Microwave endometrial ablation for menorrhagia.

Sixteen women requesting surgical treatment of menorrhagia were recruited for a study on microwave endometrial ablation. The mean age at treatment was 41.4 years and all patients had completed their family and were pre-menopausal. Average treatment time was 2 minutes 6 seconds. All patients reported a reduction in their menstrual loss and 87.5% were satisfied with their treatment after 1 year follow-up. One patient required overnight admission for analgesia while 15 patients were treated on a day case basis using light general anaesthesia. Sixty-seven per cent of patients reported a reduction in dysmenorrhoea scores at 1 year, two patients reported no change in symptoms and one patient reported a modest increase. One patient had a hysterectomy 10 months after treatment despite being amenorrhoeic. The indication for hysterectomy was pelvic pain (which was present before endometrial ablation). There were few minor complications but no uterine perforation or emergency hysterectomies.

The effect of maternal exercise on uterine artery velocimetry waveforms.

One hundred and two subjects in the second half of pregnancy were subject to an acute exercise test lasting 5 minutes on an upright bicycle ergometer. The pulsatility index (using Doppler ultrasound) of the right uterine artery was analysed before exercise and at 2, 4, 6, 8, 10, 12, 16, 20, 24 and 30 minutes after exercise. The mean exercise intensity achieved was 67.2% of sub-maximal exercise (range 51-90%). At 2 minutes post-exercise, the mean uterine artery pulsatility index was increased from the baseline value, reaching a maximum of 0.64 at 8 minutes (baseline 0.583). After 8 minutes there was a gradual decrease in the pulsatility index, and at 24 and 30 minutes the values were significantly lower (P < 0.001 and P < 0.001 respectively). Smokers had significantly higher pulsatility index values than non-smokers (P < 0.004). Primigravidae also had lower resistance indices compared with multigravidae (P < 0.001). We conclude that exercise in the second half of pregnancy appears to cause a transient increase in the maternal uterine artery pulsatility index. We also believe that at this level of exercise intensity there was no evidence of harmful effects on maternal uterine blood flow.