Evolving cervical imaging technologies to predict preterm birth.

Preterm birth, defined as delivery at less than 37 weeks' gestation, increases maternal-fetal morbidity and mortality and places heavy financial and emotional burdens on families and society. Although premature cervical remodeling is a major factor in many preterm deliveries, how and why this occurs is poorly understood. This review describes existing and emerging imaging techniques and their advantages and disadvantages in assessing cervical remodeling. Brightness mode (B-mode) ultrasound is used to measure the cervical length, currently the gold standard for determining risk of preterm birth. Several new B-mode ultrasound techniques are being developed, including measuring attenuation, cervical gland area, and the cervical consistency index. Shear wave speed can differentiate between soft (ripe) and firm (unripe) cervices by measuring the speed of ultrasound through a tissue. Elastography provides qualitative information regarding cervical stiffness by compressing the tissue with the ultrasound probe. Raman spectroscopy uses a fiber optic probe to assess the biochemical composition of the cervix throughout pregnancy. Second harmonic generation microscopy uses light to quantify changes in collagen fiber structure and size during cervical maturation. Finally, photoacoustic endoscopy records light-induced sound to determine optical characteristics of cervical tissue. In the long term, a combination of several imaging approaches, combined with consideration of clinical epidemiologic characteristics, will likely be required to accurately predict preterm birth.

Paratubal serous borderline tumor in an 85 years old woman: A case report.

Paratubal cysts are incidental, common and benign lesions with few cases of borderline tumor and adenocarcinoma been reported in the literature. Herein, we are discussing a case of an 85 years old woman who visited her Obstetrics and Gynecologist for a chief complaint of post-menopausal bleeding. Physical examination revealed a slightly enlarged uterus. The diagnosis of fibroids were made on ultrasound. A total hysterectomy with bilateral salpingo-oophorectomy was performed without complications. The gross examination of the specimen was most remarkable for multiple intramural fibroids and a right simple paratubal cyst meausirng 1 × 1 cm. Microscopical evaluation of the paratubal cyst showed a simple cyst lined by stratified cuboidal epithelium with mild cytologic atypia and no stromal invasion, findings consistent with serous borderline tumor rising in a paratubal cyst. Due to the small size of the tumor and its confinement to the cyst, a follow-up was advised. Serous borderline tumors arising in paratubal cyst are very rare with only eight cases reported in the literature. Their existence should be acknowledged to plan patient treatment and outcome.