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The external cephalic version (ECV) represents the standard for pregnancies at term with a non-cephalic presentation as it avoids planned caesareans. The aim of this study was to assess the caesarean rate and prognostic factors at birth after undergoing ECV, which was compared with scheduled caesareans for a non-cephalic presentation (SCG) and spontaneous cephalic presentations at birth (GG). No difference was observed between the caesarean rate of the ECV (n=65) and the GG (n=3711) groups (9.84% and 14.47%, respectively, p-value=0.30), and neither was found between the ECV group and both the GG and SCG (n=76) groups in the Apgar scores and postpartum pH, but for the five-minute Apgar score (9.98 and 9.84 in the ECV and SCG groups, respectively, p-value=0.04). This study provides further evidence for clinical practice regarding good perinatal outcomes after undergoing ECV. Further research is required to consistently prove the increase in the intrapartum caesarean rate after ECV that has been previously described in the literature, which has not been found in the present study. Keywords: External Cephalic Version, Breech Presentation, Caesarean Rate, Perinatal Outcomes, Apgar Score, Postpartum Ph.

Objective: To analyse the reasons for Essure® removal in a large cohort of patients. Design: Retrospective 15-year study. Setting: Office hysteroscopy unit in a teaching hospital. Methods: From 2003 to 2015, 8024 Essure® device insertions were performed in a single centre in Córdoba (Spain). Of these, 156 patients (1.89%) presented adverse events requiring device withdrawal (SG) A subset of 156 women matched for age, clinical characteristics and time since insertion were used for case-control comparisons (CG). In 47 cases, the device had already been surgically removed. Three months later, patients were questioned regarding symptoms and their general condition. Main Outcome Measure(s): Pre and post-operative adverse events, early postoperative and late complications (after the initial 3 months) and patients' satisfaction after procedures. Results: In the SG, 23.08% (36) of the patients were allergic to nickel compared to only 1.28% (2) in the CG (p

La inducción del parto supone una de las técnicas más empleadas en la obstetricia actual. Se estima que alrededor del 25 % de los partos comienza de esta forma. Son numerosas las técnicas que se han empleado con el fin de que se desencadenen contracciones regulares, y tenga lugar la expulsión de la unidad feto-placentaria. Prácticamente la totalidad de esas técnicas se pueden englobar en dos grupos. Métodos de inducción médicos y métodos mecánicos. Dentro del primero, los agentes principales son las prostaglandinas. Dentro del segundo se incluyen alternativas como son la sonda de Foley o el doble balón intracervical. Cada uno de ellos cuenta con ventajas e inconvenientes que siempre deben de ser considerados a la hora de aplicarlos en una determinada paciente. Si los métodos de inducción son diversos, las líneas de investigación que se han dedicado a ellos en la literatura científica resultan innumerables. La diversidad en la metodología que emplean estos trabajos, hace que sea tarea poco menos que imposible sacar conclusiones universales, así como guías de práctica clínica comunes para todos los centros. Es por ello que, nos proponemos abordar este apasionante tema, centrándonos en un grupo de pacientes como es el de gestantes con fetos afectos de retraso del crecimiento intrauterino (CIR). Teniendo en cuenta su fisiopatología, trataremos de comparar el misoprosol, la dinoprostona y el doble balón intracervical desde el punto de vista de la efectividad y de los costes asociados a la técnica. Con tales objetivos, hemos llegado a resultados que sitúan a las prostaglandinas como los agentes más efectivos (tiempo al parto) para la IP en fetos CIR, con similar perfil de seguridad que el DBI. Entre ellas, el misoprostol de 25mcg supone el agente más costoefectivo para este grupo de pacientes. Induction of labour is one of the most common techniques in today´s obstetrics. It is estimated that about 25 % of births begin this way. There are numerous techniques that have been used in order to trigger regular contractions and the expulsion of the fetusplacental unit. Almost all of these techniques can fall into two groups: medical or mechanical methods. In the first one, prostaglandins are included. In the second one, Foley catheter or double intracervical balloon (DIB) are some alternatives. Each of them has advantages and disadvantages that should be considered when using them in a particular patient. If the methods of induction are diverse, the lines that have been dedicated to them in the scientific literature are innumerable. The diversity in the methodology used by these papers makes impossible to draw universal conclusions, as well as guidelines of clinical practice common to all hospitals. For this reason, we try to study this exciting topic, focusing on a group of patients such as pregnant women with fetuses affected by intrauterine growth restriction (IUGR). According to its pathophysiology, we will try to compare misoprostol, dinoprostone and double intracervical balloon from the point of view of the effectiveness and costs associated with the technique. With these objectives, our results show prostaglandins as the most effective agents (time at birth) for induction of labour in IUGR fetuses with a similar safety profile as the DIB. Among them, 25mcg misoprostol is the most cost-effective agent for this group of patients.

The sentinel lymph node (SLN) refers to the first lymph node susceptible to being affected, due to the lymphatic drainage of a primary tumor. The lymph node involvement in cancer patients is one of the main prognostic factors. Without affecting the prognosis at any time, the SLN seeks to reduce the morbidity associated with lymphadenectomy, reducing surgical time, reducing intraoperative and postoperative complications, such as lymphedema or neuralgia and costs associated with conventional surgery. Although its use has extensive experience in tumors such as breast, the SG in gynecological tumors is still in the early stages. With this review we intend to make a close and current view of the use of this technique in malignant tumors of the female genital tract.