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Biomedical subjects

J Bajo

Publications and source records attributed to J Bajo.

5 recordsLinked to original sources

The labor induction: integrated clinical and sonographic variables that predict the outcome.

OBJECTIVE: To analyze the clinical and sonographic variables that predicts the success of labor induction. STUDY DESIGN: We studied the Bishop score, cervical length and parity in 196 pregnant women in the prediction of successful vaginal delivery within 24 h of induction. Logistic regression and segmentation analysis were performed. RESULTS: Cervical length (odds ratio (OR) 1.089, P<0.001), Bishop score (OR 0.751, P=0.001) and parity (OR 4.7, P<0.001) predict the success of labor induction. In a global analysis of the variables studied, the best statistic sequence that predicts the labor induction was found when we introduced parity in the first place. The success of labor induction in nulliparous was 50.8 and 83.3% in multiparous women (P=0.0001). CONCLUSIONS: Cervical length, Bishop score and parity, integrated in a flow chart, provide independent prediction of vaginal delivery within 24 h of induction.

Adult↗

Is trophoblastic thickness at the embryonic implantation site a new sign of negative evolution in first trimester pregnancy?

In this study a new sign to evaluate the evolution of pregnancy is described: the trophoblastic thickness at the embryonic implantation site. A prospective, observational study of 592 normal pregnancies with no known risk factors was carried out from January 1998 to February 1999. Serial ultrasound scans were performed from week 5 to week 12 of pregnancy. Trophoblastic thickness was measured at the embryonic implantation site to determine the significance of a difference in gestational age in weeks and a trophoblastic thickness of >/=3 mm in predicting poor prognosis in pregnancy outcome. The sensitivity of this sign in the prediction of spontaneous abortion was 82%, the specificity was 93%, the positive predictive value was 63% and the negative predictive value was 97%.

Abortion, Spontaneous↗

Contribution of transvaginal sonography to the evaluation of benign cervical conditions.

PURPOSE: We evaluated the role of transvaginal sonography in imaging the normal cervix and its benign changes. METHODS: This prospective study included 512 postmenopausal women who underwent transvaginal sonography before hysterectomy and within 15 days of a colposcopy examination that showed no malignant findings. The sonographic findings were compared to the pathology report. RESULTS: Naboth's cysts were the most common sonographic finding (102 cases), followed by cervicitis (43 cases). In 26 cases, endocervical polyps were found sonographically, and in 20 cases myomas were found. In 321 cases, the cervix showed no sonographic abnormality. Pathologic studies showed 104 Naboth's cysts, 25 cases of nonspecific cervicitis, 26 endocervical polyps, 21 myomas, and 336 normal cervices. CONCLUSIONS: The sensitivity and specificity of transvaginal sonography in diagnosing normal cervices and benign changes of the cervix are high. Transvaginal sonography provides easily obtainable, reliable information about the cervix.

Colposcopy↗

Atypical endometrial hyperplasia treatment with progestogens and gonadotropin-releasing hormone analogues: long-term follow-up.

OBJECTIVE: The aim of this study was to assess the long-term effect of gonadotropin-releasing hormone analogues (GnRH-a) in combination with high-dose progestogens in the treatment of atypical endometrial hyperplasia in selected surgical high-risk patients and in women desiring reproductive potential. We hypothesized that this therapy is effective for most couples. METHODS: In the Department of Gynecology of a university hospital, a conservative treatment was offered to a series of 22 patients with atypical endometrial hyperplasia who had a surgical or anesthetic risk history or wished to preserve their fertility potential. After informed consent, they were treated with 500 mg norethisterone acetate weekly for 3 months and 3.75 mg Triptorelin depot every month for 6 months. Three patients failed to complete the study, so the group finally consisted of 19 subjects. They were prospectively followed for 5 years by hysteroscopy and multiple selected biopsies every 6 months. RESULTS: At a 5-year follow-up, regression was noted in 16 patients (84.2%), persistence in 1 (5.1%), recurrence in 1 (5.1%), and progression in 1 (5.1%). CONCLUSION: Consistent with our hypothesis, combined treatment with progestogens and GnRH-a is an effective alternative in selected patients with atypical endometrial hyperplasia.

Adult↗

Which endometrial polyps should be resected?

STUDY OBJECTIVE: To evaluate the efficacy of color Doppler exploration after diagnostic hysteroscopy in choosing which endometrial polyps can be safely left in situ. DESIGN: Prospective, long-term follow-up study (Canadian Task Force classification II-1). SETTING: University hospital. PATIENTS: Two hundred twenty women with hysteroscopically confirmed endometrial polyps. INTERVENTIONS: Transvaginal ultrasonographic surveillance with color Doppler mapping and hysteroscopic resection. MEASUREMENTS AND MAIN RESULTS: We removed 126 (57.2%) polyps because of positive color Doppler map, and 29 (13.1%) with a negative color Doppler map because of symptoms. Sixty-five (29.5%) polyps were not removed because they did not cause symptoms and no Doppler map was found. At follow-up, six were removed because of hemorrhagic episodes. At 3 years, 59 patients with endometrial polyps remained asymptomatic by clinical and ultrasonographic follow-up. CONCLUSION: In this series, 59 patients (26.8%) avoided surgical removal of polyps. (J Am Assoc Gynecol Laparosc 6(1):71-74, 1999)

Endometrial Neoplasms↗