Uterine myomas during pregnancy: a longitudinal sonographic study.

OBJECTIVE: To evaluate volumetric changes of uterine myomas (fibroids) during pregnancy. METHODS: This was an observational, longitudinal and prospective study of 38 consecutive Caucasian women with singleton pregnancies and a total of 42 uterine myomas, enrolled from a cohort of 1492 women who took part in our first-trimester Down syndrome screening program. Myoma volume was evaluated by ultrasound at 11-14, 20-22 and 32-34 weeks of gestation. RESULTS: Mean myoma volume increased significantly throughout pregnancy. Taking a volumetric change of > 10% between gestational periods to be an increase in size, 71.4% of uterine myomas increased in size between the first and second gestational periods, while this percentage was slightly lower (66.6%) between the second and third periods. Logistic regression analysis revealed that greater maternal age was correlated with a reduction/no change in overall myoma size and multiparity was correlated with a decrease/no change between the first and second trimesters, while a higher prepregnancy maternal body mass index (BMI) was correlated with a volumetric increase between the first and second trimesters and a decrease/no change between the second and third trimesters. CONCLUSIONS: Fibroids enlarge during pregnancy regardless of their initial size or local factors, and maternal age, prepregnancy BMI and parity are apparently correlated with these changes.

[Low-dose flutamide in the treatment of hyperandrogenism in adolescents]. / La flutamide a basse dosi nell'iperandrogenismo dell'adolescente.

AIM: The aim of the study was to evaluate the results of the use of flutamide at low doses for the therapy of the iperandrogenism in adolescents. METHODS: The study enrolled 35 young women with acne and irsutism; 31 had polycystic ovary syndrome (PCOS) and 4 periferic iperandrogenism. In other 8 young women, sexually active, the flutamide has been associated with the hormonal contraceptive. On the three young women with iperinsulinism it has been decided to associate the flutamide with the metformina. All the young women were checked each month for the liver functional. Before the beginning of the therapy the menstrual situation, the Body Mass Index (BMI), the Ferriman' s and Cremoncini's score, the ovary's ultrasound aspect, and the hormonal order were evaluated. Follow-up was made after three months and after six months after the beginning of the therapy with flutamide 62.5 mg/die. RESULTS: Only in 4 cases the therapy has been suspended due to collateral effects, soon regressed after one week of the treatment interruption. The results have demonstrated a overwhelming improvement of the peripheral symptoms of iperandrogenism in all patients. CONCLUSION: The authors hope that flutamide could enter in the list of medicines normally used to treat the beauty flaws of policistic acne and to restore a hormonal order associated to an effective contraception.