RESUMENLos quistes ováricos fetales son la causa más frecuente de masa quística intraabdominal diagnosticada prenatalmente, con una incidencia en torno al 30%. Normalmente son un hallazgo casual en una ecografía de rutina y no se encuentran anomalías asociadas. Pueden resolverse espontáneamente o presentar complicaciones como rotura del quiste, hemorragia intraquística y torsión ovárica. Las diferentes opciones de tratamiento incluyen el manejo conservador, la punción con aspiración del quiste antenatal o neonatal o la quistectomía laparoscópica o por laparotomía. Tras su diagnóstico se recomiendan estudios ecográficos seriados, donde nos será de utilidad la ecografía 3D, ya que esta modalidad de ecografía nos permitirá reconstruir en tres planos el aparato reproductor femenino y estudiar con detalle numerosas patologías tanto uterinas como anexiales. Su uso en combinación con la ecografía Doppler mejora sustancialmente el diagnóstico precoz de las tumoraciones ginecológicas. PALABRAS CLAVE: Quiste ovárico, torsión ovárica, ecografía 3D, Doppler SUMMARYFetal ovarian cysts are the most common cause of prenatally diagnosed intra-abdominal cystic mass, with an incidence around 30%. They are usually an incidental finding on a routine ultrasound and anomalies are not associated. They may be resolved spontaneously or lead to complications such as cyst rupture, intracystic hemorrhage and ovarian torsion. Treatment options include conservative management, antenatal or neonatal cyst aspiration, laparoscopic cystectomy and laparotomy. After the diagnosis, serial ultrasound studies are recommended, 3D ultrasound will be useful for us, since this form of ultrasound allows us to reconstruct in three planes the female reproductive system and study in detail a number of both uterine and adnexal pathology. Its use in combination with Doppler ultrasonography improves significantly the early diagnosis of gynecologic tumors. KEY WORDS. Ovarian cyst, ovarian torsion, 3D ultrasound, Doppler
Background:The vaginal microbiome plays an important role in maintaining health, and there is evidence that microbial colonization of the upper genital tract can also influence successful embryo transfer. The aim of this study is to determine whether the vaginal and endometrial microbiome in people undergoing assisted reproduction techniques could affect the pregnancy rate. Results:Regarding the microbiome dynamics during the cycle, we observed a decrease in alpha diversity from the follicular to luteal phase in the control group, in contrast to a stable pattern in the repetitive implantation failure group. As for endometrial and vaginal microbiome, alpha diversity was higher in the endometrium (Shannon p = 0.0139, Simpson p = 0.046); differences were also observed in beta diversity (p = 0.001). Compared to the endometrium, the vagina showed a greater relative abundance of Lactobacillus spp. (83.17% vs 84.82%, p < 0.0001), Streptococcus spp. (1.59% vs 7.74%, p = 0.014) and Ureaplasma spp. (0% vs. 0.89%, p = 0.006), and a lower abundance of Delftia spp. (0.95% vs 0%, p = 0.0003), Anaerobacillus spp. (1.59% vs 0%, p = 0.0004), and Ralstonia spp. (3.17% vs 0%, p = 0.0006). We also observed differences in both alpha diversity (Shannon p = 0.0206, Simpson p = 0.0206) and beta diversity between groups, along with differences for Ralstonia spp. (0.09% study group and 0.73% control, p = 0.0012). Finally, the relative abundance of Lactobacillus spp. differed between patients that did not versus did achieve pregnancy (91% vs 99%, p = 0.0445 visit 1, 94.63% vs. 97.69%, p = 0.0268 visit 2, 97.73% vs 99.74%, p = 0.0492 visit 3). The relative abundance of L.reuteri was also different between groups (0.39% vs 0.17%, p = 0.0397 visit 1, 0.15% vs 0.30%, p = 0.0491 visit 3). Conclusions:The vaginal and endometrial microbiome pattern correlates with the pregnancy rate, and it is different in patients who do versus do not have repetitive implantation failures. No significant differences in the composition of the microbiome were observed through the different visits. The lack of dynamism in the microbiome pattern of repetitive implantation failure patients might reflect an
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