(Br.) Obstetricia

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Mortalidad por aborto séptico en el hospital de apoyo III Integrado IPSS -Tarapoto 1967 - 1987
(Universidad Nacional de San Martín. Fondo Editorial, 1991) Yumbato Pinto, Maria Elena; Estacio Pino, Nestor
This retrospective study of mortality Septic Abortion Support Hospital, III Integrated IPSS - Tarapoto, period 1967 - 1987; It was conducted at the Department of information and statistics that hospital, relying on statistical records, hospital clinics and historical case study records. We found that the death rate from septic abortion was 34.13 per ten thousand abortions. The direct cause of death was attributed to septic or 83.63% 16.6% abortion and septic abortion and uterine perforation. Of the 12 cases of deaths from septic abortion, 58.3% died in less than 24 hours, 16.6% died between 1 and 7 days and 24.9% last 7 days of hospitalization. 50% of these patients in the embryonic stage encontrabanse, while 33.3% in the fetal stage, no recorded cases of ovulation stage in gestation. The average age of patients was 28.3 years, ranging between 17 and 39 years; recorded an average of 3.8 pregnancies with ranging from 1-8 pregnancies. 66.6% of deceased patients came from rural areas and 83.3% were dedicated only to the work from home
Dispositivo intrauterino y embarazo en el Hospital de Apoyo Integrado II al IPSS – Tarapoto. periodo 1980 – 1984
(Universidad Nacional de San Martín. Fondo Editorial, 1991) Chung Garcia, Fernando; Granda Granda, Adan
10 case histories of accidental pregnancies occurred among 584 users of the IUD in the span of 1,980 and 1,984 were reviewed. Of these patients had inserted Cooper T 221, Lippes "C" 109 and 172 Lippes "D", 82 ignored. We found an incidence of 1.71% similar to that found by other authors pregnancies. 60 /. of pregnancies they occurred in patients between 21 and 30 years and the lowest 10%. between 41 years and more. The highest percentage of pregnancies occurred in users of Lipes "D", 60%. And during the first year of use, 70% .. The D.I.U. was in situ in 06 cases, GO'l., in one case I was expelled, 10%, and in 03 cases could not be precise location, 30% in 02 cases was not known how the pregnancy ended, 20%. In 08 cases, the pregnancy ended well: In 07 cases births; Term 05 cases, 50%, 02 cases preterm, 20%, 01 abortions case, 10%. and no cases of ectopic pregnancy did not. The children were all normal, There was no malformation
Embarazo gemelar: aspectos epidemiológicos Hospital de Apoyo III integrado Tarapoto (1968- 1989).
(Universidad Nacional de San Martín. Fondo Editorial, 1991) Vega Celis, Manuela Aurora; Rodriguez Gomez, Jorge Humberto
In women, pregnancy of a product is how normal conception as well corresponds The structure f unction of U uterus so that multiple pregnancy can be considered as an alteration of normal, perhaps as a border between the physiological process and pathological (1.2}. It is difficult to establish the exact incidence of twin pregnancies and many of the statistical (epidemiological) studies of twins, exclude couples whose products died at birth or before. By eliminating thus stillbirths and spontaneous abortions, incidence rates reflect pregnancies that have come to fruition in advanced gestational ages and the simple conception of twins. Also, it has been shown that twin pregnancies have an increased frequency of spontaneous abortion, pregnancy single product (2.3) as another possibility, can only lost one fetus become known as the phenomenon of "vanishing twin" (4 ). In humans there are two main types of twins, identical twins or momocigóticos resulting from the fertilization of an egg and fraternal or dizygotic twins, who come from multiple ovulation in the subsequent two eggs fertilized by different sperm. Family studies confirm that apparently only dizygotic generality is hereditary, suggesting that monozygotic twins are the result of a casual teratogenic phenomenon (5-9). It is proved that the frequency of multiple births in humans is influenced by race, heritage, parity and maternal age (5) with respect to dizygotic twins because monozygotic appear with the same frequency and is considered independent of those four factors (5). Many authors (1-5,10-19) have reported that the twin pregnancy carries a high morbidity and perinatal mortality increased frequency of malformations; cord accidents, intergemelar transfusion syndrome, intrauterine growth retardation, preterm births that are considered leading cause of obstetric trauma complications during delivery. The woman with twins also has a higher rate of complications and death. First, the rate of spontaneous abortions is more frequent (1-3), excessive nausea and vomiting anemia, preeclampsia, proteinuria is five times higher in twins than in single fetus; polyhydramnios that contributes to premature rupture of membranes and preterm delivery; have an increased risk of bleeding, the danger is in the uterine atomie and postpartum hemorrhage that result from the sudden decomposition of the uterus with excessive distension, finally the risk that arises most often by surgery (desárea) and with them the complications arising from the operation (6, 12, 20, 21); this set of factors makes women at high risk (22,23) is considered. As indicated determines that the goal key clinical is to prevent the premature and intrauterine growth retardation so that assistance has been directed towards a proper diet of pregnant, prenatal every two weeks at the beginning, I sleep early in bed before 28 weeks , prophylactic tocolysis, cervical cerclage, monitoring, fetal by biochemical tests and serial studies of ecosonography. On the other hand some of the problems of mortality and morbidity in twin pregnancies are attributable to late diagnosis or the failure to diagnose the presence of a second fetus before birth (24). The most suitable diagnostic method is ecosonography (25 - 27. 28), but never insist on the great clinical importance of considering throughout pregnancy, the possibility of twins. Another diagnostic method increases the sensitivity of diagnosing twin pregnancy are Alfa - fetoprotein and human placental lactogen level (29). Regarding the decision to the attention of twin births may depend on the presentation of the twins, knowing that pregnancy Gemelar have a higher incidence of dysfunctional labor, likewise, developments and both maternal and fetal conditions (6). The high maternal and fetal morbidity and mortality are described in twin pregnancy have prompted conduct this research study in order to know its incidence and associated epidemiological, preparing the national bibliographic little availability.
Algunos aspectos epidemiológicos y clínicos de la mortalidad perinatal en el Hospital de Apoyo Integrado III AL IPSS - Tarapoto. periodo 1985-1989
(Universidad Nacional de San Martín. Fondo Editorial, 1991) Aguilar Jimenez, Miriam; Reategui Lozano, Nelly; Ruiz Reategui, Ciceron
Se presenta un análisis estadístico de la Mortalidad Perinatal ocurrida durante los años 1985-1989 en el Hospital de Apoyo Integrado III IPSS Tarapoto. Lapso en el cual se produjeron 0512 nacimientos vivos, 161 muertes fetales tardías y 97 muertes neonatales precoces, todos con 100 grs. O más de peso al nacimiento a excepción de 14 casos encontrados, cuyo peso al nacimiento oscilaron entre 500 a 999 grs., pero que fueron registrados en el estudio por tener una edad gestacional por amorrea de 28 semanas en adelante. En la mayoría de los casos se encontraron complicaciones maternas que explican las causas de la defunción fetal; la amenaza de parto prematuro (24%), las hemorragias (15%) y las infecciones (14%), fueron las complicaciones de mayor incidencia durante el embarazo. Mientras que durante el parto, las intercurrencias que con mayor frecuencia se presentaron son: Parto Prematuro (36%), Distocias del Parto (24%) y Sufrimiento Fetal (19%). Las principales causas de muerte fueron las asfixias con 34%, la Prematuridad con 15%, las infecciones y el traumatismo obstétrico con 10% cada uno. Del total de fallecidos, el 47% murió antes de las 24 horas de vida; asociados a hipoxia moderada a grave en el 69% de los casos (índice de Apgar). De las muertes registradas el 45% correspondió a recién nacidos pre términos (28 a 30 semanas), de 37 a 41 semanas 42% y a 42 semanas 7%. El 63% del total de nacimientos correspondió a recién nacidos de bajo peso. Las madres con edades menores de 20 años, con un intervalo intergenésico corto (< 12 meses) y con un escaso control pre natal constituyeron el grupo de mayor riesgo obstétrico. Se encontró que en el 28% de los casos hubo intervención de alguna otra persona antes del ingreso de la madre al hospital. La tasa de Mortalidad Perinatal, fue de 29.74 x 1000 nacidos vivos; del cual 18.56 x 1000 nacidos vivos corresponde a Mortalidad Fetal Tardía y 11.39 x 1000 nacidos vivos a la Tasa de Mortalidad Neonatal Precoz.
Muerte materna en el Hospital Regional Docente las Mercedes – Chiclayo 1981 - 1990
(Universidad Nacional de San Martín. Fondo Editorial, 1991) Heredia Baca, Rodismeri del Carmen; Llontop Reategui, Augusto Ricardo
La tasa de muerte materna se considera como el indicador de la situación socioeconómica cultural y sanitaria de un país (2,3,13), convirtiéndose en un indicador del estado de salud de un pueblo, más aún el reflejo de la calidad de atención que se brinda a la madre y al niño (2-3-9-11,13). El estado gravídico de una mujer determina una serie de modificaciones fisiológicas que repercuten en todo sus sistemas orgánicos. Estas modificaciones son el resultado de la relación biológica de interdependencia mutua que se establece entre la madre y el feto, como mecanismo de adaptación y compensación, así planteamos que aparte de las modificaciones fisiológicas existe la influencia de factores tales como: edad, paridad, control pre natal, nivel socioeconómico, y otros que inciden sobre el riesgo de mortalidad materna. A través del presente trabajo nos propusimos los siguientes objetivos: 1._ determinar la tasa de mortalidad materna en el hospital Regional docente las Mercedes – Chiclayo, entre los años 1981 -1990. 2._ identificar los factores asociados a la mortalidad materna. Para cumplir los objetivos planteados se realizó un estudio descriptivo – retrospectivo de mortalidad materna tomando como muestra todos los casos de muerte materna ocurrido en el HRDLM entre los años 1981 – 1990. Para la recopilación de datos se utilizó un protocolo elaborado para tal fin, donde se registraron los datos obtenidos. En este periodo se atendieron 28895 nacidos vivos con cuarenta y cinco muertes maternas ya que comprendió una tasa 15.5% x 1000 N.V La edad promedio de las pacientes fallecidas fue de 26.89 años. Las pacientes en edad de riesgo obstétrico constituyen 28.88% de los 45 casos, 38 fueron muertes directas, 04 por causa indirecta, 03 por causa no materna. Hallaron una tasa de mortalidad materna de 15.51%, durante este decenio siendo la más alta 1990 con 60.20%; que ha crecido a expensas de Muerte Materna directa cuya tasa es 13.10. El aborto incompleto infectado y la endometritis post parto fueron las causas básicas más frecuentes con el 35.29% y 23.2% respectivamente del total de muertes por infección. Se demostró que la procedencia, el estado civil, el grado de instrucción, sin indicadores del nivel socioeconómico que guardan estrecha relación con la muerte materna, convirtiendo en general a la población enferma donde la infección tanto grávido puerperal como la no obstétrica cobran una alta cuota de víctimas. Por lo anteriormente dicho encontramos un alto porcentaje sin control pre natal 75.76%. Con el presente estudio se demuestra que aparte d las modificaciones fisiológicas en estado gravídico existe la influencia de factores como edad, número de gestaciones, control pre natal, nivel socioeconómico, que constituyen riesgo obstétrico por la muerte materna.
Partos con circulares de cordón umbilical y su influencia en el apgar del recién nacido en el hospital de apoyo Integrado – II – IPSS Tarapoto - 1991
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Galvez Diaz, Haydee Raquel; Llontop Reategui, Augusto Ricardo
The study of 315 consecutive births of children who produced 72 viable births Circular Cord is presented. The Circular Cord was present in 22.9% of all births, the most common d1eposic16n around the fetal neck was 97.2%, of which the Single and Double Circular was 84.7 and 12.6 percent respectively correspond to the remaining Circulars Corps (2.8%). The average length Cord was 51 cms., And average lengths Single and Double Circular loe was 53 and 63 cms., respectively. Being the minimum lengths for Simple Circular 28 cms., And for Double, 63 cms. The lower one minute is High in the group round with a frequency of presentation of 90.3 percent and the Circular No similar results are recorded, but when analyzed in relation to the type and length Circular Cord analyzes the Circular Simple to Neck Short Length mode is determined Apgar Low (score 4-6). Also recorded birth weights between 2500 - 3999 grs. 87.5 percent in the corresponding almost the same percentage of newborns to Gestational Age Term.
Ruptura prematura de membranas: factores asociados morbimortalidad materna y perinatal en el hospital regional del Amazonas Iquitos: marzo - octubre 1991
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Vigil Angulo, Lionel; Rios Rios, Lloy Mery; Estacio Pino, Nestor
Being Premature Rupture of Membranes an obstetric problem quite often leading to increased maternal and perinatal morbidity; this prospective comparative study was conducted at the Regional Hospital Amazon - Iquitos, from March to October 1991 to determine the incidence and identify factors associated with RPH also determine the latency that causes increased morbidity and mortality in the mother and the newborn. Of a total of 1,364 births, 215 RPM found pregnant representing an incidence of 15.76 \, was selected 368 pregnant women between 20-41 weeks who met protocol requirements and half of them represented the experimental group (184 ) with RPM, l other half (184) was the Control group without RPM. The rate of perinatal mortality was 37.20x1000 NV RPM, while the overall perinatal mortality rate was 23.46 X 1000 NV Factors associated with the RPH were; Primigravida adolescents, lack of prenatal and leucorrhea control. The latency period that produces increased maternal and perinatal morbidity is greater than 24 hours.
Hemorragia post – parto en el hospital de apoyo Integrado Tarapoto, 1992
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Rengifo Rios, Catalina; Melendez Torres, Nery; Llontop Reategui, Augusto Ricardo; Ballena Chumioque, Pedro
Was performed at the Hospital of Integrated Support Tarapoto descriptive, longitudinal, prospective, analytical study to determine the frequency of postpartum hemorrhage associated factors, causes and determine the average volume impacts hemodynamics of the mother. They took full term pregnant women, excluding patients with medical and obstetric complications. 399 cases were recorded, with an average volume of blood loss was 543.45 cc., Found 44.1% of cases with post-partum hemorrhage, the volume of 1259.23 cc., Which impact on the hemodynamics of the patient. The associated risk factors were prolonged labor, time delivery and fetal weight. The causes of bleeding were associated with dissociated membranes (44.74%), lethargy / hypotonia uterine (28.95%), retained placenta (18.42%), cervical laceration (5.26%) and third degree laceration (2.63%). Finally, the linear correlation analysis shows an inverse relationship with post-duck hematocrit, systolic and diastolic blood pressure and a direct relationship to heart rate.
Adolescencia y embarazo en el Hospital base de Chepen enero – diciembre de 1991
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Inga Reategui, Eliana; Llontop Reategui, Augusto Ricardo
In our time the study of pregnancy and its outcome in teenagers is of great interest because of the risks it brings, I actually listed as high risk obstetrics pregnancy. From January 19 to December 31, 1991 1593 births attended in gynecology and obstetrics Hospital Chepén service, giving birth during this period 103 adolescents; the study was compared with other similar series, conducted at national and international level The 103 cases accounted for 6.47% of all births, demographics were single and living together, coming mostly from urban areas - marginal and urban, with primary-school education, economically dependent on their parents and home ele from the point of Work view, which are factors that contribute to risk obstetrics. Most of our pregnant adolescents had their menarche most often between 12 and 14; worth mentioning that a high percentage of abortions background, 20% reported having had an abortion and 15% on two occasions, the vast majority of spontaneous type (70%). Given these results are proposed as alternative mass media programs in coordination with higher education institutions, students and teachers being responsible for programming. 62% of the cases had pre-natal control at different institutions; most of them came to term (93%), being most of them served by internal Obstetrics. The casuistry studied reveals a greater number of complications during the first trimester of pregnancy which decrease as gestational age advances, a fact that can be influenced by the pre-natal (62%) control. Most teens had an onset of spontaneous labor, with a duration of normal labor (53%); striking in our series the number of normal deliveries (84%) with a significant percentage of prolonged labor (17%), which can be explained by inadequate handling of labor due to lack of supervision Internal by professional specialty. Most newborns (64%) were born with low Apgar score, evaluated in the first minute of life; obtaining five minutes vigorous children (85%) weighing considered within normal limits at 89.3% of cases; only el4.85% were premature. Most teenagers started their sex at a very early stage (between 11-16 years) in a 7.7% ignoring aspects related to sexuality. Some information about it was received mostly by teachers and friends. These results suggest the need for counseling and training for parents. On the other hand, the contraceptive method used was the pace, followed by condom usage time was less than one year and, being 95% of them wish to use some method later. Finally, 63% expressed the desire of pregnancy, while more than a third of what they saw as an unwanted pregnancy. 21% want to have 3 or more children so this group should emphasize knowledge about sexuality, family planning and responsible parenthood. Importantly, 44% do not define their birth interval, a variable that should be included as a risk factor.
La edad en las primigestas como factor de riesgo en la morbi-mortalidad materna perinatal. Hospital Regional del Amazonas Iquitos – Perú – 1991
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Soto Del Aguila, Mercedes Del Carmen; Flores Gonzales, Marlith; Llontop Reategui, Augusto Ricardo; Estacio Pino, Nestor
El presente estudio, es un trabajo descriptivo, transversal y prospectivo, realizado en el Servicio de Maternidad del Departamento de Gineco-Obstetricia del Hospital Regional del Amazonas – Iquitos – Perú, en el periodo comprendido de Marzo a Noviembre de 1991. Se encontró que durante este periodo, hubo un total de 1548 gestantes que ingresaron en trabajo de parto, de los cuales 400 correspondieron a primigestas, donde 104 (26%) fueron adolescentes menores de 18 años, 10 (2.5%) añoseas años de 35 años a más y 286 (71.5%) conformaron el grupo control de 18 a 34 años. En ambos grupos estudiados, se encontró un alto índice de patologías durante el embarazo, parto y puerperio. Durante el embarazo destacó la toxemia y la ruptura prematura de membranas, en el trabajo de parto las distocias de contracción y de presentación para la adolescente. Para la añosa fue la de contracción y de pelvis. En el puerperio, la atonía uterina para el grupo de las añosas y las complicaciones de tipo infeccioso para las adolescentes. No se encontró muerte materna en los grupos estudiados y control. El parto vaginal espontáneo fue más frecuente en el grupo de las adolescentes y control; la cesárea fue más frecuente en las añosas. El parto instrumentado fue más frecuentes en el grupo control que los de estudio. La mayoría de los recién nacidos en los grupos de estudio y control tuvieron pesos adecuados, buen Apgar al minuto de vida y fueron a término. La hipoxia, el cefalohematoma y la infección neonatal fueron las morbilidades neonatales más frecuentes en los grupos de estudio. El parto prematuro se presentó con mayor frecuencia en el grupo de las añosas y control, siendo este la causa principal de la muerte perinatal.
Neoplasias del cuello uterino en pacientes ginecobstetricias: factores de riesgo. Hospital Regional del Amazonas – Iquitos Perú. enero – diciembre 1991
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Chumbe Culqui, Rosana; Mejia Medrano, Alberto; Tinta Junco, Federico Saturnino
Entre Enero y Diciembre de 1991, se realizó en el Hospital Regional del Amazonas – Iquitos, un estudio de 45 enfermas de neoplasia cérvicuoterino y 90 testigos para evaluar los factores de riesgo de esta neoplasia. Los principales factores de riesgo identificados fueron edad temprana de la mujer al iniciar las relaciones coitales, numero de compañeros sexuales, número de hijos nacidos por vía vaginal, no haber recibido beneficios de los programas de detección temprana, bajo nivel educativo. El 86.7% de los casos y 78.9% de los testigos afirmaron que nunca se les practicó un examen citológico (prueba de papanicolaou). Nuestros resultados indican que la necesidad de aperturar programas extensos de detección temprana, dirigidos principalmente a los grupos de alto riesgo, para reducir la elevad frecuencia de neoplasias cérvicouterinas en la ciudad de Iquitos.
Gestación en primíparas adolescentes Hospital de Apoyo – II – IPSS – Tarapoto
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Garcia Rodriguez, Miguel; Rodriguez Gomez, Jorge
Se estudiaron 210 gestantes adolescentes primíparas que acudieron al servicio de Gineco-Obstetricia del Hospital d Apoyo – II – IPSS – Tarapoto, desde Enero a Diciembre de 1991. Sobre el total de 1735 partos, el 12.10% ocurrieron en adolescentes, la edad comprendida fue de 13 a 18 años cumplidos, siendo la mayoría solteras y convivientes con bajo nivel de instrucción. El control pre-natal solo se llevó a cabo en el 60% de los casos. La complicación principal fue la anemia (16.19%), siguiendo en orden de frecuencia la prematuridad (10%) y la ruptura prematura de membranas en el 7.14%. La resolución obstétrica fue mediante parto eutócico en el 87.14% de los casos, requirieron de operatoria obstétrica (fórceps y cesárea) el 10.95%. No se encontró ningún caso de muerte materna. La mayoría de los productos fueron a término (88.10%) y con un peso mayor de 2500 grs. (82.94%). El 7.58% tuvo puntaje Apgar bajo en el primer minuto y el 0.47% a los cinco minutos de vida. La tasa de mortalidad perinatal fue de 28 x 1000 nacidos vivos. Se concluye que la gestación en la adolescencia con una vigilancia pre-natal y juicio obstétrico adecuado, no debe incrementar los índices de morbi-mortalidad materna y fetal.
Estudio de las cesáreas en adolescentes hospital de apoyo - II - IPSS - Tarapoto enero 1989 – diciembre 1991
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Delgado Ríos, Angel; Rodriguez Gomez, Jorge Humberto
Study of 78 adolescents cesareans performed in the Department of Obstetrics and Gynaecology Hospital Support - II - IPSS - Tarapoto; between 1.989 to 1.991; in order to determine the incidence and compare them to other hospitals, the reasons for cesareans, establish morbidity and mortality rates and identify complications of the operation. For this, the medical records of 78 cases were studied retrospectively. It was observed that 78 cesarean constitute 9.7% of all births in adolescents, more than 67% were single or cohabiting and in the degree of instruction a low percentage of illiterate 2.56% was found, we will also note the high percentage of uncontrolled 61.54%. singing in the background Gynecology Obstetricians 7.69% were previous cesarean. The main complication of pregnancy toxemia and was premature rupture of membranes. In our series the most widely used type of operation was the primary segmental transverse segment only one case - hysterectomy - subtotal by uterine atomía. The main cause of cesarean section was fetal-pelvic incompatibility with 28.21% in the Secondly narrow pelvis with 15.40% and thirdly breech presentation 14.10%. We conclude that the number of teenagers cesareans remains increased as the years pass, and in our cases the narrow pelvis is not the main cause of cesarean section, fetal distress and breech presentation are indications we have to take into account.
Aspectos epidemiológicos de la presentación podálica en el Hospital de Apoyo Chepén 1983 – 1991
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Chavez Mendoza, Silvia Marcela; Lazo Paredes, Victor;
En los países en desarrollo como el nuestro, el rápido crecimiento de la población, pone en peligro el desarrollo socioeconómico y el bienestar de la nación. Una de las formas de disminuir el crecimiento poblacional es con la aplicación adecuada de la planificación familiar, en el Perú hay un alto porcentaje de demanda no satisfecha de planificación familiar; lo que ocasiona embarazos no deseados, con aumento de la tasa de mortalidad materna, una gran parte de ésta debido a abortos inducidos. En planificación familiar uno de los métodos anticonceptivos más usados es el Dispositivo Intrauterino (DIU) Fue inventado a principios del siglo XX, pero su empleo se generalizó hasta el decenio de 1960, con la aparición de dispositivos que no contenían cobre ni hormonas y eran conocidos como los dispositivos “No Medicados” o inertes, como el ASA DE LIPPES. Luego aparecieron los DIUs biodegradables con hormonas, cobre y/o plata. Actualmente existen DIUs con variaciones en “T” liberadores de hormonas, los cuales no están siendo utilizados en los programas de planificación familiar.
Curva de trabajo de parto y sus alteraciones. hospital de apoyo II Integrado IPSS - Tarapoto 1989 - 1991
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Becerril Iberico, Ana Maribel; Llontop Reategui, Augusto Ricardo; Salas Pillaca, Leocadia
Statistical analysis of 1406 Medical records were made: 1171 corresponding to normal delivery and 235 dysfunctional births, selected according to inclusion criteria, the analysis was performed on the file service hospital Support - Tarapoto corresponding to parturients attending service maternity from 1989 -1991. Which have allowed us to obtain the average values of the curve of labor. Data obtained differ significantly from those established by other authors thought that the nutritional status, pain threshold, the mentality and customs of our different play some role in childbirth. It has been determined the following types of dysfunction according to the criteria established by Hurtado: Prolonged latent phase also different values protracted active phase delayed, and expulsive phase active parked; not found a factor that conditions these shortcomings, but it has been demonstrated that there is a deficiency in our hospital Obstetric care. A model of labor that can be accepted for use in the various departments of obstetrics and finally the importance of graphical method in monitoring labor for its simplicity, objective with facilities for teaching and research stresses is presented.
Mortalidad materna en el Hospital de Apoyo III "Victor Lazarte Echegaray" IPSS Trujillo, periodo 1981 - 1990
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Atilano Urbina, Roberto Gustavo; Aznaran Castillo, Francisco Arturo; Rodriguez Gomez, Jorge
Se define Muerte Materna a la defunción de la mujer por cualquier causa, durante el embarazo hasta los 42 días después de la finalización de la gestación, sin tener en cuenta la edad del embarazo en el momento de la determinación o el método por el cual el mismo fue determinado. La mortalidad materna es un indicador válido, que refleja la realidad acerca de la calidad médica obstétrica que se brinda una población determinada en cualquier centro asistencial y a la vez mide el desarrollo de un país o de una región. Si bien la muerte materna es un hecho biológico, ocurrido como consecuencia de acontecimientos fisiopatológicos fatales como hemorragia, determinar las causas infección, aborto, y los factores predisponen o agravan este hecho. etc., es necesario condicionantes que predispongan o agravan este hecho. La sorprendente reducción del índice de mortalidad materna que se ha registrado en los países desarrollados se debe a múltiples factores y circunstancias. Sin duda se han realizado importantes mejoras y progresos en la práctica médica. El amplio uso de las transfusiones sanguíneas y de los antibióticos, y el mantenimiento del equilibrio hidroelectrolitico y ácido-básico en las graves complicaciones del embarazo y del parto han trans ormado por completo la práctica de la obstetricia.
Prevalencia de anticonceptivos en la asociación de vivienda San Juan – Banda de Shilcayo, departamento de San Martin. Perú 1992
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Chavez Panduro, Lili; Bardalez del Aguila, Carmen; Llontop Reategui, Augusto Ricardo
In this context of crisis, poverty and social unrest no attention to the issue of population or demographic changes taking place, let alone take into account developments that will in the future, and their impact is provided as a source of social demands in health. It is clear to everyone that major changes are made by the process of urbanization with the excessive growth of cities based on the marginal urban areas, changes in population structure with a marked increase in teenage poblaci6n a high rate total fertility, and one of the most the tas rates of infant mortality and Maternal America, particularly affecting the most vulnerable social groups in rural and marginal urban areas and in the case of Maternal mortality is predominantly preventable causes. It is also clear and obvious how easily the most disadvantaged population groups in which the major health problems are concentrated are identified: children, adolescents, women and marginal urban and rural dispersed population. This is also obvious that most of the health problems affecting these groups are aggravated by factors susceptible reproductive risk can be controlled appropriate and rational use of family planning services. Given these precedents meet the expectation was generated in specific populations; the "PREVALENCE OF BIRTH IN HOUSING ASSOCIATION BAND SAN JUAN SAN MARTIN SHILCAVO DEPARTMENT OF PERU 1992.."; the same that addresses the socio cultural characteristics, reproductive behavior and trends of fertility regulation in all women of 15-49 years to guide programs in health. Family Planning and Sexual Education. We believe that the vast majority of people will have the opportunity to read this work known in some depth and probably use some method of contraception; can not say the same instead of most of the population of Peru that not only unknown, but in many cases fears and on to reject especially modern contraceptives methods. Finally we express that this work is not intended to reach definitive conclusions, but to make progress in the study institutions and persons concerned by population and health problems.
La episiotomía y sus complicaciones 1992
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Huivin Grandez, Militza; Melendez Salas, Sonia Mariela; Llontop Reategui, Augusto Ricardo; Salas Pillaca, Leocadia
Se estudiaron en forma descriptiva y prospectiva a 200 pacientes en quienes se efectuaron la episiotomía, con la finalidad de determinar la frecuencia, los factores asociados a las complicaciones para finalmente sugerir pautas de conducta para la prevención, en el Hospital II Integrado Tarapoto. Los casos en estudio fueron seleccionados de acuerdo a ciertos criterios utilizados, describiéndose las características demográficas, encontrando en ella que el mayor grupo de gestantes estuvo concentrado en edades entre 20 a 34 años con un promedio de 22.15 y con grado de instrucción secundaria y superior, constituido mayoría por primíparas atendidas por el interno en Obstetricia. La frecuencia de complicaciones encontrado fue del 59% influenciado por las variables asociadas y factores de riesgo y la técnica quirúrgica desarrollada, teniendo como efecto final la morbilidad. El examen de secreción vaginal. Mostró 64 resultados anormales complicándose un 71 por ciento duplicándose así la posibilidad de complicaciones tardías. No constituyen causa directa de complicaciones tardías el segundo y tercer periodo del trabajo de parto, y el número de tactos vaginales. El mayor número de higienes perinatales durante el trabajo de parto fue de 3, teniendo como tasa 6.3 higienes perinatales/100 tactos vaginales y como promedio insignificante 1.54 higienes perinatales por paciente contra 1,117 tactos vaginales cuyo promedio fue de 5.39 tactos vaginales por paciente. Sorprendentemente encontramos que el 92.5% de los operados no se lavaron las manos previo a la atención del parto alcanzando cifras de complicaciones tardías en un 55.5%; es indispensable el cambio de guantes para la epistolografía cuando la persona no lo realiza las complicaciones de riesgo aumenta en veces al asociar este factor con el lavado de manos encontramos que el riesgo se incrementa palatinamente similar e inicio de la episiotomía existen mas complicaciones.
La edad en las primigesta como factor de riesgo en la morbi-mortalidad materna perinatal, hospital regional del Amazonas Iquitos – Perú – 1991
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Soto del Aguila, Mercedes del Carmen; Flores Gonzales, Marlith; Llontop Reategui, Augusto Ricardo; Estacio Pino, Nestor
The present study is a descriptive, cross-sectional and prospective study conducted at the Maternity Service from the Department of Gynecology and Obstetrics Hospital Regional Amazon Iquitos, Peru, in the period from March to November 1991. It was found that during this period, there were a total of 1,548 pregnant women who were admitted in labor, of which 400 were for primigesta, where 104 (26%.) Were adolescents under 18 years, 10 (2.5%.) Añoseas of 35 years later and 286 (71.5%) comprised the control group 18 to 34 years In both groups studied, a high index of conditions encountered during pregnancy, childbirth and postpartum. Stressed during pregnancy toxemia and premature roptura of membranes, labor dystocia contraction and presentation for the teenager. Was aged for contraction and the pelvis. In the postpartum uterine atony for the group of añosas and complications of infectious type for adolescents. No maternal death was found in the study group and control The spontaneous vaginal delivery was more frequent in the group of adolescent and control; Caesarean section was more frequent in the añosas. The instrumental delivery was more frequent in the control group the study. Most newborns in the study and control groups were appropriate weights, good-minute Apgar gives life and went to term. Hypoxia, cephalohematoma and neonatal infection were the most common neonatal morbidities in the study groups. Preterm delivery occurred more frequently in the group of añosas and control, this being the main cause of perinatal death.
Aspectos epidemiológicos de aborto en mujeres atendidas Hospital Regional del Amazonas – Iquitos 1991
(Universidad Nacional de San Martín. Fondo Editorial, 1992) Davila Torres, Consuelo; Garcia Saldaña, Esther; Llontop Reategui, Augusto Ricardo; Huamantumba Palomino, Marina Victoria
They were prospectively studied 191 patients with a diagnosis of abortion in the regional hospital of the Amazon - Iquitos, 1991. The cases studied were divided into two groups according to the type of abortion presented, describing the epidemiological characteristics of these groups and the frequency and methods used for abortion. Both groups have similar epidemiological characteristics except more or less systemic involvement and mortality observed in induced abortions. The • frequency was higher in induced abortions than for spontaneous. • The average age was 26.5 years with a range between 15 to 44 years, registering an average parity of 3.8 for both groups. In the induced abortions dominated the cohabitation and single-grade secondary education and spontaneous cohabiting and married to the primary level. The highest percentage of women denied having had previous abortions; the interqenésico space in both groups was short and the number of family members was more than 5.For other hand, came from marginal urban areas, with an average socioeconomic status and were engaged in household chores. Finally to induce abortion the most widely used injectable were followed by the introduction of foreign bodies.

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