José Bajo

Intraobserver and Interobserver Reproducibility of Ovarian Volume, Antral Follicle Count, and Vascularity Indices Obtained With Transvaginal 3-Dimensional Ultrasonography, Power Doppler Angiography, and the Virtual Organ Computer-Aided Analysis Imaging Program

The purpose of this study was to assess intraobserver and interobserver reproducibility of the parameters of ovarian response and oocyte ability, studied by 3‐dimensional ultrasonography and power Doppler angiography (PDA), and the possible influence of the ovarian functional stage.

Predicting Atypia Inside Endometrial Polyps

Objective. To evaluate the efficacy of color Doppler exploration for assessing atypia inside endometrial polyps. Methods. A prospective study was conducted in a tertiary university hospital. Eight hundred six patients with endometrial polyps were studied with color Doppler sonography, and the resistive index inside the polyp stalk was obtained. The patients were then referred for hysteroscopic resection, and pathologic analysis was performed. Results. Thirty‐five polyps with sonographic indications of atypia were pathologically confirmed. Sonographic indications of atypia inside 16 polyps were not confirmed. Three nonquestionable endometrial polyps had atypia inside them. Conclusions. Low Doppler resistance is highly predictive of atypia inside endometrial polyps.

Clinical Usefulness of 3-Dimensional Sonography and Power Doppler Angiography for Diagnosis of Endometrial Carcinoma

The purpose of this study was to assess whether endometrial volume (EV) and 3‐dimensional (3D) power Doppler indices can discriminate between hyperplasia and endometrial carcinoma and can predict extension of the endometrial carcinoma.

Six thousand office diagnostic-operative hysteroscopies.

Objective: To compare CO2 and normal saline as distention media in office diagnostic hysteroscopy. Methods: The outcome of more than 6000 office hysteroscopies was analyzed. We used carbon dioxide or saline as distension medium. Minor hysteroscopic techniques were performed when indicated. Results: The major indication was abnormal uterine bleeding (45%). Satisfactory hysteroscopy was achieved in 92.4% with CO2 and in 98.3% with saline (P<0.05). Local anesthesia was used in 54 patients (1.5%) with CO2 and in three patients (0.1%) with saline (P<0.001). Four hundred and two women (16.3%) underwent hysteroscopic procedures under saline hysteroscopy. Endometrial polyps were removed in 281 patients, 75 IUDs were removed, 14 fibroids were extracted, uterine septa were excised in 11 cases and mild and moderate adhesions were transected in 21 patients. Conclusion: Saline office diagnostic hysteroscopy offers at least all the advantages of the CO2 hysteroscopy, and gives the possibility to easily ‘find and treat in situ’ many of the lesions observed.

Which endometrial polyps should be resected

STUDY OBJECTIVE To evaluate the efficacy of color Doppler exploration after diagnostic hysteroscopy in choosing which endometrial polyps can be safely left in situ. DESIGN Prospective, long-term follow-up study (Canadian Task Force classification II-1). SETTING University hospital. PATIENTS Two hundred twenty women with hysteroscopically confirmed endometrial polyps. INTERVENTIONS Transvaginal ultrasonographic surveillance with color Doppler mapping and hysteroscopic resection. MEASUREMENTS AND MAIN RESULTS We removed 126 (57.2%) polyps because of positive color Doppler map, and 29 (13.1%) with a negative color Doppler map because of symptoms. Sixty-five (29.5%) polyps were not removed because they did not cause symptoms and no Doppler map was found. At follow-up, six were removed because of hemorrhagic episodes. At 3 years, 59 patients with endometrial polyps remained asymptomatic by clinical and ultrasonographic follow-up. CONCLUSION In this series, 59 patients (26.8%) avoided surgical removal of polyps. (J Am Assoc Gynecol Laparosc 6(1):71-74, 1999)

Variables that predict the success of labor induction

Background.  To analyze the clinical and sonographic variables that affect the success of labor induction.

The labor induction: integrated clinical and sonographic variables that predict the outcome

Objective:To analyze the clinical and sonographic variables that predicts the success of labor induction.Study design:We studied the Bishop score, cervical length and parity in 196 pregnant women in the prediction of successful vaginal delivery within 24 h of induction. Logistic regression and segmentation analysis were performed.Results:Cervical length (odds ratio (OR) 1.089, P<0.001), Bishop score (OR 0.751, P=0.001) and parity (OR 4.7, P<0.001) predict the success of labor induction. In a global analysis of the variables studied, the best statistic sequence that predicts the labor induction was found when we introduced parity in the first place. The success of labor induction in nulliparous was 50.8 and 83.3% in multiparous women (P=0.0001).Conclusions:Cervical length, Bishop score and parity, integrated in a flow chart, provide independent prediction of vaginal delivery within 24 h of induction.

Raloxifene plus ossein-hydroxyapatite compound versus raloxifene plus calcium carbonate to control bone loss in postmenopausal women: a randomized trial

Objective:To compare the efficacy and safety of adding ossein-hydroxyapatite compound (OHC) or calcium carbonate (CC) to raloxifene (RLX) therapy for controlling bone loss in postmenopausal women. Design:Ninety postmenopausal women were assigned to treatment with RLX plus OHC (group 1, 48 women) or RLX plus CC (group 2, 42 women) for up to 3 years in an open-label, comparative study. Ultrasound measurement of amplitude-dependent speed of sound (ADSoS) was used to evaluate mean changes in bone mineral density. The primary endpoint was mean change of ADSoS from baseline. An intention to treat and per protocol analysis were carried out. Adverse effects were also recorded. Results:Over the study period, the mean ADSoS diminished in both groups even though the rate of reduction was higher in the RLX plus CC group, with a mean change in ADSoS score of −18.72 m/s from baseline to year 3 in the RLX plus OHC group and −63.64 m/s in the RLX+CC group (P = 0.006). Similar results were seen on T and Z scores. Adverse effects were infrequent and the number and type were similar between groups. Conclusions:RLX plus OHC appears to be more effective in controlling bone loss than RLX plus CC for the control of bone loss in postmenopausal women.

Contribution of transvaginal sonography to the evaluation of benign cervical conditions

We evaluated the role of transvaginal sonography in imaging the normal cervix and its benign changes.

Angiomixoma agresivo vulvar

Resumen El angiomixoma agresivo es un tumor mesenquimal poco frecuente, de crecimiento localmente infiltrativo y alto riesgo de recidiva local. Presentamos un caso de localizacion vulvar.