Accuracy of saline contrast sonohysterography in detection of endometrial polyps and submucosal leiomyomas in women of reproductive age with abnormal uterine bleeding: systematic review and meta-analysis.

OBJECTIVE: To analyze the diagnostic accuracy of two- (2D) and three- (3D) dimensional saline contrast sonohysterography (SCSH) in the detection of endometrial polyps and submucosal uterine leiomyomas in women of reproductive age with abnormal uterine bleeding compared with gold standard hysteroscopy. METHODS: A systematic review of diagnostic studies that compared 2D- and/or 3D-SCSH with hysteroscopy and anatomopathology was conducted according to PRISMA and SEDATE recommendations. The databases MEDLINE, EMBASE and The Cochrane Library were searched electronically using specific terms with no restriction on language or publication year. Quality assessment of included studies was performed using the QUADAS-2 tool. Meta-analysis was performed with the Meta-DiSk program and data presented as forest plots and summary receiver-operating characteristics (SROC) curves. Pooled sensitivity, specificity and positive (LR+) and negative (LR-) likelihood ratios of SCSH in the detection of uterine cavity abnormalities were calculated. RESULTS: A total of 1398 citations were identified and five studies were included in the systematic review and meta-analysis. Pooled sensitivity and specificity of 2D-SCSH in detecting endometrial polyps were 93% (95% CI, 89-96%) and 81% (95% CI, 76-86%), respectively, with pooled LR+ of 5.41 (95% CI, 2.60-11.28) and LR- of 0.10 (95% CI, 0.06-0.17). In the detection of submucosal uterine leiomyomas, pooled sensitivity and specificity were 94% (95% CI, 89-97%) and 81% (95% CI, 76-86%), respectively, with pooled LR+ of 4.25 (95% CI, 2.20-8.21) and LR- of 0.11 (95% CI, 0.05-0.22). 2D-SCSH had good accuracy in detecting endometrial polyps and submucosal uterine leiomyomas, with areas under the SROC curves of 0.97 ± 0.02 and 0.97 ± 0.03, respectively. Studies that analyzed the diagnostic accuracy of 3D-SCSH could not be compared due to high heterogeneity related to menopausal status, type of technique used and primary outcome being investigation of infertility. CONCLUSIONS: 2D-SCSH proved to be a highly sensitive method for detection of endometrial polyps and submucosal uterine leiomyomas, making it a potential first-line diagnostic method in the work-up for women with abnormal uterine bleeding. More studies are needed on 3D-SCSH in women of reproductive age. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

[A case of meconium peritonitis]. / Su un caso di peritonite da meconio.

A case of meconium peritonitis that was diagnosed ultrasonographically in the second trimester is presented. Fetal ascites, intra-abdominal calcification and polyhydramnios were detected on antenatal ultrasonography.

[Medically managed delivery under CT 1341 (althesin (Glaxo)) anesthesia]. / Il parto medico pilotato in narcosi con CT 1341 (althesin Glaxo).

The Authors, after illustrating the pharmacological and physiological characteristics of CT 1341 (Althesin Glaxo), have experimented this medicine in medico-piloted delivery under narcosis on two homogenous groups of 20 patients each. The Authors have evidenced the lack of any harmful effect on the proceeding of labour, the viability of the infant, the delivery of the placenta and on post-partum, provided that a time of induction not too premature with regard to the evolution of labour be respected.

[Study of the behavior of hepatic function and blood coagulation in the course of oral administration of an estroprogestogen in low dosage]. / Studio del comportamento della funzionalità epatica e della emocoagulabilità nel corso di somministrazione di un estroprogestinico a basso dosaggio per via orale.

PIP: To study its effects on liver functions and on blood clotting, a new oral contraceptive (OC) containing 0.5 mg of quingestanol acetate, and 0.05 mg. of ethinyl estradiol was administered to 12 patients, aged 21-40, for 3 consecutive cycles. The patients were accurately examined before treatment, at the 2nd and 3rd month, and again 1 month after suspension of treatment. There were no significant modifications of clinical symptoms, or modifications of laboratory tests. In 5 cases only there was an increase in bilirubinemia; in a few other patients there were thromboelastogram variations. Both changes were not serious enough to cause either liver dysfunction or thromboembolism. It is, however, extremely important to examine regularly any patient on OC.^ieng