ABSTRACT
BACKGROUND: Although preimplantation genetic screening (PGS) is widely offered, there are contradictory reports on the clinical merit of this procedure. Any gain from embryo selection following aneuploidy screening must significantly outweigh the impact of the procedure. Variability of technical expertise in embryo biopsy, blastomere fixation, fluorescence in situ hybridization analysis, along with suboptimal laboratory quality control and inappropriate patient selection may impact PGS outcomes. METHODS: To investigate such effects, a total of 1508 stimulated in vitro fertilization (IVF) cycles were retrospectively analysed. During 2004, a significant change was made to the embryo culture media used. Clinical outcomes from cycles with PGS were compared prior to and after the change in media and compared with matched controls not utilizing PGS during the same period. RESULTS: Clinical PGS success rates were found to improve following the media change. For patients aged less than 40, clinical outcomes following PGS were significantly lower than those without PGS prior to the change, but became equivalent after the change. For patients >or=40 years and Subject(s)
Culture Media
, Pregnancy Outcome
, Pregnancy Rate
, Preimplantation Diagnosis
, Abortion, Spontaneous/epidemiology
, Adult
, Aneuploidy
, Embryo Culture Techniques
, Embryo Implantation
, Female
, Fertilization in Vitro
, Humans
, In Situ Hybridization, Fluorescence
, Live Birth/epidemiology
, Maternal Age
, Middle Aged
, Patient Selection
, Pregnancy
, Retrospective Studies
ABSTRACT
OBJECTIVE: To determine the diagnostic accuracy of cytology smears in distinguishing between tube and non-tube structures. METHODS: One hundred cytology smears of fallopian tube and non-tube structures (vessels, round and ovarian ligaments) were prepared from surgically removed uterus and fallopian tube specimens and stained by the Papanicolaou method. The slides were reviewed blindly by pathologists and interpreted as tube or non-tube structures. The results were compared to the histological examination of the same specimens. FINDINGS: Results indicated an overall accuracy of 97% with a specificity of 98% and sensitivity of 96% for cytology smears, taking histology as the gold standard. Positive and negative predictive values were 96.1% and 97.9%, respectively. CONCLUSION: Cytology smears are a convenient and cost effective tool for laboratory confirmation of tubal sterilization. This method can reduce the costs of laboratory examination, especially in developing countries, where tubal sterilizations are done in large cohorts. However, histological slides remain the gold standard in cases of medicolegal problems.
Subject(s)
Carcinoma/pathology , Cytodiagnosis , Endometriosis/pathology , Fallopian Tube Neoplasms/pathology , Fallopian Tubes/pathology , Adult , Cohort Studies , Cytodiagnosis/economics , Cytodiagnosis/methods , Fallopian Tube Neoplasms/economics , Female , Humans , Middle Aged , Predictive Value of Tests , Sterilization, Tubal/economics , Sterilization, Tubal/methodsABSTRACT
Knowledge and attitudes about vaginal versus caesarean section delivery were assessed in 204 pregnant women attending a maternity centre in Kerman, Islamic Republic of Iran. Overall, 63.5% of women scored weak on knowledge questions. Knowledge was higher in women who had a history of miscarriage. Of the women, 96.5% and 33.0% had positive attitudes towards vaginal delivery and caesarean section respectively; 40.5% had negative attitudes about caesarean section. Women with higher parity and more previous caesarean deliveries showed positive attitudes towards vaginal delivery, as did housewives and women whose spouses were employed in education or health organizations. No significant differences were found in attitude and knowledge scores according to women's levels of education.
Subject(s)
Attitude to Health , Delivery, Obstetric/methods , Delivery, Obstetric/psychology , Health Knowledge, Attitudes, Practice , Women , Abortion, Spontaneous/psychology , Adolescent , Adult , Age Factors , Choice Behavior , Delivery, Obstetric/adverse effects , Delivery, Obstetric/statistics & numerical data , Educational Status , Employment , Family Characteristics , Female , Hospitals, Maternity , Hospitals, Urban , Humans , Iran , Male , Maternal Age , Negativism , Occupations , Parity , Patient Selection , Pregnancy , Surveys and Questionnaires , Women/education , Women/psychologyABSTRACT
Knowledge and attitudes about vaginal versus caesarean section delivery were assessed in 204 pregnant women attending a maternity centre in Kerman, Islamic Republic of Iran. Overall, 63.5% of women scored weak on knowledge questions. Knowledge was higher in women who had a history of miscarriage. Of the women, 96.5% and 33.0% had positive attitudes towards vaginal delivery and caesarean section respectively; 40.5% had negative attitudes about caesarean section. Women with higher parity and more previous caesarean deliveries showed positive attitudes towards vaginal delivery, as did housewives and women whose spouses were employed in education or health organizations. No significant differences were found in attitude and knowledge scores according to women's levels of education
