Clinica e Investigacion en Ginecologia y Obstetricia最新文献

{"title":"Impacto del test prenatal no invasivo en la detección de aneuploidías","authors":"C. Valldecabres Ortiz,&nbsp;F. De la Fuente García,&nbsp;S. Górriz Pintado","doi":"10.1016/j.gine.2024.100985","DOIUrl":"10.1016/j.gine.2024.100985","url":null,"abstract":"<div><h3>Background</h3><p>The non-invasive prenatal test (NIPT) is a screening test that allows for conducting a screening of major chromosomal abnormalities in the fetus during pregnancy using maternal blood. In February 2019, NIPT was included as part of the prenatal diagnosis for genetic anomalies during the first trimester of pregnancy by the Public Health System of the Valencian Community.</p><p>The objective is to assess the diagnostic and economic performance of NIPT in pregnant women within our Department since its implementation.</p></div><div><h3>Methods</h3><p>A retrospective observational study was conducted, analyzing NIPT performed since its integration into the screening for chromosomal abnormalities in pregnant women within our department. The analysis includes the number of invasive tests conducted, improvements in the detection of studied chromosomal abnormalities, and the economic feasibility in comparison to invasive testing.</p></div><div><h3>Results</h3><p>A total of 4719 combined first and second-trimester screenings were conducted with a population coverage of 98%, of which TPNI was indicated in 337 patients. Aneuploidies were detected in 4 patients: two cases of Down syndrome, one case of Patau syndrome, and one case of Turner syndrome, with the first three confirmed and the latter resulting in a false positive. The sensitivity obtained was 100%, and the specificity was 99% (95% CI). The economic savings amounted to €52,035.90.</p></div><div><h3>Conclusions</h3><p>TPNI is a highly sensitive test with high specificity. Since its incorporation into the screening for aneuploidies in pregnant women, the performance of invasive tests has been reduced, resulting in a corresponding decrease in the risk of fetal loss and significant economic savings.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100985"},"PeriodicalIF":0.1,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preeclampsia como factor de riesgo de enfermedad cardiovascular en el futuro: etiopatogenia e implicación en la práctica clínica","authors":"M. Moreno López","doi":"10.1016/j.gine.2024.100972","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100972","url":null,"abstract":"<div><p>Preeclampsia is a gestational disorder that associates arterial hypertension and organic disfunction and can have adverse consequence to both mother and fetus in the short term. The main factor implicated in its pathogenesis is an anormal placentation leading to endothelial dysfunction, as well as to the dysregulation of physiological pathways. Last evidence suggests that preeclampsia can also lead to long-terms outcomes, such an increase incidence of chronic disease, renal dysfunction and increased cardiovascular risk. This paper reviews the long-term cardiovascular consequences, their pathogenesis and the implications for clinical practice.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100972"},"PeriodicalIF":0.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Síndrome de Joubert: un reto para el diagnóstico prenatal","authors":"V. de Miguel Sánchez,&nbsp;S. López Casal,&nbsp;M. Sánchez-Andrade","doi":"10.1016/j.gine.2024.100973","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100973","url":null,"abstract":"<div><h3>Introduction</h3><p>Joubert syndrome and related disorders constitute an autosomal recessive hereditary disease, whose incidence is estimated at one case per 80,000 to 100,000 live births. It represents a developmental delay secondary to multiple congenital abnormalities, predominantly cerebellar and brainstem.</p></div><div><h3>Clinical findings</h3><p>A 37-year-old pregnant woman with an intermediate risk result in the first trimester chromosome screening. Finding in the second trimester obstetric ultrasound, absence of inferior cerebellar vermis, dysplasia of the superior vermis, vertical disposition of both cerebellar hemispheres and horizontal superior cerebellar peduncles. In the fetal resonance the presence of the «Molar tooth sign» is confirmed.</p></div><div><h3>Main diagnoses</h3><p>Cystic anomalies of the posterior fossa, specifically the Dandy-Walker malformation and Joubert syndrome.</p></div><div><h3>Therapeutic interventions and results</h3><p>Genetic study after amniocentesis, QF-PCR, Arrays CGH, without pathological findings and normal fetal karyotype of 46 XX. Confirmation was achieved by massive sequencing of 13 genes related to Joubert syndrome, evidencing the existence of 2 heterozygous pathogenic variants of the <em>CPLANE1</em> gene, each one from a parent.</p></div><div><h3>Conclusion</h3><p>Joubert Syndrome represents a challenge within prenatal diagnosis, due to its heterogeneous clinical, phenotypic and genetic presentation. This work presents the diagnostic complexity and contributes to the literature another case that allows to improve its future diagnosis.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100973"},"PeriodicalIF":0.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentación polipoide de un carcinosarcoma primario de vagina. Un caso clinicopatológico de esta neoplasia excepcional","authors":"R. Sarabia Ochoa ,&nbsp;J.P. García de la Torre ,&nbsp;A. Amezcua Recover","doi":"10.1016/j.gine.2024.100971","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100971","url":null,"abstract":"<div><h3>Introduction</h3><p>Gynecological carcinosarcoma, also called malignant mixed Müllerian tumor, is a rare, heterogeneous, aggressive, malignant neoplasm. The vagina as a primary site of carcinosarcoma is exceptional.</p></div><div><h3>Main symptoms and/or clinical findings</h3><p>95-year-old woman who consulted for vaginal bleeding. The gynecological examination revealed a polypoid tumor dependent on the right lateral wall of the vagina.</p><p>Main diagnoses, therapeutic interventions and results The CT radiological study identified a tumor measuring 6<!--> <!-->×<!--> <!-->3,4<!--> <!-->×<!--> <!-->3,5<!--> <!-->cm, which occupied the lower third of the vagina. The polypoid mass was excised in fragments, with resection of its base in the right medial 1/3 of the vagina. The histological study corresponded to a malignant spindle-cell neoplasm with areas of high cell density, intersecting fascicles and multiple edematous areas, with spindle-shaped or stellate-shaped cells with intense nuclear atypia and monstrous bizarre cells. Chondroid-like or myxoid appearance foci, frequent atypical multinucleated giant tumor cells, mitosis and some foci with evident epithelial differentiation in the form of poorly differentiated carcinoma were observed. The diagnosis was carcinosarcoma. Considering the patient's age, it was decided to perform follow-up without further interventions. Currently, one year after diagnosis, the patient has no evidence of recurrence.</p></div><div><h3>Conclusion</h3><p>Primary malignant neoplasms of the vagina are very rare. Vaginal carcinosarcoma is an extremely rare neoplasm that occurs in elderly women. The prognosis is poor and more studies are needed to better understand this neoplasm.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100971"},"PeriodicalIF":0.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of single-dose methotrexate treatment success in ectopic pregnancies: A retrospective cohort study","authors":"V. Chegini ,&nbsp;H. Pakniat ,&nbsp;M. Shora ,&nbsp;M. Mirzadeh ,&nbsp;F. Lalooha ,&nbsp;V. Chegini ,&nbsp;M.D. Griffiths ,&nbsp;Z. Alimoradi","doi":"10.1016/j.gine.2024.100967","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100967","url":null,"abstract":"<div><h3>Objective</h3><p>The present study investigated the predictors of single-dose (50<!--> <!-->mg/m²) methotrexate (MTX) treatment success in ectopic pregnancies.</p></div><div><h3>Method</h3><p>A retrospective cohort study was conducted using information databases from a single academic tertiary care hospital among 396 participants referred for treatment of ectopic pregnancy (EP). Data were collected on age, history of EP, basal level of β-hCG, features of vaginal ultrasound (left or right), mass size, presence of hematoma around the mass and free pelvic fluid, and demand of subsequent doses of MTX or surgery. The patients were divided into success and failure groups based on whether they were treated with a single-dose of methotrexate (single dose MTX), or required subsequent doses of MTX or surgery.</p></div><div><h3>Results</h3><p>The success rate of single-dose MTX treatment was approximately 74%. The failure chance was significantly higher in right adnexal masses (OR: 3.45), history of EP (OR: 28.19), presence of hematoma on ultrasound (OR: 26.69), and serum β-hCG<!--> <!-->&gt;<!--> <!-->719<!--> <!-->mIu/ml (OR: 5.19). A mass size<!--> <!-->&gt;<!--> <!-->19<!--> <!-->mm was associated with a 79% increased chance of failure (<em>p</em> <!-->=<!--> <!-->0.10). These variables accounted for approximately 45–66% of the failure variance for single-dose MTX treatment. Based on ROC curve analysis, initial β-hCG level of 719<!--> <!-->mIu/ml was the best cutoff for patients with EP (with a sensitivity of 82% and specificity of 63%).</p></div><div><h3>Conclusion</h3><p>The treatment outcome of single dose MTX can be successfully predicted based on the previous history of EP, the presence of hematoma on ultrasound, mass location, and measurement of β-hCG levels before treatment.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100967"},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malaria grave en gestante con trombocitopenia severa y afectación placentaria: manejo en zona no endémica. A propósito de un caso","authors":"A. Llamazares de la Moral ,&nbsp;M.J. Cuerva ,&nbsp;J.L. Bartha","doi":"10.1016/j.gine.2024.100969","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100969","url":null,"abstract":"<div><h3>Introduction</h3><p>Malaria presents a significant challenge during pregnancy, even in non-endemic environments like Spain. Pregnant women face severe complications due to placental parasite accumulation, leading to conditions such as severe anemia, miscarriage, intrauterine growth restriction, and perinatal death. In this article, we present a clinical case illustrating the complexities and successful management strategies of malaria during pregnancy in a non-endemic setting.</p></div><div><h3>Major symptoms and clinical findings</h3><p>A 37-week pregnant woman from Equatorial Guinea presents with fever and hemoptoic sputum. Laboratory analysis reveals severe thrombocytopenia, anemia, and hyperbilirubinemia, prompting suspicion of malaria.</p></div><div><h3>Major diagnoses, therapeutic interventions and outcomes</h3><p><em>P.<!--> <!-->falciparum</em> antigen is detected in the blood, meeting criteria for severe malaria based on clinical and analytical findings. Treatment with intravenous artesunate results in rapid parasitemia reduction. On the second day, the patient enters labor and undergoes a eutocic delivery, giving birth to a healthy baby girl with negative <em>P.<!--> <!-->falciparum</em> antigen. Parasites are found in the placental intervillous space upon analysis. Postpartum oral therapy with dihydroartemisinin-piperaquine proceeds without incident. Discharge occurs three days later.</p></div><div><h3>Conclusions</h3><p>Effective management of malaria during pregnancy requires early suspicion, a multidisciplinary approach, and targeted treatment to optimize maternal-fetal outcomes. Vaginal birth at term is recommended to mitigate perinatal complications and promote maternal recovery. Oral dihydroartemisinin-piperaquine therapy emerges as a promising option for postpartum preventive treatment, yielding favorable short- and long-term results.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100969"},"PeriodicalIF":0.1,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descripción de un caso. Duplicación del cromosoma 1q: diagnóstico prenatal, manifestaciones ecográficas y pronóstico perinatal","authors":"M.C. Restrepo-Guarnizo ,&nbsp;I. Dávila Neri ,&nbsp;R.L. Aragón Mendoza","doi":"10.1016/j.gine.2024.100968","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100968","url":null,"abstract":"<div><h3>Introduction</h3><p>Mosaicism due to duplication of chromosome 1q is recognized as a cytogenetic anomaly, characterized by low frequency and few cases reported in the literature.</p></div><div><h3>Clinical findings</h3><p>In this case, we present a primigravida patient at 24 weeks of pregnancy, with a fetus displaying abnormal ultrasound findings. These include ventriculomegaly, micrognathia, hypotelorism, and associated diaphragmatic hernia.</p></div><div><h3>Primary diagnoses</h3><p>Amniocentesis was performed, and karyotype analysis revealed a prenatal diagnosis of mos 46,XY,dup(1)(q23q44)[19]/46,XY[41] mosaicism. Subsequently, the patient experienced preterm delivery with early perinatal demise.</p></div><div><h3>Therapeutic interventions and outcomes</h3><p>Due to the lack of evidence regarding fetal therapy and the prenatal diagnosis of this condition, postnatal assessment was awaited for appropriate therapeutic management. Subsequently, the patient had preterm delivery with early perinatal death.</p></div><div><h3>Conclusion</h3><p>Heterogeneity of findings is observed to depend on the size and location of the chromosomal alteration, and factors such as the concurrent development of diaphragmatic hernia are associated with a poorer prognosis and higher rates of mortality due to the degree of pulmonary hypoplasia.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100968"},"PeriodicalIF":0.1,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141439280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preservación de la fertilidad en el paciente pediátrico y adolescente con cáncer","authors":"M. Andrés Moreno ,&nbsp;H. Martínez Sánchez ,&nbsp;F. Moreno Macián","doi":"10.1016/j.gine.2024.100966","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100966","url":null,"abstract":"<div><p>The significant increase in pediatric and adolescent cancer survivors in the last few decades, has highlighted on options to minimize long-term side effects related to treatment. Fertility preservation alternatives in girls after a cancer diagnosis are moving from being considered experimental to becoming an increasingly widespread healthcare practice. On the other hand, the real possibilities in prepubertal boys still have a longer way to improve. Since these are minor and especially vulnerable patients, multidisciplinary work is essential, with homogeneous criteria in patient selection and application of techniques. The following publication summarizes the state of the art on this subject, emphasizing the differentiating features in relation to the adult population.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 3","pages":"Article 100966"},"PeriodicalIF":0.1,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141067919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual self-concept and intimacy in context of vaginismus: A case–control study","authors":"M. Banaei ,&nbsp;F. Alidost ,&nbsp;H. Shahrahmani ,&nbsp;F. Yazdani ,&nbsp;Z. Sepehri ,&nbsp;N. Kariman","doi":"10.1016/j.gine.2024.100965","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100965","url":null,"abstract":"<div><h3>Background</h3><p>As sexuality and its related issues are significantly associated with sociocultural settings, addressing the sexual health status of individuals in different societies is of the utmost importance. Women with vaginismus have more stress, anxiety, depression, and they also feel hopeless and have low self-esteem. And this problem can disturb intimacy between couples and women's sexual self-concept. Therefore, the present study was to determine and compare sexual self-concept and intimacy in women presenting with and without vaginismus.</p></div><div><h3>Methods</h3><p>This case–control study was conducted in 2021–2022 on 240 women with and without vaginismus, referring to selected sexual health clinics based in Iran. The data collection tools recruited were the demographic characteristics’ information, the Multidimensional Sexual Self-Concept Questionnaire, and the Sexual Intimacy Scale. To calculate the odds ratio of the studied variables, the logistic regression analysis using the SPSS Statistics software (ver. 25) was also employed.</p></div><div><h3>Results</h3><p>The mean age of women with and without vaginismus was 27.85<!--> <!-->±<!--> <!-->4.62 and 28.51<!--> <!-->±<!--> <!-->4.34, respectively. According to the regression results, the variables of sexual intimacy (odds ratio (OR)<!--> <!-->=<!--> <!-->0.864, <em>P</em> <!-->&lt;<!--> <!-->0.001), sexual awareness (OR<!--> <!-->=<!--> <!-->6.090, <em>P</em> <!-->=<!--> <!-->0.003), sexual-anxiety (OR<!--> <!-->=<!--> <!-->1.613, <em>P</em> <!-->&lt;<!--> <!-->0.001), fear of sex (OR<!--> <!-->=<!--> <!-->1.338, <em>P</em> <!-->=<!--> <!-->0.021) and sexual problem prevention (OR<!--> <!-->=<!--> <!-->0.765, <em>P</em> <!-->=<!--> <!-->0.016) were significantly associated with vaginismus.</p></div><div><h3>Conclusions</h3><p>According to these results, sexual intimacy, sexual awareness, sexual-anxiety, fear of sex and sexual problem prevention were significantly associated with vaginismus. Therefore, it is suggested that for the treatment of women with vaginismus, interventions can be designed to improve sexual intimacy, sexual knowledge and positive sexual self-concept and reduce sexual anxiety.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 3","pages":"Article 100965"},"PeriodicalIF":0.1,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140947760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine leiomyoma in adolescents: A case report and a review of the literature","authors":"M. Derme ,&nbsp;M. Briante ,&nbsp;G. Masselli","doi":"10.1016/j.gine.2024.100957","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100957","url":null,"abstract":"<div><h3>Introduction</h3><p>Fibroids are common benign gynecological tumors but a rare finding in adolescents. Although infrequent, some symptomatic cases have been described in literature.</p></div><div><h3>Main symptoms and/or clinical findings</h3><p>A 16-year-old Caucasian patient came to our attention for abdominal pain and dysmenorrhea appeared two months before. Her gynecological history was characterized by regular menstrual cycles, normal in quantity, with dysmenorrhea. Bimanual pelvic examination revealed an anteverted mobile uterus, no adnexal tenderness or masses. Speculum examination showed a normal cervix. No vaginal bleeding or discharge was observed during the visit.</p></div><div><h3>Main diagnoses</h3><p>Transabdominal/transvaginal ultrasound demonstrated an anteverted uterus of 71<!--> <!-->mm<!--> <!-->×<!--> <!-->44<!--> <!-->×<!--> <!-->48<!--> <!-->mm, with a heterogeneous myometrial structure and a hypoechoic subserosal-intramural mass (FIGO leiomyoma subclassification system: O-4) localized in the posterior uterine wall, measuring 26<!--> <!-->mm<!--> <!-->×<!--> <!-->19<!--> <!-->mm<!--> <!-->×<!--> <!-->16<!--> <!-->mm, slightly vascularized at the Color-Doppler (Color Score 2). Magnetic resonance imaging confirmed the ultrasound diagnosis.</p></div><div><h3>Therapeutic interventions and outcomes</h3><p>Considering pelvic mass dimension and the patient age, a “wait and see” approach was chosen and the patient was re-evaluated a month and three months after the first ultrasound. The second and the third transvaginal ultrasound exam showed an unchanged picture.</p></div><div><h3>Conclusion</h3><p>The management of leiomyoma in young patients should be targeted to dimension and symptoms of the mass. When facing myomas of small dimension, paucisymptomatic or asymptomatic, with no signs of malignity, we suggest an expectant management.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 3","pages":"Article 100957"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0210573X24000200/pdfft?md5=5ec3b3e49dd3a680d3c03852355e179b&pid=1-s2.0-S0210573X24000200-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140338603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}