OBJECTIVES: To determine the maternal characteristics with statistical probabilities of association with neo natal infection in patients rum premature rupture of membranes (PROM), both at term, as premature. Evaluate the perinatal morbidity and mortality MATERIAL AND METHODS: Retrospective observational study, case-control (infected-no newborn infected) between April 1998 and March 1999, according to protocol established in the Department of Obstetrics Loayza Hospital, entering pregnant with a single fetus, active, without fever and diagnosed with RPM. RESULTS: Of 3985 deliveries, 284 had RPM: 263 were to term and 21 preterm; 8 infants were not assessed (transferred by malformations, four mature, four premature). 259 pregnancies to term 42 infants were infected (16.2%) and 17 premature 11 were infected (64.7%). In term pregnancies, unmarried marital status was statistically significant i...

Objective: To determine the intrauterine growth retardation associated risk factors. Methods and design: Case control study in the obstetric service of Loayza Hospital during 1998. Of 396 alive neonates with intrauterine growth retardation, we took a representative sample (144). Maternal and perinatal Hospital Nacional natal indicators were evaluated. Results: Maternal age, prenatal control, preconceptional weight, maternal size, body mass index, maternal weight gain and hemoglobin during pregnancy do not show any significant differences. The most common associated pathologies concerning intrauterine growth retardation (p < 0,05) were multifetal gestotion, preeclampsia, uteroplacentol insufficiency, premature delivery and syphilis. The type of delivery was similar in both groups. Apgar score was significantly low in the cases, both atone and five minutes, without asphyxia compromise. Con...

OBJECTIVE: To determine the incidence and maternal characteristics, birth and neonatal delayed asymmetrical and symmetrical growth. MATERIALS AND METHODS: A descriptive, retrospective study of 396 live births with fetal growth retardation (RCF). RESULTS: The annual incidence was 10.1%, with asymmetrical 242 (61.1%) and symmetrical 154 (38.9%). In single mothers it was higher asymmetrical and cohabitants, symmetrical. There was adequate prenatal care in 71.7%. There were no differences between anthropometric measures, weight gain and maternal hemoglobin between the two types. Preeclampsia, urinary tract infection, premature rupture of membranes, previous cesarean section, premature birth and multiple pregnancy were associated pathologies more frequent, taking the last two significant relationship with symmetrical delay. The fetal malformations represented 4.5% and 4.1% in infants with sy...

OBJECTIVE: To evaluate the first experiences of HIV+ pregnant women who delivered at the Loayza General Hospital in 1996 and 1997. MATERIAL: Retrospective stay of 20 pregnant women HIV+. RESULTY: The incidence was 0,18% and increased from one year to anotherin about 50% (0,15% in 1996 to 0,22% in 1997). Four were classified as AIDS and sixteen as HIV+. Fourteen mothers were bettween 21 and 30 years old (70%) and four between 16 and 20 years (20%). Single mothers represent 35%. Secondary students or some with any year of high school total 95%, 20% of them began sexual activity before 15 years, 45% were pregnancy the first time. Twelve pregnant women (60%) bad an adequate prenatal care, they received zidovudine (AZT) during 10,7 weeks in average, giving hirth eight of them by elective cesarean section (5 arrived to the obstetric room with complete dilatation). Three patients presented cond...

Objectives: To determine the effectiveness of low dose salicylic acid acetate (aspirin) in preeclampsia prevention. Design: Clinical randomized trial. Setting: Loayza General Hospital Obstetrical Service. Material and methods: Forty-three primigravidae less than 20 weeks pregnant with hypocalciuria received 100 mg/d of salicylic acid acetate. Other 43 primigravidae with similar clinical characteristics were controls. Results: The incidence of preeclampsia was 16,3% in both groups. Conclusion: The use of low dose salicylic acid acetate did not change the incidence of preeclampsia in this group of patients.

Objectives: To determine the effectiveness of low dose salicylic acid acetate (aspirin) in preeclampsia prevention. Design: Clinical randomized trial. Setting: Loayza General Hospital Obstetrical Service. Material and methods: Forty-three primigravidae less than 20 weeks pregnant with hypocalciuria received 100 mg/d of salicylic acid acetate. Other 43 primigravidae with similar clinical characteristics were controls. Results: The incidence of preeclampsia was 16,3% in both groups. Conclusion: The use of low dose salicylic acid acetate did not change the incidence of preeclampsia in this group of patients.

OBJECTIVE: To evaluate the first experiences of HIV+ pregnant women who delivered at the Loayza General Hospital in 1996 and 1997. MATERIAL: Retrospective stay of 20 pregnant women HIV+. RESULTY: The incidence was 0,18% and increased from one year to anotherin about 50% (0,15% in 1996 to 0,22% in 1997). Four were classified as AIDS and sixteen as HIV+. Fourteen mothers were bettween 21 and 30 years old (70%) and four between 16 and 20 years (20%). Single mothers represent 35%. Secondary students or some with any year of high school total 95%, 20% of them began sexual activity before 15 years, 45% were pregnancy the first time. Twelve pregnant women (60%) bad an adequate prenatal care, they received zidovudine (AZT) during 10,7 weeks in average, giving hirth eight of them by elective cesarean section (5 arrived to the obstetric room with complete dilatation). Three patients presented cond...

Objective: To determine the intrauterine growth retardation associated risk factors. Methods and design: Case control study in the obstetric service of Loayza Hospital during 1998. Of 396 alive neonates with intrauterine growth retardation, we took a representative sample (144). Maternal and perinatal Hospital Nacional natal indicators were evaluated. Results: Maternal age, prenatal control, preconceptional weight, maternal size, body mass index, maternal weight gain and hemoglobin during pregnancy do not show any significant differences. The most common associated pathologies concerning intrauterine growth retardation (p < 0,05) were multifetal gestotion, preeclampsia, uteroplacentol insufficiency, premature delivery and syphilis. The type of delivery was similar in both groups. Apgar score was significantly low in the cases, both atone and five minutes, without asphyxia compromise. ...

OBJECTIVES: To determine the maternal characteristics with statistical probabilities of association with neo natal infection in patients rum premature rupture of membranes (PROM), both at term, as premature. Evaluate the perinatal morbidity and mortality MATERIAL AND METHODS: Retrospective observational study, case-control (infected-no newborn infected) between April 1998 and March 1999, according to protocol established in the Department of Obstetrics Loayza Hospital, entering pregnant with a single fetus, active, without fever and diagnosed with RPM. RESULTS: Of 3985 deliveries, 284 had RPM: 263 were to term and 21 preterm; 8 infants were not assessed (transferred by malformations, four mature, four premature). 259 pregnancies to term 42 infants were infected (16.2%) and 17 premature 11 were infected (64.7%). In term pregnancies, unmarried marital status was statistically significant i...

OBJECTIVES. To determine both endometrial hyperplasia associated risk factors and effective use of diagnostic procedures. DESIGN: Retrospective, clinical study. SETTING: Gynecology Service, Arzobispo Loayza National Hospital, a teaching hospital. PATIENTS: Women with abnormal uterine bleeding and/or thickened endometrium by ultrasound. INTERVENTIONS: Associated risk factors were determined in 196 women –152 premenopausal and 44 postmenopausal–, with histology diagnosis of either endometrial hyperplasia (with or without atypia) or normal endometrium (proliferative or secretory). x2, odds ratios, 95% confidence intervals and logistic regression were used. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were determined. MAIN OUTCOME MEASURES: Endometrial hyperplasia associated risk factors. ReSULTS. In the premenopausal group 34 had normal ...

OBJECTIVE. To determine fetal growth of appropriate and small for gestational age twins by ultrasound. MATERIAL AND METHODS. Live twin deliveries attended at A. Loayza General Hospital between January 1, 1996 and December 31, 2000, with minimum 3 ultrasound studies during pregnancy when biparietal diameter, abdominal circumference, femur length and estimated fetal weight were determined. Seventy-nine adequate (AGA) and small (SGA) for gestational age were studied, mcluding sexgender, placenta type and complications. RESULT. The abdominal circumference between twin AGA and SGA reaches a difference of 20 mm at 39,2 weeks, 15 mm at 35,6, and 10 mm at 31,1 weeks. Biparietal diameter differed 5 mm at 39,6 weeks, 4 mm at 30,4 and 3 mm at 25,2 weeks, Femur length reached maximum difference of 2,81 mm at 17,4 weeks and fetal weight 17% at 28,8 weeks. No significant differences were found with r...

OBJECTIVES. To determine both endometrial hyperplasia associated risk factors and effective use of diagnostic procedures. DESIGN: Retrospective, clinical study. SETTING: Gynecology Service, Arzobispo Loayza National Hospital, a teaching hospital. PATIENTS: Women with abnormal uterine bleeding and/or thickened endometrium by ultrasound. INTERVENTIONS: Associated risk factors were determined in 196 women –152 premenopausal and 44 postmenopausal–, with histology diagnosis of either endometrial hyperplasia (with or without atypia) or normal endometrium (proliferative or secretory). x2, odds ratios, 95% confidence intervals and logistic regression were used. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were determined. MAIN OUTCOME MEASURES: Endometrial hyperplasia associated risk factors. ReSULTS. In the premenopausal group 34 had normal ...

OBJECTIVE. To determine fetal growth of appropriate and small for gestational age twins by ultrasound. MATERIAL AND METHODS. Live twin deliveries attended at A. Loayza General Hospital between January 1, 1996 and December 31, 2000, with minimum 3 ultrasound studies during pregnancy when biparietal diameter, abdominal circumference, femur length and estimated fetal weight were determined. Seventy-nine adequate (AGA) and small (SGA) for gestational age were studied, mcluding sexgender, placenta type and complications. RESULT. The abdominal circumference between twin AGA and SGA reaches a difference of 20 mm at 39,2 weeks, 15 mm at 35,6, and 10 mm at 31,1 weeks. Biparietal diameter differed 5 mm at 39,6 weeks, 4 mm at 30,4 and 3 mm at 25,2 weeks, Femur length reached maximum difference of 2,81 mm at 17,4 weeks and fetal weight 17% at 28,8 weeks. No significant differences were found with r...

OBJECTIVE: To know the characteristics of multiple pregnancies in a Limenian hospital. DESIGN: Descriptive retrospective study of multiple pregnancy. MATERIAL AND METHODS: 222 multiple pregnancies attended at Arzobispo Loqyza National Hospital betweenjanuary 1, 1991 and December 31, 1995. RESULTS: There were 219 twin and 3 triple pregnancies, maternal ages between 15 and 42. Only 63.5% bad adequate prenatal control, diagnosis was done by ultrasound in 73.4% and during delivery in 1-53%. There was past history of multiple pregnancy in 29.7%. In 49.1 % gestation did not reach term and most frequent associated pathologies were anemia, preeclampsia and threatened preterm labor. Pregnancy enden by cesarean section in 113, due to fetal malposition (38.5%), preeclampsia (25.5%) and premature rupture of membranes (11.1%). In 79.7% interval of birth between twins was 15 minutes or less and 83.5% ...

Objectives: To determine the risk of pregnancy complications by untreated bacterial vaginosis. Design: Retrospective study of historical cohort. Materials and Methods: Clinical histories were reviewed at the time of delivery for diagnosis of bacterial vaginosis in the first prenatal control. Results: One hundred thirty pregnant women with bacterial vaginosis did not complete their treatment and 447 pregnant women did not have bacterial vaginosis. There was no significant differences in maternal age, parity, history of vaginal discharge, presence of vaginal secretion, birth weight and route of delivery between the groups. Pregnant women with bacterial vaginosis had more risk of abortion (RR 4,185; p = 0, 01) and endometritis (RR 2,441; p = 0, 034). Risk for preterm delivery, chorioamnionitis, premature rupture of membranes and low birth weight was not significant. Conclusions: Bacterial v...

Objective: To evaluate the efficacy of selective ambulatory regional analgesia in term pregnant women. Material and methods: Prospective cohort study done at Loayza Hospital Obstetrical Service between September and December 1998. Twenty pregnant women without risk were included and double catheter analgesia was indicated; controls were twenty other pregnant women without risk that delivered posteriorly. Results: Age, parity, gestational age, weight, pre natal control and serum hemoglobin were similar in both groups, as well as, newborn weight and gestational age. Cases received analgesia in the active phase of labor (average dilatation 5,3 cm), with good active phase in 100% and regular expulsive phase in 4 cases (20%). There was no difference in delivery route. Expulsive phase duration was 5 minutes more in cases, as well as the need for oxytocin stimulation (p<0,05), and no obstetrica...

OBJETIVE: To evaluate the characteristics and complications of induced labor with intravaginal misoprostol versus intravenous oxytocin in pregnant women at term with premature rupture of membranes (PROM) without evidence of spontaneous labor. DESIGN: Retrospective, descriptive and comparative study. LOCATION: Department of Obstetrics of Loayza Hospital. MATERAIL AND METHODS: The medical records of 92 pregnant women at term with RPM was reviewed under conditions to be induced. The effects of intravenous oxytocin in 49 patients (group 1], according to protocol, versus intravaginal misoprostol in 43 patients (Group 2), or 50 mg every 4 hours was assessed to achieve adequate uterine contractions or reach 300 mg RESULTS.: The induction was more successful in the misoprostol group (74.4%) compared to oxytocin (61.2%), but without statistical significance (p = 0.18). The interval from the start...

Objectives: To determine the risk of pregnancy complications by untreated bacterial vaginosis. Design: Retrospective study of historical cohort. Materials and Methods: Clinical histories were reviewed at the time of delivery for diagnosis of bacterial vaginosis in the first prenatal control. Results: One hundred thirty pregnant women with bacterial vaginosis did not complete their treatment and 447 pregnant women did not have bacterial vaginosis. There was no significant differences in maternal age, parity, history of vaginal discharge, presence of vaginal secretion, birth weight and route of delivery between the groups. Pregnant women with bacterial vaginosis had more risk of abortion (RR 4,185; p = 0, 01) and endometritis (RR 2,441; p = 0, 034). Risk for preterm delivery, chorioamnionitis, premature rupture of membranes and low birth weight was not significant. Conclusions: Bacterial v...

OBJETIVE: To evaluate the characteristics and complications of induced labor with intravaginal misoprostol versus intravenous oxytocin in pregnant women at term with premature rupture of membranes (PROM) without evidence of spontaneous labor. DESIGN: Retrospective, descriptive and comparative study. LOCATION: Department of Obstetrics of Loayza Hospital. MATERAIL AND METHODS: The medical records of 92 pregnant women at term with RPM was reviewed under conditions to be induced. The effects of intravenous oxytocin in 49 patients (group 1], according to protocol, versus intravaginal misoprostol in 43 patients (Group 2), or 50 mg every 4 hours was assessed to achieve adequate uterine contractions or reach 300 mg RESULTS.: The induction was more successful in the misoprostol group (74.4%) compared to oxytocin (61.2%), but without statistical significance (p = 0.18). The interval from the start...

Objective: To evaluate the efficacy of selective ambulatory regional analgesia in term pregnant women. Material and methods: Prospective cohort study done at Loayza Hospital Obstetrical Service between September and December 1998. Twenty pregnant women without risk were included and double catheter analgesia was indicated; controls were twenty other pregnant women without risk that delivered posteriorly. Results: Age, parity, gestational age, weight, pre natal control and serum hemoglobin were similar in both groups, as well as, newborn weight and gestational age. Cases received analgesia in the active phase of labor (average dilatation 5,3 cm), with good active phase in 100% and regular expulsive phase in 4 cases (20%). There was no difference in delivery route. Expulsive phase duration was 5 minutes more in cases, as well as the need for oxytocin stimulation (p<0,05), and no obstetr...