Chitosan Gauze in the Management of Acute Postpartum Hemorrhage in a Mexican Third-Level Institution: A Case Report.

Obstetric hemorrhage is the main cause of maternal death worldwide; over the years, its management has been based on uterotonic drugs as well as definitive and non-definitive surgical techniques. We report the case of a patient with multiple risk factors for obstetric hemorrhage who was given the classic management for postpartum hemorrhage before the addition of chitosan gauze, which resulted in adequate remission of the condition. The patient had an adequate in-hospital evolution; the chitosan gauze was removed after 24 hours, and she was discharged after 48 hours without active bleeding.

[Latzko surgery in recidivant vesicovaginal fistulae. Two case reports and literature review].

Recurrent vesicovaginal fistulae represent a clinical problem of the utmost importance due to the impact on the patients' quality of life. The current standard of treatment for this problem is surgical, with an abdominal approach, notwithstanding, may authors state that this repair should be done with the technique and approach that the surgeon feels most comfortable. We have successfully treated two patients with recurrent vesicovaginal fistulae using a vaginal approach, therefore we suggest it as a viable alternative in the treatment of this condition.

[A technique for total laparoscopic hysterectomy with vaginal morcellation on large uteri in order to maintain minimal invasion].

The advancement and increasing popularity of laparoscopic hysterectomy and the patient's foremost cosmetic concern has made the need for performing laparoscopic hysterectomy in a less morbile and time-consuming manner, we present a technique for large uteri using only three 5 mm entry ports, with tissue morcellation and removal vaginally using the Koh colpo-pneumo occluder.

[Endometrial ossification: a report of four cases and literature review].

Endometrial ossification is a rare endometrial pathology. Its predisposing factors include history of uterine curettage to metabolic abnormalities. It usually presents in patients with secondary infertility and history of first trimester pregnancy loss, accompanied by severe dysmenorrhea and dyspareunia.

[Uterine and jejunum perforation due to intrauterine device. A report of a case and literature review].

The application of a copper IUD can perforate completely the uterus and involve adjacent organs such as the bladder, small bowel, colon, rectum or appendix. Once the diagnosis is established, complete extraction must follow. We present a case report of a 33 year-old patient in which a copper IUD was placed in a medical office, three months after a third cesarean, without history of sepsis.

[Perinatal mortality: a proposed analysis].

Perinatal mortality is an epidemiologic indicator that evaluates materno-infantil quality care indirectly. Obtaining rates of perinatal mortality from continuous and confident information systems allow us a more precise evaluation of quality care in developed countries. In developing countries as Mexico, there aren't yet evaluating health programs that let us to know the actual situation of our medical care.