Objective-To compare the diagnostic accuracy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for assessing myometrial infiltration (MI) in patients with low grade endometrioid endometrial cancer.Methods-Observational prospective study performed at a single tertiary care center from 2016 to 2020, comprising 156 consecutive patients diagnosed by endometrial sampling as having an endometrioid grade 1/grade 2 endometrial cancer. TVS and MRI were performed prior to surgical staging for assessing MI, which was estimated using subjective examiner's impression and Karlsson's method for both TVS and MRI. During surgery, intraoperative assessment of MI was also performed. Definitive pathological study considered as reference standard. Diagnostic accuracy for ultrasound, MRI, and intraoperative biopsy was estimated and compared.Results-Sensitivity and specificity of TVS for detecting deep MI were 75 and 73.5% for subjective impression and 65 and 70% for Karlsson method, respectively (P = .54). Sensitivity and specificity of MRI for detecting deep MI were 80 and 87% for subjective impression and 70 and 71.3% for Karlsson method. MRI subjective impression showed a significant better specificity than MRI Karlsson method (P = .03). MRI showed better specificity than TVS when subjective impression was considered (P <.05), but not for Karlsson method. Sensitivity and specificity of intraoperative were 75 and 97%, respectively. Intraoperative biopsy showed better specificity than ultrasound and MRI either using examiner's impression or Karlsson method (P <.05).Conclusions-MRI revealed a significant higher specificity than TVS when assessing deep myometrial infiltration. However, the intraoperative biopsy offers a significant better diagnostic accuracy than preoperative imaging techniques.

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Hypertensive states of pregnancy are a set of disorders that occur during gestation whose common nexus is hypertension. They must be given special emphasis due to their implication in maternal and neonatal morbidity and mortality. A classification is made of the different hypertensive states, with special emphasis placed on preeclampsia. This article defines the symptoms and signs of the disease and a differential diagnosis is made amongst diseases that must be ruled out. It is important to identify expectant mothers with preeclampsia, and it is of even greater importance in such cases to rule out some criterion of seriousness, as this will enable a different management to be carried out. The article includes the indications and the moment when the pregnancy finalises. Similarly, it details the controls that must be made if an expectant management is chosen for the benefit of the premature baby. The different anti-hypertensive therapeutical options are detailed, as well as the prophylactic treatment of eclampsia with magnesium sulphate. Because of their intrinsic interest, we draw special attention to the HELLP syndrome and to eclampsia as complications. The treatment and conduct that must be followed in gestation is described.

Hypertensive states of pregnancy are a set of disorders that occur during gestation whose common nexus is hypertension. They must be given special emphasis due to their implication in maternal and neonatal morbidity and mortality. A classification is made of the different hypertensive states, with special emphasis placed on preeclampsia. This article defines the symptoms and signs of the disease and a differential diagnosis is made amongst diseases that must be ruled out. It is important to identify expectant mothers with preeclampsia, and it is of even greater importance in such cases to rule out some criterion of seriousness, as this will enable a different management to be carried out. The article includes the indications and the moment when the pregnancy finalises. Similarly, it details the controls that must be made if an expectant management is chosen for the benefit of the premature baby. The different anti-hypertensive therapeutical options are detailed, as well as the prophylactic treatment of eclampsia with magnesium sulphate. Because of their intrinsic interest, we draw special attention to the HELLP syndrome and to eclampsia as complications. The treatment and conduct that must be followed in gestation is described.

No abstract