ResumoA implantação da gravidez na cicatriz de cesárea é considerada uma forma rara de gestação ectópica com uma alta taxa de morbidade e mortalidade. Este tipo de gestação ectópica pode causar complicações graves, em função dos riscos de ruptura e hemorragia volumosa, que pode resultar em histerectomia e comprometimento do futuro reprodutivo da mulher. Reportamos um caso de uma gestação ectópica em cicatriz de cesárea em uma mulher de 28 anos que foi tratada com sucesso com a combinação de três métodos: metotrexate, embolização da artéria uterina e curetagem guiada por ultrassom. Dessa forma foi preservada sua fertilidade. AbstractImplantation of a pregnancy within a cesarean delivery scar is considered to be the rarest form of ectopic pregnancy, with a high morbidity and mortality. Pregnancy in a cesarean delivery scar may cause catastrophic complications which may result in hysterectomy and compromise the reproductive future of a woman. We report an ectopic pregnancy in cesarean scar case in a 28-year old pregnant woman that was treated with success with the association between three treatment modalities (methotrexate, uterine artery embolization and curettage) and preserve her fertility.

To evaluate hippocampal volume in patients with AD and aMCI, and correlate its atrophy with verbal episodic memory performance.MethodsWe studied 42 individuals older than 50 years, including 14 with amnestic mild cognitive impairment (aMCI), 14 with mild Alzheimer’s disease (AD) and 14 normal controls. All individuals were submitted to the Rey auditory verbal learning test (RAVLT) to evaluate episodic memory. They were also submitted to the forward (FDS) and backward digit span (BDS) subtest of WAIS-R to evaluate working memory and attention, and to the Mini Mental State Examination (MMSE). Hippocampal volumetric measurements were performed according to anatomic guidelines from a standard protocol using high-resolution T1-inversion recovery 3-mm coronal MRI slices. Hippocampal volumes (HV) were corrected for the variation in total intracranial volume. There was no significant difference between the three groups concerning age and education.ResultsOn RAVLT, there was a continuum between the three groups, with AD recalling less words, controls more, and aMCI subjects showing an intermediate performance on all sub-items. We found an asymmetry between HVs, with smaller mean left HV for all groups. ANOVA and post hoc Tukey’s test for comparisons of HV showed a significant difference among groups, with difference between controls and both AD and aMCI, although there was no significant difference between AD and aMCI groups.ConclusionsThere was a significant correlation between hippocampal volumes and scores on RAVLT, confirming that medial temporal structures are closely associated with memory performance in normal ageing as well as in aMCI and AD.

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