Tumor de células de la granulosa de patrón difuso sarcomatoide. Presentación de un caso

Granulosa-cell tumors are rare malignant neoplasms characterized by a long natural history and a tendency to recur years after the initial diagnosis.     

Encuesta SEGO. Tratamiento de la amenaza de parto pretérmino en los hospitales españoles

Objective

To determine how threatened preterm labor is treated in Spanish hospitals.

Material and method

Under the aegis of the Spanish Society of Obstetrics and Gynecology, an Internet questionnaire on basic aspects of the treatment of threatened preterm labor was sent to 41 Spanish hospitals (37 public and four private hospitals).

Results

All hospitals use tocolysis in threatened preterm labor before 34th weeks. The most widely used tocolytic agent is atosiban (73,7%), followed by betamimetics (21.9%) and nifedipine (4.9%). Only 7.3% of the hospitals use tocolytics in threatened preterm labor after 34 weeks. All the hospitals use corticosteroids to accelerate lung maturation: 92.7% use betamethasone and 7.3% prefer dexamethasone. In 90% of the hospitals, steroid therapy is not repeated. In multiple pregnancies, the same steroid dose as that used in single pregnancies is administrated in all centers.

Conclusions

The most widely used tocolytic agent in Spanish hospitals is atosiban and the preferred corticosteroid is betamethasone.     

«Ganglio de la hermana María José»

Umbilical cutaneus metastases, also termed Sister Mary Joseph’s node, is a very uncommon sign and it has poor prognosis. It is asociated with malignant intraabdominal tumours and, in some cases is the only manifestation of internal malignancie. The most frequently cancer associated are gastrointestinal cancer, and secondly gynaecological cancers. Despite it’s most common histology is adenocarcinoma, we present, in this article, a case report of a seventy years old woman with an squamous cervical cancer and with a diagnostic of sindromic umbilical metastases.     

Inicio de un síndrome de Guillain-Barré durante la gestación

We present the case of a pregnant woman who developed severe Guillain-Barré syndrome in the third trimester and who required admission to the intensive care unit of the referral hospital for suspected disease progression. No clinical improvement was observed. Because the onset of diaphragm paralysis was suspected and the fetus was in the podalic position, emergency cesarean was performed. Given the rarity of onset of Guillain-Barré syndrome in pregnancy, we review this entity to improve knowledge of maternal and fetal management.     

Recurrencia del tumor ovárico de las células de la granulosa

We present the case of a 79-year-old woman who was misdiagnosed with an ovarian fibroma 5 years previously. The patient presented with pain in the right iliac fossa with leukocytosis and was diagnosed with diverticulitis. A mass was incidentally found in the anterior abdominal wall, which was later confirmed as metastasis from a granulosa cell tumor of the ovary.We provide a literature review, focussing on the clinical findings and treatment of this tumor. Few reports have been published of this uncommon entity, characterized by a long natural history and tendency to recur years after the initial diagnosis.     

Ayuno vs. dieta líquida. Estudio aleatorizado controlado para evaluar la duración de la labor de parto,tasa de cesáreas y satisfacción con la labor

Aim

To evaluate the benefits of allowing oral intake of clear liquids in terms of labor duration, the cesarean section rate, and personal satisfaction.

Methods

A randomized controlled trial was carried out to assess the effects of a clear liquid diet in a low risk population. The primary outcome was labor duration. The secondary outcome was the incidence of cesarean section. A satisfaction survey was performed within the first 2 h after delivery to evaluate the patient's perception of labor.

Results

A total of 348 patients were randomized. The mean duration of labor was 257.75 min in the liquid diet group and 288.40 min in the fasting group (p = NS). There was no statistically significant difference (per-protocol analysis and intention-to-treat analysis) in the cesarean section rate.Patients reported greater satisfaction when allowed to drink during labor than when fasting.

Conclusion

A clear liquid diet during labor did not alter the duration of labor or the cesarean section rate. Allowing a liquid diet during labor was associated with a better perception of the birth process and a higher degree of satisfaction.     

Defectos de cierre de la pared abdominal: gastrosquisis

Objetive

Gastroschisis is an abdominal wall defect, usually located to the right of the umbilical cord insertion, leading to freely floating bowel loops outside the fetal abdomen. Contact with irritants in the amniotic fluid causes the intestinal injury, the most important factor in neonatal outcome.

Methods

The incidence of this entity has increased in recent years, possibly due to improved prenatal diagnosis rates. Ultrasound diagnosis and monitoring have allowed the prevention of complications, the main cause of morbidity and mortality in these cases. Therefore, a therapeutic-diagnosis plan to coordinate the obstetrician, pediatrician and pediatric surgeon is of the utmost importance.

Conclusion

This study was conducted to analyze the most controversial issues in the monitoring and treatment of this defect, and to compare the results obtained in our center with those reported in the literature.     

Enfermedad de Paget de la mama y síndrome de Rokitansky. Una excepcional asociación

We present the case of a woman with Rokitansky syndrome who developed Paget's disease of the breast at the age of 70 years. This is the first report in the literature of the simultaneous association of these two diseases.