RESUMO
OBJECTIVE: To investigate the necessity of colposcopically directed biopsy for more accurate detection of cervical neoplasm. METHODS: Cytology and colposcopically directed biopsy were performed in 114 patients and the patients were subsequently underwent conization or hysterectomy from January, 1998 to December, 2001. RESULTS: The complete diagnostic agreement of cytology with permanent biopsy was 57.9% (66 of 114) and the diagnostic agreement within one degree was 80.6% (92 of 114). The complete diagnostic agreement of colposcopically directed biopsy with permanent biopsy was 62.3% (71 of 114) and the diagnostic agreement within one degree was 85.1% (97 of 114). The difference between two tests was statistically significant (p<0.001). CONCLUSION: We concluded that colposcopically directed biopsy can reduce the false negative rate of cytology for screening test of cervical neoplasm. The difference between colposcopically directed biopsy and permanent biopsy was caused by inappropriate resection of the lesion and unskilled physician.
Assuntos
Humanos , Biópsia , Conização , Diagnóstico , Histerectomia , Programas de Rastreamento , Neoplasias do Colo do ÚteroRESUMO
Intramural pregnancy implanting in the previous cesarean section scar is one of the rarest form of an ectopic pregnancy and probably the most dangerous form because of its risk of rupture and hemorrhage. For its sonographic diagnosis, the gestational sac should be in the anterior wall of uterine isthmic portion, there should be no myometrium between bladder and gestational sac, and it should be verified that uterine cavity and cervix should be isolated from gestational sac. For young patients who wish to maintain their fertility, an earlier diagnosis and more conservative treatment are desirable. We have recently experienced a case of intramural pregnancy implanting in the scar of cesarean section, treated with systemic methotrexate injection. So, we report this case with a brief review of the literature.