Objectives: To determine differences between the simplified surgical technique and the Richardson’s technique for abdominal hysterectomy, in relation to surgical time, presentation and type of complications. Design: Descriptive, transversal, prospective and comparative study. Setting: Instituto Nacional Materno Perinatal, Lima, Peru. Participants: Patients undergoing abdominal hysterectomy. Interventions: Twenty six patients underwent abdominal hysterectomy with a simplified technique from February 1st, 2005, through May 31st, 2006 and compared with same number of patients intervened with the Richardson’s technique. Main outcome measures: Causes of hysterectomy, surgical time, presentation and type of complications. Results: The most frequent indication for abdominal hysterectomy was uterine myomas (76,9%). Complications were present in 17,3% of patients, with similar frequency with ...

Uterine arteriovenous malformation (UAMV) is an abnormal connection between arteries and veins, lacking an intermediate capillary network, which compromises the myometrium and can cause life-threatening hemorrhage. Generally secondary to gynecobstetric surgical procedures such as uterine curettage, cesarean sections, conservative treatments forectopic pregnancy, etc., its diagnosis depends fundamentally on an adequate transvaginal ultrasonographic and Dopplerevaluation, in order to perform accurate and timely treatment, with the intention of preserving the uterus and thus fertility

Introduction: Interstitial ectopic pregnancy is a rare condition with increasing incidence due to assisted reproductive treatments and prior tubal surgeries. Case presentation: This report describes the case of a 34-year old patient with a history of bilateral adnexectomy due to borderline ovarian cancer, who developed an interstitial ectopic pregnancy following in vitro fertilization with donated eggs. Management involved a minimally invasive approach with ultrasound-guided intrasac methotrexate injection at a dose of 1 mg/kg. The patient remained clinically stable, experienced mild hypogastric pain, and showed a progressive decrease in beta-hCG levels, confirming treatment success. Conclusion: This case underscores the role of transvaginal ultrasound as a pivotal tool for early diagnosis and conservative management, aimed at uterine preservation and fertility.

Objectives: To determine differences between the simplified surgical technique and the Richardson’s technique for abdominal hysterectomy, in relation to surgical time, presentation and type of complications. Design: Descriptive, transversal, prospective and comparative study. Setting: Instituto Nacional Materno Perinatal, Lima, Peru. Participants: Patients undergoing abdominal hysterectomy. Interventions: Twenty six patients underwent abdominal hysterectomy with a simplified technique from February 1st, 2005, through May 31st, 2006 and compared with same number of patients intervened with the Richardson’s technique. Main outcome measures: Causes of hysterectomy, surgical time, presentation and type of complications. Results: The most frequent indication for abdominal hysterectomy was uterine myomas (76,9%). Complications were present in 17,3% of patients, with similar frequency with ...

Uterine arteriovenous malformation (UAMV) is an abnormal connection between arteries and veins, lacking an intermediate capillary network, which compromises the myometrium and can cause life-threatening hemorrhage. Generally secondary to gynecobstetric surgical procedures such as uterine curettage, cesarean sections, conservative treatments forectopic pregnancy, etc., its diagnosis depends fundamentally on an adequate transvaginal ultrasonographic and Dopplerevaluation, in order to perform accurate and timely treatment, with the intention of preserving the uterus and thus fertility

Introduction: Interstitial ectopic pregnancy is a rare condition with increasing incidence due to assisted reproductive treatments and prior tubal surgeries. Case presentation: This report describes the case of a 34-year old patient with a history of bilateral adnexectomy due to borderline ovarian cancer, who developed an interstitial ectopic pregnancy following in vitro fertilization with donated eggs. Management involved a minimally invasive approach with ultrasound-guided intrasac methotrexate injection at a dose of 1 mg/kg. The patient remained clinically stable, experienced mild hypogastric pain, and showed a progressive decrease in beta-hCG levels, confirming treatment success. Conclusion: This case underscores the role of transvaginal ultrasound as a pivotal tool for early diagnosis and conservative management, aimed at uterine preservation and fertility.

The asseessment of ovarian reserve is one of the cornerstones of the diagnosis of the infertile couple. The measurement of follicle stimulating hormone (FSH) has been considered the gold standard for such assessment, however ultrasonographic evaluation (antral follicle count and ovarian volume average) is an alternative that has advantages for its low cost and easily reproducible from technical point of view. The aim of this paper is to review and publicize the ultrasound technique of assessing ovarian reserve in order to unify criteria for implementation in hospitals.

El embarazo heterotópico es infrecuente. Se presenta el primer caso reportado en el Instituto Nacional materno Perinatal de Lima, de embarazo heterópico tratado con la técnica de inyección local intrasacular con cloruro de potasio (KCl) del embarazo extrauterino ubicado en la cicatriz de cesárea preservando la viabilidad del embrión intrauterino.  

Ectopic pregnancy is a gyneco-obstetric pathology whose management has changed today, going from being a purely surgical management pathology to a medical management entity with surgical indications. Transvaginal ultrasound has revolutionized evaluation in gynecology and in the first trimester of pregnancy, which has allowed the diagnosis of new pathologies.

El conteo de folículos antrales (antral follicle count: AFC) junto con el dosaje sérico de la hormona antimulleriana(AMH), son los dos test de evaluación de reserva ovárica que más se utilizan en medicina reproductiva, pues son los que correlacionan mejor con los resultados de los tratamientos de reproducción asistida. Sin embargo, no existe un consenso en cuanto a la valoración ultrasonográfica de los folículos lo cual se presta a confusión. Es por lo que en este artículo revisaremos las publicaciones que nos servirán para establecer una guía para dicha valoración.

El Síndrome de Ovario Poliquístico (PCOS), es una afección endocrino-metabólica cuya prevalencia varía de acuerdo con los criterios diagnósticos que se utilicen, afectando del 5 a 20% de las mujeres en edad reproductiva. Históricamente, una combinación de anovulación e hiperandrogenismo es el sello distintivo. La adición de características ultrasonográficas de los ovarios agrego un criterio más pero que a su vez, propicio la aparición de fenotipos y algunas controversias que subsisten sin resolver.

Introduction. Cervical ectopic pregnancy is a challenge both in diagnosis and in its treatment. Hysterectomy is no longer the most widely used treatment, with medical and minimally invasive treatments being the most widely used. Objective. To describe the efficacy of the Shirodkar-type cervical cerclage in the management of cervical pregnancy. The study. It is presented a case series treated at the Instituto Nacional Materno Perinatal in pregnant women attended between 2015 and 2021. The modified Shirodkar cervical cerclage technique was performed for hemostatic purposes, so that it allows us to aspirate the gestational sac contained in the cervical canal, preventing bleeding. Finding. Six cases of cervical ectopic pregnancy were treated with the modified Shirodkar technique, all of them successfully, since the embryonic tissue contained in the cervical canal was evacuated, controlling p...

Adenomyosis is a pathology that compromises the fertility and quality of life of women of reproductive age, with ultrasound being the most important tool for diagnosis, timely management.prognosis evaluation, and disease evolution. Hence the importance of knowing the ultrasonographic criteria of this disease that allows us to make an early diagnosis for timely management.

The asseessment of ovarian reserve is one of the cornerstones of the diagnosis of the infertile couple. The measurement of follicle stimulating hormone (FSH) has been considered the gold standard for such assessment, however ultrasonographic evaluation (antral follicle count and ovarian volume average) is an alternative that has advantages for its low cost and easily reproducible from technical point of view. The aim of this paper is to review and publicize the ultrasound technique of assessing ovarian reserve in order to unify criteria for implementation in hospitals.

El embarazo heterotópico es infrecuente. Se presenta el primer caso reportado en el Instituto Nacional materno Perinatal de Lima, de embarazo heterópico tratado con la técnica de inyección local intrasacular con cloruro de potasio (KCl) del embarazo extrauterino ubicado en la cicatriz de cesárea preservando la viabilidad del embrión intrauterino.  

Ectopic pregnancy is a gyneco-obstetric pathology whose management has changed today, going from being a purely surgical management pathology to a medical management entity with surgical indications. Transvaginal ultrasound has revolutionized evaluation in gynecology and in the first trimester of pregnancy, which has allowed the diagnosis of new pathologies.

El conteo de folículos antrales (antral follicle count: AFC) junto con el dosaje sérico de la hormona antimulleriana(AMH), son los dos test de evaluación de reserva ovárica que más se utilizan en medicina reproductiva, pues son los que correlacionan mejor con los resultados de los tratamientos de reproducción asistida. Sin embargo, no existe un consenso en cuanto a la valoración ultrasonográfica de los folículos lo cual se presta a confusión. Es por lo que en este artículo revisaremos las publicaciones que nos servirán para establecer una guía para dicha valoración.

El Síndrome de Ovario Poliquístico (PCOS), es una afección endocrino-metabólica cuya prevalencia varía de acuerdo con los criterios diagnósticos que se utilicen, afectando del 5 a 20% de las mujeres en edad reproductiva. Históricamente, una combinación de anovulación e hiperandrogenismo es el sello distintivo. La adición de características ultrasonográficas de los ovarios agrego un criterio más pero que a su vez, propicio la aparición de fenotipos y algunas controversias que subsisten sin resolver.

Introduction. Cervical ectopic pregnancy is a challenge both in diagnosis and in its treatment. Hysterectomy is no longer the most widely used treatment, with medical and minimally invasive treatments being the most widely used. Objective. To describe the efficacy of the Shirodkar-type cervical cerclage in the management of cervical pregnancy. The study. It is presented a case series treated at the Instituto Nacional Materno Perinatal in pregnant women attended between 2015 and 2021. The modified Shirodkar cervical cerclage technique was performed for hemostatic purposes, so that it allows us to aspirate the gestational sac contained in the cervical canal, preventing bleeding. Finding. Six cases of cervical ectopic pregnancy were treated with the modified Shirodkar technique, all of them successfully, since the embryonic tissue contained in the cervical canal was evacuated, controlling p...

La adenomiosis, definida inicialmente por Cullen en 1908 y diferenciada de otros tipos de endometriosis por Sampson en 1921, ha visto mejoras significativas en su diagnóstico gracias a avances en ultrasonido y resonancia magnética (RM), lo que ha aumentado su incidencia detectada. El ultrasonido, desde su introducción en los años 80, ha evolucionado con tecnologías como transductores endocavitarios de alta resolución y ecografía 3D, permitiendo una evaluación detallada de la enfermedad, especialmente en la zona de unión endometrial. A pesar de que la RM ofrece imágenes de mayor resolución, estudios han mostrado poca diferencia significativa en el valor diagnóstico entre ambas técnicas para la adenomiosis, posicionando al ultrasonido como una herramienta diagnóstica inicial valiosa por su seguridad, bajo costo y disponibilidad. Los criterios ultrasonográficos para el diagn�...