ABSTRACT
OBJECTIVE: This study was conducted to evaluate the status and role of cervical cytology affected by human papillomavirus infection and other infectious diseases screened during routine prenatal checkups. METHODS: We retrospectively examined medical records containing the screening results for infectious diseases and cervical cancer in women who delivered neonates in our hospital from 2014 to 2017. RESULTS: Among 3393 deliveries, 18.8% of women underwent a regular cervical cancer screening within 1 year of becoming pregnant, and 2641 women underwent a cervical cytology screening during this pregnancy. The cytological diagnostic results showed that 2562 women (97.0%) were negative for intraepithelial lesions or malignancy, whereas 79 (3.0%) had abnormal results. Of those with abnormal cytology results, 70 had abnormal cytology that was newly detected in this pregnancy, and 42 had grade ≥1 cervical intraepithelial neoplasia lesions. Spatulas were the most frequently used cytological sampling instruments, followed by cotton swabs. Cervical cytology revealed no major adverse reactions during these pregnancies. CONCLUSIONS: Our results confirm the importance of screening for infectious diseases during pregnancy. Only 20% of the women underwent a regular pre-pregnancy cervical cytology screening. Cervical cytology screening during pregnancy may currently be playing a crucial role in preventing cervical cancer in Japan.
Subject(s)
Communicable Diseases , Papillomavirus Infections , Uterine Cervical Dysplasia , Uterine Cervical Neoplasms , Colposcopy , Early Detection of Cancer/methods , Female , Humans , Infant, Newborn , Mass Screening , Papillomaviridae , Papillomavirus Infections/diagnosis , Pregnancy , Retrospective Studies , Uterine Cervical Neoplasms/pathology , Vaginal Smears , Uterine Cervical Dysplasia/diagnosisABSTRACT
The efficacy and feasibility of proton beam therapy (PBT) for recurrent ovarian carcinoma had not been determined. Here we presented a case of recurrent ovarian carcinoma that was successfully treated with PBT. A 48-year-old woman who was diagnosed as left ovarian clear cell carcinoma underwent surgery without removal of two tumors. After achieving complete remission with postoperative chemotherapy, a recurrent tumor was found in the sigmoid colon, for which a colostomy was performed. Because second-line chemotherapy was not effective, PBT was selected; there were no complications, except for a transient low-grade fever. After 1 year of PBT, the tumor completely disappeared and the patient had been disease-free for over 8 years. PBT may be an effective and less invasive treatment modality for recurrent ovarian carcinoma.
Subject(s)
Carcinoma/radiotherapy , Neoplasm Recurrence, Local/radiotherapy , Ovarian Neoplasms/radiotherapy , Proton Therapy/methods , Female , Humans , Middle Aged , Treatment OutcomeABSTRACT
OBJECTIVE: Cesarean delivery at a preterm gestational age has been related to maternal complications such as bleeding and infection. However, previous reports are conflicting, and there is no consensus on the matter. We aimed to clarify the adverse effect of preterm cesarean delivery with an emphasis on maternal bleeding. STUDY DESIGN: We conducted a retrospective study comparing the frequency of maternal adverse outcome between preterm emergency cesarean delivery and term emergency cesarean delivery. Nine hundred and forty seven preterm cases and 1056 full-term cases were included in the study. We analyzed the frequency of abnormal bleeding defined as 1500 mL or more as primary outcome, blood transfusion rate, and rate of postoperative administration of antibiotics as secondary outcome. Logistic regression analysis was performed for confounding variables; age at delivery, primiparity, obesity, prior history of uterine surgery, abnormal placental position, abnormal glucose tolerance, hypertension during pregnancy, early rupture of membranes, and general anesthesia use during operation. As secondary analysis, to study the effects of method of incision, we compared adverse outcomes among classical cesarean delivery, inverted T incision, and upper segment incision within preterm emergency cesarean delivery. RESULTS: Preterm cesarean delivery had significantly higher rates of abnormal bleeding, transfusion and use of antibiotics than term cesarean delivery. Among the preterm delivery, classical incision was related to increased rate of blood transfusion and need for antibiotic treatment. CONCLUSION: Preterm cesarean delivery increases the risk of maternal bleeding. This should be considered especially in the setting of early preterm birth.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Blood Loss, Surgical/statistics & numerical data , Blood Transfusion/statistics & numerical data , Cesarean Section/adverse effects , Adult , Case-Control Studies , Cesarean Section/methods , Cesarean Section/statistics & numerical data , Emergencies , Female , Gestational Age , Humans , Logistic Models , Postpartum Period , Pregnancy , Pregnancy Trimester, Second , Premature Birth , Retrospective StudiesABSTRACT
As labor may mask a symptom of the rupture of ovarian cyst and delivery is a risk factor of its rupture, the possibility of rupture of ovarian cyst should always be considered during delivery.
