ABSTRACT
A hospital-based, prospective study was done in 350 women of 20-50 years to compare VIA with Pap smear for early detection of cervical dysplasia at Maternity Hospital, Thapathali, from May 2004 to December 2004. Pap smear was taken from each woman followed by VIA. Women with positive VIA and/or positive Pap smear were referred for colposcopy-directed cervical biopsy. The variables studied were age group, presenting complaint, age of marriage, parity, smoking habit and appearance of cervix. The incidence of positive VIA and Pap smear was 2.86 and 0.57 respectively. Pelvic pain was the most common presenting complaint. The majority of the women were married before 20 years of age. All women with either positive VIA and/or Pap smear were of parity two or above. There was no significant association between smoking and positive VIA (P=0.699) or Pap smear (P=0.397). Approximately 36.57% of the women screened had abnormal looking cervix. There were two women with high grade intraepithelial lesion (HSIL) and both were VIA positive and this was statistically significant (Fischer exact P=0.0007). Of the ten VIA positive women, on histopathological examination six showed chronic cervicitis, one acute cervicitis, one showed cervical intraepithelial neoplasia (CIN) II, one had normal finding and one was lost to follow up. VIA as a screening test for cervical neoplasia did not miss any lesion detected by Pap smear and confirmed by cervical biopsy.
Subject(s)
Acetates/diagnosis , Adult , Biopsy , Cervix Uteri/pathology , Colposcopy , Early Detection of Cancer , Female , Humans , Mass Screening/methods , Middle Aged , Outpatient Clinics, Hospital/statistics & numerical data , Prospective Studies , Referral and Consultation , Uterine Cervical Dysplasia/pathology , Uterine Cervical Neoplasms/diagnosis , Vaginal Smears/methods , Young AdultABSTRACT
Placenta accreta is defined as an abnormal adherence, either in whole or in part, of the afterbirth to the underlying uterine wall. Placenta increta occurs when the placenta invades deeply into the myometrium. Placenta increta is a life threatening condition. We report a case of placenta increta managed by unilateral uterine artery and ovarian artery ligation followed by B-Lynch Brace suturing of the uterus to control bleeding from the placental bed.