[Norplant: a 3-year experience of the National Institute of Perinatology in Mexico]. / Norplant: experiencia de tres años en el Instituto Nacional de Perinatología.

We present the experience from Instituto Nacional de Perinatología (INPer) with the use of subdermal contraceptive implants Norplant from 1995 to 1997. The purpose was to Know the sociodemographic characteristics and evaluate contraceptive efficacy, adverse effects and tolerance on the users of Norplant. We carried out a prospective, observational trial in the Family Planning Clinic, during the period january 1o, 1995 through december 31, 1997. Women with desire of long term hormonal contraception, and without contraindications for the use of progestins were eligible for the study. The follow up consisted in visits every 6 months, and in some cases we obtain the information by telephonic interviews. One hundred an two women were included in the study; the median age of the subjects was 21.6 years, the median number of pregnancies were 2.0. In 53% of the subjects an obstetric risk factor was present such as adolescence (25.5%), social (8.8%), and others. Seventy-four women were followed up, and accumulated 1,064 months of observation. (Average 14.4 months). Menstrual irregulaties (83%), and headache (30%) were the most frequent adverse effects. The continuity rate was 81%, and during the study no pregnancy was observed. The principal causes for the extraction of the implants were menstrual irregulaties and headache. The contraceptive subdermal implants Norplant, constitutes and excellent choice because of its high efficacy, safety and good tolerance.

[Usefulness of ultrasonographic markers in chromosomal abnormalities]. / Utilidad de los marcadores ultrasonográficos de cromosomopatía.

During a 3 and 1/2 years, 132 pregnancies were diagnosed as having a wide variety of congenital abnormalities. A high resolution ultrasound and multidisciplinary approach was used. In 95 cases fetal karyotyping was made. In this group the incidence of chromosomal abnormalities diagnosed during the period and phenotypic expression of the different types of chromosomal abnormalities was investigated. 29 abnormal karyotypes were found; 11 trisomy 18, 7 in monosomy X, 4 in trisomy 21, 3 in trisomy 13, 1 with tetraploidy (92XXYY), 1 Turner mosaic (45XO 68% 46XY 32%), 2 inversions of choromosome 9. Of the total abnormal chromosomal diagnosed during the period (N = 57), this group represented 49.2%, compared to 5 to 15% found in other risk groups. 224 congenital abnormalities were found. 43 (19%) isolated, and 181 (81%) associated. Of the 224 congenital abnormalities diagnosed, 80 (36%) were associated with chromosomal abnormalities. The most associated markers were duodenal atresia, heart defect, microcephaly, enlarged posterior fossa, and cystic hygromata. A specific markers pattern was found for each aneuploidy; heart defects for trisomy 18, holoprosencephaly and faciel cleft for trisomy 13, and cystic hygromata for monosomy X. It was concluded that the ultasound can be the most useful method to select the group of pregnant women with a higher risk of abnormal karyotype.