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

Ectopic pregnancy: 5 year experience in Saudi German hospital, Saudi Arabia

The aim of this study was to assess the prevalence of ectopic pregnancy, the possible risk factors, presentations, different modalities of diagnosis, role of laparoscopy in the management and the follow up after conservative laparoscopic surgery. The study showed that the rate of ectopic pregnancy was 1.8% of the live births, salpingitis was the most common risk factor and was found in 40% of the patients. 85% of the patients were symptomatic but clinically stable or asymptomatic. 80% of the cases were diagnosed by transvaginal sonography, 95% of the patients by laparoscopy and 80% of the laparoscopic operations were conservative