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OBJETIVO Analizar las características poblacionales y los métodos diagnósticos de patología cervical para la prevención del cáncer de cérvix de tres hospitales españoles para mejorar y unificar los programas de cribado y prevención. MATERIAL Y MÉTODOS Estudio retrospectivo de las características demográficas y clínicas de 408 mujeres con patología cervical uterina diagnosticadas en 3 hospitales españoles. Se comparan los factores de riesgo, el proceso diagnóstico y la indicación de tratamiento de dos grupos: las que requirieron conización cervical (n=222) y las que no precisaron tratamiento quirúrgico (n=186). También se analizan las recomendaciones vacunales y su grado de cumplimiento. RESULTADOS Las mujeres conizadas usaron más anticoncepción hormonal y tienen un mayor hábito tabáquico mientras que el número de compañeros sexuales es mayor en pacientes no conizadas. Más del 50% de pacientes con biopsia cervical positiva presentaron un resultado igual o más grave en la anatomía patológica de la pieza quirúrgica. Existen diferencias significativas en sensibilidad y valor predictivo positivo de la citología y de la determinación de HPV entre hospitales. La recomendación de vacunación en ambos grupos fue similar, el porcentaje de mujeres que no la cumplieron fue elevado y significativamente mayor entre pacientes conizadas. CONCLUSIÓN En nuestro medio las mujeres conizadas tienen características clínicas y epidemiológicas diferentes a las no conizadas, existen diferencias entre las técnicas diagnósticas de distintos hospitales y sin embargo la concordancia entre biopsia y resultado del cono es elevada. Sigue siendo necesaria una correcta educación sanitaria en relación con la vacunación en mujeres con patología cervical.

BACKGROUND To analyse the characteristics of the population and diagnostic methods related to the cervical cancer prevention program in three different-level hospitals of a Spanish region in order to improve and unify the screening program. METHODS We retrospectively studied demographic and clinical characteristics of 408 women with cervical lesions diagnosed in three hospitals in Aragon (Spain). Correlation between risk factors, diagnosis process and conisation indication was analysed divided in two groups: conisation required (n=222) or non-conisation (n=186). We also assessed the number of vaccine recommendations made to the patients and the degree of compliance. RESULTS Conisaited women more frequently used a combined hormonal contraceptive method and are more smokers, while the sexual partners are more in women without conisation. More than 50% of women con positive biopsy was confirmed after surgical treatment. There are significant differences between sensibility and positive predictive value of pap-smear and HPV determination in different hospitals. The recombinant vaccine was recommended to both groups at a similar rate. The percentage of women who were recommended to receive the vaccine but chose not to do it, was high in both groups but significantly higher in the Conisation group. CONCLUSION In our environment conisaited women have different clinical and epidemiological profiles, there are differences between diagnosis techniques in different hospitals, however, the concordance between biopsy and definitive result is high. A good sanitary education is necessary in relation with the vaccination of women with cervical pathology.

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Objetivo: detectar mujeres con alguna complicación vascular gestacional posiblemente relacionada con trombofilia y realizar consejo anticonceptivo. Material y métodos: estudio prospectivo descriptivo que incluye todas las complicaciones vasculares gestacionales del 2012 en el Hospital Clínico Universitario Lozano Blesa de Zaragoza. Se realizó estudio de trombofilia genética, plasmática y de factores de riesgo trombótico. Se ofrecen recomendaciones de hábitos de vida y anticoncepción basadas en los criterios de elegibilidad de la Organización Mundial de la Salud. Resultados: de 351 mujeres aceptan participar 136. 46,7% presentaban al menos un factor de riesgo trombótico diferente de trombofilia. 38,2% presentaban trombofilia, siendo el 90,4% defectos únicos. Para el consejo anticonceptivo se han utilizado los criterios de elegibilidad de la Organización Mundial de la Salud así como las preferencias de cada mujer, individualizándose su riesgo, según también otros factores de riesgo trombótico. Conclusiones: la trombofilia en la obstetricia es un tema en auge, el estudio de esta asociación podría ser útil para ofrecer recomendaciones para futuras gestaciones, anticoncepción y profilaxis de enfermedad tromboembólica venosa (AU)

Objective: Pregnancy vascular complication probably related with maternal thrombophilia detection and contraceptive counsel. Material and Methods: Prospective and descriptive study including every pregnancy vascular complication in 2012 in the University Clinical Hospital Lozano Blesa of Zaragoza. A thrombophilia plasmatic and genetic, and thrombosis risk factors was accomplished. Some life habits recommendations and contraception counsel based in elegibility World Health Organization criteria were given to women. Results: From 351 women 136 agree to participate. 46.7% of patients present at least one trombotic different risk factor of thrombophilia. 38.2% present thrombophilia being the 90.4% only defaults. Contraceptive counsel were given based on World Health Organization elegibility criteria, as women preferences and individual risk according to other thrombotic risk factors. Conclusions: Thrombophilia in Obstetrics is a booming topic, this association study can be used to future pregnancy recommendations, contraception counsel and thromboprophylaxis (AU)

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BACKGROUND: Abdominal wall Actinomycosis is a rare disease associated with the use of intrauterine device and as a complication of abdominal surgery. Diagnosis is difficult because it is unusual and behaves like a malignant neoplasm. AIM: A case report is presented of a patient who had used an intrauterine device for four years and developed a stony tumour in the abdominal wall associated with a set of symptoms that, clinically and radiologically, was simulating a peritoneal carcinomatosis associated with paraneoplastic syndrome, even in the course of an exploratory laparotomy. CLINICAL CASE: The patient attended our hospital with a two-month history of abdominal pain and symptoms that mimic a paraneoplastic syndrome. The diagnosis of abdominal actinomycosis was suspected by the finding of the microorganism in cervical cytology together with other cultures and Actinomyces negative in pathological studies, confirming the suspicion of a complete cure with empirical treatment with penicillin. CONCLUSIONS: Actinomycosis should be considered in patients with pelvic mass or abdominal wall mass that mimics a malignancy. Antibiotic therapy is the first treatment choice and makes a more invasive surgical management unnecessary.

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El síndrome de ovario poliquístico es la alteración endocrino-metabólica que más frecuentemente afecta a las mujeres en edad reproductiva. Sus síntomas y signos característicos son las irregularidades menstruales, amenorrea, acné, hirsutismo, obesidad e infertilidad. El síndrome de ovario poliquístico tiene implicaciones significativas para la salud a largo plazo, que pueden conducir a morbilidad psicológica y a una calidad de vida disminuida. Este artículo revisa la literatura actual en relación con el síndrome de ovario poliquístico y la calidad de vida relacionada con la salud, y evalúa cómo algunas manifestaciones clínicas del síndrome de ovario poliquístico afectan la calidad de vida de las mujeres que lo padecen.

Polycystic ovary syndrome is the most frequent endocrine and metabolic disorder in women of reproductive age. Its characteristic signs and symptoms are menstrual irregularities, amenorrhea, acne, hirsutism, obesity and infertility. Polycystic ovary syndrome has major effects on long-term health, which can lead to psychological morbidity and decreased quality of life. This paper reviews the current literature on polycystic ovary syndrome and health-related quality of life; in addition, it assesses how some clinical manifestations of polycystic ovary syndrome affect the quality of life of women who suffer this disorder.

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Positive serum beta-human chorionic gonadotropin (beta-HCG) in reproductive-age women generally indicates a pregnancy in healthy women. Nevertheless, this result can also be associated to other different etiologies that every gynecologist must know. A case report of a 41-year-old woman who had an elevated beta-HCG serum level without pregnancy is presented, which turned out to be the first sign of lung cancer.

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Uterine artery pseudoaneurysm is a rare but serious complication of pelvic surgery (although there are some cases reported following normal delivery), which can manifest as a severe bleeding in the postoperative period. Doppler ultrasound has an important role in the differential diagnosis of the causes of postpartum hemorrhage, and should guide us to this rare complication that can benefit from treatment by uterine artery angiographic embolization. Pseudoaneurysm is typically diagnosed by symptoms associated with the rupture, causing hemorrhage. It can also be asymptomatic, may thrombose, or may cause pain. We report the case of a uterine artery pseudoaneurysm diagnosed in the second episode seven weeks after cesarean delivery.

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Cornual pregnancy is a rare type of ectopic pregnancy. Its diagnosis is challenging as the fetus usually appears as being inside the uterus on ultrasound scanning. Cornual pregnancy is more dangerous than other forms of ectopic pregnancy since a severe maternal hemorrhage can result during a cornual rupture. A case of a uterine rupture in a 14-week cornual pregnancy is reported.

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Abnormal fusion of the mullerian ducts causes variyng degrees of congenital uterine anomalies, associated with reproductive problems. Twin gestation in a case of bicornuate uterus is extremely rare and with a poor reproductive performance. We are reporting this case because there are only a few cases, less than 20, in previous reports.

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