Frecuencia de control prenatal inadecuado y de factores asociados a su ocurrencia. RESUMENObjetivo: Determinar la frecuencia de pacientes con control prenatal (CPN) inadecuado y los factores asociados a dicho evento. Material y métodos: Se realizó un estudio descriptivo transversal donde se entrevistó a puérperas en el Hospital Nacional Cayetano Heredia entre agosto 2010 y enero 2011, y se revisó la historia clínica y carnet materno perinatal (CLAP). Se definió CPN inadecuado al incumplimiento del número mínimo y cronograma de visitas propuesto por el Ministerio de Salud. Se compararon factores epidemiológicos, maternos y socioeconómicos entre grupos de gestantes con CPN adecuado e inadecuado.Resultados: Se incluyeron 384 puérperas, 66,05% recibieron 6 ó más controles prenatales y sólo 7,36% tuvo CPN adecuado. Ciento cuarenta y cinco puérperas tuvieron su primer CPN antes de las 12 semanas. Los factores que se presentaron con mayor frecuencia en el grupo de CPN inadecuado fueron paridad mayor a 2 (p=0,02) y no planificación de la gestación (p=0,003). Conclusiones: El porcentaje de CPN inadecuado fue elevado. El CPN inadecuado se asoció con paridad mayor a 2 y gestación no planificada. (Rev Med Hered 2011;22:169-175).PALABRAS CLAVE: Atención prenatal, factores de riesgo, embarazo. SUMMARYObjective: To determine the frequency of patients with inadequate prenatal care (PNC) and the factors associated with this event. Material and methods: A cross-sectional, descriptive study and data was obtained interviewing the mothers, reviewing clinical records and Maternal Perinatal Card between August 2010 and January 2011 at the Hospital Nacional Cayetano Heredia. We defined inadequate PNC as the failure of the minimum number of visits and schedule proposed by the Ministry of Health. We compared epidemiological, maternal and socioeconomic factors in groups with adequate PNC and non-adequate PNC. Results: We included 384 women, 66.05% received 6 or more prenatal controls and only 7.36% had an adequate PNC. 145 women had her first PNC before the 12 weeks of pregnancy. The factors with more frequency in the non-adequate PNC was a maternal parity more than 2 (p=0.02) and a non-planning pregnancy (p=0.003). Conclusions: The rate of non-adequate PNC was high. Having a maternal parity more than 2 and a non-planning pregnancy were associated with non-adequate PNC. (Rev Med Hered 2011;22:169-175).

Background:The radical hysterectomy (RH) surgical technique has improved along the years. It is used for the treatment of cervical cancer, endometrial cancer when affecting the cervix, and upper vaginal carcinomas. Our aim was to describe the historical evolution of the technique after the introduction of laparoscopy at our institution. Methods:We performed a retrospective review of medical records of patients who underwent RH, grouped in three periods according to the year of surgery: 1990-1999, 2000-2009 and 2010-2013. Patients?characteristics, pathologic details, intraoperative and postoperative complications were analyzed and compared throughout the time periods. Results:A total of 102 cases of RH were performed at our center during the study period. Among all data collected, the presence of necrosis, age, number of lymph nodes, surgery route, operating time, hospital stay, blood loss and transfusion requirement were statistically significant different among groups. Conversion to laparotomy rate was 19% for the second period compared to the absence of cases in the last one. No significant differences (P=0.124) were observed in the adjuvant treatment received among the three different groups. At the time of the last contact the patients free of disease were 12 (85.7%), 53 (91.3%) and 26 (86.6%) respectively (P=0.406). Regarding the disease-free interval, we found significant better outcomes in the group of laparotomy compared to laparoscopy (P=0.015). Conclusions:Laparoscopic RH is an acceptable surgery with advantages like magnified vision of the operation抯 field, lower surgical complications, shorter hospital stay and earlier resumption to daily activities.