Scielo RSS http://scielo.pt/rss.php?pid=1646-583020170002&lang=es vol. 11 num. 2 lang. es http://scielo.pt/img/en/fbpelogp.gif http://scielo.pt http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200001&lng=es&nrm=iso&tlng=es http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200002&lng=es&nrm=iso&tlng=es Pre-eclampsia is a common and potentially serious disorder of pregnancy. An antiangiogenic state appears to be central to its development. In particular, the sFlt-1/PlGF ratio increases in pre-eclampsia, leading to its potential use as a marker for prediction and diagnosis. Immunoassays for the sFlt-1/PlGF ratio are now commercially available and can assist in the diagnosis of women with a clinical suspicion of pre-eclampsia, leading to a decrease in hospital admissions. Remarkably, information is missing on the impact of its use in pregnancy outcomes http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200003&lng=es&nrm=iso&tlng=es The Robson Ten-Group Classification System has been viewed by the majority of the clinicians as way of classifying cesarean section according to maternal characteristics. Recent WHO and FIGO statements suggest that Robson classification should be used by all healthcare facilities where deliveries occur to collect and analyze perinatal data http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200004&lng=es&nrm=iso&tlng=es Overview and Aims: In the presence of an unfavorable cervix, pre-induction cervical ripening is an important part of the labour induction process. Both mechanical and pharmacological methods are available for this purpose, with Foley catheter being the most commonly used mechanical method. We intend to describe the efficacy of Foley catheter for cervical ripening and to describe maternal and neonatal outcomes. Furthermore, we analyze the same results in high risk subgroups. Study Design: Retrospective observational study Population: 44 women with a singleton pregnancy, live fetus, cephalic presentation, intact membranes, with medical indication for labour induction and Bishop score ≤6. Methods: Medical records were reviewed and analyzed. Foley catheter was introduced until expulsion or for a maximum of 24 hours. Cervical ripening was considered effective when Bishop score after catheter was ≥8. Maternal outcomes considered were tachysystole, chorioamnionitis, post-partum bleeding and uterine rupture. Neonatal outcomes assessed were Apgar score, need for hospitalization in neonatal care unit and days of hospitalization. In the subgroup analysis, we divided the risk population in two subgroups: Group 1- Fetal growth restriction and/or oligohydramnios; Group 2- Previous caesarean section. Results: 72.7% of the labour inductions were indicated by maternal or fetal disease. The efficacy of cervical ripening was 65.9% and vaginal delivery rate was 63.6%. Regarding maternal and neonatal outcomes, there were only two cases (4.5%) of clinical chorioamnionitis. In subgroup analysis, the efficacy of cervical ripening and vaginal delivery rates were, respectively, 60.9% and 69.6% in Group 1 and 72.2% and 50% in Group 2.There was one case of chorioamnionitis in each subgroup. Conclusions: Foley catheter is an effective and safe method for cervical ripening. Due to its low association with adverse outcomes, it appears to be a good alternative for high-risk populations http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200005&lng=es&nrm=iso&tlng=es Overview and Aims: The concept of "genitourinary syndrome of menopause" (GUSM), created in 2013, is widely used, despite the lack of studies and validation. This survey intended to evaluate the knowledge, agreement and concerns of Portuguese gynaecologists about it. Study design, population and methods: An online survey was sent to Portuguese gynaecologists (all the members of the Portuguese Society of Gynaecology, personal contacts and specific groups in social networks). Results: Out of 118 completed surveys, 66.1% belonged to specialists and 43.9% to residents. It was reported by 83.9% that they were acquainted with the GUSM, without differences between specialists and residents (85.0% vs. 83.3%, p=1.000). Most (66.7%) use "vaginal atrophy" or "atrophic vaginitis" in their daily practice; GUSM is used by 6.1% and 27.3% use both denominations. Considering "0" to be total disagreement and "10" total agreement, the justifications for the creation of this syndrome were rated as follows: "vaginitis implies infection or inflammation, which is not always the case" 8.1±2.57; "urinary signs and symptoms tend to be overlooked" 6.4±2.96; "atrophy has a negative connotation" 4.7±3.46 and "vagina is not generally a well-accepted term by women and the media" 3.4±3.41. It was considered by 37.9% that it may lead to sub-diagnosis/no diagnosis of sexual dysfunction; of vulvar pathology by 32.6% and of urinary tract pathology by 23.7%. Globally, 77.8% agree with the concept of GUSM, without differences between specialists and residents (80.0% vs. 73.5%, p=0.459); 75.4% consider that they will use it in the future (residents 57.9% vs. specialists 83.3%, p=0.053). Conclusion: Most Portuguese gynaecologists are aware of the concept of GUSM, and intend to use it the future, despite not fully agreeing with the assumptions that led to its creation. http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200006&lng=es&nrm=iso&tlng=es Overview and Aims: The aim of this study was to assess the predictive factors for pregnancy rate after intrauterine insemination. Study Design: Retrospective study Population: 698 couples undergoing intrauterine insemination Methods: All cycles were preceded by ovarian stimulation using gonadotropin. Pregnancy rates were evaluated according to female age, body mass index, duration, type and etiology of infertility, number of preovulatory follicles, endometrial thickness and total motil sperm count. Results: In this study involving 1262 cycles, the clinical pregnancy rate per cycle was 12.2% and per couple was 21.3%. Logistic regression analysis confirmed the presence of two or more pre-ovulatory follicles as a predictor of pregnancy (p = 0.01). The pregnancy rate showed no independent relationship with woman's age, duration of infertility, number of cycles, endometrial thickness and number of sperm inseminated. Conclusions: The simplicity of the treatment and its non-invasive nature make intrauterine insemination a first-line option for many infertile couples. Considering the limited number of cycles that each couple can perform and the positive influence of the presence of more than one preovulatory follicle, the intrauterine insemination should preferably occur when two follicles exists. http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200007&lng=es&nrm=iso&tlng=es «Vulvovaginitis» are one of the main reasons that lead women to visit their gynecologist. Most physicians in this area tend to base their diagnostic evaluation on the signs, symptoms and physical examination of the patient, overlooking the microscopic evaluation of the vaginal discharge. This practice leads to a high percentage of underdiagnosed «vulvovaginitis». Cytolytic vaginosis is one of these rarely diagnosed pathologies, due to the fact that it mimics vulvovaginal candidiasis http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200008&lng=es&nrm=iso&tlng=es In the past, accidental detection of an adnexal tumor in pregnancy was a rarity, occurring most often during a caesarean section. This diagnosis has become more common due to the widespread use of ultrasound in early pregnancy. Most of these tumors are benign and spontaneously resolve, but if they persist there is a risk of torsion, rupture, or obstruction of labor. The possibility of dealing with cancer should also be considered. The clinical management can be challenging, so it's essential to establish the diagnostic criteria and to define the expectant or surgical approach to adopt http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200009&lng=es&nrm=iso&tlng=es Myeloid sarcoma is defined as a tumour of myeloblasts and immature myeloid cells that occurs in an extramedullary tissue. It is a rare form of presentation, which may arise in different locations and the cervix is one of the most unusual places. The available therapeutic options are chemotherapy and radiotherapy. The main prognostic factors are the response to initial treatment and cytogenetic abnormalities. This article describes the case of a woman presenting pelvic pain and vaginal discharge as chief complaints. After detection of a mass in the uterine cervix, the diagnosis was established by histology and immunophenotyping http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200010&lng=es&nrm=iso&tlng=es Suburethral tension-free sling procedure has become one of the most popular techniques for the treatment of stress urinary incontinence. Erosion of sling materials into the urethra is an uncommon but serious complication following synthetic tape placement. Diagnosis requires a high index of suspicion as it often presents several weeks or months postoperatively. There is no consensus regarding the optimal management of this patients but it usually includes mesh excision and urethroplasty. We present the case of a patient with urethral erosion after suburethral retropubic sling who presented 15 months after placement. http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000200011&lng=es&nrm=iso&tlng=es Suburethral tension-free sling procedure has become one of the most popular techniques for the treatment of stress urinary incontinence. Erosion of sling materials into the urethra is an uncommon but serious complication following synthetic tape placement. Diagnosis requires a high index of suspicion as it often presents several weeks or months postoperatively. There is no consensus regarding the optimal management of this patients but it usually includes mesh excision and urethroplasty. We present the case of a patient with urethral erosion after suburethral retropubic sling who presented 15 months after placement.