Ginecología y obstetricia de México
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Randomized Controlled Trial Comparative Study Clinical Trial
[Transcutaneous electric stimulation (TENS) to reduce pain after cesarean section].
The main goal of this work was to evaluate the efficacy of transcutaneous electrical nerve stimulation (n = 25), comparatively with the effects induced by the intravenous administration of 1 g of Dipyrone (n = 25), to reduce postoperative pain during the immediate period (4 hours) following cesarean section. We undertook a clinical study in order to analyze the following variables: pain intensity, duration of pain, and additional consumption of analgesic drugs. Our data showed that both treatments resulted insufficient in order to eliminate completely postoperative pain, requiring the administration of additional analgesic drugs. ⋯ These actions may be related to the position of the stimulus electrodes, as well as to the frequency of stimulation used in our study. Taken together, our results are indicative that transcutaneous electrical nerve stimulation constitutes an alternative treatment in order to reduce postoperative pain during the immediate period following cesarean birth; reduces the requirements of analgesic drugs; helps on keeping alert the mothers and therefore able to attend the newborn; and avoids secondary effects of analgesic drugs over mother-newborn relationship. Nevertheless, it is necessary to further explore transcutaneous electrical nerve stimulation, changing the position of the stimulus electrodes, and the frequency of stimulation, in order to evaluate its effects on visceral pain.
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In the last decades has been a worldwide trend to increase the number of cesarean sections as an alternative of obstetric resolution, phenomenon for which it was proposed a variety of explanation, this fact remains practically unknown in the institutions of the National Health System (NHS) in Mexico. To identify the trend of the pregnancy to end for cesarean sections during the years of 1991-1995 in the 32 states of de country, as well as of all the institutions of the National Health System. Descriptive, cross sectional and retrospective. ⋯ There was a tendency to increment for all states which varied from 23.55% for the state Chiapas and 67.97% for the states of Querétaro, all increments were statistically significant. We conclude, that rates of cesarean section for both, institutions of NHS and states of the Mexican Republic, are of the highest in the world, no matter what big the interinstitutional and interstate variation are. The highest rates occurred in institutions attending closed population, and the states with a higher degree of socioeconomic development.
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In obstetrics, the uterine tamponade has been used for the control of acute uterine bleeding. However, the control of the acute hemorrhage from the nonpuerperal uterus is more difficult. ⋯ There were not complications. The uterine tamponade with Foley catheter is a therapeutic option before the radical surgical treatment.
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The objective was to determine the usefulness of laparoscopy for treatment of gynecological emergencies. In this work were studied 78 cases of patients which were treated in the Emergency Room of ABC Hospital, with symptomatology associated to reproductive organs. The age of patients was 27.7 +/- 6.3 years. ⋯ In 25.6% of the cases endoscopy turned in laparotomy; massive hemoperitoneum in tubal rupture in cases of ectopic pregnancy was the most frequent indication of this conduct. As conclusion, laparoscopy is useful in most of cases of gynecological emergencies. Fast detection or abdominal pathology, in special ectopic pregnancy can be to lower conversion of laparoscopy to open surgery.
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Review Case Reports
[Peritonitis secondary to perforated pyometra in a patient with cervical cancer: report of a case].
We describe a clinical case of a postmenopausal woman with a perforated pyometra with clinical manifestations of generalized peritonitis. In the English literature there are 15 reported cases and only 2 secondary to cancer of cervix, our case in the 3rd. case reported in detail. We make pertinent considerations regarding the management of this extremely rare complication.