Polihidramnios secundario a corioangioma placentario / Polyhydramnios due to placental chorioangioma

El corioangioma es el tumor placentario mas frecuente, se presenta en aproximadamente un 1% de las gestaciones. Es un tumor vascular benigno formado por vasos fetales unidos mediante tejido conjuntivo, que se localiza habitualmente en contacto con la placa coriónica o en sus cercanías. El tamaño es muy variable, lo más frecuente es que tengan un diámetro 5 cm. Éstos presentan, en ocasiones, zonas de infarto o trombosis y están asociados con más frecuencia a complicaciones de la gestación como hidramnios, amenaza de parto prematuro o insuficiencia cardíaca fetal. El diagnóstico del corioangioma se realiza fundamentalmente en el segundo o tercer trimestre y se basa en el estudio ecográfico. Se observan imágenes nodulares en la cara fetal de la placenta o en su interior. El estudio Doppler pone de manifiesto la presencia de vascularización en el interior de la masa o en su periferia, aunque este hallazgo no esté siempre presente. El tratamiento de este tumor va desde la simple observación de la evolución hasta las actuaciones más invasivas, como la alcoholización del tumor o la coagulación con láser (AU)

Chorioangioma is the most common tumor of the placenta, occurring in approximately 1% of pregnancies. This entity is a benign vascular tumor composed of fetal vascular elements joined by connective tissue and is usually found in contact with the chorionic plate or surrounding areas. Size is highly variable but chorioangiomas usually have a diameter of less than 4 cm. Larger chorangiomas (5 cm or more) can occur in areas of infarction or thrombosis and are more frequently associated with complications such as polyhydramnios, preterm labor, and fetal congestive heart failure. Diagnosis of chorioangioma is made in the second or third trimester by ultrasound, which shows nodular images in the fetal side of the placenta or the inner placenta. Doppler studies reveal the presence of vascularization inside or on the periphery of the mass, although this finding is not always present. The management of this tumor ranges from close surveillance of the pregnancy to more invasive procedures such as chemosclerosis with absolute alcohol or laser devascularization. We report a case of large chorioangioma with polyhydramnios, diagnosed at 33 weeks of gestation (AU)

Comparison of the efficacy and tolerability of dexketoprofen and ketoprofen in the treatment of primary dysmenorrhea.

Dexketoprofen, the pure S(+)-enantiomer of ketoprofen, is a promising new analgesic, but few clinical trials have yet examined its efficacy and tolerability. In this study, patients with a history of primary dysmenorrhea were treated with dexketoprofen doses of 12.5 and 25 mg, ketoprofen 50 mg, and placebo using a randomized, four-way crossover design. Efficacy analyses showed that dexketoprofen 12.5 and 25 mg and racemic ketoprofen 50 mg significantly reduced pain intensity compared with placebo from 1 h after dose to 4-6 h after dose. Interestingly, dexketoprofen at 12.5 mg was significantly superior to placebo at 30 min after dose. Mean pain relief scores also demonstrated that both doses of dexketoprofen and racemic ketoprofen were significantly superior to placebo at 1-6 h after the first dose. No indices of analgesic efficacy showed any significant differences between the two doses of dexketoprofen or between dexketoprofen and ketoprofen. After repeated dose administration, similar results were obtained. There were no significant effects of any treatment on activities of daily living, menstrual flow, or associated symptoms. Dexketoprofen was effective, well tolerated, and had no difference in the incidence of adverse events compared to ketoprofen or placebo.