Intraplacental choriocarcinoma is a rare malignant tumor diagnosed after an abortion, an ectopic pregnancy, or a term or preterm pregnancy or following the diagnosis of a hydatidiform mole. During pregnancy, it may be more common than reported, as most patients are asymptomatic and placental choriocarcinomas are usually inconspicuous macroscopically and are often mistaken for an infarct. Based upon a case study methodology, we describe 2 cases of intraplacental choriocarcinoma: the first case was identified in the product of a uterine curettage following an incomplete miscarriage and the second in one of the placentas of a bichorionic twin pregnancy. Maternal investigation did not reveal evidence of metastatic disease and neither did the infants' one in the second case. The two cases underwent maternal surveillance with serum hCG and remained disease-free until the present. In conclusion, intraplacental choriocarcinoma is easily underdiagnosed but with current treatment, even in the presence of metastasis, the prognosis is excellent. A routine microscopic examination of all the placentas and products of miscarriage can increase the real incidence of this entity and consequently improve its management.

We report one of the largest series evaluating the influence of BMI on AMH levels and, consequently, on ovarian reserve. BMI does not seem to affect AMH levels. The reported concerns on infertility in overweight and obese women may be related to follicular development/oocyte maturation or endometrial disorders, rather than decreased ovarian reserve.

Acute aortic dissection is a rare life-threatening event. No further pregnancies in women who had a previous acute aortic dissection have been reported. We present the case of a chronic hypertensive woman, who in her previous gestation was submitted to an acute aortic dissection repair at 28 weeks of gestation with cesarean delivery at the same operative procedure. The index pregnancy was uneventful. An elective cesarean was performed at 33 weeks' gestation. Aneurysm expansion, rupture or redissections are potential complications of operated aortic dissection. Normal blood pressure values and close cardiologic and obstetrical follow-up are essential to obtain a favourable outcome.

Among the measures used to prevent bleeding from esophageal varices in children wit11 PH, endoscopic sclerotherapy is becoming a most promising one. Nine children with a mean age of 6.7 years (range 3.4 -9.2) with EPH were submitted ta injection sclerotherapy. Before treatment, the mean number of bleeding episodes was 4.1 (range 1 -11); and the mean lengh of time between bleedings was 5.6 months (range 0.5 -16.8). All the children had grade 111 varices with red spots. A mean of 4.5 sessions (range 2 -7) were performed at 3 to 4 weeks intervals. A volume of 0.5 to 2 ml of a 5% solution of ethanolamine oleate was injected in each varix. Following sclerotherapy, only transient mild complications were refered: fever in six children; hemoglobinuria in five; retrosternal pain in four; disphagia in one. Mean observation time after the begining of treatment was 15.4 months (range 9 -26), during which no bleeding occurred. Endoscopies performed 6 months after last sclerotherapy session revealed grade I and few grade I1 esophageal varices. The differences between the means of the periods of time between bleedings before treatment and the post-treatment observation times were statistically significant ( P < 0.01) (t test for paired samples). It is concluded that sclerotherapy is an effective measure in preventing variceal bleeding and improving the quality of life in children with EPH. 1984. Although all cases had bled on at least two occasions before sclerotherapy rebleeding occurred in only six (one with PVO) from 2-6 years after variceal obliteration. Mild chest pain and fever were common for 48hrs after injection and 5 children developed oesophageal strictures which were relieved by simple dilatation.Abnorrna1 oesophageal motility caused intermittent dysphagia in 2 cases. Five died from progression of their liver disease. Sclerotherapy is a safe and effective means of preventing rebleeding from oesophageal varices, particularly in children with PVO.It is also useful in IHD where its use does not increase the difficulty of liver transplantation,should this become necessary later.--. . . Hospital I n f a n t i l "Val1 d-Hebu5n",Barcelona, Spain.Orthotopic l i v e r transplantation(0LT) is a therapeutic option f o r children with end-stage l i v e r diseases. Once t h e OLT has been completed immvlosupression with pr&isolone(P) and cyclosporine(C1 is s t a r t e d . The two major problems in the p s to~r a t i v e p e r i d ( W P ) a r e r e l a t e d t o r e j e c t i o n and drug induced hepatotoxicity(DM) both manifested by similar byochanical and c l i n i c a l symptcmatology. To w a l u a t e both problans is t h e aim o f this w p r .MEIWODS: The POP of 1 3 children t h a t underwent OLT w i t h succes, has k e n reviewed. The evidence of rejection o r DM, have been searched f o r .RESULTS: N l p a t i e n t s presented in t h e FOP a coagulopathy r i s e i n serum transaminases, gamaCT,alkaline phosphatase and b i l i r r u b i n . 12 of than improved with P bolus, and l a t e r on, C l e v e l s and l i v e r bio...