Asunto(s)
Anemia Megaloblástica/complicaciones , Preeclampsia/complicaciones , Adulto , Anemia Megaloblástica/diagnóstico , Anemia Megaloblástica/terapia , Transfusión Sanguínea , Femenino , Ácido Fólico/administración & dosificación , Humanos , Preeclampsia/diagnóstico , Preeclampsia/terapia , Embarazo , Resultado del EmbarazoAsunto(s)
Síndrome de Klippel-Trenaunay-Weber/cirugía , Complicaciones Cardiovasculares del Embarazo/cirugía , Adulto , Pérdida de Sangre Quirúrgica , Transfusión Sanguínea , Cuello del Útero/irrigación sanguínea , Cesárea , Femenino , Humanos , Embarazo , Vagina/irrigación sanguínea , Várices/etiología , Vulva/irrigación sanguíneaRESUMEN
Uterine balloon ablation (UBT) is an established treatment of women with menorrhagia. Success rates in terms of amenorrhoea following UBT vary between about 15 and 40%. The aim of these case reports was to attempt to explain some of the reasons behind the low amenorrhoea rate as well as the variation seen in outcome. This was facilitated by intraoperative ultrasound observation of the position of the heater element within the uterine cavity, including its proximity to the endometrial walls and the direction of microbubbles produced by the heater element. These findings were then correlated with postoperative ultrasound findings and clinical outcome. The position of the balloon catheter within the uterine cavity varied and we hypothesise that this may have an effect on outcome. A thin postoperative endometrium on ultrasound signifies successful ablation, yet is not always associated with a cessation of troublesome menorrhagia, nor patient satisfaction.
Asunto(s)
Cateterismo , Histeroscopía/métodos , Monitoreo Intraoperatorio/métodos , Hemorragia Uterina/diagnóstico por imagen , Hemorragia Uterina/terapia , Adulto , Femenino , Humanos , Cuidados Intraoperatorios , Menstruación , Persona de Mediana Edad , Satisfacción del Paciente , Cuidados Posoperatorios , Resultado del Tratamiento , Ultrasonografía , Hemorragia Uterina/fisiopatologíaRESUMEN
OBJECTIVE: To test a new software package (Color Quantifier, Kinetic Imaging, Liverpool, United Kingdom) that quantifies power Doppler energy and to determine its reproducibility. DESIGN: Intraobserver and interobserver reproducibility study. SETTING: University tertiary referral center. PATIENT(S): Transvaginal power Doppler ultrasound images were recorded from women taking part in a study evaluating the physiological vascular changes in the uterus and ovaries during the normal menstrual cycle. INTERVENTION(S): Nineteen consecutive frames of regions of interest in the uterus, ovary, and follicle, respectively, were analyzed by each of four observers on 10 occasions. MAIN OUTCOME MEASURE(S): Analysis of variance to determine the image and observer effect as well as the intraobserver and interobserver coefficients of variation. RESULT(S): Significant image and observer effects were found. However, the image effect was by far the largest component of the total variation. The large image-to-image variability was expected because the cardiac cycle was included within the 19 frames (images) analyzed. The combined intraobserver and interobserver variation, expressed as the coefficients of variation, was found to be small for the above indices (as low as 1.9%), particularly for total ovary and endometrium. CONCLUSION(S): The indices obtained with this color quantification software are reproducible in an in vitro setting using prerecorded images. Its applicability as a useful assay in the clinical setting requires further evaluation.