Role of computed abdominal tomography (C.A.T. Scan) in the follow up of ovarian tumors.

This study evaluates the possible use of computed tomography not as an alternative diagnostic method but, rather, as a supplement to laparotomy in patients treated for ovarian cancer. The following conclusions can be drawn: in patients presenting no clinical evidence of persistent or relapsing disease C.T. Scan is not a mandatory but, rather, an optional test since it entails 25% false negatives, a 66.6% predictive value and because the involved patients will need, in any case, a further intervention. Conversely, C.T. Scan is clearly indicated in patients presenting clinical evidence of disease. It can prove helpful in detecting metastases in areas that prove difficult to be clinically examined; in assessing whether the retroperitoneal areas conceal neoplastic tissue or in planning the right operation for masses that have been palpated only before chemotherapy, and then in regression. When, despite chemotherapy, tumour progresses, surgery may became useless, and the C.T. Scan may therefore prove helpful in defining the condition and guiding non surgical treatment. Therefore, in the follow up of ovarian cancer the C.T. Scan may be performed on the basis of clinical course, instead than on a rigid aprioristic planning.

What are the most suitable fetoplacental tests in the monitoring of the third trimester of pregnancy?

The case-series of the Institute of Obstetrics and Gynaecology were examined to evaluate the suitability of urinary estriol, total plasma estriol, unconjugated plasma estriol, unconjugated plasma estetrol, plasma placental lactogen, plasma S.P.-1 glycoprotein, plasma alphafetoprotein and biparietal diameter in correctly forecasting the perinatal risk, when performed after the 25th week of pregnancy. In high-risk pregnancies, according to our results, S.P.-1 glycoprotein and urinary estriol are the most sensitive tests, while S.P.-1 glycoprotein, placental lactogen and biparietal diameter are found to have the highest predictive value. The repetition of the considered tests increases their sensitivity, but not their predictive value. In pregnancy mass screening the most suitable tests, on the basis of the "relative risk" are S.P.-1 glycoprotein (or even placental lactogen), estriol and biparietal diameter. For the last one a single measurement seems to be enough during the third trimester.