Dilatation and curettage fails to detect most focal lesions in the uterine cavity in women with postmenopausal bleeding

In a prospective study, 105 women with postmenopausal bleeding and endometrium >/5 mm at transvaginal ultrasound examination underwent diagnostic hysteroscopy, D and C and hysteroscopic resection of any focally growing lesion still left in the uterine cavity after D and C. Twenty-four women also underwent hysterectomy. If the histological diagnosis differed between specimens from the same patient, the most relevant diagnosis was considered the final one. 80% [84/105] of the women had pathology in the uterine cavity and 98% [82/84] of the pathological lesions manifested a focal growth pattern at hysteroscopy. In 87% of the women with focal lesions in the uterine cavity, the whole of parts of the lesions of the lesion remained in situ after D and C. D and C missed 58% [25/43] or polyps, 50% [5/10] of hyperplasias, 60% [3/5] of complex atypical hyperplasias and 11% [2/19] of enclometrial cancers. The agreement between the D and C diagnosis and the final diagnosis was excellent [94%] in women without focally growing lesions at hysteroscopy. In conclusion, if there are focal lesions in the uterine cavity, hysteroscopy with endometrial resection is superior to D and C for obtaining a representative endometrial sample in women with postmenopausal bleeding and endometrium >/5 mm

Vaginal pH and parabasal cells in postmenopausal women

This is a prospective study to determine a specific range of vaginal pH level that correlates with elevated parabasal cells in vaginal smears. To be used clinically as an indicater of hypoestrogenism. Seventy four postmenopausal women presenting to the gynecology clinics of Al Galaa Teaching Maternity Hospital complaining of urinary incontinence, hot Flushes or other post menopausal symptoms were studied. Women were excluded if they had vaginal infections or pelvic organ prolapses past the hymen. pH was measured and cytology smears made from the mid-vagina. A pathologist who was not aware of pH results evaluated the smears. Spearman rho was used to correlate pH and percentage of parabasal cells. Logistic regression was used to analyze the relationship between pH and increased parabasal cells in vaginal smears. Predictive values were used to select a pH level as a cutoff point to predict increased cells. Seventy-four women were included in this study but 70 women completed it. The correlation coefficient between pH and percentage of parabasal cells was 0.6 [P < .001]. Logistic regression showed association of pH with 20% or more parabasal cells [P < 0.001]. Positive and negative predictive values for pH level above 6.0 as a predictor of 20% or more parabasal cells were 96.3% and 87.5%, respectively. The prevalence of elevated parabasal cells was 22.9%. Vaginal pH above 6.0 correlates with high levels of parabasal cells [20% or more] from the midvagina and can be used clinically and in research work as an indicator of hypoestrogenism

Anticardiolipin antibodies and the severity of preeclampsia eclampsia

This is a cross sectional study carried out in Al Galaa Teaching Maternity Hospital to identify and compare anticardiolipin antibodies [aCL] in patients with eclampsia, different grades of preeclampsia and women with normotensive pregnancy. The study was conducted in 13 patients with eclampsia, 39 with preeclampsia [13 severe, 26 mild], and 52 normotensive pregnant women. All of them were studied in the 3rd trimester of pregnancy. The aCL were determined by an ELISA method. There were no significant differences in IgG aCL [F=0.33, p=0.80] and IgM aCL[F=1.64 .P=0.18 between patients with eclampsia [6.9 +/- 3.9 U/GPL and 4.0 +/- 2.0 U/MPL], severe preeclampsia [5.7 +/- 3.5 U/GPL and 2.9 +/- 1.3 U/MPL], mild preeclampsia [6.8 +/- 3.9 U/GPL and 2.8 +/- 1.0 U/MPL] and normotensive pregnant women [6.4 +/- 3.4 U/GPL and 3.0 +/- 1.8 U/MPL]. None of the values of the aCL were considered as positive. Serum a CL levels were similar in patients with different grades of Preeclampsia- eclampsia and women with normotensive pregnancy