Dystocia birth: Handling - forceps, vacuum, breech, shoulder dystocia, pediatric aspects

Ectopic pregnancy is a pathology often encountered in the gynecologist practice. It is possible to have diverse extra-uterine implantation sites, some of them unsuspected. A case of cornual (stump) ectopic pregnancy with absent tube due to salpingectomy performed a year earlier for ectopic pregnancy and evidence of ovulation from the contra-lateral ovary (evidence of corpus luteum) and tube intact, corresponding to abdominal pregnancy, is presented. Resection of trophoblast was performed by laparoscopy, thus corroborating the anatomic and pathologic diagnosis of ectopic pregnancy. Postoperative outcome was satisfactory.

A rare case of a spontaneous heterotopic pregnancy, intrauterine and ovarian, seen at Clinica Santa Isabel in Lima is presented. A 35-year-old patient was seen for menstrual delay, scanty vaginal bleeding and positive pregnancy test. Transvaginal ultrasound showed small gestational sac with absence of embryonic echoes. Uterine curettage was performed on 01/11/2006 obtaining chorial villi with non-molar hydropic degeneration at histologic examination. Ten days later, transvaginal ultrasound control was done because of persistent vaginal bleeding and abdominal pain, showing a left ovary mixed tumor with small inner echolucid image. An emergency laparotomy was performed; findings were 200 mL hemoperitoneum and an elongated, retrouterine, soft, purple mass dependent of left ovary, in relation to ectopic ovarian pregnancy.

Objectives: To determine benefits of levonorgestrel intrauterine device (IUD) in uterine leiomyomatosis associated with hypermenorrhea. Design: Descriptive, retrospective study. Participants: Women with uterine leyomiomatosis and hypermenorrhea. Interventions: Levonorgestrel IUD was applied to 15 patients with uterine leiomyomatosis and hypermenorrhea as an alternative to usual surgical treatment. Patients with 2 to 5 cm average diameter leiomyomas not localized within the cavity were included, at most 4 in number, and followed for 12 months. Main outcome measures: Reduction of both leiomyoma size and menstrual volume. Results: One  patient expelled the IUD at 3 months from insertion. In 8 of the remaining 14 (57,1%) there was reduction of the leiomyoma size between 25 and 50% in relation to the original size; in 5 patients (35,7%) the size remained the same and in one (7,1%) it grew. M...

Ectopic pregnancy is a pathology often encountered in the gynecologist practice. It is possible to have diverse extra-uterine implantation sites, some of them unsuspected. A case of cornual (stump) ectopic pregnancy with absent tube due to salpingectomy performed a year earlier for ectopic pregnancy and evidence of ovulation from the contra-lateral ovary (evidence of corpus luteum) and tube intact, corresponding to abdominal pregnancy, is presented. Resection of trophoblast was performed by laparoscopy, thus corroborating the anatomic and pathologic diagnosis of ectopic pregnancy. Postoperative outcome was satisfactory.

Objectives: To determine benefits of levonorgestrel intrauterine device (IUD) in uterine leiomyomatosis associated with hypermenorrhea. Design: Descriptive, retrospective study. Participants: Women with uterine leyomiomatosis and hypermenorrhea. Interventions: Levonorgestrel IUD was applied to 15 patients with uterine leiomyomatosis and hypermenorrhea as an alternative to usual surgical treatment. Patients with 2 to 5 cm average diameter leiomyomas not localized within the cavity were included, at most 4 in number, and followed for 12 months. Main outcome measures: Reduction of both leiomyoma size and menstrual volume. Results: One  patient expelled the IUD at 3 months from insertion. In 8 of the remaining 14 (57,1%) there was reduction of the leiomyoma size between 25 and 50% in relation to the original size; in 5 patients (35,7%) the size remained the same and in one (7,1%) it grew. M...

A rare case of a spontaneous heterotopic pregnancy, intrauterine and ovarian, seen at Clinica Santa Isabel in Lima is presented. A 35-year-old patient was seen for menstrual delay, scanty vaginal bleeding and positive pregnancy test. Transvaginal ultrasound showed small gestational sac with absence of embryonic echoes. Uterine curettage was performed on 01/11/2006 obtaining chorial villi with non-molar hydropic degeneration at histologic examination. Ten days later, transvaginal ultrasound control was done because of persistent vaginal bleeding and abdominal pain, showing a left ovary mixed tumor with small inner echolucid image. An emergency laparotomy was performed; findings were 200 mL hemoperitoneum and an elongated, retrouterine, soft, purple mass dependent of left ovary, in relation to ectopic ovarian pregnancy.

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% ...