Cervical cancer screening with pattern of pap smear. Review of multicenter studies

To estimate the frequency of abnormal cervical smears and to compare the findings with earlier reported data from Saudi Arabia. The study was divided into 2 parts. The prospective part was conducted at King Abdul-Aziz University Hospital and a private laboratory by using the Bethesda System criteria and diagnostic entities in evaluating all the pap smears that were received during the period of January 2000 to December 2004. All reliable published literature on pap smear performed at different hospitals from 1990-2004, from the Western and Abha regions of Saudi Arabia were retrospectively evaluated. A total of 5132 cases were evaluated in the prospective part of the study. The percentage of abnormal pap smears was 4.7%. The significant categories were atypical squamous cell of undetermined significance [2.4%], low grade squamous intraepithelial lesion [0.6%], high grade squamous intraepithelial lesion [0.4%] and atypical glandular cells of undetermined significance [1.1%]. The malignant categories were squamous cell carcinoma [0.08%], adenocarcinoma of cervix in situ [0.02%] and invasive [0.04%]. Other malignancies were 0.04% and neuroendocrine carcinoma was 0.02%. In the second part of the study, the total number of cases reported in the literature were 45596. The percentage of abnormal pap smear was 1.4%. The total cases evaluated in the current study and the previous published studies were 50, 728 and the frequency of abnormal pap smear was 1.6%. The percentage of abnormal pap smear was higher in the prospective part of this study than the previously reported results. Unified national programs for diagnosing cervical precancerous lesions should be established covering different region of the Kingdom to evaluate the magnitude of the problem

Correlation of interleukin-6 in vaginal secretions with neonatal infection, histologic chorioamnionitis, and umbilical cord pH in patients with premature prelabor rupture of membranes

The objective of this study was to evaluate the diagnostic value of interleukin-6 bedside test in vaginal secretions for neonatal infections, histologic chorioamnionitis and neonatal acidemia in pregnant ladies with prelabor premature rupture of membranes above 34 weeks. The study was a prospective clinical study performed on 50 patients with prelabor premature rupture of membranes above 34 weeks. Interleukin-6 in vaginal secretions was determined in less than 20 minutes by and immunochromatographic bedside test. A positive strong correlation was present between vaginal interleukin-6 and each of the three parameters [p=0.000]: histologic chorioamnionitits [r=0.561], early onset neonatal infection [r=0.836], and umbilical pH [r=0.723]. The test showed sensitivity [87.5%, 72.7%, 95%], specificity [88.4%, 84.6%, 80%], positive predictive value [87.5%, 80%, 90.4%] and negative predictive value [88.4%, 78.5%, 96.4%] respectively. Vaginal interleukin-6 represents an effective bedside test for the screening and prediction of early on set neonatal infection, histologic chorioamnionitis and neonatal acidemia in premature prelabor rupture of membranes

Vaginal gram stains as a simple test for the diagnosis of group B-Streptococci in patients with premature rupture of membranes

The most two common bacterial pathogens in the neonatal period are groub B-hemolytic streptococci [GBS] and Escherichia coli accounting for 70% of all systemic neonatal bacterial disease. More significant is the ascension of group B-hemolytic streptococci as a major cause of life threatening neonatal infection. The present work studied. The efficiency of vaginal Gram stain as a simple test for detection of [GBS] in patients with premature rupture of membranes 92 pregnant female attending for delivery with premature rupture of membranes. Two culture swabs were obtained from the outer one third of the vagina immediately on adminission. and also an air dried smear to prepare a Gram stain. 28 of 92 Cram stains were + re for Gram positive cocci giving an incidence of [30%] of these 9 cultures were subsequently positive for GBS and one for staphilo-cocci representing incidence of [32%]. No cultures were positive on Gram negative semears. The sensitivity of vaginal gram statin in this study was 100% so it can be used in patients with premature rupture of membranes for detection of GBS carriers as it is easy and simple