A pesar de que el aborto terapéutico (AT) está aprobado por ley en el Perú desde el año 1924 (1), solo recientemente desde el Ministerio de Salud (junio 2014) ha sido aprobada la Guía Nacional para Interrupción Voluntaria del Embarazo por Razones Terapéuticas (2). Sin embargo, las mujeres peruanas aún no disponen de un adecuado acceso a los servicios en los hospitales públicos. Esta deficiencia es en gran medida responsable de que las causas indirectas de muerte materna se presenten cada vez con mayor frecuencia (3). Los profesionales de la salud de los establecimientos públicos que prestan servicios de salud sexual y reproductiva carecen de información suficiente y mantienen aún estigmas contra las mujeres que se interrumpen la gestación y contra los profesionales que las atienden, debido a que falta aún estandarizar la atención, para seguridad de las mujeres y de los pro...

Al decir de uno de los viejos maestros, la preeclampsia es tanantigua como la civilización humana. Esta enfermedad es unade las complicaciones más frecuentes que encontramos en laobstetricia y contribuye con muchas complicaciones y muertes(1).Por esta última afirmación de la preeclampsia habría que definirlacomo un problema de salud pública, dada la alta frecuencia de supresentación y el daño que de ella se deriva. No podríamos decirque es prevenible, por cuanto aún no conocemos la verdaderaetiología.

Objective: To recail abuse prevalence against women attended at Lima's South Cone obstetrical services and to establish association between violence and both maternal and perinatal pathology and perinatal mortality. Design: Analytical retrospective cohort investigation. Setting: Maria Auxiliadora Hospital and Cesar Lopez Silva Mother and Child Hospital, Villa El Salvador. Participants: Hospitalized puerperal women. Interventions: Between March and november 2005 we applied a survey to 7333 puerperal women before discharge from the hospital in order to identify the presence of violence against women. Answers were classified in three groups: without violence (30,7%), with violence history (37,4%) and with violence during this pregnancy (31,9%). Wereviewed the perinatal clinical history in each case and verified demographic variables as well as maternal and perinatal complications. We also d...

More than a decade that Peru made a commitment to reach a level of health for Peruvians in 2000 that allows us a socially and economically productive level. Within this context, albeit some countries on the continent have already achieved many of the objectives proposed by the Region of the Americas, we are far from achieving and according to the evolution of the facts and the missing years to finish the century is reasonable to accept that lack a greater commitment and effort in excess of that has been making to date to deal with this noble challenge.

We present an study of 49 cases on hemorrhage shock treated in Obstetrics and Gynocology Departament at Maria Auxiliadora Hospital Lima- Perú, from July 1. 1988 to December 31, 1989. In this period occurred 6,243 deliveries. The most frequent causes were ectopic pregnancy, abort and abruptio placentae. It is important also, then pregnancies were in first 12 weeks.  the management was: general measures and specific measures to treat the hemorrhage. There was I maternal death.

It is gratifying for those who exert university teaching at undergraduate level and in the training of future specialists, to make a stop along the way and jointly participate in a reflection on, what's happening with the training of our human resources. Nearly three decades there has been talk in academic environments Peru of the need to "train the doctor that the country needs" means. In that sense or Academic Faculties of Medicine and especially the Peruvian Association of Medical Schools have undertaken several programs local and national calls in order to get closer to that goal-image.

This is the third ethics symposium published by the Peruvian Journal of Gynecology and Obstetrics (RPGO) in the last 11 years, given the importance of this discipline for medical practice, especially for the gynecologist-obstetrician(1,2). Because of the topic’s transcendence, the Peruvian Society of Gynecology and Obstetrics (SPGO) hosted an event in 2009, highlighting various issues in sexual and reproductive health ethics(3). That same year, the Society participated in a Values Clarification Workshop in Trinidad, Bolivia(4).

Purpose: To examine the historical process for institutionalization of therapeutic abortion in Peru and to explain its current condition. Methodology: Review of bibliographic information available in the country regarding the process conducted by many institutions to have the Ministry of Health approve the National Guide for Therapeutic Abortion. Subsequently, the lead researcher met with 10 heads of the Gynecology and Obstetrics Service/Department from the same number of hospitals, from whom he requested information, as they have been regulating the provision of therapeutic abortion services by means of local Guides or Protocols for the last 5 years. Results: The formalization of the National Guide for the provision of therapeutic abortion services by the Ministry of Health has been a persistent endeavor of many institutions of civil society, but the 10 convened hospitals have already b...

The author has taken as the basis of this manuscript the content of the Presentation to a similar symposium published in 2009 in the Peruvian Journal of Gynecology and Obstetrics (RPGO) (1). The ultimate goal of medicine, has traditionally been to seek the improvement of the sick person avoiding harm, according to the maxim dubiously attributed to Hippocrates primum non nocere; However, Bioethics as a discipline did not appear until the second half of the 20th century. For many researchers, the birth of the concept of bioethics, although it was not called by that term, occurs in Seattle (USA) when a non-medical committee was created in the early 1960s to decide who had preference for hemodialysis. The fundamental question was: why a medical breakthrough should create medical discrimination? How and who chose the candidates? The answer to these questions did not fall on the doctors, but o...

In 1991 and 1992, the "Maria Auxiliadora" Hospital 1500 was chosen maternity cases, of which 587 were nulliparous and 913 multiparous. To all of them they applied the following criteria: chronology of pregnancy between 37 and 41 weeks, absence of pathology, delivery start and spontaneous evolution, no medication during childbirth normal pelvis, cephalic presentation and newborn 2500-4000 gr with score 6 higher Apgar at birth. After applying these criteria, we finally met 317 nulliparous (with intact membranes 209 and 108 with ruptured membranes) and 306 multiparous (231 with intact membranes and 75 with ruptured membranes). All patients were supine during labor and were controlled in the obstetrics center using the partograph designed by CLAP and make careful records graphics from 4-5 cm of cervical dilation on. Data from the dilation of the cervix in relation to time were processed by c...

From 1988 to 1992, 18 732 deliveries were attended in Obstetrics and Gynecology Department of Maria Auxiliadora Hospital. During this period 1,309 women also were attended with preeclampsia and 146 with eclampsia (incidence 7,0% and 0,8% respectively). Using a cases and control investigation we found the next risk factors associated to preeclampsia-eclampsia in patients of Cono Sur of Lima-Perú: age 10-19 years, age 35 years and older, obesity, unmarried, nuliparity, grand multiparity, new pregnancy after 8 years, anemia, multiple pregnancy, cronic hypertension and urinary infection.

Since the launch in Nairobi Safe Motherhood Initiative in 1987, the emphasis was on the world to a series of interventions in order to reduce maternal deaths. It's been just over 20 years and still these deaths have not declined, particularly in third world countries. Within the multiple that is supported for maternal mortality in the end the death occurs because a woman's pregnancy complication, which if severe can result in death is inserted. From there then that if the woman is taken care of in this situation by qualified personnel and in a suitable environment, it can overcome the occurrence of this complication and attend a successful outcome.

Caesarean section is an operation whose purpose is to artificially remove the fetus through the abdominal approach, focusing on the uterus. It has been written that this operation goes back many centuries. In ancient Rome it was a must carry it out in the pregnant woman after her death. It is said that Julius Caesar was born through this intervention, but it is a hard fact to accept, since his mother lived many years after he was born. The first caesarean in Peru was conducted at the Maternity of Lima by Dr. Camilo Segura 1861, in a patient who died during childbirth. The May 31, 1931 at the Maternity of Lima Dr. Alberto Barton cesarean section obtaining a live newborn. The mother died a few hours. In 1926 Dr. Ricardo Palma performed the first caesarean section in Chiclayo. Between 1927 and 1936 Dr. Manuel Jesus Castaneda made the first Caesarean section in Arequipa and in 1931 Dr. Callo...

In recent times, the country has witnessed tragic events. Urban fires with terrible consequences have marched in parallel with fires in the rural areas of northern Peru. There have been criminal events involving the loss of human lives that have mourned many households. Violence, particularly against women, remains a worrying pre-eminence, despite drastic legislation.

A few weeks ago, one of the leading figures in medical science and champion of Family Planning in Peru, Dr. Roger Guerra-García Cueva, ceased to exist, possessing a number of qualities that need to be highlighted and imitated. Dr. Roger Guerra-García was born on April 02, 1933 in the city of Pacasmayo, La Libertad, although his ancestors came from Cajamarca, where he used to go frequently to enjoy nature and fulfill the responsibilities of his position. Dr. Guerra was a doctor from San Marcos University, with a postgraduate degree at Mount Sinai Hospital in New York and the Boston University School of Medicine, having achieved his doctorate at Cayetano Heredia Peruvian University.

Labor is a rhythmic and coordinated uterine activity whereby progressive cervical dilation eventually completely dilate the cervix is achieved.

A descriptive study of maternal deaths in the Maria Auxiliadora Hospital from October 1986 to December 1992. During this period 31 have died 64 women out of 27540 live births occurs, representing a rate of 232 deaths 100 000. The most frequent ages were between 20 and 24 years and parity was predominantly less than 3. Social factors marital status, level of education and occupation have confirmed the findings of other authors. In most there was no birth control or this was insufficient. 60% of deaths occurred in the postpartum period. The direct cause of death predominated (68.5%) where he highlighted the puerperil infection, toxemia, abortion and bleeding. Indirect causes accounted for 29.7%, with first tuberculosis. One case of maternal death is recorded incidental causes. Clearly, the maternal mortality rate is declining significantly, however stands 73.3% of avoidable deaths.

Starting June 1, 1989, an operational investigation on ambulatory management of noncomplicated incomplete abortion was performed at Maria Auxiliadora's Hospital, Lima-Peru, to establish advantages or disadvantages. Previously, management of incomplete abortion the year before was evaluated, period when all cases were hospitalized during two days. Cases selected as "noncomplicated incomplete abortion" were prepared in the emergency room and sent for dilatation and curettage in a special room in the Obstetrical Center. The procedure was done with analgesia or local anesthesia and then the patient was sent for two hours observation in a contiguous room and finally dismissed home with indications to return for control in one month. The year before the study, abortion rate was 193,3 per thousand live newborns, 1990, 1078 abortions bad been attended (rate 26-0 x 1000 l.n.), including 641 (60%)...

Objective: To update information on misoprostol obstetrical use in order to determine availability mapping in Latin America and the Caribbean countries. Design: Survey type study. setting: Latin America and the Caribbean countries. Participants: Public and prívate sources. Methodology: A survey semiestructured format was elaborated and sent to key Latin America and the Caribbean informers. They consulted different public and private sources in each country. Answers were ncorporated in a database to obtain frequencies of each variable studied. main outcome measures: Misoprostol trademarks, content and availability. Results: Misoprostol is obtained in different trademarks in Latin America and the Caribbean, usually in 200 μg oral tablets presentations and only one is presented as 25, 50, 100 y 200 μg vaginal tablets. Few presentations associate misoprostol to an antiinflammatory. There ...

From july 1988 to june 1992, 18 732 deliveries were atended in Obstetrics and Gynecology Department of María Auxiliadora Hospital. During this period 1309 women with preeclampsia and 146 women with eclampsia also were atended (incidence 7,0% and 0,8% respectively). Using a cohorte investigation model we found that PIH is an important risk factor to thirth trimester heamorrage, induced labor, cesarea section, postapartum heamorrage, puerperal infection and preterm delivery. Besides, we found among PIH patients most frecuency of low weigth newborn, asfixia, respiratory distress syndrome, ictericia and infection of newborn. Finally, PIH is clearly a very important risk factor to maternal mortality and perinatal mortality.