Clinica e Investigacion en Ginecologia y Obstetricia最新文献

{"title":"Análisis de prácticas y protocolos de formación de equipos obstétricos en distocia de hombros en hospitales españoles","authors":"K.M. Faundez-Inostroza ,&nbsp;R. Salvador-López ,&nbsp;C. Gomar-Sancho ,&nbsp;E. Jiménez-Belio ,&nbsp;A. Puertas ,&nbsp;A. Posadas ,&nbsp;M. Molina ,&nbsp;C. Riera-Claret ,&nbsp;M. Linares Aranda ,&nbsp;M.L. de la Cruz Conty ,&nbsp;Ó. Martínez-Pérez ,&nbsp;en representación de los investigadores principales del Grupo Español de Seguridad Obstétrica","doi":"10.1016/j.gine.2024.100992","DOIUrl":"10.1016/j.gine.2024.100992","url":null,"abstract":"<div><h3>Introduction</h3><p>Shoulder dystocia (SD) is an emergency with risks for mother and newborn. The training of professionals in its resolution is essential to reduce morbidity and mortality and simulation is considered a useful strategy to improve the training of obstetric teams. The aim of this study was to determine the training status of obstetric interprofessional teams in the resolution of shoulder dystocia in hospitals belonging to the Spanish Obstetric Safety Group (GESO).</p></div><div><h3>Materials and methods</h3><p>A specific survey was carried out between June and December 2023 in hospitals belonging to the GESO group to assess training in SD, addressing protocols, case registry and training programs.</p></div><div><h3>Results</h3><p>Of the 71 hospitals surveyed, 94,4% responded. These hospitals, mostly public (88%) performed 121,141 deliveries during 2022, representing 37,5% of births in Spain. The incidence of SD was 1.79% and the incidence of obstetric brachial palsy at discharge was 1,08/1000 vaginal deliveries. Regarding the management of SD, 85,1% of the hospitals follow a specific protocol and 88,1% record these cases. Regarding simulation training, 55,2% have programs, 35% of which are voluntary and annual, 5.4% are mandatory and biannual and 2.7% are mandatory and annual. 73,1% have accredited instructors (219 in total between midwives and obstetricians) and 85,1% have their own simulators.</p></div><div><h3>Conclusion</h3><p>The survey has revealed hitherto unavailable information on the training of obstetric teams and on the frequency and management of SD. Protocols exist in practically all the hospitals surveyed and the number of available SD simulation instructors in the country is noteworthy. Nevertheless, current training programs have room for improvement in order to meet international standards.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100992"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011879","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":"Neoplasia de células epitelioides perivasculares (PEComa) del tracto genital femenino: una revisión sistemática","authors":"I. Vieira Martins,&nbsp;S. Proença","doi":"10.1016/j.gine.2024.100983","DOIUrl":"10.1016/j.gine.2024.100983","url":null,"abstract":"<div><p>Perivascular epithelioid cell tumors (PEComa) are rare mesenchymal neoplasms composed by perivascular epithelioid cells that express melanocytic and smooth muscle markers. Most cases are benign, but a small group behaves malignantly. Unfortunately, as they dońt appear frequently, reliable criteria to predict malignancy have not yet been established. The PEComas of the female genital tract represent approximately 25% of the PEComas reported in the literature and the most common site of appearance is in the uterine body; less common sites include the cervix, the ovaries, the fallopian tubes, the vagina/vulva or the round or broad ligament. Uterine PEComas are not distinguishable from other uterine tumors, such as leiomyoma and leiomyosarcoma, before an anatomopathological diagnosis is made. Surgery is the most recommended primary treatment, although adjunctive therapy is generally reserved for high-risk cases. However, the best approach is not well established due to the shortage of cases described until now.</p><p>This methodical review aims to summarize, according to of current literature, what is known about the etiopathogenesis, clinical and pathological characteristics of PEComas, focusing on the approach to gynecological cases.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100983"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953369","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":"Guideline update: Systematic fetal cardiac ultrasound during the first trimester","authors":"J. Arenas Ramírez ,&nbsp;S. Fernández García ,&nbsp;E. Pérez Carbajo ,&nbsp;A. Armijo Sánchez ,&nbsp;J.A. Sainz-Bueno","doi":"10.1016/j.gine.2024.100987","DOIUrl":"10.1016/j.gine.2024.100987","url":null,"abstract":"<div><p>Fetal cardiac evaluation in the first trimester should be evaluated systematically: 1st. Heart rate. 2nd. Situs. 3rd. Cardiac axis. 4th. 4 chamber view. 5th. Outflow tract. Although its mandatory visualization is a matter of controversy and would bring us closer to a maximum protocol, current technology allows it in most cases, either directly or indirectly thanks to the three-vessel view and facilitated by the systematic use of the Color Doppler. There is evidence of its importance in contributing to increasing detection rate. We must recommend attempting its systematic evaluation, although it is difficult to consider it mandatory.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100987"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0210573X24000509/pdfft?md5=766ad3e0c608781a2b0ae563ad93a8c4&pid=1-s2.0-S0210573X24000509-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953994","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}

{"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":"2024-10-01","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":"2024-10-01","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":"2024-10-01","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: síndrome de pseudo Meigs con leiomioma uterino","authors":"J. Sánchez España,&nbsp;D.A. Sánchez Torres,&nbsp;F.J. Salazar Arquero","doi":"10.1016/j.gine.2024.100984","DOIUrl":"10.1016/j.gine.2024.100984","url":null,"abstract":"<div><h3>Introduction</h3><p>Meigs syndrome is an underdiagnosed pathology and should be suspected in the presence of an ovarian tumor associated with pleural and peritoneal effusion. In addition, it usually presents elevation of the tumor marker CA-125. All these clinical and analytical parameters improve after surgical removal of the tumor. Most cases are associated with benign ovarian tumors (fibroids). When it is associated with another type of ovarian/uterine tumor, whether benign or malignant, it is called «Pseudo Meigs Syndrome.» The diagnostic confirmation of the tumor will be histological.</p></div><div><h3>Main symptoms and/or clinical findings</h3><p>The clinical case of a patient is presented, in which a uterine tumor is observed that produces repetitive vasovagal syncope due to compression of pelvic organs, associated with right pleural effusion and ascites with mild-moderate elevation of CA-125.</p></div><div><h3>Main diagnoses</h3><p>The main suspected diagnosis is Pseudo-Meigs syndrome, due to the association of a uterine tumor with pleural effusion and ascites.</p></div><div><h3>Therapeutic interventions and results</h3><p>After resection of the tumor, which turned out to be a uterine leiomyoma, both effusions resolved and the tumor marker CA-125 normalized, corresponding to Pseudo Meigs Syndrome.</p></div><div><h3>Conclusion</h3><p>In the differential diagnosis of a pleural effusion associated with ascites, the presence of an ovarian/uterine tumor must be ruled out, since, if observed, we could be dealing with Meigs/Pseudo Meigs Syndrome; which will be confirmed by the disappearance of the pleural effusion, ascites and normalization of the CA-125 marker after surgical resection of the tumor and which represents its resolution.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100984"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977997","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":"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":"2024-10-01","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":"Preconceptional micronutrient supplementation and spontaneous pregnancy rates in women of higher reproductive age and unexplained infertility: A comparative study","authors":"J. Aschauer ,&nbsp;H. Halát ,&nbsp;M. Imhof","doi":"10.1016/j.gine.2024.100988","DOIUrl":"10.1016/j.gine.2024.100988","url":null,"abstract":"<div><h3>Background</h3><p>The mean age for women giving birth to their first child is increasing globally, with few therapeutic options to counteract an age-related decline in female fertility. This study aimed to investigate the effect of dietary micronutrient supplements on spontaneous pregnancy rates in women of advanced reproductive age with infertility of unknown etiology.</p></div><div><h3>Materials &amp; methods</h3><p>This was a retrospective, comparative study of 270 infertile women aged 35–40 years with non-pathological fertility work-up and normal male partner semen analysis attending a fertility clinic in Vienna, Austria. 146 women received an oral micronutrient preparation (omega-3 fatty acids, coenzyme Q10, vitamin E, folic acid, selenium, catechins and glycyrrhizin) daily for 6 months and subsequent monthly rates of spontaneous clinical pregnancy were compared to a control group of 124 women receiving only daily folic acid supplements. No other fertility-related interventions took place during the observation period.</p></div><div><h3>Results</h3><p>The total spontaneous pregnancy rate after 6 months was significantly higher in the study group, reaching 43.8%, compared to 29.8% in the control group (<em>p</em> <!-->=<!--> <!-->0.018). Moreover, the cumulative pregnancy rate in the study group taking micronutrient supplementation was 54.5%, and 34.1% in the control group.</p></div><div><h3>Conclusions</h3><p>The findings of this study suggest that the intake of specific micronutrients might be associated with a higher occurrence of spontaneous pregnancies and thus improvement in female fertility among women of advanced reproductive age who experience unexplained infertility.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100988"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136896","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":"2024-07-01","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}