Diagnostic accuracy of sonohysterography and transvaginal sonography as compared with hysteroscopy and endometrial biopsy: a prospective study.

AIM: The aim of the study was to compare the diagnostic accuracy between transvaginal sonography (TVS) and sonohysterography (SHG) versus hysteroscopy (Hys) plus endometrial biopsy (EB) to evaluate uterine cavity. METHODS: One hundred and sixteen patients were enrolled. These presented with infertility and/or abnormal uterine bleeding and/or suspicious uterine cavity pathology. Women consecutively underwent during the same day, to TVS, SHG and Hys plus EB by three different operators. RESULTS: TVS shows excellent specificity (95.7%) in uterine polyps detection, good sensitivity (85,7%) and specificity (89.2%) in investigating endometrial hyperplasia, and excellent NPV (92.2%) in the diagnosis of submucous myomas. Diagnostic accuracy of TVS for synechiae is not evaluable. SHG demonstrates high specificity (92.8%) in the detection of uterine polyps, and high sensitivity (92.9%) and specificity (96.8%) in the diagnosis of endometrial hyperplasia. In addition it shows high sensitivity (90%), specificity (99%), PPV (92.2%), and NPV (99%) for detection of submucous myomas. Finally, SHG shows high PPV (100%) and NPV (100%) for synechiae assessment. CONCLUSION: TVS could be used as first step investigation to exclude uterine pathologies. TVS could reduce the number of diagnostic Hys normally performed in women with normal uterine cavity. Furthermore SHG should be useful to diagnose the pathologies and to decide between operative Hys in-office or resectoscopic treatment.

Maternal and embryonal/fetal beta-endorphin concentrations during the first trimester of pregnancy.

In this study, we have determined the beta-endorphin concentrations in the plasma of 11 cases during the first 3 months of pregnancy, as well as the corresponding products of conception, collected by hysterosuction, during the course of voluntary abortion. The purpose of this study is to compare the values obtained by the analysis of maternal plasma and the material collected by hysterosuction. The beta-endorphin concentrations were obtained by radioimmunologic methods using a kit which allows a separation from beta-lipotropin. The specimens obtained by hysterosuction (8 +/- 1.7 pmol/l) showed significantly higher levels of beta-endorphin than those observed in the maternal plasma (2.6 +/- 0.3 pmol/l). Thus, already in the earliest gestational period, the data are consistent with a feto-placental origin for this opioid peptide.