[Induced abortion in Mexico: what do Mexican Ob/Gyn know, think and do]. / Aborto inducido en México: qué piensan y hacen los ginecoobstetras.

BACKGROUND: The causals for legal abortion in Mexico vary as established by the Constitution of each State; from 2007 it is legal in Mexico City. OBJECTIVE: To identify knowledge, attitudes and practice of abortion between gynecologists and obstetricians. MATERIAL AND METHODS: Survey study conducted between some of the gynaeco-obstetricians attended the 64th Mexican Congress of Gynecology and Obstetrics held in Mexico City, October 2013. RESULTS: From the 1,085 respondents, 77% correctly identified that abortion is legal accord to Constitutional Signs of each State; 17.5% said it is never legal and 5.7% thought that is always legal. The 67% comment that public institutions should have infrastructure and trained medical personnal to legal abortion practice. The 72% response they would attend or denounce the woman who underwent an abortion outlawed. The remaining 28% showed negative attitudes, from informing the couple or parents (18%), scold women (2%) or reporting it to the authorities (8%). In 39%, they felt that the medical profession who practice discriminates abortions; 28% admit stigmatize partener and 27% feel stigmatized if performing abortions. Percentage high hospitalized patients in case of early abortions, for surgical or medical treatment. CONCLUSIONS: It is necessary to increase and improve knowledge technical and legal about abortion, especially among gynaeco-obstetricians, they are who responsibility to comply about prescribed by law, in accordance with international recommendations and the exercise of reproductive rights of women.

[Vulvar carcinoma in situ in 19 year old woman: a case report and literature report]. / Carcinoma vulvar in situ en mujer de 19 años, reporte de un caso y revisión de la bibliografía.

The vulvar cancer is a rare disease. It's incidence is about 2.2 cases per 100, 000 women. The presentation of invasive vulvar cancer and in situ vulvar cancer has arrise in it's presentation with an increse of 2.4% per year. The National Cancer Institute has reported that vulvar cancer has been one of the twelve maliganant tumors that have increased thei incidence. The following is a case report of a 19 years old woman with diagnose of in situ vulvar cancer found incidentally on the perineal skin during the performing of a uterine curettage, with the diagnosis of abortion. The treatment consisted in a wide resecction of the perineal skin and residual condilomas and evaporation of vaginal condilomas with laser argon, following vulvar reconstruction. After the surgical treatment 5% imiquimod cream was used in the site of the surgery three times a week for an eight weeks period. Complete remision was achived and there was not early recurrences.

[Primary carcinoma of the peritoneum. Case report and literature review]. / Carcinoma primario de peritoneo. Reporte de un caso y revisión de la bibliografía.

Peritoneal primary carcinoma is an unusual tumor originated on the pelvic and abdominal peritoneal surface. It is believed that it is originates from a secondary müllerian system giving place to a peritoneal primary carcinoma very similar to the epithelial ovarian cancer in its clinical presentation, histological aspect, spread patron and its treatment and prognosis. It's complex clinical presentation difficult the differentiation from an epithelial tumors from the ovary. Both tumors present ascitis, elevated CA 125 and signs of peritoneal carcinomatosis on the tomographic images. In this report is exposed the case of a 39 years old women with a pre-surgical diagnosis of primary carcinoma of the ovarian, wich was discarded during surgery founding that the primary tumor was on the peritoneal surface of the descending colon.

[Reversible long-duration contraceptives: an efficient strategy to reduce non-planned pregnancies]. / Anticonceptivos de larga duración reversibles: una estrategia eficaz para la reducción de los embarazos no planeados.

Long-term contraception, reversible, have shown high rates of effectiveness and long-term compliance, with few contraindications. However, despite that Mexico has a variety of reversible contraception, most women still using less effective options. The resulting health benefits of contraception are important because they prevent unintended pregnancy, reduce the number of abortions and the incidence of death and disability related to pregnancy and childbirth complications. The Committee for Reproductive Health and Sexual Rights of the Mexican Federation of Colleges of Obstetrics and Gynecology (FEMECOG) conducted a literature review to evaluate the use of long-term contraception reversible as an effective and accessible tool to reduce the incidence unintended pregnancy and its consequences.

[Review by expert group in the diagnosis and treatment of anemia in pregnant women. Federación Mexicana de Colegios de Obstetricia y Ginecología]. / Opinión de un grupo de expertos en diagnóstico y tratamiento de la anemia en la mujer embarazada.

BACKGROUND: According to data from the World Health Organization and UNICEF from year 2009, iron deficiency is the most widespread nutritional deficiency worldwide. This deficiency causes an imbalance between needs and iron supply, which consequently results in anemia. Around the world, two million people suffer from anemia, half of which is due to iron deficiency. The most impacted groups are children and teenagers, due to their highest requirements derived from the growing process, and women in their reproductive age, due to their loss of iron derived from menstruating or to their highest iron needs during pregnancy. This increase in needs is not satisfied by the regular diet, since it includes an insufficient amount and/or low bioavailability of iron. PURPOSE: To share with the medical community treating pregnant women the experience of an expert group so that they always bear in mind the repercussions caused by anemia during pregnancy, know more about the diagnostic possibilities and have a reference point for prescribing iron supplements. METHOD: The consensus method was used through the expert panel group technique. Two rounds were taken for structuring the clinical questions. The first one was to facilitate working groups their focusing in the clinical topics and the population of interest; the second one was to aid in posing specific questions observing the Patient, Intervention, Compare and Outcome (PICO) structure. The primary and clinical secondary study variables were defined by the working groups from the previously developed questions and during the face-to-face working period, according to the natural history of the disease: risk factors, diagnostic classification, (either pharmacological or non pharmacological) treatment and prognosis. The level of evidence and clinical recommendation was classified based on the Evidence Classification Level and Clinical Recommendation of the Medicine Group based on Evidence from Oxford University. RESULTS: In Mexico, 20.6% of pregnant women suffer from anemia, especially those between 15 and 16 years old, who prevail in 42.4% and 34.3% percent, respectively. Almost half the cases are due to iron deficiency. This type of anemia is associated with a higher risk of pre-term delivery, of low birth weight and perinatal death. The first assessment of an anemic pregnant woman shall include the medical history, a physical examination and the quantification of the erythrocyte indices, serum concentrations of iron and ferritin. The measurement of this last one has the highest sensitivity and specificity for diagnosing iron deficiency. Daily oral iron supplementation, at a 60-to-120 mg dosage, may correct most of mild-to-moderate anemias. The most appropriate treatment is with iron salts (iron sulfate, polimaltose iron complex or iron fumarate). In case of intolerance to iron sulfate or fumarate, polimaltose iron is a better tolerated option. Treatment shall be administered until the hemoglobin values are > 10.5 g and ferritin is between 300 and 360 microg/dL, and such levels shall be observed for at least one year. Parenteral administration is an alternative for patients with a severe intolerance to oral administration; even when the possibility of anaphylaxis shall be considered it is lower when using ferrous sacarate. Transfusion is reserved for patients with hemoglobin lower than 7 g/dL or having an imminent cardio-respiratory decompensation. CONCLUSIONS: Iron deficiency is the highest prevailing nutritional deficiency worldwide and its consequences during pregnancy may be highly risky for both the mother and her child. Anemia diagnosis may easily be achieved through a blood analysis including the serum ferritin determination. Serum iron measurement shall not be used as the only marker to set the diagnosis. It is important to rule out other causes, in addition to the deficiencies, which produce anemia in a patient. It is essential to suggest the administration of iron supplements not only during the antenatal period but also after birth o even after a miscarriage to fulfill the need for depleted iron. In severe anemias (hemoglobin being lower than 9.0 g/L), iron doses higher than 120 mg a day may be required. Treatment shall always begin orally, and if this is not well tolerated, parenteral administration shall be used.