Objectives:The aim of this study is to compare transperineal and endovaginal ultrasonography in the evaluation of the endometrium, assess for image quality and for a systematic difference in endometrial thickness measured by the two techniques. Methods: Transperineal and endovaginal ultrasonography evaluation of the endometrial thickness was performed on 58 women, in Dona Estefânia Hospital, between November 2005 and March 2007. Two physicians reviewed the images and rated the relative diagnostic value of the techniques for assessing the endometrial thickness. We identified two groups (G1 -visualized; G2 -not visualized). In G1 data were analyzed to determine if there is a correlation between the two approaches using the Spearman test, with a statistical significance of 5% (p < 0.05). In GI and G2 we concluded about the uterine position. Results: Fifty-eight women (average age 57.51) were divided in two groups (G1 n = 45; G2 n = 13). In G1 the Spearman test result was R = 0.933, which reveals a strong correlation between the two techniques. In this group 97.78% (44/45) of uterine position was anteversus or intermediary. In G2 the uterine positions were: anteversus 53.85% (7/13), intermediary 7.69% (1/13) and retroversus 38.46% (5/13). In the majority the transabdominal approach reveals worse quality images. Conclusions: Both transperineal and endovaginal ultrasonography can provide satisfactory images of the endometrium, but endovaginal images are frequently superior to transperineal images. With this study we can conclude that transperineal approach is correlated with endovaginal images for endometrial thickness evaluation, especially in anteversus and intermediary uterus. It had patient acceptance and tolerance, without the need for vaginal penetration, and could be a method of choice in virginal or in postmenopausal women with genital atrophy. This technique needs further study to validate its potential application.

Objetivo: avaliar a prevalência da cesárea em mulheres com HIV no município de Fortaleza-CE. Método: trata-se de um estudo descritivo e quantitativo realizado em três maternidades públicas de referência no atendimento de gestantes que vivem com HIV. Resultado: o parto operatório foi o mais realizado pelas gestantes com HIV (82,7%), embora algumas delas tivessem condições de realizar o parto vaginal. Conclusão: a motivação para escolher a via de parto deve ser algo concomitante não apenas com a vontade do profissional de saúde, mas sim com as informações que o ministério da saúde passa e disponibiliza para realizar a cesariana ou parto vaginal e a própria escolha da mulher.