First-trimester chromosome diagnosis by lavage of the uterine cavity.

Fetal karyotyping of trophoblast cells obtained by lavage of the uterine cavity was evaluated on 86 first-trimester irrigation fluid samples. Villus fragments were observed in 72 fluid samples indicating an 83.7 per cent sampling success rate. The amount of villi in these samples ranged from 1 to 32 mg. In most cases, villus fragments showed degeneration of the external syncytiotrophoblast layer and absence of blood vessels. In the first phase of this study (15 samples), a high degree of maternal cell contamination was observed after long-term cultures. In the following phase (71 samples), this obstacle was overcome by the application of a semi-direct method. Chromosome preparations were set up after 24 h incubation of villus fragments and QFQ-banded metaphase spreads were scored for chromosome number and sex. Sixty samples showed the presence of villus fragments and the fetal karyotype was established in 40. Male and female chromosome complements were observed in 16 and 24 cases, respectively. In four cases, an abnormal fetal karyotype was diagnosed. These included trisomy of chromosomes 13, 15, and 16, and one mosaic with trisomy 12. Our results indicate that first-trimester fetal karyotyping might be feasible by a semi-direct method using chorionic villus fragments obtained at intrauterine lavage.

[Resectoscopic endometrial ablation in the treatment of recurrent, dysfunctional menometrorrhagia: our experience]. / L'ablazione di endometrio tramite resettoscopio nel trattamento delle menometrorragie recidivanti disfunzionali: nostra esperienza.

UNLABELLED: Advances in hysteroscopic surgery provide additional options to hysterectomy for the treatment of dysfunctional uterine bleeding resistant to medical therapy and multiple curettages. Two techniques are now available: (a) Resectoscopic endometrial ablation. (b) Electrocoagulation or laser photovaporisation of endometrium. 52 patients underwent resectoscopic endometrial ablation at the Gynaecology Department of Parma University from January 1991 to April 1993. All patients suffered from dysfunctional uterine bleeding without atypical histologic findings on endometrial biopsies and had a normal shaped uterine cavity. 41 patients were subsequently contacted for follow-up. Follow-up period ranged from a minimum of 3 months to a maximum of 24 months. 78.1% of the patients reported a satisfactory outcome (amenorrhea or decreased menstrual flow). No operative complication occurred. Post operative complications included one case of hematometra. CONCLUSIONS: resectoscopic endometrial ablation is an advantageous technique but our follow-up period is relatively short and long term sequelae have yet to be determined.

[Biopsy of the chorionic villi in the early diagnosis of chromosomal diseases]. / La biopsia dei villi coriali nella diagnosi precoce di malattie cromosomiche.

In the first trimester of pregnancy two simple chorionic villus sampling method, carried out under ultrasound guidance, with transabdominal or transcervical aspiration, was evaluated in 257 cases at risk for chromosomic diseases. The high efficacy of the transabdominal aspiration was demonstrated by obtain villus tissue for karyotyping in all but one case. In only one sample the abnormalities detected were not confirmed (one case of false positive).

[The role of microcolpohysteroscopy in the diagnosis of endometrial pathology]. / Ruolo della microcolpoisteroscopia nella diagnosi della patologia endometriale.

In this study it's valued the utility of microcolpohisteroscopy, as diagnostic investigation in gynecology. This technique proved to be easy to do, welcomed by the patients, innocuous and full of information about the physiology, physiopathology and pathology of the structures studied. The examination has to be done in the second half of the endometrial proliferation, anaesthesia isn't necessary and it can also be performed to out-patient women. In 1984, in Obstetric and Gynecology Clinic of Parma, this method practised using Homou's microcolpohysteroscope, has been used in 96 patients, whose age was between 20 and 68 years: our women affected by numerous gynecological pathologies like metrorrhage or intermenstrual blood loss, and sterility. It was possible to prove several pathological alterations: endometrial hyperplasia and endometrial polypuses were the most frequent. In sterile women examined we found synechie and endometrial atrophy more frequently. Only in 4 out of 96 women patients underwent this exam no lesion to be evidenced by microcolpohysteroscopy.