Postmenopausal Pregnancy Via Oocyte Donor and Suspected Focal Placenta Accreta: A Case Report.

Advances in assisted reproductive technologies have enabled postmenopausal women to achieve pregnancy beyond their reproductive lifespan. Although rare, these pregnancies are challenging and require a multidisciplinary approach due to the higher prevalence of medical comorbidities in this population. The placenta accreta spectrum is characterized by an abnormal invasion of chorionic villi into the myometrium. Risk factors associated with the placenta accreta spectrum include prior uterine surgeries, advanced maternal age, multiparity, in vitro fertilization, and placenta previa. We present a case of a 59-year-old postmenopausal woman with chronic hypertension, stage II chronic kidney injury, and superimposed pre-eclampsia who underwent cesarean delivery complicated by suspected focal placenta accreta. Histopathological examination revealed significant deviations from normative placental architecture, emphasizing the invasion of the villi. Further, congested blood vessels and the presence of inflammatory cells, along with heightened collagen deposition, suggest an underlying pathological process affecting placental health. These findings underscore a perturbation of placental homeostasis, emphasizing the necessity for further investigation into the mechanisms contributing to placental pathology in postmenopausal pregnancies.

Women's Understanding of the Term 'Pap smear': A Comparison of Spanish-Speaking Versus English-Speaking Women.

Objective To compare the understanding of the term 'Pap smear' among Spanish-speaking women, as compared to their English-speaking counterparts. Methods Surveys were distributed to English and Spanish speaking female patients in an urban Obstetrics and Gynecology clinic. Patients were at least 18 years old or they were less than 18 years old and pregnant. Results A majority of participants (77.3 % English-speaking vs. 74.1 % Spanish-speaking, respectively) were able to identify at least one correct descriptor for the term Pap smear. However, Spanish-speaking women were significantly less likely to choose incorrect descriptors. Spanish-speaking women were much less likely to say that a Pap smear was the same as a Pelvic exam (45.7 vs. 78.8 %; p = 0.001), or a test for a sexually transmitted disease (25 vs. 60.6 %; p = 0.001). Conclusions for Practice Compared to English-speaking women, Spanish-speaking women are much less likely to conflate a pelvic exam with a Pap smear. Overall understanding was suboptimal, regardless of primary language, indicating that major efforts are still needed to improve functional health literacy with respect to cervical cancer screening.

Women's understanding of the term 'Pap smear'.

To assess the understanding of the term 'Pap smear' among women across the entire adult lifespan after recent changes to the guidelines on cervical cancer screening. Women attending the Obstetrics and Gynecology clinic at a large safety net teaching hospital in a Midwestern city were provided one of two versions of a confidential and anonymous survey to complete. The difference between the two versions was the way the primary research question was worded. There were 174 participants ranging in age from 15 to 69 (mean = 33.9) years. Of the 73 women who completed version A of the survey, 74 % were able to identify at least one correct descriptor for the term 'Pap smear.' Women who could identify at least one correct descriptor for the term 'Pap smear' were on average older than those who could not (mean = 36.9 vs. 28.7 years; p = 0.012). Of the 94 patients completing survey version B, 67 % could not differentiate a pelvic exam from a Pap smear. There was no association between age and ability to differentiate a pelvic exam from a Pap smear. The majority of women cannot distinguish a Pap smear from a pelvic exam. The unexpected finding of less understanding among younger women prompts a need for further research and invites discussion of whether more cervical cancer prevention education, with more emphasis on HPV vaccines in recent years, has neglected the importance of Pap smears-which is beginning to show up in knowledge of younger women. Both these findings suggest a need for increased patient education during female preventive health clinic visits.