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A review of the literature was done and according to our knowledge this case of epignathus describes the first one reported in our country in fetal period. [ABSTRACT FROM AUTHOR]

SUMMARY The aim of this study is to present the analysis of the leading causes of mortality found in all the cases of maternal death at the Hospital de Ginecobstetricia (HGO) and Hospital de Especialidades (HE) del Centro Médico Nacional de Occidente (CMNO), during a period of 12 years, to achieve a winder view and to find a solution to reduce maternal mortality (MM). We reviewed files and reports of the maternal mortality committee of 151 women who were hospitalized and died at the HGO and HE del CMNO in Guadalajara, Jalisco, México, between January firths, 1985 and December 31, 1996. During this period the maternal death ratio was 64 per 100,000 live births. The main cause of maternal death was toxemia 25%, follow by hemorrhage 23%, pulmonary thromboembolism 16%, infection 13%, and anesthetic complications 6%. 73% were foreseen deaths and 23% were unforeseen deaths. At the patients arrival to the hospital 37% were avoidable deaths. 66% were direct obstetric deaths and 34% were avoidable deaths. 66% were direct obstetric deaths and 34% were indirects. In 50% of the cases the end of pregnancy was done by cesarean section. The professional responsability existed in the 72% and the hospitalary in the 23%. We made an analysis related factors and we propose strategies to diminish the maternal mortality. [ABSTRACT FROM AUTHOR]

SUMMARY The partnership the insulin-like growth factor (IGF) in women with polycystic ovary syndrome (PCOS) is characterized by mechanisms underlying alterations in the GH/IGF-1, axis. In the pathogenesis exist a sinergism markedly enhanced between IGF-1 and insulin, and IGF-1 with LH to increase androgen production, causing a reduced IGFBPs and SHBG production, the resulting hyperandrogenism, within and ouside the ovary, may inhibitor follicular maturation and the biosynthesis of estrogen. At the present, the data suggests up to date paracrine, autocrine as well as endocrine actions in the ovary in normal conditions and the lost of this homeostasis can be followed by neuro-endocrine. [ABSTRACT FROM AUTHOR]

SUMMARY Nitric oxide (_GCB_NO) produced by the majority of animal cells, has been considered a second messenger, since it is the result of a transduction process induced by a first stimulus. Biochemically, _GCB_NO is produced during the conversion of L-arginine to L-citruline by a reaction catalized by the enzyme nitric oxide syn-thetase. Two ixoenzymes have been characterized from this enzyme: a constitutive isoenzyme activated by hormones produced by the endothelial cells and acting on smooth muscle relaxing properties and the other, an inducible isoenzyme whose synthesis is stimulated by cytokines, and produced by macrophages. As pregnancy progresses, the concentrations of _GCB_NO, its metabolites, nitrates and nitrites, cGMP and the synthesizing enzyme, nitric oxide synthetase, increase parallelly until reaching a maximum peak before birth. It is considered that _GCB_NO is the molecule that maintains the typical vasodilated tone during prgnancy. During preeclampsia, this free radical, as well as its metabolites are found to be significantly decreased, in addition, the administration of _GCB_NO donors or of the precursor of L-arginine reverts the vascular abnormalities of this condition. The mechanism of action behind _GCB_NO on the vascular endothelium is by its stimulating effect on the enzyme cyclase guanilate, causing an increase in cGMP concentration and the relaxation of the smooth muscle. The nitric oxide generates by macrophages acts as a defense mechanism when linked with other radicals as the superoxide anion (O[sub2]). [ABSTRACT FROM AUTHOR]

RESUMEN Los productos de la peroxidación, los radicales libres y los compuestos antioxidantes aumentan notablemente durante la ovulación, la implantación y a medida que transcurre la gestación. La concentración del radical anión superóxido (O[sub2-]) aumenta aproximadamente seis veces en el proestro, mientras que su enzima reguladora, la superóxido dismutasa, disminuye. La presencia del radical superóxido está relacionada con el edema y la proliferación celular del estro. Este radical también está relacionado con el aumento de la fluidez y polaridad de las membranas durante la implantación. A medida que evoluciona la preñez aumentan los productos de lipoperoxidación y los compuestos antioxidantes, sugiriendo que los lipoperóxidos durante esta etapa evocan a los mecanismos de defensa, de tal manera que al final de la gestación los antioxidantes superan a los fenómenos peroxidativos. Por otro lado, el radical óxido nítrico ha cobrado gran importancia durante la gestación, ya que es considerado como uno de los relajantes mas potentes del músculo liso. La inhibición de su síntesis provoca signos semejantes a los de pre-eclampsia y su administración logra revertir muchas alteraciones vasculares. El papel de los radicales libres no se limita a efectos nocivos, sino que oportunamente y en concentraciones adecuadas, éstos participan como inductores de factores de crecimiento o en la fluidez de las membranas.SUMMARY The peroxidation products, the free radicals, and the antioxidants compounds notable increase durang ovulation, implantation, and pregnancy evolution. Superoxide anion (O[sub2-]) rise six time more on the proestrous, than on other stages, while its regulation enzyme, the superoxide dismutase (SOD), decreases. The presence of superoxide anion is related with the edema and... [ABSTRACT FROM AUTHOR]