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Background: Breast cancer occupies first place in mortality by neoplasms in women in Mexico; mammography screening (MS) interpreted by BI-RADS (Breast Imaging-Reporting and Data System), allows suspicion of malignancy, which will be confirmed when having the histopathological result (HPR)., Objective: o evaluate whether suspicious findings for breast cancer in MS are associated with malignant HPR in women aged ≥ 40 years., Material and Methods: Observational, analytical, cross-sectional, prolective study. Patients aged ≥ 40 years, with MS with BI-RADS 4a, 4b, 4c and 5, and RHP of sample obtained by Trucut, excisional or ultrasound-guided biopsy were analyzed. Sociodemographic, anthropometric, clinical variables, BI-RADS classification and HPR variables were recorded., Results: 148 patients were included, median age 53 years; these were stratified into BI-RADS 4a, BI-RADS 4b, BI-RADS 4c and BI-RADS 5. Suspicious findings of malignancy due to MS were associated with HPR. MS BI-RADS 4c, palpable lesion and late menopause were identified as risk factors for malignant HPR; as well as MS BI-RADS 5 and palpable lesión., Conclusion: MS with suspicious findings of malignancy is associated with the malignant HPR obtained by biopsy., (Licencia CC 4.0 (BY-NC-ND) © 2024 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Women in advanced maternal age (older than 35 years of age) are at higher risk of obstetric complications and adverse perinatal outcomes than younger women., Objective: To know the maternal and perinatal morbidities associated to advanced age in pregnant women., Material and Methods: Analytical cross-sectional study. Women with resolution of pregnancy in the medical unit were included and distributed in two groups: group 1, advanced age, ≥ 35 years, and group 2, < 35 years. Clinical data, maternal and perinatal morbidities of the newborn (NB) were collected from the medical record., Results: We included 240 patients, 120 per group; a significant association of advanced maternal age with maternal morbidities such as diseases prior to pregnancy was demonstrated (p < 0.0001), including diabetes mellitus during pregnancy (p = 0.002), hypertensive disease of pregnancy (p = 0.0001), pregnancy resolution by cesarean section (p = 0.04), obstetric hemorrhage (p = 0.0002), prenatal control with < 5 consultations (p = 0.008), as well as those with perinatal morbidities of the NB: preterm gestational age (p = 0.001), intrauterine growth retardation (p = 0.01), low weight for gestational age (p = 0.001) and admission of the NB to the neonatal intensive care unit (p = 0.007); with multivariate analysis, an association of advanced maternal age with diabetes mellitus, hypertensive disease of pregnancy and obstetric hemorrhage was observed (R2 = 0.9884; p < 0.0001)., Conclusion: The maternal and perinatal morbidities are associated with advanced age in pregnant women., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Abnormal uterine bleeding (AUB) is the most common cause of blood loss. Obesity and overweight are risk factors for AUB., Objective: To compare the association between body mass index (BMI) and tri-ponderal mass index (TMI) with the presence of acute AUB and chronic AUB., Material and Methods: Observational, cross-sectional and analytical study. Women between 18 and 45 years of age with an alteration in the regular uterine bleeding pattern were included. Postmenopausal women, carriers of an intrauterine device as a method of family planning who have developed alterations in the menstrual rhythm after it, those who suffered from chronic diseases (chronic kidney disease, diabetes mellitus and uncontrolled hypothyroidism) and those with medication consumption that alter coagulation were not included. Pregnant patients were excluded., Results: A total of 292 women with AUB were analyzed, with a median age of 38.5 (IQR 33-41), with bleeding of 205.4 mL (±142.9) and 116 (39.86%) of them with overweight. When analyzing the BMI with SUA, we found no significant difference in the presence of acute or chronic bleeding in the overweight (p = 0.46) and obese (p = 0.41) groups. When analyzing the IMT with the presence of acute or chronic AUB, it was not possible to find a significant difference in the overweight (p = 0.98) and obesity (p = 0.93) groups., Conclusions: The BMI was compared with the TMI for the presence of AUB, without finding a significant association., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: More than 120 million women worldwide want to avoid pregnancy, but most are not using contraception. This could be because they may not have received clear instructions on how to use the method properly, may not have obtained the most appropriate method for their needs, or may not have been aware of the side effects., Objective: To compare the acceptance of family planning methods (FPM) in women attended for childbirth, caesarean section, and curettage., Material and Methods: Cross-sectional, analytical, prolective study. Women between 18 and 40 years of age in the immediate puerperium attended at a third level hospital were included. A survey which included 5 items with multiple choice answers and 7 with open answers was applied. General data were gathered, included the acceptance or not of some planning method, and the reason for its use or rejection. In addition, it was identified which methods they knew, if they received counseling and the perspective of effectiveness., Results: A total of 648 women were included; 216 women in each group. It was found that there is a higher percentage of acceptance of FPM in women attended by cesarean section, compared to those attended by delivery and curettage (p = 0.0158)., Conclusions: Women attended by cesarean section are more willing to approve FPM, compared to those attended by delivery and curettage. Those patients who receive counseling are the most informed and the ones who approve FPM. Nurses and family physicians are the health workers who offer more counseling., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Women across the globe are at risk of physical or sexual abuse by an intimate partner or other offender. Violence against women can lead to physical injuries, impaired mental health, and specific chronic diseases. In some cases, such types of violence can even result in disability or death for some victims., Objetive: To identify the factors that cause domestic violence in women of Guanajuato., Material and Methods: Prospective, observational, analytical and cross-sectional study. 325 patients of 18 years or older who were literate and visited a third level hospital were included. The Scale of Violence in Couple Relations with a Likert-type response was administered. Data were analyzed by descriptive statistics. Frequencies and percentages of all variables, chi-square test, and bivariate analysis were used., Results: Of 325 women of 36 (30-46) years of age, 214 (65.8%) were married. The majority were high school graduates, 152 (46.8%). 52% of women reported having experienced domestic violence at least once. Knowing the existence of a domestic violence protection law produced an OR 0.34 (0.20-0.57), p-0.001 and knowing the meaning of domestic violence gave an OR 0.35 (0.21-0.58 ), p<0.001., Conclusions: A high percentage of women reported having experienced domestic violence at least once. The determinants of violence were similar in women with and without exposure to it. Protective factors were knowledge of the law and the meaning of domestic violence., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Recent studies have confirmed the relationship between some inflammatory indexes and preeclampsia (PE); however, they have not been analyzed in PE with and without severity criteria., Objective: To know the association between inflammatory indexes and the severity of PE., Material and Methods: Analytical cross-sectional prolective study. Pregnant patients were included, divided into group 1 (PE without severity criteria); group 2 (PE with severity criteria); group 3 (normotensive pregnant women). Records were reviewed and inflammatory indexes [(neutrophil-lymphocyte ratio [NLR], platelet-lymphocyte ratio [PLR], lymphocyte-monocyte ratio [LMR] and systemic immune index [SII]) were calculated., Results: 240 patients were analyzed, 80 per group; age 28 (IQR 27-29) years. A significant difference was observed between group 1, group 2 and group 3, NLR 3.29 (IQR 2.82-3.69), 3.59 (IQR 2.83-4.2) and 3.42 (IQR 3.17-3.92), respectively, p = 0.02; PLR 121.59 (IQR 103.78-132), 108.32 (IQR 92.96-127.43) 136 (IQR 115.18-157.56), respectively, p = 0.01; LMR and SII showed no difference between the groups. LMR made possible to distinguish PE with and without severity criteria, cut-off point of ≥ 3.20, sensitivity 56%, specificity 56%, AUC 0.56, p = 0.01, and cut-off point ≥ 3.24, sensitivity 58%, specificity 58%, AUC 0.57, p = 0.04, respectively; the LMR ≥ 3.24 was associated with PE without severity criteria (OR 2.02 [95%CI 1.08-3.80], p = 0.03)., Conclusions: The MLR was the only inflammatory index analyzed that was associated with the presence of PE without severity data. No inflammatory index was associated with PE with severity data., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Anomalous adhesions of the placenta, known as placenta accreta and its variants, are the cause of obstetric hemorrhages that put the pregnant woman at risk. Accretism is strongly associated with a history of uterine surgery (cesarean section, myomectomy, curettage), as well as ultrasonographic signs, such as the presence and size of placental lacunae, loss of the placenta/bladder interface, location on the anterior face of the placenta, and presence of Doppler flow; these markers can be assessed by prenatal ultrasound., Objective: To analyze the association of prenatal diagnosis of placenta accreta by ultrasound with the histopathological result using the Tovbin index., Material and Methods: Observational, cross-sectional and analytical study. 63 patients who had placenta accreta data by ultrasound measured with the Tovbin index and by means of the histopathological result obtained from the platform of the Mexican Institute for Social Security (IMSS) were included. The association between the two studies with the presence of placenta accreta was analyzed., Results: 63 patients were analyzed; the Tovbin index was positive in 89% of the patients with a diagnosis of placenta accreta confirmed by histopathology. Both the Tovbin index and the histopathology report showed a statistically significant association with a p value of 0.04 for the diagnosis of placenta accreta., Conclusion: The Tovbin index as an ultrasonographic prenatal diagnosis of placenta accreta has a statistically significant association with histopathology diagnosis., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Urinary incontinence (UI) is a medical and social problem that has a great impact on the quality of life of women. Pelvic floor muscle strengthening exercises have been shown to be a form of conservative treatment. However, there is still high failure in this treatment., Objective: To analyze the factors associated with low home therapeutic adherence to pelvic floor exercises in patients with UI., Material and Methods: An analytical cross-sectional prolective study was carried out in women aged 20-85 years, with UI and under conservative treatment with pelvic floor muscle exercises. They were questioned about their demographic data; the Morisky Green therapeutic adherence questionnaire and the Likert-type satisfaction scale were applied on the results of the questionnaire., Results: 235 women with UI and with a prescription for pelvic floor muscle exercises, with a median of 55 (46-64) years, were analyzed. The lack of adherence to pelvic floor exercises was observed in 130 (55.32%), whose causes were their work (37.69%), forgetfulness (23.08%) and lack of interest (12.08%). The risk factors for non-adherence were having 3 or less children (OR 1.81 [95% CI 1.10-3.23], p = 0.02), and not feeling satisfied with the exercises (OR 6.70 [95% CI 3.75-11.97], p < 0.001., Conclusion: The factors associated with low home therapeutic adherence to pelvic floor exercises in patients with urinary incontinence were having 3 or less children and not being satisfied with the results., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Adolescent pregnancy may be associated with medical complications related to the biological immaturity of the mother, and adult primiparous mothers may present perinatal outcomes associated with pre-existing age-related chronic changes., Objective: To compare unfavorable perinatal outcomes in adolescent and adult primiparous women., Material and Methods: Observational, cross-sectional, retrospective and analytical study. Records of adolescent women from 12-19 years and adult women from 20-40 years in their first pregnancy, with a gestation of more than 20 weeks, who entered the Obstetrics Area of a third level hospital for pregnancy resolution were included. Perinatal outcomes were compared using chi-squared, Fisher's exact test, or Mann-Whitney U test., Results: 220 records of primiparous women, 110 adolescents aged 18 (16-19) and 110 adults aged 24 (21-25) were included. Adolescent mothers presented as unfavorable perinatal outcomes newborns (NB) small-for-gestational-age (SGA): odds ratio (OR) 2.95 (95%CI 1.10-7.85), p = 0.04. Adult pregnant women presented more comorbidities (gestational hypertension [11.82 vs. 3.64%] and preeclampsia [10.91 vs. 4.55%], gestational diabetes [6.36 vs. 0.91%], [p = 0.006]) that were associated with prematurity (p = 0.018) and with hospitalization in the NB (p = 0.008)., Conclusions: Adolescent mothers presented twice more SGA NB. Prematurity and hospitalization of the NB was associated with the presence of comorbidities in adult mothers., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)