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Ex-Hacienda el Hospital, Mexico

Sanhueza Smith P.,Secretariat of Health of Mexico City | Pena M.,Gynuity Health Projects | Dzuba I.G.,Gynuity Health Projects | Martinez M.L.G.,Hospital Materno Infantil Inguaran | And 3 more authors.
Reproductive Health Matters

Extensive evidence exists regarding the efficacy and acceptability of medical abortion through 63 days since last menstrual period (LMP). In Mexico City's Secretariat of Health (SSDF) outpatient facilities, mifepristone-misoprostol medical abortion is the first-line approach for abortion care in this pregnancy range. Recent research demonstrates continued high rates of complete abortion through 70 days LMP. To expand access to legal abortion services in Mexico City (where abortion is legal through 12 weeks LMP), this study sought to assess the efficacy and acceptability of the standard outpatient approach through 70 days in two SSDF points of service. One thousand and one women seeking pregnancy termination were enrolled and given 200 mg mifepristone followed by 800 μg misoprostol 24-48 hours later. Women were asked to return to the clinic one week later for evaluation. The great majority of women (93.3%; 95% CI: 91.6-94.8) had complete abortions. Women with pregnancies ≤8 weeks LMP had significantly higher success rates than women in the 9th or 10th weeks (94.9% vs. 90.5%; p = 0.01). The difference in success rates between the 9th and 10th weeks was not significant (90.0% vs. 91.2%; p = 0.71). The majority of women found the side effects (82.9%) and the use of misoprostol (84.4%) to be very acceptable or acceptable. This study provides additional evidence supporting an extended outpatient medical abortion regimen through 10 weeks LMP. © 2015 Reproductive Health Matters. Source

Vadillo-Ortega F.,Instituto Nacional Of Medicina Genomica | Osornio-Vargas A.,University of Alberta | Buxton M.A.,University of Michigan | Sanchez B.N.,University of Michigan | And 6 more authors.
Medical Hypotheses

Preterm birth is a public health issue of global significance, which may result in mortality during the perinatal period or may lead to major health and financial consequences due to lifelong impacts. Even though several risk factors for preterm birth have been identified, prevention efforts have failed to halt the increasing rates of preterm birth.Epidemiological studies have identified air pollution as an emerging potential risk factor for preterm birth. However, many studies were limited by study design and inadequate exposure assessment. Due to the ubiquitous nature of ambient air pollution and the potential public health significance of any role in causing preterm birth, a novel focus investigating possible causal mechanisms influenced by air pollution is therefore a global health priority. We hypothesize that air pollution may act together with other biological factors to induce systemic inflammation and influence the duration of pregnancy. Evaluation and testing of this hypothesis is currently being conducted in a prospective cohort study in Mexico City and will provide an understanding of the pathways that mediate the effects of air pollution on preterm birth. The important public health implication is that crucial steps in this mechanistic pathway can potentially be acted on early in pregnancy to reduce the risk of preterm birth. © 2013 Elsevier Ltd. Source

Castillo-Castrejon M.,Instituto Nacional Of Medicina Genomica | Castillo-Castrejon M.,National Autonomous University of Mexico | Meraz-Cruz N.,Instituto Nacional Of Medicina Genomica | Gomez-Lopez N.,Wayne State University | And 4 more authors.
American Journal of Reproductive Immunology

Problem: Human parturition is associated with an intrauterine pro-inflammatory environment in the choriodecidua. Evidence that some mediators of this signaling cascade also elicit responses leading to labor prompted us to characterize the cellular sources of these mediators in the human choriodecidua. Method of study: Leukocyte-enriched preparations from human choriodecidua (ChL) and intervillous placental blood leukocytes (PL) were maintained in culture. Secretions of inflammatory cytokines, chemokines, and MMP-9 were documented. Leukocyte phenotype of ChL and PL was determined by flow cytometry using specific fluorochrome-conjugated antibodies. Results and Conclusions: ChL showed a distinct pro-inflammatory secretion pattern of cytokines and chemokines when compared with PL, including higher amounts of TNF-α and IL-6, and decreased secretions of IL-4 and IL-1ra. ChL also secreted more MIP-1α and MCP-1 and MMP-9 than PL. No significant differences were found in leukocytes subsets between compartments. Based on our findings, we propose that ChL isolated from fetal membranes at term are functionally different from PL and may collaborate to modulate the microenvironment linked to induction and progression of human labor. © 2013 John Wiley & Sons Ltd. Source

Romero-Salinas G.,Hospital Materno Infantil Inguaran | Romero-Salinas G.,Metropolitan Autonomous University | Romero-Salinas G.,Instituto Nacional Of Diagnostico Y Referencia Epidemiologica | Hugo V.,Hospital Materno Infantil Inguaran | And 9 more authors.
Clinica e Investigacion en Ginecologia y Obstetricia

Fetal heart rate (FHR) values and accelerations were determined in fetuses with restricted growth and development and were compared with those in a control group. The study design was open, prospective, comparative and exploratory.The sample consisted of 40 patients divided into two groups. Group 1 (problem group) was composed of 20 pregnant women diagnosed with restricted fetal growth and development. Group 2 (control group) consisted of 20 patients with normal pregnancies.Ultrasound was used to determine the biparietal diameter of the fetuses. FHR and uterine contractility were measured. The Apgar test was used to evaluate neonatal status. Neonates were weighed and measured.Basal FHR in group 1 was 5 beats higher with an amplitude of 3 beats less than in the control group. These differences were highly significant.Dispersion diagrams were drawn and linear regression was calculated for the parietal diameters of fetuses with restricted growth. The equation was y=0.547x+64.38 and the correlation coefficient was R2=0.3561. In the control group the equation for the linear regression was y=2.0344x+12.944 and the correlation coefficient was R2=0.9981.The means of the biparietal diameters of groups 1 and 2 were compared but no significant differences were found. The mean values for uterine height and abdominal perimeter for the two groups were 33.45. cm and 101.15. cm, respectively.The physical status of the newborns was evaluated using the Apgar test. At 1. min, two neonates were depressed with an Apgar score of 6. Twelve neonates were vigorous with scores ranging from 7 to 9 and the six remaining neonates were not tested. At 5. min, scores ranged from 7 to 9.When the two groups of neonates were compared, the weights and heights of those in group 1 were 243. g and 2. cm lower and these differences were significant (p<0.05). © 2009 Elsevier España, S.L. Source

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