Is cryotherapy friend or foe for symptomatic cervical ectopy?

Objective: To evaluate the success rates and clinical outcomes of cervical cryotherapy applied to cervical ectopy for symptomatic relief

Subjects and Methods: A total of 124 women who underwent cryotherapy for symptomatic treatment of cervical ectopy were included in this study. Indications for treatment were: abundant leucorrhoea [n = 114], post-coital bleeding [n = 22], recurrent cervicitis [n = 30] and pelvic pain [n = 12]. Cryotherapy consisted of the use of carbon dioxide at -89[degree]C to destroy the ectopic columnar epithelium by freezing, and it was transmitted to the ectopy through a flat cryoprobe. No routine anaesthesia or analgesia was administered. All patients were questioned about the status of their symptoms after 6 weeks of treatment

Results: The highest success rate was obtained in patients with abundant leucorrhoea [n = 102; 89.5%], while the lowest success rate was achieved in subjects with pelvic pain [n = 7; 58%]. After treatment, no severe complications were observed, except for hydrorrhoea for a few days. Success rates were 9 times lower in patients who had 3 or more cervicitis episodes per 6 months

Conclusion: In this study, the success rate of cryotherapy was highest in patients with abundant leucorrhoea and lowest in patients with pelvic pain and recurrent cervicitis. Hence, we recommend that clinicians perform the procedure in such patients without much delay

Laparoscopic removal of an intrauterine device from the sigmoid colon

Uterine wall perforation which is commonly seen through the posterior wall of the uterus is the most serious complication of an intrauterine device [IUD]. We present a case of laparoscopic removal of an IUD from the sigmoid colon in a 31-years-old female who was admitted to hospital with a history of pelvic pain and abnormal vaginal bleeding for one month. The dislocated IUD was removed from the sigmoid colon of laparoscopic intervention without any complications. In conclusion, the treatment modality for the removal of a dislocated IUD is possible by laparoscopic surgery in selected patients where the dislocated IUD is accessible

Perimortem Cesarean Delivery Following Severe Maternal Penetrating Injury

The case of a severely traumatized pregnant patient, in whom a perimortem cesarean section, in the emergency department, led to the birth of a viable baby, with long-term survivor, is described. A postmortem cesarean section, resulting in fetal survival, performed after 45 minutes of maternal cardiopulmonary resuscitation is reported in a patient with multiple penetrating injuries. A 27-year-old primigravida suffered cardiopulmonary arrest at the 34th week of gestation following multiple knife injuries. Although extensive advanced cardiopulmonary resuscitation was performed for 45 minutes, her vital signs did not return to normal levels. A low segment cesarean delivery was performed, and a female baby was delivered. The time interval between cardiopulmonary arrest and delivery, prior maternal health status, and continued cardiopulmonary resuscitation are important determinants of fetal survival. A perimortem cesarean section is advised in case of multiple penetrating injuries, even after 45 minutes of cardiopulmonary resuscitation, since it may result in fetal salvage.