[Diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours]. / Exactitud diagnóstica del índice de riesgo de malignidad II en mujeres posmenopáusicas con tumor anexial.

BACKGROUND: The purpose of the diagnostic evaluation of adnexal tumours is to exclude the possibility of malignancy. The malignancy risk index II identifies patients at high risk for ovarian cancer. The cut-off value is greater than 200. OBJECTIVE: To evaluate the diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours in relation to the histopathological results. MATERIAL AND METHODS: A total of 138 women with an adnexal mass were studied. The malignancy risk index II was determined in all of them. They were divided into two groups according to the histopathology results; 69 patients with benign tumours and 69 patients with malignant tumours. A diagnostic test type analysis was performed with respect to the results of malignancy risk index II ≤ 200 or greater than this. RESULTS: The percentages and 95% confidence intervals were calculated. The accuracy was 81.8% (75.5-88.3), sensitivity 76.8% (66.9-86.7), specificity 87% (79.1-94.9), with a positive predictive value of 85.5% (76.7-94.3), and a negative predictive value of 78.9% (69.7-88.1). The positive likelihood ratio was 590, and the negative likelihood ratio was 0.266. CONCLUSIONS: The malignancy risk index II has good performance in the proper classification of post-menopausal women with adnexal masses, both benign and malignant, with an accuracy of 81.8%.

Muerte fetal / Fetal death

Se estudiaron todos los casos de muerte fetal ocurridos en el Hospital Regional de Especialidades. No. 23 del IMSS de Monterrey, N.L., durante un periodo de 10 meses, comprendido del 1o. de octubre de 1985 al 31 de julio de 1986. Se atendieron 19,148 nacimientos, de los cuales fueron 200 óbitos. Se incluyeron solamente a los que pesaron 1,000 g o más (153-76.5%). Se encontró una tasa de muerte fetal del 8.07. El 66% de los casos ocurrió en pacientes entre los 20-30 años de edad, casi 50% de los casos se presentaron entre las 37 y 42 semanas de gestación, 62% en primigestas y secundigestas. Se observó que siguen prevaleciendo como las principales cusas de muerte fetal las malformaciones congénitas incompatibles con la vida y los trastornos funiculares; por último, se demostró que el control prenatal adecuado disminuye el riesgo de muerte fetal