C. Pérez

Conservative management of retained trophoblastic tissue and placental polyp with diagnostic ambulatory hysteroscopy

OBJECTIVE To analyse the results of our conservative management of retained trophoblastic tissue and placental polyp with diagnostic ambulatory hysteroscopy and to describe our experience and guidelines. STUDY DESIGN Descriptive retrospective study. Eighty-four women with suspected retained trophoblastic tissue after pregnancy underwent hysteroscopic examination and extraction of all residual tissue in the office under direct visualization of the uterine cavity, without anaesthesia or cervical dilatation. RESULTS Hysteroscopic examination was tolerated by all but one patient. In 82 cases (97.4%), the diagnosis after hysteroscopic examination was placental polyp or retained trophoblastic tissue. This diagnosis was histologically confirmed in 79 cases (94.7%). In 43.6% (36) of the cases, complete evacuation of the uterine cavity was achieved during a single hysteroscopic examination. The only complication after hysteroscopy was one case of major vaginal bleeding requiring curettage. CONCLUSIONS Diagnostic-operative ambulatory hysteroscopy is a suitable alternative to blind curettage in the management of retained trophoblastic tissue. This technique can be performed in the office without anaesthesia and with a low rate of complications.

Severe menorrhagia due to Glanzmann thrombasthenia treated with hydrothermal ablation

Glanzmann thrombasthenia is a rare platelet disorder inherited as an autosomal recessive trait. Abnormal uterine bleeding is a common problem in women with the disease. Medical management may not always be effective and further treatment may be necessary. Two women underwent endometrial ablation with a continuous-flow circulating hydrothermal ablator. After follow-up of 12 and 18 months, both women remained without abnormal uterine bleeding.

Colestasis intrahepática del embarazo: diagnóstico y manejo

Resumen La colestasis intrahepatica del embarazo es una forma reversible no obstructiva de colestasis intrahepatica. Los acidos biliares son eliminados de forma incompleta por el higado de las gestantes, lo que aumenta sus concentraciones en sangre y liquido amniotico. Es una patologia benigna para la gestante que se asocia con un incremento de la muerte fetal intrautero.

A simulation model including vaccination and seasonality for inflenza A-H1N1 virus

We have described a SIR simulation model for the influenza AH1N1 virus including variable population, periodic transmission coefficient and constant vaccination rate for any age and time. Also, it has been considered the natural mortality rate due to the infection. We analyze the model by means of simulations using several scenarios. The epidemic threshold, that is time and seasonality dependent, has been obtained.

Cerclaje abdominal: nuestro primer caso

Resumen El cerclaje istmicocervical por via abdominal es una tecnica escasamente utilizada, de mayor riesgo que el cerclaje convencional, pero que puede constituir la unica opcion terapeutica en determinados casos de insuficiencia istmicocervical. En este trabajo presentamos nuestra primera experiencia con esta tecnica, realizada en la semana 11 a una paciente con mala historia obstetrica y que permitio una evolucion favorable del embarazo.