Hemorragia posparto precoz: uso de la radiología intervencionista en el control / Early postpartum hemorrhage treated by interventional radiology

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Endometriosis recto-sigmoidea: a propósito de un caso / Rectosigmoidal endometriosis: apropos of a case

La endometriosis intestinal es frecuentemente asintomática, siendo diagnosticada incidentalmente durante una laparotomía o laparoscopia realizada por otro motivo. En aquellos casos en los que es sintomática, las manifestaciones clínicas suelen ser inespecíficas e idénticas a las de otros trastornos gastrointestinales. Generalmente la endometriosis intestinal no se sospecha de forma preoperatoria, salvo en aquellas pacientes con antecedentes de endometriosis o con manifestaciones clínicas cíclicas coincidiendo con la menstruación. La endometriosis intestinal puede asemejar diversas alteraciones gastrointestinales como la enfermedad de Crohn, la diverticulitis, la colitis isquémica o incluso con neoplasia. Las pruebas diagnósticas suelen aportar poca información, pero la colonoscopia, la resonancia magnética, la ecoendoscopia y, sobre todo, la toma de biopsias pueden ser de utilidad para el diagnóstico y para descartar malignidad, principalmente en las lesiones rectosigmoideas(AU)

Intestinal endometriosis is often asymptomatic and is diagnosed incidentally during laparotomy or laparoscopy performed for other reasons. When this entity is symptomatic, the clinical manifestations are usually nonspecific and identical to those of other gastrointestinal disorders. Intestinal endometriosis is not usually suspected preoperatively, except in patients with a history of endometriosis or cyclical manifestations coinciding with menstruation. Intestinal endometriosis may mimic various gastrointestinal disorders such as Crohn’s disease, diverticulitis, ischemic colitis or even neoplasia. Diagnostic tests usually provide little information, but colonoscopy, magnetic resonance imaging, echoendoscopy and especially biopsy may be useful for diagnosis and to rule out malignancy, mainly in rectosigmoidal lesions(AU)

Fertility preservation in heterotopic cervical pregnancy: what is the best procedure?

We describe a patient who underwent assisted reproduction techniques and was diagnosed with heterotopic cervical pregnancy, and then discuss the management of this entity, which is rare and has no standard protocols. Treatment consisted of intra-arterial methotrexate (50 mg/m(2) body surface area) and simultaneous selective embolization of uterine arteries. The literature is also reviewed to identify other approaches and outcomes.

Trombosis de la vena ovárica con extensión a la vena cava inferior en el posparto / Ovarian vein thrombosis spreading to the inferior vena cava

La trombosis de la vena ovárica es una complicación que puede aparecer durante el puerperio o después de una intervención quirúrgica pélvica. Es una entidad poco frecuente pero potencialmente grave, de ahí la importancia del diagnóstico y el tratamiento temprano. Debe sospecharse ante la aparición de fiebre y dolor abdominal agudo en los primeros días posparto. La prueba diagnóstica de elección sigue siendo la tomografía computarizada (TC) con contraste. Tras la administración de antibióticos de amplio espectro y heparina, la mejoría clínica es inmediata.Presentamos un caso de trombosis de la vena ovárica que aparece como complicación tras la realización de una cesárea (AU)

Ovarian vein thrombosis is a complication that can appear during the postpartum period or after pelvic surgery. This complication is a rare but serious entity requiring early diagnosis and treatment and should be suspected in patients with fever and acute abdominal pain at the beginning of the postpartum. Imaging diagnosis with contrast computed tomography remains the gold standard. Administration of broad-spectrum antibiotics and heparin therapy produces immediate clinical improvement.We report a case of ovarian vein thrombosis after a cesarean delivery (AU)

The levonorgestrel intrauterine system as an alternative to hysterectomy for the treatment of idiopathic menorrhagia.

AIM OF THE STUDY: Prospective, observational study to determine the percentage of hysterectomies cancelled after a year of treatment with levonorgestrel intrauterine system (LNG-IUS) among women diagnosed with idiopathic menorrhagia. MAIN FINDINGS: Eighty-two women with a mean age of 44.3 + or - 4.9 were enrolled. Throughout 1-year follow-up, progressive and significant reduction was observed in number of days of bleeding (8.9 + or - 4.0 vs. 5.0 + or - 5.4), number of sanitary measures (29.3 + or - 19.4 vs. 8.1 + or - 10.8) and percentage of patients having intense/very intense bleeding (98.8%vs. 6.4%). Duration of menstrual cycle significantly increased from 26.9 + or - 5.5 to 52.6 + or - 33.6 days. Significant improvement in overall health-related quality of life was achieved. Patient satisfaction was good/very good in 70.7%. Considering only women who attended 12-month visit satisfaction reached 91.2%. 75.6% of scheduled hysterectomies were cancelled. Adverse effects were recorded in less than 40% of patients with no significant differences between visits. Adverse effects led to premature discontinuation of treatment in seven cases. No serious adverse effects were encountered. INTERPRETATION OF RESULTS: LNG-IUS meets the effectiveness and tolerability criteria for being considered as a first choice treatment option for women with idiopathic menorrhagia. Its use may contribute to decrease the large number of hysterectomies scheduled in Spain.

Utilización de métodos anticonceptivos en España por grupos de edad: resultados de 4 encuestas nacionales / Use of contraceptive methods in Spain by age groups: results of four national surveys

Objetivos: Conocer los métodos anticonceptivos utilizados según la edad de las mujeres. Material y métodos: Desde 1997 los autores venimos realizando, en España, una encuesta bienal sobre la utilización de métodos anticonceptivos en las mujeres en edad fértil (15-49 años).Resultados: En el grupo de mujeres adolescentesel método más utilizado es el condón. En el grupode 20 a 29 años, el condón sigue siendo el métodomás utilizado, seguido de la píldora. El grupo de30-39 años es el que más utiliza el dispositivo intrauterino (DIU). En el grupo de mujeres de 40-49 años los métodos quirúrgicos son utilizados hasta por el 28% de las mujeres.Conclusiones: En los últimos 6 años se ha incrementado el uso de métodos anticonceptivos en la población española. Se observan diferenciasen la elección del método anticonceptivo según la edad de las mujeres

Objectives: To determine the use of contraceptive methods according to women’s age.Material and methods: Since 1997, we have conducted a biennial national survey in Spain ofthe use of contraceptive methods among women ofchildbearing age (15-49 years).Results: Among adolescent girls, the most widelyused contraceptive method is the condom. In thegroup aged 20-29 years, the most widely used method continues to be the condom, followed by the contraceptive pill. In the group aged 30-39 years, intrauterine devices are most frequently used than in other age groups. In the group of women aged 40-49 years, surgical methods areused by up to 28% of the women.Conclusions: In the last 6 years, the use ofcontraception in Spain has increased. The choice of contraceptive method differs according to women’s age (AU)