (4,09), neonatal a...

Cervical ectopic pregnancy is one of the rarest forms of ectopic pregnancy. Fahmy reported that the frequency is 1 in 9,575 births -152.219, however, some authors report that is much more frequent since there are cases that are not reported or are not diagnosed.

This is a retrospective epidemiological control case type study of twenty-four deaths caused by septic abortion attended at our Hospital from 1985 through 1992. Control group consisted of 72 pregnant women who survived.. Septic abortion mortality rate was 67,3 per 100000 live newborns. Highest rate, 176,6, occurred in 1991. Mortality rate factor were 5 or more pregnancies (OR=1,7), gestational age over 16 week (OR=5,0), time from abortion maneuvers over 5 days (OR=1,7), septic shock (OR=8,5), anemia (OR=3,4), acute renal failure (OR=17,0), uterine perforation (OR=3,4), disseminated intravascular coagulation (OR=60,0), pelvic thrombophlebitis (OR = 10,2), multisystemic failure (OR=6,5) and lung shock (OR = 6,5). Significant symptoms were yellowish foul odor discharge, jaundice, petechiae, disnea and muscular pain. Main medical and surgical treatment consisted in blood and plasma transfusi...

In order to determine the incidence, causes and risk factors associated to fetal death, trying to establish what the change would be in the study population if a factor is neutralized, a prospective study of the cohort type was held in the National Hospital Cayetano Heredia, based on the analysis of perinatal data computer system of all births in the years 1992 - 1993. 192 stillbirths found a total of 8309 births, fetal death rate of 23.1 per 1000 born. The causes of death are infection (28%), hemorrhage (20%) and toxemia (14%). Risk factors of fetal death are: kill-multiparity (RR 2.3), induced labor (RR = 3.5), CPN (RR = 4), breech presentation (RR = 5.1), maternal diseases (RR = 5.5), preterm delivery (RR = 17). Maternal disease, the most important were: bleeding in the second quarter (RR = 19), preterm delivery (RR = 10.6), HTT (RR = 8.5), other infections (RR = 5.8) , eclampsia (RR ...

Prospective longitudinal cohort type study done at the obstetrical service of Cayetano Heredia National Hospital, 1992 to December 1994 to determine the caracteristics and risks of deliveries in adolescents. Reviewing the informatic system data bank, we determined that 15% of deliveries attended were in adolescents; 52% lacked prenatal complications, especially premature rupture and preeclampsia. Abdominal delivery occurred between 14 and 24 %, especially due to cephalopelvic disproportion, breech presentation and preeclampsia. Height in less than 16 years girls was smaller than in the other groups (p<0,05). Risks for early adolescents were unstable union, nulliparity, preeclampsia, cephalopelvic disproportion, low birtweight and prematurity. For late adolescents, unstable union, nulliparity, preeclampsia and cephalopelvic disproportion.

Estudio retrospectivo, transversal, clínico, tipo caso control de 24 muertes por aborto séptico, comparadas con 72 controles escogidas mediante un muestreo sistemático de la población que no falleció. La tasa de mortalidad por aborto séptico para el periodo 1985-1992 fue de 67.3 por 100,000 nv., la más alta se obtuvo para 1991 con 176.6. el 42% de ingresos a Ginecología fu aborto, siendo el 8% séptico. Los factores de riesgo para mortalidad fueron 5 o más gestaciones (OR=1.7), edad gestacional mayor de 16 semanas (OR=5.0), tiempo de maniobras abortivas mayor de 5 días (OR=1.7), shock séptico (OR=8.5), anemia (OR=3.4), insuficiencia renal aguda (OR=17.0), perforación uterina (OR=5.5), coagulación intravascular diseminada (OR=60.0), tromboflebitis pélvica (OR=10.2), falla multiorgánica (0R=6.5) y pulmón de shock (OR=6.5). Los síntomas y signos con diferencias sig...

Retrospective study of the first 70 ambulatory scalpelless vasectomies performed at the Planned Parenthood Clinic of Cayetano Heredia National Hospital from january 1992 through August 1994. Age, education, number of children of patients and information source, time between decision and performance of the operation, and surgical technique are described. Surgery duration was 23 minutes and postoperative morbidity was 7 %.

OBJECTIVE: To determine knowledge on reproductive health of adolescent mothers and the determinant factors involved. DESIGN: Comparative study done at the Obstetrical Service, Cayetano Heredia National Hospital. Inquiry to 183 post-partum adolescents, between September 1 and December 15, 1994. RESULTS: 25.7% had no adecuate prenatal control, 60,7% did not attend a prenatal talk, 51% pregnancies were not wished, 86.8% knew some contraceptive method, but only 42, 1 % had used it in some occassion; from these, 50,6% used natural methods, but 46% inapproppiately; 63,9% feared the use of contraceptive methods, especcially the modern ones. Time between first sexual relation and beginning of pregnancy was one year or less in 50,4%; 87,9% knew about sexually transmitted diseases, mainly AIDS and 55,2% knew about fecundation. CONCLUSION: The more education and number of prenatal talks, better kno...

OBJECTIVE: To establish the level of knowledge and acceptation of hormonal replacement therapy in patients over 39 Yearold. DESIGN: Transversal descriptive study. SUBJECTS: 212 patients over 39 yearold. LOCATION: Outpatient Gynecology Service of Cayetano Heredia National Hospital between February and April 1995. RESULTS: 84% were climacteric or menopausal. Most known symptoms were neuropsychiatric, 72% knew about treatment, only 6% used it, 97% accepted HRT and 61% were willing to receive HRT for live, but only 25% knew the benefits. There was fear of bleeding and gestation in 37% and 58% respectively. CONCLUSION: Patients with better education bad more knowledge of HRT benefits. Patients who receive HRT know more about the benefits of hormonal therapy.

OBJECTIVE: To establish the level of knowledge and acceptation of hormonal replacement therapy in patients over 39 Yearold. DESIGN: Transversal descriptive study. SUBJECTS: 212 patients over 39 yearold. LOCATION: Outpatient Gynecology Service of Cayetano Heredia National Hospital between February and April 1995. RESULTS: 84% were climacteric or menopausal. Most known symptoms were neuropsychiatric, 72% knew about treatment, only 6% used it, 97% accepted HRT and 61% were willing to receive HRT for live, but only 25% knew the benefits. There was fear of bleeding and gestation in 37% and 58% respectively. CONCLUSION: Patients with better education bad more knowledge of HRT benefits. Patients who receive HRT know more about the benefits of hormonal therapy.

Induction of labor with oral prostaglandin E2 (PGE2) in 110 patients, succeeded in 100 vaginal births; there were 9 failures of induction and cesarean section, with an effectiveness rate of 90.9%. Resultdos analysis of 100 pregnant women with vaginal delivery is done: 53 were elective and 47 indicated; by post maturity (18 patients), dysfunctional labor (13), premature rupture of membranes (9), toxemia (5), diabetes (2). 86% had a single labor induction session without difference between elective and indicated. PGE2 was administered in doses of progressive time from 0.5 to 2 mg. The patients had clinical scoring MONITORING incidents related to stimulation, labor, delivery and newborns. Pelvic Bishop score was taken as a prognostic indicator of successful induction. 24.5% of elective inductions and 47% of the indicated higher scores were 7, considered very favorable. This indicator keeps ...

Induction of labor with oral prostaglandin E2 (PGE2) in 110 patients, succeeded in 100 vaginal births; there were 9 failures of induction and cesarean section, with an effectiveness rate of 90.9%. Resultdos analysis of 100 pregnant women with vaginal delivery is done: 53 were elective and 47 indicated; by post maturity (18 patients), dysfunctional labor (13), premature rupture of membranes (9), toxemia (5), diabetes (2). 86% had a single labor induction session without difference between elective and indicated. PGE2 was administered in doses of progressive time from 0.5 to 2 mg. The patients had clinical scoring MONITORING incidents related to stimulation, labor, delivery and newborns. Pelvic Bishop score was taken as a prognostic indicator of successful induction. 24.5% of elective inductions and 47% of the indicated higher scores were 7, considered very favorable. This indicator keeps ...

OBJECTIVES: Introductory study of contraceptive monthly deposit, 25 mg of medroxyprogesterone acetate (AM) plus 5 mg estradiol cypionate (EC), the National Hospital Cayetano Heredia, to assess their effectiveness, continuity and reasons for discontinuation. DESIGN: Prospective, longitudinal descriptive of 159 women who would come to the family planning clinic and after counseling voluntarily chose AM + CE for contraception. They were given one injection every 30 days and were followed up for two years, evaluating the efficacy and side effects. For data analysis a life table was used. RESULTS: No pregnancies were observed. The most common side effects were irregular pattern of monthly bleeding, amenorrhea, headache and nausea. The rate of continuing the second year was 43.3 and causes of discontinuation included bleeding, amenorrhea, medical reasons and the desire of pregnancy. CONCLUSION...