ABSTRACT
INTRODUCTION: Loop electrosurgical excision procedure (LEEP) is a basic procedure in the conization performed on patients with CIN II/III. After excisional therapy, close follow up is essential for the earlier detection of residual and recurrent disease. The value of PAP-smear and HPV-DNA tests for investigation of residual and recurrent disease in patients diagnosed with high-grade intraepithelial lesion after LEEP treatment was purposed. MATERIALS AND METHODS: 42 patients were included in the study for whom epithelial cell anomalies were detected at PAP-smear screening. HPV-DNA test, colposcopy, cervical biopsy and endocervical curettage and then LEEP procedures were performed. The patients were followed with HPV DNA and PAP-smear tests in terms of recurrence and residual disease at 3-month intervals. RESULTS: HPV-DNA examination revealed that 36 patients (85.7%) were positive for high-risk HPV-DNA before treatment. Histopathological evaluation of LEEP materials revealed the presence of CIN I in 4 and CIN II/III in 38 patients. Surgical margin was positive in five patients. No sign of invasive cervical neoplasia was detected. The high-risk HPV DNA's persistence was observed in 11 (30.6%) of the 36 patients of whom HPV-DNA positivity had been detected before the treatment. HSIL was detected in four patients using PAP-smear on the third month examination. Positive LEEP surgical margins were found to be positively correlated both with HPV-DNA positivity detected during the follow-up examination and with the presence of residual disease in the follow-up PAP smear. CONCLUSION: LEEP is a basic procedure in the conization performed on patients with CIN II/III. In spite of high recurrence and residual disease rates, this kind of patients requires close monitoring. Follow-up with HPV and PAP-smear tests after LEEP treatment is of great importance in the detection of residual or recurrent disease.
Subject(s)
DNA, Viral/analysis , Electrosurgery/methods , Uterine Cervical Dysplasia/surgery , Adult , Biopsy , Female , Follow-Up Studies , Humans , Middle Aged , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Neoplasm Recurrence, Local/virology , Neoplasm, Residual/pathology , Neoplasm, Residual/virology , Papanicolaou Test , Papillomaviridae/genetics , Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Prospective Studies , Recurrence , Treatment Outcome , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/surgery , Uterine Cervical Neoplasms/virology , Vaginal Smears , Uterine Cervical Dysplasia/pathology , Uterine Cervical Dysplasia/virologyABSTRACT
PURPOSE: We investigated the relation between body mass index (BMI) value during labor and pregnancy outcomes in a group of Turkish population. METHODS: The data on 9,112 singleton pregnancies were reviewed retrospectively. Patients were classified into three groups according to their BMI values: normal (BMI 20-25 kg/m(2), n = 5,685, 62.4%), overweight (BMI 20-25 kg/m(2), n = 2,214, 24.3%) and obese (BMI >30 kg/m(2), n = 1,213, 33.3%). RESULTS: Gestational diabetes mellitus (P = 0.000), risk of delivering a baby >90th percentile (P = 0.000) and preeclampsia (P = 0.000) were increased in parallel with increased BMI. A statically significant difference was observed between the normal and obese groups in terms of the abdominal cesarean rates (P = 0.020). However, a significant difference was not observed in terms of preterm delivery (P = 0.846), birthweight <10th percentile (P = 0.484), placenta previa (P = 0.880), ablatio placenta (P = 0.499) and intrauterine death (P = 0.175) between the groups. CONCLUSIONS: Regardless of the gestation, BMI is a factor that affects the fetal and maternal outcomes. The obese and overweight women should be followed up carefully during the labor and delivery.
