Minerva ginecologica
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Minerva ginecologica · Jun 2008
Case Reports[Subamniotic hematoma: 3D and color Doppler imaging in the differential diagnosis of placental masses and fetal outcome].
The aim of this study was to evaluate the role of 3D and color Doppler (CD) imaging in prenatal diagnosis and management of placental subamniotic hematoma and to speculate about the prenatal diagnosis of the solid and cystic placental masses protruding from the fetal surface of the placenta. Five pregnancies in which a large mass was seen protruding from the fetal surface of the placenta were studied in the period between January 2006 and January 2008. 3D and color flow imaging were settled in order to monitor the sonographic features of the mass during pregnancy, to evaluate the continuity of the solid portion of the mass with the fetal placental surface and to detect the blood flow signals within the mass. This study reports the clinical outcome and the histologic findings of five cases of subamniotic hematomas detected in the course of prenatal ultrasound examinations between January 2006 and January 2008. ⋯ The main differential diagnosis in the case of a cystic mass overlying the fetal plate of the placenta, covered by a thin membrane, during the ultrasound examination, is between a placental cyst and a large pseudocysts of the umbilical cord at the placental insertion. In the case of a pseudocyst, the transonic formation is clear and lacks of a solid mass within. The correct differential diagnosis between subamniotic hematoma and the pseudocysts of the umbilical cord is required because of the association between chromosomal anomalies and pseudocysts.
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Minerva ginecologica · Feb 2008
Review Comparative StudyEvidence-based approach for the use of ultrasound in the management of polycystic ovary syndrome.
Polycystic ovary syndrome (PCOS) is a complex endocrinopathy, affecting 5-10% of women in the reproductive age group, with a wide spectrum of phenotypes. The cardinal features are hyperandrogenism, ovulatory dysfunction and/or polycystic ovary (PCO) appearance. Three major diagnostic criteria for PCOS have been proposed by the National Institute of Health (NIH 1990), the Rotterdam European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine sponsored PCOS Consensus Workshop Group (ESHRE/ASRM 2003) and the recent task force of the Androgen Excess Society (AES 2006). ⋯ In particular, ovarian stromal area/total area (S/A) ratio seems to have the most efficient diagnostic performance for hyperandrogenism. Three-dimensional (3D) ultrasound is a relatively new imaging modality that has the potential to improve the sensitivity and specificity of ultrasound without adding much to the practical management of the syndrome. In addition to its role in the definition of PCO, ultrasound is helpful to predict fertility outcome in patients undergoing treatment.
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Minerva ginecologica · Feb 2008
Comparative StudyMetabolic and cardiovascular consequences of polycystic ovary syndrome.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting 5-10% of reproductive aged women, about 1 out of 15 women worldwide. Traditionally it was considered as a reproductive disorder showing hyperandrogenism, chronic anovulation and infertility; it is now well accepted that PCOS represents a ''multifaceted'' syndrome with substantial metabolic and cardiovascular long term consequences. ⋯ Pathogenetic mechanisms of these impairments are not completely clarified yet, but IR appears to play a critical role, such as the key factor linking hypertension, glucose intolerance, obesity, lipid abnormalities and coronary artery disease. In conclusion, although increased incidence of metabolic abnormalities and metabolic disease like type 2 diabetes, and several cardiovascular abnormalities have been widely demonstrated in PCOS women, larger and multicenter trials of long term cardiovascular outcomes are required to better define the incidence of cardiovascular risk and cardiovascular disease in PCOS.
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Minerva ginecologica · Oct 2007
Comparative Study[Endometrial ablation versus hysterectomy in women treated with tamoxifen].
The aim of our study is the assessment of the importance of the endometrial ablation versus hysterectomy in patients treated with tamoxifen for previous breast cancer. ⋯ Our results show the utility of endometrial ablation especially in selected cases in therapy with tamoxifen for previous breast cancer.
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Minerva ginecologica · Aug 2007
Review[Individualization of low-dose oral contraceptives. Pharmacological principles and practical indications for oral contraceptives].
The contraceptive pill has been a revolution of the last 40 years. In Italy, however, it is much less widely used than in other countries. Explanations for this phenomenon range from religious implications and customs to misinformation and word-of-mouth communication of negative experiences. ⋯ Since high plasma concentrations of androgens have been recorded in these women, a progesterone with antiandrogen and antiedema activity can be beneficial. Finally, it is worth recalling that monophasic pills with low estrogen doses, such as the formulations mentioned above, ensure good mood control, reducing the depressive symptoms often associated with oral contraceptive use. In conclusion, formulations containing drospirenone are a valid alternative to conventional oral contraceptives for the personalisation of these drugs.