Compared with hysterectomy, UAE is safe and effective for treatment of bleeding fibroids, necessitates a shorter hospital stay, and results in fewer major complications.
A prospective study of 40 women diagnosed as suffering from tubo-ovarian abscesses was carried out in order to compare the outcome after treating these abscesses with intensive antibiotic therapy alone or in association with early ultrasound-guided vaginal drainage. Patients were assigned to two groups, distributed on a random basis, with a clinical and ultrasound diagnosis of tubo-ovarian abscess of less than 10 cm maximal diameter. Both groups received an antimicrobial combination of clindamycin and gentamicin. In the study group, we performed, in addition, early transvaginal drainage of the abscess. Both short-term (48-72 h) and medium-term (4 weeks) responses to the treatment were evaluated. In the study group we observed a favorable short-term response in 90% of the cases, whereas this was 65% in the control group. In the medium-term follow up, one patient in the study group and three in the control group had an adnexal mass on transvaginal sonography.
Objectives. The purpose of this study was to assess intraobserver and interobserver reproducibility of the parameters of ovarian response and oocyte ability, studied by 3-dimensional ultrasonography and power Doppler angiography (PDA), and the possible influence of the ovarian functional stage. Methods. Twenty-nine women were included in an in vitro fertilization program. Fourteen women were evaluated after pituitary suppression (basal group), and 15 were scanned on the human chorionic gonadotropin administration day, after gonadotropin ovarian stimulation (stimulated group). A first observer acquired 2 volumes for each ovary. Another observer performed a second analysis of the volumes acquired by the first observer. We analyzed ovarian volume, follicle number in the basal group, vascularization index, flow index, and vascularization-flow index. The volumes were processed by the Virtual Organ Computer-Aided Analysis imaging program using plane A and 15°rotational steps. Results. Ovarian volume showed excellent intraobserver and interobserver agreement, with an intraclass correlation coefficient (Intra-CC) and an interclass correlation coefficient (Inter-CC) close to the unit. The Intra-CC and Inter-CC about the number of follicles were 0.964 and 0.978, respectively. Vascularity indices showed an Intra-CC greater than 0.90. The vascularization index and the vascularization-flow index showed higher interobserver than intraobserver reproducibility (Inter-CC > 0.96 for both). The flow index Inter-CC was 0.898. The reproducibility differences between the basal and stimulated ovary measurements were not significant. Conclusions. There is an excellent intraobserver and interobserver reproducibility of the ovarian volume, follicle counts, and 3-dimensional PDA indices. The ovarian functional stage has no influence on the reliability. Three-dimensional ultrasonography and PDA improve the study of ovarian parameters, and their reliability impels a change in the current clinical routine of performing and interpreting ultrasonography.
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