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Background: Cervical cancer is a common gynecological malignancy and public health problem that can be prevented, but the utilization of screening is just 2.6%-5% in India. Healthcare providers mainly nursing personnel are crucial and play a vital role in raising awareness and educating the public about implementation of low-cost cervical cancer screening approaches in low-resource settings. Objectives were to determine baseline information about knowledge of cervical cancer and explore attitude and practice of pap smear screening among staff nurses. Methods: The questionnaire containing mostly recognition and some recall type questions about demographics, knowledge about cervical cancer, its risk factors, screening techniques, attitudes towards cervical cancer screening and its practices and their knowledge was tested. Results: Analyses of knowledge showed that majority of nurses recognized the risk factors and symptoms associated with carcinoma of cervix. A considerable lack of knowledge was observed on the treatment of cervical cancer but a significant portion of nurses knew about prevention. A positive attitude was observed on all aspects of cervical cancer and its prevention. Conclusions: This study demonstrates a good knowledge and positive attitude about carcinoma of cervix and its prevention amongst the nurses which plays a key role in the campaign to prevent cervical malignancy. Poor practice seen in this study emphasizes the need to translate the awareness to practice. Easier availability of HPV testing and better distribution of HPV vaccine is paramount to successfully prevent cervical cancer in future.
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Cervical fibroids are very rare accounting for 2% of all uterine fibroids. We report the case of a 48-year P4L4 with a large posterior wall cervical fibroid with a history of CVA and DVT of upper limb. Non-surgical interventional modalities like UAE were explored as a stop gap procedure. There was minimal reduction in size of mass after UAE but significant reduction in dysmenorrhoea and menorrhagia. Medical optimization of patient was achieved before definitive surgical intervention. D-J stenting of the ureters was done to prevent any injury.
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Background: Objective of the study was to compare the effectiveness of VIA and pap smear for screening of premalignant lesions of cervix and to compare the performance of VIA used alone and combined with pap smear for screening of premalignant lesions of cervix.Methods: VIA and Pap smear were performed in 260 patients attending routine gynaecology OPD. Positive cases of either or both screening tests were subjected to colposcopy and biopsy if indicated. The reports of histopathology were correlated with the pap smear and VIA findings and thereby sensitivity, specificity, positive and negative predictive values of each of the screening methods were calculated and results were analysed.Results: 260 patients were screened for premalignant lesions of cervix by VIA and pap smear both, 37 of 260 patients, (14.2%) were VIA positive, 30 of 260 patients (11.5%) were pap smear positive, 20 of 260 patients (7.69%) were positive for VIA as well as pap smear, 25 of 260 patients (9.6%) were confirmed of premalignant lesions on histopathology, 24 patients were diagnosed CIN and one patient was diagnosed with CIS.Conclusions: VIA has lower sensitivity and specificity compared to Pap smear but the results are comparable. Both the tests are fairly accurate. A combination of VIA and Pap smear increased the sensitivity and specificity to 100%.
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El embarazo ectópico de implantación baja incluye al embarazo cervical, localizado entre el istmo y la cicatriz de cesárea. Se caracteriza por la implantación del blastocisto fuera de la cavidad uterina. Esta condición se presenta entre 1% y 2% de todos los embarazos y es la principal causa de muerte materna en el primer trimestre de gestación. Tiene baja incidencia en comparación con otras localizaciones, y alto riesgo de morbilidad materna debido a la probabilidad de sangrado durante la intervención. Se presenta un caso en el Hospital Militar Central de Bogotá de un embarazo ectópico ístmico cervical posterior al proceso de fertilización in vitro en mujer de 37 años con antecedente cesárea, ultima hace 17 años, y esterilización quirúrgica. El objetivo es documentar el proceso y las intervenciones, ya que el manejo de esta patología depende de las condiciones clínica y el deseo de reproducción de la mujer. (provided by Infomedic Intl).
Low implantation ectopic pregnancy includes cervical pregnancy, located between the isthmus and the cesarean scar. It is characterized by implantation of the blastocyst outside the uterine cavity. This condition occurs in 1% to 2% of all pregnancies and is the leading cause of maternal death in the first trimester of gestation. It has a low incidence compared to other locations, and a high risk of maternal morbidity due to the probability of bleeding during the intervention. We present a case of a cervical isthmic ectopic pregnancy following in vitro fertilization in a 37 year old woman with a history of cesarean section, last 17 years ago, and surgical sterilization at the Hospital Militar Central de Bogotá. The objective is to document the process and the interventions, since the management of this pathology depends on the clinical conditions and the woman's desire to reproduce. (provided by Infomedic Intl).
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Resumen Introducción : Objetivo: comparar sensibilidad diag nóstica de videocolposcopia con inteligencia artificial (IA) auxiliar, con la videocolposcopia común realizada por colposcopistas. Métodos : Estudio descriptivo de corte transversal retrospectivo, en 782 historias clínicas anonimizadas del Sistema Informático para el Tamizaje (SITAM), de mujeres a las cuales se les efectuaron videocolposcopia con IA y colposcopías con videocolposcopio común rea lizadas por especialistas, con sus biopsias (gold standard). Se evaluó la relación entre los resultados de videocol poscopia con IA y videocolposcopia común con resulta dos de las biopsias. Se calculó precisión global de cada procedimiento diagnóstico. Se determinó sensibilidad y concordancia de los resultados de la videocolposcopia con IA, con el gold standard. Resultados : Se analizaron 395 historias clínicas de pacientes con videocolposcopia con IA y 387 con vi deocolposcopia común. La precisión diagnóstica de resultados fue 80% (IC 95%: 75-83%) en videocolposco pias con IA y 65% (IC 95%: 60-69%) en videocolposcopia común (p<0.001). Los resultados de videocolposcopia con IA y colposcopia común se correlacionaron signifi cativamente con los resultados de las biopsias, rs=0.75 vs. rs=0.57 respectivamente (p<0.001). La sensibilidad de videocolposcopia con IA fue 96% (IC 95%: 94-98%), y 93% (IC 95%: 89-95%) en colposcopías comunes. La concordancia general de las impresiones colposcópicas clasificadas por videocolposcopia con IA y enfermedad fue mayor que la de la interpretación colposcópica de los colposcopistas (90% frente a 83%, Kappa 0.59 frente a 0.47, p<0.001). Conclusión : La alta precisión diagnóstica de video colposcopia con IA permite aumentar la sensibilidad del estudio y mejorar la detección precoz de lesiones precursoras de neoplasias cervicouterinas.
Abstract Introduction : To compare the diagnostic sensitivity of artificial intelligence (AI) assisted videocolposcopy with standard videocolposcopy performed by specialist colposcopists. Methods : A descriptive retrospective cross-sectional study, 782 anonymized medical records from the Com puterized System for Screening (SITAM) of women who underwent videocolposcopy with AI and colposcopy with common videocolposcopy performed by specialists, with their corresponding biopsies (gold standard) were analyzed. The relationship between the results of IA videocolposcopy and regular videocolposcopy and the results of biopsies was evaluated. The overall accuracy of each diagnostic procedure was calculated. The sensitiv ity and concordance of the results of AI videocolposcopy with the gold standard (biopsy) were determined. Results : A total of 395 patient records of patients with IA videocolposcopy and 387 with regular vi-deocolposcopy were analyzed. The accuracy of results was 80% (IC 95%: 75-83%) in IA videocolposcopy and 65% (IC 95%: 60-69%) in regular videocolposcopy (p<0.001). Videocolposcopy results with IA and com mon colposcopy were significantly correlated with bi opsy results, rs=0.75 vs. rs=0.57 respectively (p<0.001). The sensitivity of videocolposcopy with AI was 96% (95% CI: 94-98%), and 93% (95% CI: 89-95%) for regu lar colposcopy. The overall agreement of colposcopic impressions classified by videocolposcopy with AI and disease was higher than that of colposcopic interpretation by colposcopists (90% vs. 83%, Kappa 0.59 vs. 0.47, p<0.001). Conclusion : The high diagnostic accuracy of AI vi-deocolposcopy allows obtaining highly sensitive studies that help in the early detection of precursor lesions of cervical neoplasia.
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Resumen Introducción : La inspección visual con ácido acé tico (IVAA) es una alternativa primaria para mer mar la incidencia y mortalidad por cáncer de cuello uterino (CaCu). El objetivo del estudio es conocer la proporción de mujeres de 30 a 49 años que usaron el test de IVAA en los últimos dos años y los factores asociados con el uso de la prueba, en el ámbito de la atención primaria. Métodos : Estudio transversal y multicéntrico, partici paron 706 mujeres de 30 a 49 años, usuarias de centros de atención primaria en una región del Perú. La variable dependiente fue el uso del test de IVAA, en los últimos dos años y las independientes los factores sociodemo gráficos, sociosanitarios, de información y actitud. Resultados : La proporción de mujeres que usaron el test de IVAA, fue del 30.6%. Se asociaron con mayor uso de la prueba, el área de residencia urbana, haber recibido recomendación para realizarse la IVAA, sentir preocupación por adquirir CaCu, haber oído hablar del CaCu y del virus del papiloma humano, el considerar tener mayor o igual probabilidad de desarrollar CaCu respecto a mujeres de su edad y con menor uso de la prueba, el proceder de la sierra y considerar riesgoso realizarse la IVAA. Conclusión : El programa de tamizaje del CaCu, me diante IVAA no estaría logrando el impacto deseado. Se requiere fortalecer estrategias e intervenciones en atención primaria, para mejorar las conductas y tasas del cribado.
Abstract Introduction : Visual inspection with acetic acid (VIA) is a primary alternative to reduce cervical cancer (CaCu) incidence and mortality. The study aimed to determine the proportion of women aged 30-49 years who used VIA in the last two years and the factors associated with the use of the test in the primary care setting. Methods : Cross-sectional, multicenter study. Seven hundred and six women aged 30 to 49 years partici pated, users of primary health care centers in a region of Peru. The dependent variable was the use of the VIA test in the last two years and the independent variables were sociodemographic, socio-health, information and attitudinal factors. Results : The proportion of women who used the VIA test was 30.6%. The following factors were associated with greater use of the test: urban area of residence, having received a recommendation for VIA, feeling worried about acquiring CaCu, having heard about CaCu and the human papilloma virus. Also, considering having a greater or equal probability of developing CaCu compared to women of the same age, and with lower use of the test, coming from the highlands and considering it risky to undergo VIA. Conclusion : The VIA screening program for CaCu would not be achieving the desired impact. There is a need to strengthen strategies and interventions in primary care to improve screening behaviors and rates.
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RESUMEN Los schwannomas cervicales son tumores encapsulados benignos de la vaina nerviosa que corresponden a menos del 0,1% de los tumores de cabeza y cuello. Suelen presentarse como una tumoración cervical asintomática. Son lesiones cuyo tratamiento de primera línea es la resección quirúrgica. Es fundamental el uso de neuromonitorización durante el procedimiento y realizar una cirugía en conjunto con un especialista en nervios periféricos. En ocasiones resulta dificultoso conservar la funcionalidad del nervio involucrado. Se presenta el caso de una paciente de 27 años que consulta por una tumoración cervical derecha. Se realizaron tomografía computarizada y resonancia magnética nuclear cervical que evidenciaron una imagen sugestiva de schwannoma de neumogástrico. Se realizó la exéresis completa de la lesión con neuromonitorización intraoperatoria. Presentó una disfonía transitoria en posoperatorio.
ABSTRACT Schwannomas are encapsulated benign tumors that arise from the peripheral nerve sheaths and account for 0.1% of head and neck tumors. They usually present as asymptomatic lateral neck masses. Surgical resection is the first-line therapy of these lesions. Intraoperative neuromonitoring is essential, and a neurosurgeon specializing in peripheral nerves needs to participate during surgery. Preservation of nerve functioning is sometimes difficult. We report the case of a 27-year-old female patient sought medical care due to a mass in the right lateral region of the neck. Computed tomography scan and nuclear magnetic resonance imaging suggested the presence of a pneumogastric schawannoma. The tumor was totally resected with intraoperative neuromonitoring. The patient evolved with transient dysphonia.
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SUMMARY: In literature were described variations in foramen transversarium in cervical vertebrae, as well as their clinical importance, and the information about them boils down to the individual case reports or population morphological studies. The aim of this paper is to contribute to the knowledge of morphological characteristics of the transverse openings on vertebrae of the cervical region. The study was performed on 60 typical vertebrae that are part of the collection of the Department of Anatomy in Nis. The characteristics of permanent openings were measured and accessory foramina were recorded. It was found that the diameter of the openings on the left side was 5.595±0.92 x 5.390±1.507 mm, and on the right 5.766±1.201 x 6.101±1.401 mm. Unilateral completely separated accessory foramina were recorded in 10.17 % of cases, dominant on the left side, and incompletely separated cases in 5.09 %. The research has demonstrated a relatively high incidence of accessory foramina and deviations from circular shaped openings.
En la literatura se describen variaciones en el foramen transverso de las vértebras cervicales, así como su importancia clínica, y la información sobre ellas se reduce a informes de casos individuales o estudios morfológicos poblacionales. El objetivo de este trabajo fue contribuir al conocimiento de las características morfológicas de los forámenes transversos de las vértebras cervicales. El estudio se realizó en 60 vértebras típicas que forman parte de la colección del Departamento de Anatomía de Nis. Se midieron las características de los forámenes constantes y se registraron los forámenes accesorios. Se encontró que el diámetro de los forámenes del lado izquierdo era de 5,595±0,92 x 5,390±1,507 mm, y del derecho de 5,766±1,201 x 6,101±1,401 mm. Se registraron forámenes accesorios unilaterales completamente separados en el 10,17 % de los casos, dominantes en el lado izquierdo y casos incompletamente separados en el 5,09 %. La investigación ha demostrado una incidencia relativamente alta de forámenes accesorios y desviaciones de forma circular.
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Humans , Cervical Vertebrae/anatomy & histology , Anatomic VariationABSTRACT
Cervical cancer remains a significant cause of mortality among women worldwide. Screening methods play a crucial role in identifying individuals with cervical pre-cancerous lesions, allowing for timely intervention to prevent progression to invasive disease. Treatment modalities for cervical intraepithelial neoplasia (CIN) are effective, straightforward, and safe. The choice between ablative techniques (such as cryotherapy or thermal ablation) and excisional techniques (like large loop excision or cold knife conization) depends on lesion characteristics and transformation zone type. Ablative techniques are particularly suitable for low-resource settings due to their simplicity, low complication rates, and cost-effectiveness. In areas where access to colposcopy and histopathology services is limited, strategies such as visual inspection with acetic acid (VIA) followed by immediate ablative treatment for VIA-positive individuals are recommended by the World Health Organization. This approach not only prevents the progression of high-grade CIN but also ensures high compliance among screen-positive individuals. Overall, effective screening and treatment strategies are essential in reducing the burden of cervical preinvasive lesions and preventing the development of cervical cancer.
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A 39-year-old, gravida 3 para 0+2 presented at 26+4 weeks gestation with a clear vaginal discharge which upon speculum examination revealed prominent bulging amniotic membranes and a pool of clear amniotic fluid in the vagina. Abdominal ultrasound showed a single viable fetus in longitudinal lie, cephalic presentation and fetal heart rate (FHR) 150 beats per minute, regular. Estimated fetal weight 863g. The past history included 2 previous missed miscarriages. A diagnosis of pre-term premature hind water rupture of membranes was made. Intravenous antibiotics, magnesium sulphate, intramuscular progesterone and antenatal steroids were administered and emergency (double) cervical cerclage was performed after amnioreduction. The next day, the patient showed features of frank rupture of membranes and severe oligohydramnios on ultrasound. Six weeks after cerclage (32+4) considering the persistent amniotic fluid leakage with severe oligohydramnios, planned Caesarean section delivery was performed and a male fetus, weighing 1790 grams was delivered with APGAR scores of 7 and 8 at 1 and 5 minutes respectively. NICU care included invasive volume targeted ventilation, double dose surfactant administration and management of neonatal sepsis with ?-haemolytic streptococci. Echocardiographic assessment was normal and feeds were initiated after 3 days of oral immune therapy using colostrum. After 14 days of NICU stay, the neonate was discharged.
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For optimal cervical cancer care pathway, effective communication among colposcopist professionals regarding colposcopic findings, diagnosis, and treatment of intraepithelial lesions is crucial; standardization of the colposcopic report may serve as a beneficial strategy for this purpose. Elaborate and validate the colposcopic report for screening intraepithelial lesions and cervical cancer using a committee of specialists. This validation study used the item-level content validity index (I-CVI) to verify the agreement of judges per item, and the scale-level content validity index (S-CVI) to determine the mean of the proportion of items classified as "no disagreement"; items with an I-CVI?0.80 and S-CVI?0.90 were considered approved. The binomial test was used to select the items that should be revised based on the p value of the proportion (rejecting the H0 if p?0.8); statistical significance was set at p<0.05. Results: Seven judges participated in this study. The 11 items of the Colposcopic Report were validated, but items classified as “disagreement” (1, 2, 5, and 9) or “neither agree nor disagree” (3, 10, and 11) were taken to a consensus meeting. Six of the seven judges of the first stage participated in the consensus meeting. Suggestions for modifying item nine were not accepted, and item 11 underwent a slight modification. The colposcopic report was validated and achieved greater reliability, suggesting its inclusion in the cancer information system.
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Background: Cancer of the cervix is the leading cause of cancer among women in India. Human papilloma virus plays an important role in the causation of preneoplastic and neoplastic cervical lesions. HPV type-specific oncoproteins interact with cellular regulatory proteins resulting in upregulation of p16, a cyclin dependent kinase inhibitor. This has made p16, a valuable surrogate biomarker of HPV infection, useful in evaluating HPV associated preneoplastic and neoplastic lesions of cervix. The aim of this study was to evaluate p16 expression in preneoplastic and neoplastic cervical lesions. Methods: A total of 93 specimens diagnosed histopathologically as cervical preneoplasia and neoplasia were included in this prospective study of one year duration. Maximum cases were of Neoplastic lesions followed by preneoplastic lesions. Majority of the neoplastic lesions were Squamous cell carcinoma. Immunohistochemical (IHC) staining for p16 was performed and was scored by percentage positivity and reaction intensity. p16 positivity in neoplastic lesions was significantly (p<0.0001) higher than preneoplastic lesions. Results: Of the 93 cases, 17 (18.28%) were preneoplastic and 76 (81.72%) neoplastic lesions. In the preneoplastic group, 52.94% cases were p16 positive while 47. 06% cases revealed p16 negativity. Among the neoplastic group, 85.53% cases were p16 positive while 14.47% cases were p16 negative. Conclusions: p16 expression progressively increased with increasing grades of cervical preneoplastic and neoplastic lesions, establishing p16 as a supplementary marker for early diagnosis of cervical cancer.
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Cervical ectopic pregnancy is a rare life-threatening condition with an incidence of less than 1% among all ectopic pregnancies. A 27-year-old primigravida presented with spotting per vaginum following 4 weeks 5 days of amenorrhea. Transvaginal ultrasound done at 4 weeks 5 days showed a gestational sac located in the anterior wall of cervix, diagnosis of cervical ectopic pregnancy was made. Initial serum beta hCG titre was 4106 mIU/ml. Serial monitoring of serum beta hCG done showed increasing values. Hence, decided for medical management with single dose of injection methotrexate, as the diagnosis was made at an early gestation and patient was hemodynamically stable. On follow up, serum beta hCG did not fall significantly, hence multidose methotrexate regimen was initiated. She responded to it, but she continued to have persistent bleeding per vaginum with fall in hemoglobin levels, hence sorted for surgical management which included suction and evacuation, after ligation of descending cervical artery and subsequently cervical tamponade. Intraoperative period was uneventful. On follow-up, patient was asymptomatic and vitals stable. Serum beta hCG done 2 weeks post procedure was below 5 mIU/ml and resumed spontaneous cycles after a month. Thus, early detection and accurate diagnosis of cervical ectopic pregnancy using ultrasound and serial beta hCG titre monitoring becomes a cornerstone of management. We present this case as it was her index pregnancy, with a need to preserve future fertility, successful conservative management of Cervical ectopic pregnancy with combination of medical and surgical intervention.
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Twenty to thirty percent of women in the reproductive age group are affected with leiomyomas, the most frequent benign tumor of the uterus. Only 300 occurrences of vaginal leiomyomas have been documented, hence they are still a rare condition. Because of their low incidence and wide range of nonspecific clinical symptoms, tumors are assumed to originate from Mullerian smooth muscle cells in the sub-epithelium of the vagina. However, these cells can easily be misdiagnosed. Usually located in the anterior vaginal wall are vaginal leiomyomas. Here, we describe a case of left upper lateral vaginal wall leiomyoma in a 40-year-old multigravida. She presented with pelvic fullness. Cervical fibroid was diagnosed based on physical examination and MRI. Under anesthesia, the tumor was removed vaginally, and histology revealed a vaginal leiomyoma. Vaginal leiomyomas are uncommon tumors; however, they can present with a range of clinical symptoms and be mistakenly classified as cervical fibroid before surgery. The most effective therapy approach seems to be vaginal tumor excision followed by a histological investigation. To raise awareness of the disease and lower the possibility of a misdiagnosis and improper treatment, the current instance was disclosed.
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Cervical adenomyomas are extremely rare benign tumors and are often overlooked as a differential diagnosis of large cervical masses. Herein, we report a case of a 23-year-old nulliparous woman with polypoid adenomyoma arising from the endocervix. The mass was filling up the vagina and stretching the anterior fornix up into the lower abdomen, hence the origin of the mass could not be identified on clinical examination or imaging. Therefore, management of this mass was challenging. Excision of this mass was done using an abdominoperineal approach. Histologically, the polypoid lesion was composed of endocervical epithelium with interlacing fascicles and bundles of tumor cells intermixed with endocervical glands. Clinicians should be aware of such lesions so that they can decide upon the appropriate course of management.
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Cervical pregnancy is a rare type of ectopic pregnancy and it represents <1% of all ectopic pregnancies. Tubal ectopic, Interstital, caesarean scar pregnancy, cornual, ovarian, Intramural are other types of ectopic pregnancy. Timely diagnosis and Treatment are key to management any type of ectopic pregnancy. Cervical ectopic pregnancy is the implantation of blastocyst in the intracervical canal. Cervical pregnancy are high risk cases as they may present with an unexpected life-threatening hemorrhage secondary to the erosion of cervical blood vessels, which may require hysterectomy to save the patient. Here is case of 22yr old primi patient with 6 weeks and 2 days of cervical ectopic pregnancy planned for dilatation and evacuation followed by medical management span; Improved ultrasound resolution and earlier detection of these pregnancies have led to the development of more conservative treatments that attempt to limit morbidity and preserve fertility.
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Background: Preterm birth is truly a global problem. Cervical length is one of the major determinants of preterm births. Diagnosis of cervical insufficiency can be made by history of previous mid trimester loss, on clinical evaluation or sonographically by measuring cervical length or seeing funnelling of OS. The mainstay treatment of cervical insufficiency is the cervical cerclage.Methods: Present study includes 55 cases of cervical length less than or equal to 2.5 cm on TVS examination between 18 to 22 weeks of gestation of singleton pregnancy was conducted at department of obstetrics and gynaecology at SMT NHL medical municipal hospital, Ahmedabad from July 2022 to December 2023 and shows comparison of rate of full term and preterm deliveries.Results: Out of 55 patients with cervical incompetence, 22 (40%) patients were diagnosed on examination. Out of 55 patients with cervical incompetence 33 (60%) patients had preterm births and only 19 (35%) patients delivered full term, 3 (5%) had abortions. Present study shows there were 35% full term deliveries, 60% preterm deliveries and 5% had abortion among patients having cervical length less than or equal to 2.5 cm.Conclusions: Internal OS status of every patient should always be examined by ultrasound between 18 to 22 weeks. Thus, cervical length is very useful in prognostication and prediction of preterm birth. There are highest chances of late preterm in cervical incompetent patients. Our study showed better outcome with OS tightening group compared to conservative group.
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Background: Numerous drugs have been used to shorten the active phase of labor. Do they really shorten the duration of labor? What adverse effects do they have on the baby and the mother? These questions were the basis to perform the present study of comparing two of such drugs, injection Camylofin dihydrochloride and injection Valethamate bromide with control subjects. Aim of the study was to assess the effect of camylofin dihydrochloride and valethamate bromide on active phase of first stage of labour.Methods: This is an open label randomized controlled study of 120 eligible women with spontaneous onset of labour at SSG hospital, Vadodara, India. Women were randomized to receive either a single intra-muscular Camylofin, 3 doses of intra-venous Valethamate or third as control group. The main outcome measure was duration of active phase of first stage of labour and rate of cervical dilatation. The study was conducted over a period of 9 months from May 2022 to January 2024.Results: Mean duration of active phase of labour was 4.33±1.32 hours, 6.74±1.26 hours and 6.83±1.65 hours in Camylofin, Valethamate and control group respectively with p value <0.0001. Mean rate of cervical dilatation was 1.47±0.41 cm/hour, 0.91±0.23 cm/hour and 0.87±0.18 cm/hour in three groups respectively. There was no significant difference in maternal side effects and neonatal outcome among them.Conclusions: Considering the results of this study, it can be concluded Camylofin is superior to Valethamate in decreasing total duration of active phase of first stage with higher cervical dilatation rate.
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Background: Cervical cancer arises when cells in the cervix undergo abnormal changes, leading to tumor formation. Although preventable, it remains the fourth most commonly diagnosed cancer and the leading cause of cancer-related deaths among women. This study aimed to assess the prevalence of cervical cancer among village women.Methods: This prospective observational study was conducted at Upazilla Health Complex (UHC), Sariakandi, Bogura, Bangladesh from January 2023 to December 2023. As the study subjects, a total of 1186 village women who participated in the cervical cancer screening program of the mentioned UHC were enrolled purposively. For data analysis, MS Office tools were applied.Results: In this study, the majority of participants belonged to the >40 years’ age group (53.2%), were housewives (73%), married at the age of 20 or younger (59%), and reported negative vaginal discharge (53%). Among the total participants, the prevalence of cervical cancer, as determined by visual inspection with acetic acid (VIA) tests, was found to be 1.18%.Conclusions: In comparison to other South Asian or African countries, the prevalence of cervical cancer among village women in Bangladesh is relatively low. However, housewives aged over 40 years, experiencing negative vaginal discharge, and marrying at age 20 or younger are particularly susceptible to such diseases here.
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Introduction: Preterm birth, before 37 weeks of gestation, is the main determinant of neonatal morbidity and mortality and is associated with serious consequences,including compromised quality of life for the affected individual and physical, psychological, and economic costs. Objective: To evaluate the correlation of obstetric history, cervicovaginal infections, and cervical length with preterm birth. A prospective, blind cohort study evaluated 1,370 pregnant women from Ribeirão Preto between 20 and 25 weeks of gestation. Materials and methods: The correlation between obstetric history, cervical length, and gestational age at birth was obtained by calculating the relative risk of the different variables. Results: The distribution of pregnant women according to cervical length (CL) showed a predominance of women with a cervix longer than 2.5 cm (n = 1,308, 95.8%), followed by women with a cervix between 2 and 2.49 cm (n = 42, 3.1%) and < 2 cm (n = 15, 1.1%). Among the 1,370 pregnant women evaluated, 133 had spontaneous preterm birth (< 259 days); 14 (10.5%) preterm births occurred in women under 19 years of age, 105 (79%) in women between 19 and 35 years, and 14 (10.5%) in women older than 35 years. Microbiological analysis showed the growth of Mycoplasma hominis, Ureaplasma urealyticum, and other bacteria in 8, 17, and 16 women with preterm birth, respectively. Among the 133 women with spontaneous preterm birth, CL was < 2.5 cm in 15 women, < 2 cm in 3, < 1.5 cm in 3, and < 1 cm in 2. Conclusion: The identification of pregnant women at high risk for preterm delivery can reduce the incidence of preterm birth. Although no gold standard test exists for the prediction of preterm birth, this study confirms that the measurement of CL is a good individual predictor.
Introducción: El nacimiento pretérmino, antes de las 37 semanas de gestación, es el principal determinante de la morbimortalidad neonatal y se asocia a graves consecuencias,incluyendo el compromiso de la calidad de vida del individuo afectado y costes físicos, psicológicos y económicos. Objetivo: Evaluar la correlación de los antecedentes obstétricos, infecciones cervicovaginales y longitud cervical con el parto prematuro. Estudio de cohorte prospectivo, ciego, evaluando 1.370 gestantes de Ribeirão Preto entre 20 y 25 semanas de gestación. Material y métodos: La correlación entre los antecedentes obstétricos, la longitud cervical y la edad gestacional al nacer se obtuvo calculando el riesgo relativo de las diferentes variables. Resultados: La distribución de las gestantes según la longitud cervical (LC) mostró un predominio de mujeres con cuello uterino mayor de 2,5 cm (n = 1,308, 95.8%), seguidas de mujeres con cuello uterino entre 2 y 2,49 cm (n = 42, 3.1%) y menor de 2 cm (n = 15, 1.1%). De las 1,370 embarazadas evaluadas, 133 tuvieron un parto prematuro espontáneo (< 259 días); 14 (10.5%) partos prematuros se produjeron en mujeres menores de 19 años, 105 (79%) en mujeres de entre 19 y 35 años, y 14 (10.5%) en mujeres mayores de 35 años. Los análisis microbiológicos mostraron la proliferación de Mycoplasma hominis, Ureaplasma urealyticum y otras bacterias en 8, 17 y 16 mujeres con parto prematuro, respectivamente. Entre las 133 mujeres con parto prematuro espontáneo, la CL fue < 2.5 cm en 15 mujeres, < 2 cm en 3, < 1.5 cm en 3 y < 1 cm en 2. Conclusión: La identificación de las gestantes con alto riesgo de parto prematuro puede reducir la incidencia de parto prematuro. Aunque no existe una prueba de referencia para la predicción del parto prematuro, este estudio confirma que la medición de la longitud cervical es una buena predicción individual.