[Timing of pregnancy after surgery for tubal pregnancy].

OBJECTIVE: To investigate the outcome of pregnancy in women after surgical treatment of tubal pregnancy and measures to improve the rate of successful postoperative pregnancy. METHODS: A retrospective study was conducted among 424 women who underwent surgical treatment for tubal pregnancy between Jan 1999 and Jan 2004. All patients desiring a second pregnancy were followed up for 18-72 months for the outcome. Cumulative fertility and recurrence curve were compared and calculated by life-table. RESULTS: Of the 424 women with tubal pregnancy, 177 (41.7%) had intrauterine pregnancy after the operation, while 102 (24.1%) had recurrent ectopic pregnancy. Among the 177 women with intrauterine pregnancy, 85 (48.02%) became pregnant within 6 months after the operation, 133 (75.14%) within one year, and the cumulative intrauterine pregnancy rate approached 94.92% within 2 years. But among the 102 women with recurrent ectopic pregnancy, only 10 (9.8%) were pregnant within 6 months after the operation, and 49 (48.04%) within 18 months, with a cumulative ectopic pregnancy rate of 67.65%. CONCLUSION: For women receiving surgery for ectopic pregnancy, the chance for intrauterine pregnancy can be the greatest within 6 months after operation and reduced markedly after 2 years, when recurrent ectopic pregnancy can be likely. Early plans for pregnancy and hydrotubation following the surgery may prove beneficial for raising the chances for postoperative intrauterine pregnancy.

[Combining high-risk human papillomavirus DNA test and cytological test to detect early cervical dysplasia].

OBJECTIVE: To assess the value of combining high-risk human papillomavirus (HPV) DNA test and cytological test in detection of early cervical dysplasia. METHODS: During January 2003 to June 2004, a total of 5210 women were screened by combining high-risk HPV DNA test (hybrid capture II, HC-II) and cytological test (liquid-based ThinPrep cytology test), and the abnormal cytological or HPV DNA findings were further biopsied under the colposcope. RESULTS: The age of the patients was between 17 to 80, the average was 34 +/- 9. Final pathological diagnosis was HPV infection in 890 cases, cervical intraepithelial neoplasia (CIN) I in 83 cases, CIN II in 73 cases, CIN III in 80 cases, invasive cervical cancer in 54 cases, endometrial cancer in 5 cases, vaginal intraepithelial neoplasia in 1 case and cervical tuberculosis in 1 case. Based on the criteria of histology and pathology, the sensitivity, specificity, positive-predictive value and negative-predictive value of high-risk HPV DNA test for detecting all cases of CIN II, III were 92.22%, 74.71%, 5.19% and 99.84% respectively. In detecting all cases of CIN II, III by cytological test, for atypical squamous cell of undetermined signification (ASCUS), the sensitivity, specificity, positive-predictive value and negative-predictive value were 90.00%, 80.34%, 11.94% and 99.63% respectively; for low-grade squamous intraepithelial lesion (LSIL), the sensitivity, specificity, positive-predictive value and negative-predictive value were 70.13%, 91.58%, 11.11% and 99.51% respectively; for high-grade squamous intraepithelial lesion (HSIL), the sensitivity, specificity, positive-predictive value and negative-predictive value were 48.05%, 98.46%, 31.90% and 99.21% respectively. By the combination of high-risk HPV DNA test and cytological test, the sensitivity, specificity, positive-predictive value and negative-predictive value for detecting all cases of CIN II, III were 98.70%, 73.08%, 5.21% and 100.00% respectively. The infection rate of HPV in cervical cancer was 85.2% (46/54), in CIN III 92.5% (74/80), in CIN II 86.3% (63/73) and in CIN I 45.8% (38/83). CONCLUSIONS: High-risk HPV DNA test has high sensitivity and negative-predictive value. The combination of high-risk HPV DNA test and cytological test increases the sensitivity and negative-predictive value, but it does not increase the specificity. The performance of biopsy under the colposcope can help the diagnosis of cervical dysplasia.

[Pregnancy and delivery outcomes after loop electrosurgical excision procedure of cervical intraepithelial neoplasia].

OBJECTIVE: To investigate the effects of loop electrosurgical excision procedure (LEEP) on pregnancy and delivery outcomes of patients with cervical epithelial neoplasia (CIN). METHOD: The delivery data of 27 pregnant women who had LEEP from May 1995 to April 2002 were retrospectively collected and analysed. RESULTS: The mean age of the 27 women was 30.3 years (range 23 approximately 40 years). Ten women underwent artificial abortion. One ectopic pregnancy and two spontaneous miscarriages occurred at 6 to 8 weeks of gestation. There were 14 term pregnancies, 9 of them via vaginal delivery and 5 via caesarean section. The birth weight of newborns ranged from 2905 to 4000 g. All of newborns had a high Apgar score. No asphyxia occurred. CONCLUSIONS: LEEP is a safe and effective treatment for patients with CIN. It will not increase the risk of pregnancy and delivery of the patients.