[Maternal metabolic diseases related to pre-pregnancy overweight and obesity in mexican women with high risk pregnancy]. / Enfermedades metabólicas maternas asociadas a sobrepeso y obesidad pregestacional en mujeres mexicanas que cursan con embarazo de alto riesgo.

INTRODUCTION: Pre-pregnancy obesity has been proposed as a risk factor related to gestational diabetes and hypertensive disorders during pregnancy. OBJECTIVES: Identify pregnancy related diseases associated with pre-pregnancy obesity as a risk factor ina high risk preganancy patient population. METHODS: 600 patients whose pre-pregnancy obesity had been assessed as a high risk factor were included in the study. The means, standard deviation, median, interquartile intervals, Pearson and Spearman correlation and logistic regression to estimate risk with the odds ratio and 95% confidence intervals were calculated. RESULTS: The mean pre-pregnancy body mass index was 29.59 ± 6.42 kg/m2. The mean for recommended pregnancy weight gain was 2.31 ± 1.03 kg, but the mean of real weight gain was 8.91 ± 6.84 kg. A significant correlation between pre-pregnancy obesity and family history of diabetes mellitus (p=0.000), systemic hypertension (p=0.003), cardiac diseases (p=0.000), dyslipidemia (p=0.000) and obesity (p=0.000) was identified. Pre-pregnancy obesity was identified as a risk factor for the development of gestational diabetes (OR: 1.95; IC95%: 1.39 to 2.76; p=0.000) in this kind of patient. DISCUSSION AND CONCLUSION: 75% of high risk pregnancy women in a high specialty hospital in West Mexico are overweight or obese when they become pregnant. These are risk factors in the development of gestational diabetes.

[Sacrococcygeal teratoma: report of a case and review of the literature]. / Teratoma sacrococcígeo: reporte de un caso y revisión de la bibliografía.

Sacrococcygeal teratoma is the most common tumor in infants. About 80% of these tumors are types 1 and 2, and are unlikely to cause metastases whose incidence is 10% in the neonatal period, against nearly 100% at the age of 3 years. These tumors can acquire huge and contain large proportions depriving blood flows to the developing fetus, the tumor hypervascularity generates a hyperdynamic state in the fetus, and that as the tumor grows, it increases its flow to behave as a short circuit and to be similar to that of the lower limbs of the fetus, increasing venous return and cardiac output, heart failure causing fetal and maternal eclampsia.

[Lymphocyte subsets and preeclampsia]. / Poblaciones de linfocitos y preeclampsia.

BACKGROUND: Preeclampsia origin has no conclusive explanation. As part of its etiology it has been proposed immunologic disorders. This work explores several lymphocytes subsets and postulates possible mechanisms involved in a lost of immune tolerance in this entity. OBJECTIVE: To compare cellular populations of CD3+ CD56+, CD4+ CD25+, T lymphocytes (CD4+ and CD8+) and NK cells subsets in preeclamptic and pregnant healthy women. PATIENTS AND METHODS: Through flow cytometry antibodies, peripheral blood mononuclear cells were obtained from both groups of patients. CD3+ CD56+, CD4+ CD25+, T lymphocytes (CD4+ and CD8+) and NK cells were identified. Mean and standard deviation, Student ttest and Pearson correlation were calculated to analyze differences between groups and correlation between mean blood pressure and different lymphocytes subsets; p < 0.05 was considered significant. RESULTS: CD3+ CD56+ cells percentage was lower in preeclamptic patients (2.7 vs 6.1%; p < 0.002), CD4+ CD25+ cells percentage tend to be lower too (22.11 vs 33.86; p = NS). Mean blood pressure shown negative correlation with CD3+ CD56+ cells percentage (rp - 0.666; p = 0.001) and with CD25 on CD4+ T lymphocytes surface (rp - 0.526; p < 0.025). CONCLUSIONS: Based on the association between mean blood pressure and lymphocytes percentage for these two cellular subsets, data obtained suggest that CD3+ CD56+ and CD4+ CD25+ cells play an important role in preeclampsia development.

[Laparoscopic surgery complications in a reproductive biology service]. / Complicaciones de la laparoscopia ginecológica en un servicio de biología de la reproducción.

BACKGROUND: Poor report of difficulties in using laparoscopic technique has limited the knowledge of its advantages and disadvantages. OBJECTIVE: To evaluate complications in patients treated with laparoscopic surgical procedures in a biologic reproductive service, MATERIAL AND METHODS: Retrospective study in 525 patients treated with conventional laparoscopy due to any gynecological procedure. All pre- and post-operative variables were considered. RESULTS: There were 16 (3%) complications within the 525 patients studied: six (37.5%) cases with uterine perforation, three (18.8%) with wall bleeding, and two (12.5%) with subcutaneous emphysema. The rest of complications (31.2%) were: post-puncture headache (1), anaphylactic reaction (1), perirectal serous laceration (1), anexial hematoma (1), and ovarian vessels bleeding (1). There was a case of wall hematoma and another with ovarian vessels injury that required a second intervention. Patient with anaphylactic shock required intensive care attention and mechanic ventilation. Mean physicians years of experience were 12 +/- 7 (1 to 20 years). During the period of time of the study there were no dead due to gynecologic laparoscopic procedures. CONCLUSION: Gynecological surgical laparoscopy is a viable alternative to traditional surgery due to less postoperative pain, minimal hospital stay, fast recovery, and better esthetic results and less infectious morbidity.

[Analysis of maternal mortality during three periods at Hospital de Ginecología y Obstetricia del Centro Médico Nacional de Occidente]. / Análisis de la mortalidad materna, en tres periodos, en el Hospital de Ginecología y Obstetricia del Centro Médico Nacional de Occidente.

BACKGROUND: Most of deceases due to pregnancy, delivery, puerperium and them attention are avoidable with current medicine resources. OBJECTIVE: To analyze some basic elements of epidemiologic behavior of a hospital environment maternal mortality in a third level hospital during a period of 21 years. MATERIAL AND METHODS: Analytical cross-sectional study, 222 maternal deaths registered at Hospital de Ginecologia y Obstetricia, Centro Medico Nacional de Occidente del Instituto Mexicano del Seguro Social, were included, during the period 1985-2005. Deaths were analyzed in three periods of 7 years each one. The analysis of results was made based on descriptive statistic. chi2 was used for comparison between periods. RESULTS: Maternal death ratio was 73 per 100,000 live births during the 21 years. Maternal mortality was lower in the group of women under 20 years and increase agreed maternal age. Frequency of direct obstetric deaths decreased when comparing the 3 periods. The main causes of maternal death were preeclampsia/eclampsia and obstetric hemorrhage, which were responsible for almost 50% of maternal deaths. There was no significant difference to anticipation by comparing periods, between 28 and 37% of deaths were foreseen. 98% of deaths occurred at Intensive Care Units. CONCLUSIONS: Direct and indirect maternal deaths show very similar values in the third period, which translates in an improvement in anticipation. It must be reinforce the simple and opportune information to the patient with regard to warning signs and the permanent medical training must be a priority at the 3 medical levels.