[Heterotopic pregnancy with intrauterine dizygotic twins following embryo transfer in the blastocyst phase]. / Embarazo heterotópico con gestación intrauterina dicigótica después de transferencia de embriones en etapa de blastocisto.

Ectopic pregnancy is a common complication of in vitro fertilization and embryo transfer (IVF-ET). On other hand, heterotopic pregnancy complicates 1-2% of all IVF-ET pregnancies. Tubal damage as reason for treatment and multiple embryo transfer might predispose patients to this complication. We present a successful treated case of an infertile patient that developed simultaneous twin intra- and single extra- uterine pregnancy after blastocyst-stage embryo transfer. In IVF-ET patients presence of an intrauterine gestation not exclude the possibility of a concomitant extrauterine pregnancy. Awareness of the possibility of heterotopic pregnancy after IVF-ET plays an important role in the successful treatment of this reproductive complication. Transfer of good quality embryos can be a risk factor to develop heterotopic pregnancy.

[A physiopathological overview of climacteric and menopause]. / Un punto de vista fisiopatológico del climaterio y la menopausia.

Today, million of woman in the world lived enough to experience the menopause ant it's seculae. In the last few years the research of the events associated with this age has gained enormous attention. Hormonal replacement therapy has been shown to reduce the incidence of cardiovascular disease, osteoporosis and other complications in postmenopausal woman. In this paper we review the endocrinology of the menopause, benefits and risks of hormonal replacement therapy, Prescription choices, compliance and health care professional attitudes are too analysed.

[Intestinal endometriosis as an acute surgical emergency]. / Endometriosis intestinal como enfermedad quirúrgica aguda.

Endometriosis is rarely found by the general surgeon and sometimes it may seem a surgical disease. Two cases with abdominal pain, requiring surgical treatment, are presented. The first case gave history of dysmenorrhea and dyspareunia, she was admitted with acute abdomen due to acute appendicitis, and laparoscopic appendectomy was performed without complications; she had slight endometriosis at left utero-sacrum ligament and histopathological report showed endometriosis at the appendix. The second patient presented with incomplete obstruction related to ileocecal damage that it was resected with an histopathological report of endometriosis at cecum, ileon and appendix. The patient presented with endometriosis, degree IV, and had medical treatment with gestrinohn, during six months; latter on, HTA+SOB, was done, she received hormonal therapy. Endometriosis may be a cause for acute abdomen in women, and it should be considered in the differential diagnosis.

[2 cases of abdominal endometriosis]. / A propósito de dos casos de endometriosis de la pared abdominal.

Abdominal wall endometriosis usually occurs in the surgical scar of previous cesarean sections. This condition often presents as a mass with cyclical pain and swelling. Two cases of abdominal scar endometriosis are reported. The definitive diagnosis was established by pathologic analysis. Both patients were premenopausal with no history of endometriosis. Pelvic endometriosis was not detected in the patient undergone laparotomy. The management consisted in perform and adequate excision to prevent recurrence. The utility of drug therapy is evaluated.