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Fifty patients with metastatic or invasive gestational trophoblastic disease (GTD) were admitted at the "Hospital das Clínicas" of the Ribeirão Preto School of Medicine of the São Paulo University between January 1980 and December 1990. Of these 50 patients, 44 (88%) had GTD following abortion, 5 (10%) after term pregnancies and one (2%) after an ectopic pregnancy. Thirty five (70%) had invasive GTD and 15 (30%) metastatic GTD. The sites of metastases were: lung, 8 (53.3%), pelvis, 4 (26.6%), central nervous system, 2 (13.3%) and right auricle, 1 (6.6%). Human chorionic gonadotropin, pelvic arteriography and ultrasonography were used in the diagnosis of invasive GTD. 25 of the 41 patients with low-risk metastatic and invasive GTD were treated with monochemotherapy. There were 6 (24%) failures and the remaining 19 patients (76%) had complete remission of the disease after 2.89 mean cycles. Sixteen patients were treated with polichemotherapy, there were 2 (12.5%) failures and the remaining 14 had complete remission after a 2.3 mean cycles. No statistical differences between the two types of chemotherapy were observed. Four (8%) deaths were recorded.

A retrospective study of 40 hysterectomies due to hemorrhage performed at the "Hospital das Clínicas, Faculdade de Medicina de São Paulo", from January 1978 to August 1989 was conducted in order to determine which type of hysterectomy (total or subtotal) is better indicated during the pregnant-puerperal period. We analyzed operating time, quantity of blood derivatives transfused during the intra- and postoperative periods, time of postoperative hospitalization, number of intra- and postoperative complications, and deaths. The results did not show statistically significant differences between the two types of hysterectomy. We conclude that total hysterectomy is preferable in any clinical situation, especially in the presence of uterine atony and low implanted placenta.

Twenty-five women with fibrocystic breast disease were investigated in a double-blind study using treatment with bromocriptine (5 to 7.5 mg/day for 3 months) or placebo. Estradiol and progesterone measurements did not show any changes before, during or after treatment. Serum prolactin levels were reduced during the use of bromocriptine. Histologic evaluation demonstrated a decrease of epithelial hyperplasia and arrest of the cystic dilation picture after treatment with bromocriptine.

A retrospective review of 85 hysterectomies performed during the pregnant-puerperal period was conducted at the Clinics Hospital of Medicine of Ribeirão Preto (University of São Paulo) from 1978 to August 1989 with the purpose of evaluating the number of concomitant oophorectomies. 25 oophorectomies with histological studies were performed, of which 11 (44%) presented normal ovaries; six (24%), despite the normal histological results, had adnexal hematomae requiring resection in the laparotomy; and the last eight (32%) had infection. Average age of the patients was 32.8 years. The authors concluded that there was a high number of unnecessary oophorectomies.