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The authors report their experience of the ultrasonic follow-up of endometriomas after laparoscopic enucleation. Fifty women with sixty-six endometriomas were treated: the average diameter of the endometriomas is 4.2 cm. The clinical and ultrasonic follow-up of 21 months shows: -the disappearance of the ovary's solution of continuity after laparoscopic enucleation of the endometriomas; -the persistence of deep endometriomas; -the presence of residual fragments of the endometrioma's capsule; -the appearance of relapsing endometriomas.

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This study analyzes 13 cases of pregnant women affected by varying degrees of preeclampsia, and correlates the patients' data (height, weight, preeclampsia symptoms according to intensity and time of onset) to the amount of mean daily intake of nutrients (proteins, lipids, carbohydrates, starch, total calories, Na). The amount of nutrients was obtained processing with a special computer software the patients' weekly dietary diaries. The analysis of the data shows the correlation between the onset of preeclampsia symptomatology and the excess of certain nutrients: excess in calories and/or proteins, and/or lipids, and/or simple sugars, and/or sodium. A reduction in the amount of these nutrients, especially proteins and Na when applied during the early stage of preeclampsia symptoms, favours the disappearance of the clinical signs of the disease.

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The authors report their experience in endometrial ablation, a new hysteroscopic surgery technique, which is now proposed as an alternative to hysterectomy in cases of persistent uterine bleeding like meno-metrorrhagia not supported by myoma or endometrial atypia. The clinical indications and the resectoscopic technique are treated. From 1-1-1992 to 31-10-1993 14 women were treated with partial endometrial ablation and the result was good (shorter menstruation) in 80% and amenorrhea took place in 20%. The authors carried out an hysteroscopic follow-up in seven women which showed smaller uterine cavity with some adhesion and in all cases it was possible to perform biopsy with Novak cannula.

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Prenatal screening for Down's syndrome (DS) can be achieved by combining maternal age risks and maternal serum additional parameters (AFP, HCG, uE3) by computer assisted statistical analysis. Nevertheless this measure of risk is far from broad and practical application in Italy, due to cultural and organization difficulties. So we suggest a different technical approach, the age specific risk being multiplied by the HCG/AFP likelihood ratio. HCG and AFP can be tested by an automated Elisa assay, and calculations performed by a simple method, excluding computer and software package use. About 100 pregnancies were evaluated both by a modified version of the Wald test and the method described hereafter. Using the automated HCG and AFP Elisa Testing and Crossley statistical calculation a higher False Positive Rate was observed. On the other hand no different Detection Rate was observed for the two tests. On a retrospective study we found that 5 sera from affected pregnancies were correctly identified both by the modified Wald test and the other method. It is concluded that, despite different False Positive Rates, the choice of which test to use depends on evaluation of local resources, one test being easier-to-perform and more sensitive, the other one probably being more specific but more difficult to perform.

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The authors make a careful examination of a very new surgical hysteroscopic technique, endometrial ablation, which is proposed as an alternative to hysterectomy in cases of persistent uterine bleeding not supported by endometrial atypia or adenocarcinoma. In addition to examining the indications for this type of surgery the authors also assess the state of the art of two techniques currently used: the laser technique and the method based on electroresection. The risks, benefits, collateral effects and results are evaluated for each method.

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The authors report their experience regarding the use of ultrasonic instruments to control the postoperative iter of gynecological, oncological or urological surgery. These types of surgery may be complicated by urethral lesions, retroperitoneal or subfascial sero-hematic stasis, lymphocele, urethrohydronephrosis or vescical dysfunctions with urinary stasis which, if identified at an early stage, can be resolved by surgery. Out of 88 cases of gynecological surgery with a high risk of complications which were followed using ultrasound during the postoperative period, complications occurred in 11 cases (12.5%): their early identification also enabled adequate treatment to be performed using an echo-guided aspirated needle technique or using the application of drainage catheters.

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The risks connected with children's cerebral lesions are examined by means of two different surveys related to a retrospective study over a period of about 10 years. One of these surveys is clinical and is based in the obstetric case history of children carrying psychomotor handicaps. The other survey is instrumental and concerns 100 cases of pathologic cardiotocography during labour associated with fetal suffering. The results of border surveys are discusses. For the assessment of the obstetric risk the sum of the pathologic conditions that emerged during pregnancy and delivery have to be taken into consideration. Cardiotocography is still a fundamental diagnostic examination to recognise the suffering fetus and the data collected real a close association between cardiotocography diagnosis and the conditions of the baby at the birth.

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The study reports on the follow-up in 25 cases of uterine sarcoma from 1979 to 1988. 56% of them are leiomyosarcoma, 28% mixed mullerian tumors and 16% sarcoma of the endometrial stroma. The women affected are mostly 40 to 70 years old; 80% of them are pluriparae, in menopause for 64% of them at the time of the diagnosis. Metrorrhagia is the initial symptom in 72% of the cases, 76% of which diagnosed after surgical intervention. The majority of the surgical interventions are integrated with chemo and/or radiotherapy. After three years 66.6% are surviving at the first stage, 33.4% at the second stage, none at the third stage.

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The influence of maternal corticosteroid administration was studied on the ACTH and cortisol concentrations in neonatal blood of 24 premature infants whose mothers received betamethasone for prevention of RDS, compared with 11 untreated subjects. Cord blood was taken at birth and from venous sample in 5th day. All samples were analyzed for ACTH and Cortisol by radioimmunoassay. No statistically significant differences between these groups were noted. Additional analysis of ACTH and Cortisol levels in 9 RDS premature infants versus 26 control ones failed to demonstrate any deficiency of corticosteroids in newborn infants with RDS. The findings provide a justification for the prepartum treatment of respiratory distress syndrome with glucocorticoids because this dose of betamethasone does not expose the newborn to potentially harmful effects.

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