<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412017000700449</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Sistema intrauterino liberador de levonorgestrel en el tratamiento del sangrado uterino anormal secundario a miomatosis uterina]]></article-title>
<article-title xml:lang="en"><![CDATA[Levonorgestrel-releasing intrauterine system in the treatment of abnormal uterine bleeding secondary to uterine leiomyomas]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zavala-Chaparro]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Uribe]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rendón-Macías]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-Aldeco]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad La Salle Facultad Mexicana de Medicina ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad La Salle Facultad Mexicana de Medicina ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Mexicano del Seguro Social UMAE Hospital de Pediatría CMN siglo XXI Unidad de Investigación en Epidemiología Clínica]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad La Salle Facultad Mexicana de Medicina ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2017</year>
</pub-date>
<volume>85</volume>
<numero>7</numero>
<fpage>449</fpage>
<lpage>456</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412017000700449&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412017000700449&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412017000700449&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES: el sangrado uterino anormal por miomatosis intramural de pequeños elementos es una indicación frecuente de histerectomía; el tratamiento hormonal puede disminuir la necesidad de esta cirugía.  OBJETIVO: evaluar si con el sistema liberador de levonorgestrel disminuye el sangrado uterino anormal por miomatosis intramural de pequeños elementos.  MATERIALES Y MÉTODOS:  ensayo clínico fase II de un solo brazo al que se incluyeron mujeres de 35 a 45 años de edad, con diagnóstico de sangrado uterino anormal por miomatosis intramural de pequeños elementos, con útero menor a 12 cm (eje longitudinal por ultrasonido) y biopsia de endometrio sin enfermedad maligna; a todas se les colocó el sistema liberador de levonorgestrel. Se evaluó: el sangrado con la escala PBACs (Pictorial Blood Assessment Chart score), el dolor pélvico con escala de EVA, la recuperación hematológica (hemoglobina sérica), volumen uterino (mm3) y recuperación de la actividad física y sexual antes de la colocación del sistema liberador de levonorgestrel y a los 3, 6 y 9 meses posteriores.  RESULTADOS: se estudiaron 20 pacientes, de éstas 3 con histerectomía antes de cumplir los tres meses de seguimiento. A los tres meses 76.4% (IC 95%: 55.9-97) redujeron el sangrado en más de 50% del basal, a los seis meses todas habían reducido más de 50% el sangrado y a los nueve meses, nueve eran amenorreicas, el resto con reducción promedio de 90%. El dolor se redujo y permitió recuperar la actividad física y sexual en 90% de los casos. Las concentraciones de hemoglobina se incrementaron, en promedio, 0.8 g/dL, y no hubo reducción clínicamente significativa del tamaño uterino.  CONCLUSIONES: el sistema liberador de levonorgestrel disminuyó de manera muy significativa el sangrado uterino anormal por miomatosis intramural de pequeños elementos a partir de los tres meses de tratamiento.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  BACKGROUND: abnormal uterine bleeding due to small intramural leiomyomas is a frequent indication of hysterectomy; hormone treatment may decrease the need for this surgery.  OBJECTIVE: to evaluate if using the levonorgestreal-releasing system decreases abnormal uterine bleeding caused by small intramural leiomyomas.  MATERIALS AND METHODS:  a phase II single arm clinical trial that included women from 35 to 45 years with a diagnosis of abnormal uterine bleeding caused by small intramural leiomyomas in less than 12 cm uteri (longitudinal axis on ultrasound) and endometrial biopsy with no malignant disease; all the women had the levonorgestrel-releasing system placed. We evaluated: bleeding with the PBAC scale (Pictorial Blood Assessment Chart score), pelvic pain with the EVA scale, hematological recovery (serum hemoglobin), uterine volume (mm3) and recovery of physical and sexual activity before placement of the levonorgestrel-releasing system 3, 6 and 9 months later.  RESULTS: 20 patients were studied, 3 of these had a hysterectomy before the three month follow up period. After three months 76.4% % (IC 95%: 55.9-97) decreased bleeding more than 50% compared to baseline, after six months, all had decreased bleeding more than 50% and at nine months, nine had amenorrhea and the rest had an average reduction of 90%. Pain decreased and allowed them to recover physical and sexual activity in 90% of cases. Concentrations of hemoglobin increased an average of 0.8 g/dL and there was no clinically significant reduction of the uterine size.  CONCLUSIONS: the levonorgestrel-releasing system significantly decreased abnormal uterine bleeding caused by small intramural leiomyomas after three months of treatment.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[sistema intrauterino liberador de levonorgestrel]]></kwd>
<kwd lng="es"><![CDATA[miomatosis uterina]]></kwd>
<kwd lng="es"><![CDATA[sangrado uterino anormal]]></kwd>
<kwd lng="en"><![CDATA[levonorgestrel-releasing intrauterine system]]></kwd>
<kwd lng="en"><![CDATA[uterine leiomyomas]]></kwd>
<kwd lng="en"><![CDATA[abnormal uterine bleeding]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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