Serum CA125 level modifications in women undergoing repeated IVF cycles.

In the present paper, serum CA125 modifications in patients undergoing their first IVF cycle were compared with those of patients in their second attempt. A significant increase of this marker was detected in each group of patients at day 14 after embryo transfer. However, the level of CA125 monitored in the patients in their second attempt was significantly higher than that determined in patients undergoing their first ovarian stimulation. This condition does not influence either ovarian response or oocyte and embryo quality. Moreover similar IVF outcome was obtained. Therefore we propose that patients undergoing repeated assisted reproductive technology (ART) cycles may suffer from ovarian surface epithelial damage and/or altered cellular growth rate.

Pelvic relapses in ovarian cancer. Role of CA-125, transvaginal ultrasound and color Doppler.

From January 1995 to January 2001, 40 patients with epithelial ovarian cancer were treated at our Institution. Fourteen of these, with a clinical CR after surgery and platinum-based chemotherapy, were evaluated monthly by gynecological examination, Ca-125 RIA assay, pelvic ultrasound with transabdominal and transvaginal probe and color Doppler. Six pelvic relapses, from 1.5 to 3.0 cm, were detected by transvaginal ultrasound (US). They showed a rich neovascularization with low resistance, high flow, PI from 0.3 to 1.0 and RI < 0.5 in all cases. US did not reveal any sign of relapse in the remaining eight patients. In all cases of pelvic relapses ultrasonic signs of recurrence preceded the increase of Ca-125 by one to six months (average 3.8).

[CIN: multicentric study of therapeutic strategies]. / CIN: studio multicentrico sulle strategie terapeutiche.

BACKGROUND: Cervical Intraepithelial Neoplasia (CIN) is a dysplastic lesion that precedes cervical cancer. The diagnosis is made by colposcopic, cytologic and bioptic exams. Therapy may be physical, pharmacological or surgical. METHODS: We prepared a model of interview (consisting of 9 questions) for 33 colposcopic centers in the Lazio region. Our aim was to evaluate their therapeutic strategies for CIN and cervical condylomata. We referred to SIGO 1999 guidelines for CIN therapy and to European guidelines for cervical condylomata therapy. RESULTS: The centers used drugs more for HPV infections (57%) than for dysplasia (33%). Drug therapy was used more in the past (66.67%). Actually they prefer treating CIN I with electrocoagulation diathermy (DTC), CIN II with loop electrosurgical excision procedures (LEEP) or Laser, CIN III with cold knife conization or LEEP, cervical condylomata with laser or DTC. CONCLUSIONS: The results show that the centers prefer physical therapy. Therapeutic strategies comply with SIGO 1999 guidelines for therapy of CIN and with European guidelines for cervical condylomata partially.

[Bleedings during the third term: which complications?]. / Emorragie del terzo trimestre: quali complicanze?

BACKGROUND: The aim of this research was to study the maternal and prenatal complications which may occur in the abruptio placentae and in placenta praevia. METHODS: All the patients who were hospitalized in the Obstetrics and Gynaecology Department of the Policlinico Umberto I, from January 1993 to July 2000 have been studied. Moreover, a comparative study between the onset of complications of the two pathologies considered and the ones found in a control group was carried out. We found 62 cases of placenta previa and 48 cases of abruptio placentae. The total amount of childbirths was 6861, so the incidence of abruptio placentae was 0.007%, while the incidence of placenta previa was 0.009%. RESULTS: The results show that the most frequent maternal complication, in both pathologies, was haemorrhage. We did not find any statistically meaningful difference between the percentage of haemorrhage in the two pathologies ( p=0.0608), but we noted a higher percentage of haemorrhage compared to the control group. The number of hysterectomies was higher in patients with placenta previa compared to patients with abruptio placentae. The most frequent fetal complication was premature birth, significantly more frequent than in the control population (p=0.0210). CONCLUSIONS: As a matter of fact, we can affirm that, in all its clinical manifestations abruptio placentae is a more dangerous disease than the placenta previa, except in the complications of the discharge of the afterbirth and of the postpartum, where haemorrhage and uterus atony lead to a great number of hysterectomies.