Hospital infections are high when there is no adequate control of the multiple factors involved. During 2010 and part of 2011 rate of vaginal delivery puerperal endometritis rate was three times that of national standards. Therefore, we applied the World Health Organization (WHO)’s multimodal strategy intervention of hand washing that consists in 1) system change, 2) education and training, 3) feedback, 4) recalls, and 5) organizational climate. Objectives: To diminish puerperal endometritis rates in vaginal deliveries. Design: Quasi experimental, prospective a longitudinal study. Setting: Hospital Nacional Docente Madre Niño San Bartolome, Lima, Peru. Participants: Medical staff, residents, interns rotating in the delivery room. Interventions: Based on WHO Multimodal Strategy of hand washing. Main outcome measures: Rates of puerperal endometritis. Results: Puerperal endometritis star...

Hospital infections are high when there is no adequate control of the multiple factors involved. During 2010 and part of 2011 rate of vaginal delivery puerperal endometritis rate was three times that of national standards. Therefore, we applied the World Health Organization (WHO)’s multimodal strategy intervention of hand washing that consists in 1) system change, 2) education and training, 3) feedback, 4) recalls, and 5) organizational climate. Objectives: To diminish puerperal endometritis rates in vaginal deliveries. Design: Quasi experimental, prospective a longitudinal study. Setting: Hospital Nacional Docente Madre Niño San Bartolome, Lima, Peru. Participants: Medical staff, residents, interns rotating in the delivery room. Interventions: Based on WHO Multimodal Strategy of hand washing. Main outcome measures: Rates of puerperal endometritis. Results: Puerperal endometritis star...

Objetive: To ascertain whether the use of uterine compression suture (B-Lynch technique) during a cesarean section with uterine atony decreases the amount of blood loss and prevents postpartum hysterectomy. Material and Methods: Retrospective study of all the cesarean section deliveries complicated by uterine atony from January 1, 1990 through December 31, 2003 at San Bartolome Hospital in Lima. The standard management of uterine atony included uterine massage, use of uterotonic agents (ocytocin, prostaglandins), uterine/hypogastric artery ligature and, finally, postpartum hysterectomy. Maternal and Infant clinical charts were reviewed and variables were entered into a computer system analysis (SPSS version 10). Results: Forty six cases were identified: B-Lynch technique was used in 30 cases and the standard method in 16 cases. There was no difference in maternal characteristic between b...

Objetive: To determine healthy neonates birthweight born from healthy Lima pregnant women without obstetrical complications. Materials and Methods: A retrospective, analytic and transversal study was conducted. Maternal and perinatal data was retrieved from the Department of Obstetrics/Gynecology and Pediatrics Database at Hospital Nacional Docente Madre-Niño San Bartolome from January 1, 1991 through December 31, 1999. Healthy singleton pregnant women 20 to 30 years old, BMI 20 to 25 kg/mt2 , without obstetrical complications, with a difference ± 2 weeks between last menstrual period and gestational age by physical assessment of the healthy living neonate were selected. Results: Birthweights of 5,443 healthy neonates in Lima [50th percentile [10th percentile- 90th percentile]) at 35, 36, 37, 38, 39, 40, 41, and 42 gestational weeks were 2640 (2346-3356), 2850 (2430- 3344), 3100 (2688-...

Objetive: To establish values for neonatal ponderal index (PI) in a group of healthy fetuses born from healthy singleton pregnant women at Lima, Peru. Materials and Methods: A retrospective, analytic and transversal study was conducted. Maternal and perinatal data from January 1, 1991 through December 31,1999 was retrieved from the Department of Obstetrics/Gynecology and Pediatrics Database at Hospital Nacional Docente Madre-Niño “San Bartolome”. Healthy singleton pregnant women between 20 and 30 years old, BMI between 20 and 25 kg/m2 , without obstetrical complications, with a difference ± 2 weeks between last menstrual period and gestational age by physical assessment of a live-healthy neonate were selected. PI was defined as birthweight in grams x 100/ [crown-heel length]3 . Results: The PI [50th percentile (10th percentile- 90th percentile)] in 5,443 Lima healthy neonates at 35...

Objectives: 1) To determine the association between maternal characteristics and the microbial flora of the vagina in pregnancies with high risk of prematurity; and, 2) To determine the association between the microbial flora of the vagina and the maternal and perinatal outcome in pregnancies with high risk of prematurity. DESIGN: Case-control study, between January 1994 and December 1995. Material and methods: Case group comprised 238 singleton-pregnant women who were admitted because of preterm premature contractions, preterm labor, increased vaginal fluid, acute pylonephritis and arterial hypertension. All cases underwent a wet preparation to establish the microbial flora. The control group included 3 850 singleton pregnant women who delivered a term neonate at the same institution. Case group was further divided into women with bacterial vaginitis (n=136), bacterial vaginosis (BV, n=...

During normal pregnancy, the cytotrophoblast becomes their epithelial phenotype to endothelial phenotype (termed pseudo-vasculogenesis) and invade the maternal spiral arteries. This physiological transformation myometrial spiral arteries increases blood flow and nutrient supply to the fetus at the end of the first quarter. Vascular, such as vascular endothelial growth factor (VEGF), placental growth factor (PIGF), the tyrosine kinase-1 soluble fms-like receptor (sFlt1) factors involved in this process. At the origin of circulating angiogenic proteins involved preeclampsia. Furthermore, serum from women with preeclampsia reduced the viability of the trophoblast, which is related to changes in the sensitivity of trophoblast to Fas-mediated apoptosis, which could be mediated by proinflammatory cytokines, which have been found increased in patients with preeclampsia. In preeclompsia, there i...

During normal pregnancy, the cytotrophoblast becomes their epithelial phenotype to endothelial phenotype (termed pseudo-vasculogenesis) and invade the maternal spiral arteries. This physiological transformation myometrial spiral arteries increases blood flow and nutrient supply to the fetus at the end of the first quarter. Vascular, such as vascular endothelial growth factor (VEGF), placental growth factor (PIGF), the tyrosine kinase-1 soluble fms-like receptor (sFlt1) factors involved in this process. At the origin of circulating angiogenic proteins involved preeclampsia. Furthermore, serum from women with preeclampsia reduced the viability of the trophoblast, which is related to changes in the sensitivity of trophoblast to Fas-mediated apoptosis, which could be mediated by proinflammatory cytokines, which have been found increased in patients with preeclampsia. In preeclompsia, there i...