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Objetivo: Determinar si la ansiedad preoperatoria supone un factor de riesgo independiente para la percepción de dolor severo durante la realización de una histeroscopia quirúrgica ambulatoria. Material y métodos: Estudio de cohortes en el que incluimos179 pacientes. Se ha aplicado el formulario STAI-S para valorar la ansiedad preoperatoria de las pacientes y distribuirlas en dos cohortes: Pacientes con ansiedad (STAI-S >50) y pacientes sin ansiedad (STAI-S<50). Se ha valorado mediante una escala EVA el dolor percibido por las pacientes, considerando dolor severo una puntuación EVA>7. Se ha calculado la asociación y el riesgo entre ambas variables mediante el Test X 2 y el Riesgo Relativo (RR). Se ha utilizado el test de correlación de Pearson para valorar la correlación entre ambas variables. Se ha considerado estadísticamente significativo un valor de p<0.05. Resultados: Las pacientes que percibieron dolor severo durante la entrada a la cavidad uterina (78,3% vs 29,5%; p<0,001) y durante la realización del proceso quirúrgico (78,8% vs 26,2%; p<0,001) fueron en su mayoría pacientes con ansiedad preoperatoria. El RR de las pacientes con ansiedad para percibir dolor severo es de 6,46 (IC 95%; 2,52-16,60) durante la entrada y de 6,61 (IC 95%; 3,04-14,38) durante la resección. Existe una correlación moderada y positiva entre las puntuaciones obtenida en la escala STAI-S y la puntuación EVA, tanto durante la entrada a la cavidad (r = 0,629; p = 0,042) como durante el proceso quirúrgico (r = 0'661; p =0'021). Conclusiones: Las pacientes con ansiedad preoperatoria tienen más riesgo de percibir dolor severo durante la entrada en la cavidad uterina y durante la realización de la intervención histeroscópica.

Background and Purpose: To evaluate the use of prostaglandins and oxytocin in labour induction according to different indications. Perinatal outcomes, rate of vaginal delivery and complation of labour were studied and compared. Methods: Cross-sectional descriptive study from January 2012 to December 2012. 530 women who required labour induction were included. Seven groups were created according to the methods of induction. Women with twin pregnancies, induction of dead foetus, two previous caesarean sections or an incomplete clinical history were excluded. Results: The rate of vaginal deliveries in women that only received prostaglandins the first day was 84.6%; similar in women with prolonged pregnancies, 85.2%. The induction with oxytocin directly showed the highest rate of caesarean section. The rate of vaginal deliveries was 50% in women with previous caesarean section. Conclusions: A high rate of vaginal deliveries with a single dose of prostaglandin and within 24 hours of beginning induction. Administration of prostaglandins must be used when cervix is unfavorable and previous to oxytocin stymulation.

Background:: A retrospective study that analysed data for three consecutive years from the Hysteroscopy Clinic at the Department of Obstetrics and Gynecology, Valme University Hospital. Objective:: To analyse the data of lesions removed in the hysteroscopy clinic in comparison with those scheduled for the operating room to show that hysteroscopy could be a more effective procedure. Method:: Patients undergoing operative hysteroscopy for various indications were included. The 5 mm Bettocchi hysteroscopes and the 5.8 mm Palex Mini-Resectoscope were used. Results:: A total of 1233 patients were seen in the hysteroscopy clinic between 2015 and 2017. In 2015, 344 hysteroscopies were performed, of which 57 (16.5%) were performed in the operating room. In 2016, 445 hysteroscopies were performed and 46 (10.3%) were scheduled in the operating room. During 2017, a total of 444 hysteroscopies were performed, of which only 6 (1.3%) were performed in the operating room (P < 0.001). Five large fibroids and one case of complex polyp were removed in the operating room in 2017. The mini-resector was used in 202 cases (45.4%). Paracervical local anaesthesia was given to 383 (86.2%) patients. Conclusion:: The data obtained in our study shows a significant reduction in the number of hysteroscopies scheduled for surgery in 2017 (1.3%) and, therefore, hysteroscopy has been shown to be a more effective procedure. This trend may be due to the introduction of the mini-resectoscope and the use of paracervical local anaesthesia.