ABSTRACT
Ectopic pregnancy is a common condition with the immediate risk of life-threatening hemorrhage and subsequent risks of infertility and recurrence. Despite remarkable advances in diagnosis and treatment, ectopic pregnancies account for 9% of all maternal deaths. Early diagnosis has led to the development of innovative surgical and nonsurgical options. The choice of treatment, including expectant, medical, and surgical approaches, depends on ectopic location, symptoms, gestational age, and future fertility desires. Goals are to make the diagnosis of ectopic pregnancy early and provide the most effective and least invasive procedure while sparing future fertility when desired.
Subject(s)
Gynecologic Surgical Procedures/methods , Laparoscopy , Pregnancy, Ectopic/surgery , Adult , Fallopian Tubes/surgery , Female , Hemostasis, Surgical , Humans , Pregnancy , Pregnancy, Ectopic/epidemiology , Pregnancy, Tubal/surgery , Salpingostomy , United States/epidemiologyABSTRACT
OBJECTIVE: The study was undertaken to determine the accuracy of the liquid-based Papanicolaou (Pap) smear in the detection of Trichomonas vaginalis organisms in women. STUDY DESIGN: Two hundred three consecutive patients who had the liquid-based Pap smear also underwent a culture for T vaginalis. A wet mount was performed if symptomatic. Results were analyzed for sensitivity, specificity, and positive and negative predictive values. RESULTS: Forty-four patients (21.6%) had a positive culture. On the liquid-based Pap smear, 28 patients (13.8%) were positive for T vaginalis, showing a sensitivity of 61.4%, a specificity of 99.4%, a positive predictive value of 96.4%, and a negative predictive value of 90.8%. When wet mount and culture were compared, a sensitivity of 50%, a specificity of 93%, a positive predictive value of 77%, and a negative predictive value of 80% were obtained. CONCLUSION: The presence of T vaginalis organisms, as stated by the liquid-based Pap smear pathology report, is accurate and warrants treatment without further testing.
Subject(s)
Papanicolaou Test , Trichomonas vaginalis/isolation & purification , Vaginal Smears/methods , Adult , Aged , Aged, 80 and over , Animals , Female , Humans , Middle Aged , Predictive Value of Tests , Sensitivity and Specificity , Vaginal Smears/standardsABSTRACT
BACKGROUND: A viable intrauterine pregnancy with salpingitis has been reported rarely. CASE: A 27-year-old woman at 10 weeks' gestation developed abdominal pain, fever, leukocytosis, peritoneal signs, closed cervix and a viable pregnancy. Progression from acute salpingitis to septic abortion was documented. CONCLUSION: Acute salpingitis in the presence of a viable pregnancy warrants aggressive intervention.
