José Enrique Pons

A risk reduction strategy to prevent maternal deaths associated with unsafe abortion

Introduction: Worldwide, 13% of maternal deaths are caused by complications of spontaneous or induced abortion, 29% in Uruguay and nearly half (48%) in the Pereira Rossell Hospital.

Unsafe abortion in Uruguay

We conducted a retrospective study of induced abortion as a cause of death in Uruguay for the period 1997–2001. Results show that although the maternal mortality rates of Uruguay are similar to those of developed countries death from unsafe abortion is the main single contributor to that rate and one of the highest in the world. For the lowest-income women the absolute frequency of deaths due to this cause is considerably higher than for the rest of the nation’s population. Maternal mortality is the most dramatic consequence of pregnancy-related complications. It is also the health indicator the most clearly related to inequity in the distribution of obstetric care. (excerpt)

Comparison of retropubic and transobturator tension‐free vaginal implants for the treatment of stress urinary incontinence

To compare the perioperative complications, failure rate, operating time, and length of hospital stay associated with 2 minimally invasive suburethral slings in the management of stress urinary incontinence in women.

Tocolysis and delayed delivery versus emergency delivery in cases of non‐reassuring fetal status during labor

Aim:  To determine whether fetal intrauterine resuscitation using tocolysis and delayed delivery is better for the fetus than emergency delivery when fetal hypoxia is suspected because of a non‐reassuring fetal heart‐rate (FHR) pattern using conventional heart rate monitoring.

Group B streptococcus colonization among pregnant women in Uruguay

Group B streptococcus (GBS) is one of the most common causes of neonatal sepsis. In the United States, 5%–10% of neonatal deaths are caused by this organism [1]. Early-onset GBS disease is defined as an infection occurring in the first week of life and accounts for approximately 70% of all GBS diseases in the first 3 months of life [2]. Sepsis develops in approximately 1% of neonates born to colonized women. It has been estimated that between 10%–30% of pregnant women are colonized by GBS. These figures have been reported mainly from high-income countries, with few studies from Latin America [1]. The objective of the present study was to determine the prevalence of GBS colonization in pregnant women using the method recommended by the Centers for Disease Control and Prevention (CDC) [2].

Pulmonary alveolar microlithiasis and pregnancy.

The following is the case of a 36-year old pregnant woman reaching term, suffering from advanced pulmonary alveolar microlithiasis. To our knowledge, this is the first record of such a case.

Polypropylene hernia mesh for urinary stress incontinence.

In 2001 Delorme proposed a new surgical procedure to treat urinary incontinence in females by way of a trans-obturator foramen route. In 2002 a simple Prolene hernia mesh was used instead of the original one adapting the procedure to local conditions. With this approach a broad curve needle is introduced from the skin of the groin through the pelvic insertions of the adductors and obturator externus muscles proceeding around the ischio-pubic bone branch and passing through the obturator membrane and the obturator internus muscle reaching the homolateral vaginal incision. The mesh end is tightly fixed to the needle sharp end and is pulled backwards to reach the skin opening. The same procedure is repeated on the opposite side of the body. When both ends of the tape are exteriorized the needle is removed. (excerpt)