[Adnexal torsion caused by Fallopian tube cancer]. / Torsión anexial causada por cáncer de trompa de Falopio.

Fallopian tube cancer is the less frequent gynecological cancer. It occurs typically between 40 and 65 years old. Diagnosis is usually achieved earlier than in ovarian cancer cases, due to early symptoms (typically abdominal pain, hydro-hematorrhea and adnexal mass). Preoperative correct diagnosis is infrequent, being most cases diagnosed during the surgery or in the pathological study. Histologically and clinically is similar to ovarian cancer, being the serous low differentiated the most frequent type. An early suspicion and a correct intervention are essential to obtain correct diagnosis and treatment. Treatment protocols are similar to those of ovarian cancer recommended by the FIGO.

[Comparative study between pregnancies induced for premature rupture of membranes and for prolonged pregnancy]. / Estudio comparativo entre gestaciones finalizadas electivamente por rotura prematura de membranas y por gestación cronológicamente prolongada.

BACKGROUND: To decrease maternal and fetal morbidity oftem is indicated the elective termination of pregnancy; when the cervix is unfavourable, it is possible to try to artificially reproduce these changes with exogenous prostaglandins. OBJECTIVES: Comparative evaluation of maternal and fetal results between patients in which cervical ripening is practiced with indication of premature rupture of membranes and those with prolonged pregnancy. MATERIAL AND METHOD: Historic cohorts study about pregnancies requiring cervical ripening, either for premature rupture of membranes or for gestational age > or = 41 weeks, in the "Miguel Servet" Hospital (Zaragoza, Spain), from 15/11/2005 to 15/05/2008. In all the cases dinoprostone (slow release vaginal system) was employed and the initial Bishop score was < 7. The main analysed outcomes were: intrapartum fetal heart monitoring characteristics, type of delivery, umbilical artery pH, Apgar score, hospitalization in neonatal unit requirement and time from cervical ripening start to delivery. RESULTS: Neonatal hospitalization was significantly more frequent in the ruptured membranes cohort (11.70% vs 2.33%); p = 0.001. This difference could be justified by gestational age (OR: 2,623. IC: 0.515-13.353. P = 0.246). It was observed more time cervical ripening - delivery in prolonged pregnancies cohort (25.96h vs 20.11h); p < 0.001. Umbilical cord medium pH was significantly superior in ruptured membranes group (7.25 vs 7.23); p = 0.017. No significant differences were observed in the rest of analyzed outcomes. CONCLUSIONS: Pregnancies electively ended for premature rupture of membranes are associated with a shorter time to delivery and a slightly superior umbilical cord pH than induced prolonged pregnancies. Neonatal hospitalization requirement is determined by gestational age but not by the rupture of the membranes. Cervical ripening in those patients has been demonstrated to be secure and effective.

[Mammary ductal ectasia child. Diagnostic and therapeutic approach]. / Ectasia ductal mamaria infantil. Aproximación diagnóstica y terapéutica.

Mammary duct ectasia in childhood is a rare disease. It appears typically as a periareolar mammary mass and/or nipple discharge. Even though in the adult age is an acquired disease, its occurrence in children suggests it may constitute a development mammary gland anomaly. Sonography is highly useful in the diagnosis. Differential diagnosis must include other nipple discharge and mammary mass causes as the juvenile fibroadenoma or malignant pathology. This usually is a self-limited process, so that a conservative approach is recommended, even though occasionally surgical treatment is required. We report the case of a 13 years old girl with nipple discharge who finally was diagnosed bilateral mammary duct ectasia.

Síndrome de Meckel. Diagnóstico prenatal y diagnóstico diferencial / Meckel syndrome. Prenatal diagnosis and differential diagnosis

El síndrome de Meckel es un infrecuente y letal síndrome polimalformativo de herencia autosómica recesiva. Su incidencia oscila entre 1:1.300 y 1:140.000 nacimientos. Las malformaciones que se observan con más frecuencia son a nivel del sistema nervioso central (frecuentemente meningoencefalocele occipital), displasia renal multiquística bilateral, fibrosis hepática y polidactilia. La alteración genómica que lo produce puede localizarse en diversos loci. El diagnóstico prenatal es posible mediante sospecha ecográfica y, en muchos casos, mediante estudio del ADN fetal. Presentamos el caso de una paciente que tuvo 2 embarazos consecutivos en los que se diagnosticó dicho síndrome (AU)

Meckel syndrome is an infrequent and lethal syndrome characterized by multiple malformations. Inheritance is autosomal recessive. The incidence of this syndrome ranges from 1:1,300 to 1:140,000 births. The most common malformations are those affecting the central nervous system (usually occipital meningoencephalocele), bilateral renal cystic dysplasia, fibrotic changes of the liver and polydactyly. The associated genomic alteration can involve distinct loci. Prenatal diagnosis is feasible with ultrasound findings and, in numerous cases, with fetal DNA analysis. We present the case of a woman who had two consecutive pregnancies with a diagnosis of Meckel syndrome (AU)

Spontaneous uterine rupture caused by placenta percreta at 18 weeks' gestation after in vitro fertilization.

We report a case of spontaneous uterine rupture caused by placenta percreta at 18 weeks' gestation after in vitro fertilization. Spontaneous uterine rupture is an extremely infrequent obstetric complication that may compromise the lives of the fetus and the mother. We describe the case of a pregnant woman at 18 weeks' gestation who presented with sudden abdominal pain and severe hemoperitoneum. We noticed a uterine rupture and carried out an urgent obstetric hysterectomy. The patient died due to hypovolemic shock and severe generalized coagulopathy. The pregnancy had been obtained via in vitro fertilization techniques. The patient did not have any risk factor or antecedent. The anatomopathological study showed a fundus uterine rupture caused by placenta percreta.