characteristics women with cervical cancer referred for radiotherapy and /or chemotherapy

Cervical cancer is the most common gynecologic cancer in women in the world, most arise from infection with human papiloma virus. Other host factors also affect the neoplastic progression following initial infection. To determine characteristics of Iraqi women with carcinoma of the uterine cervix during the last 11 years in Iraq. Retrospective study; done on records in Radiotherapy and Nuclear Medicine Hospital- Baghdad; 488 cases of cervical carcinoma referred for chemotherapy and or radiotherapy, from 1999 to 2009. Clinical and pathological data were reviewed and analyzed. The data that was obtained from the radiotherapy and nuclear medicine hospital showed that the women with cervical carcinoma constitute only 2.1% of total women with malignancies during 1999-2009. Highest; were in 2003 and 2004. Largest proportion presented in late stage [62.32%] and only 37.67% with early stage. Squamous cell carcinoma counted 98.38% and only 1.62% were adenocarcinoma. Median and mean age was 45-50. Median parity between 4 and 6. Majority of patients from Baghdad [43.02%], Basra [10.93%] and lowest percentage from North; been collectively [10.46%]. Only 6.55% had positive family history. [53.72%] with history of smoking; significantly associated with late stage. Most common clinical presentation was vaginal bleeding [65.81%]. The most common stage at time of presentation was stage two [36.51%]. Most of referred patients had surgical interventions as total abdominal hysterectomy with bilateral salpingooophorectomy [sub optimal surgery] 60.93%. Most patients with carcinoma of cervix in Iraq presented in late stage due to absence of screening program.

Postevacuation hCG levels and risk of gestational trophoblastic neoplasia in women with complete molar pregnancy

Complete molar pregnancy represents part of the spectrum of gestational trophoblastic diseases which are important and interesting part of gynecological oncology. Women diagnosed with complete hydatidiform molar pregnancy are typically counseled that their risk of developing gestational trophoblastic neoplasia [GTN] requiring further management with chemotherapy is 15-20%. To have beta-hCG criteria of persistent gestational trophoblastic disease and to outline beta-hCG levels indicating remission. During the 12 months study period, 80 patients with complete molar pregnancy were followed after evacuation by weekly beta-hCG measurements until either a spontaneous remission where they were shifted to monthly checking or GTN was diagnosed. During the period from the 3[rd] to 8[th] week post-evacuation, patients were subdivided into 4 groups according to their beta-hCG level and their outcome. Fifty seven patients [71.3%] had spontaneous remission, while 23 patients [28.7%] were diagnosed to have GTN. There was no statistically significant difference between the two groups regarding the mean age of the patients and parity, while those women with uterine size larger than date on presentation are more likely to develop GTN with a statistically significant difference between the groups [p value = 0.027]. beta-hCG behavior curves showed that the mean beta-hCG level for the patients with GTN at each week is higher than those patients with remission, with an overall slower decline followed by rising titers seen around the 6[th] week post-evacuation. Those patients who had their hCG level declined < 50 IU/1 during the first 8 weeks post-evacuation can be reassured that they have very low risk of developing GTN while those with beta-hCG level > 200 IU/1, the risk of GTN increased over the subsequent weeks after evacuation peaking at the 8[th] week [Odds ratio = 224] and they should be counseled for chemotherapy

effect of valvular heart diseases on maternal and fetal outcome of pregnancy

Profound hemodynamic alterations occur during pregnancy, labour and in the postpartum period. These changes can adversely affect both maternal and fetal outcome, if a women encounter a valvular heart disease during her pregnancy. We try to evaluate the effect of valvular heart disease on maternal and fetal outcome of pregnancy. This is a cross section descriptive study, carried out in Baghdad teaching hospital, throughout the period from September 2007 to October 2008. Seventy eight pregnant women with valvular heart diseases, in labour, were enrolled in this study. Their medical and obstetrical records were reviewed on admission. We looked for maternal outcome after delivery [method of delivery, heart failure, arrhythmia, need for medication and period of hospitalization], additional to fetal outcome [prematurity, viability and birth weight]. Mitral valve disease is predominate valvular heart disease in pregnancy, most of them of mild severity. All maternal and fetal outcome parameters adversely increase among pregnant women with valvular heart diseases. Valvular heart diseases carried a higher risk for both mother and fetus. The risk related directly to severity of valvular heart diseases