Targeted and tailored diagnostic strategies in women with perimenopausal bleeding: advantages of the sonohysterographic approach.

Background And Aim Of The Work: Diagnosis and treatment of endometrial pathology nowadays ranges from clinical examination to transvaginal ultrasound (TVS), saline infusion sonohysterography (SIS), hysterosalpingography (HSG) and hysteroscopy (HYS). However, many gynaecologists prescribe blind endometrial biopsies, such as Vacuum ABRAsion (VABRA), as single strategy. The purpose of this work is to evaluate whether the procedure of VABRA should still be performed alone in perimenopausal women with abnormal uterine bleeding, compared to biopsies and samples obtained after a previous transvaginal sonohysterography.

Ultrasound screening in second and third trimester of pregnancy: an update.

Ultrasound screening of structural fetal malformations is mainly based on the use of ultrasounds during the second trimester of pregnancy. The diagnostic sensibility of ultrasounds varies in the different multicentric studies reported in literature and is correlated to different factors: gestation period, type of malformation, number of ultrasounds performed, operator experience, etc. Third trimester ultrasounds may identify late-onset malformations and offer adequate information for postnatal assistance.

Diagnostic accuracy of fetal renal pelvis anteroposterior diameter as a predictor of significant postnatal nephrouropathy: second versus third trimester of pregnancy.

Objective: The objective of the study was to determine the most effective fetal renal pelvis anteroposterior diameter thresholds and the best gestational age in predicting significant neonatal nephrouropathy and neonatal nephrouropathy requiring surgery.

Study Design: Eighty-three newborns with prenatal ultrasound evidence of unilateral or bilateral fetal renal pelvis dilatation (anteroposterior diameter 4 mm or more) before the 26th week of gestation were systematically and prospectively investigated prenatally and postnatally.

Results: Receiver operating characteristic curve analysis showed that third-trimester anteroposterior diameter cut-offs were more reliable than second-trimester cut-offs in predicting significant neonatal nephrouropathy, the best threshold being 8 mm.