Maternal and perinatal outcomes in women with placenta praevia and accreta in teaching hospitals in Western Turkey

WOS: 000340297200002PubMed: 24734898In this retrospective study, we investigated patient characteristics and fetal and maternal outcomes of placenta praevia and accreta at two tertiary hospitals in Istanbul. A total of 364 pregnancies complicated by placenta praevia with (n = 46) and without (n = 318) placenta accreta managed between January 2005 and December 2010 were reviewed. Among 364 women, 46 (12.6%) had placenta accreta and 318 (87.4%) had placenta praevia without accreta. The rates of curettage history and caesarean delivery were significantly higher in the group with placenta accreta. Furthermore, we found that emergency surgery had negative effects on maternal outcomes in the placenta praevia group. In addition, when accreta was suspected at ultrasound examination in women who had placenta praevia, the mean estimated blood loss during surgery was reduced significantly. If placenta praevia is detected, a careful ultrasound examination should be performed and the patient should undergo elective surgery at a tertiary referral hospital

A novel preoperative scoring system for predicting endometrial cancer in patients with complex atypical endometrial hyperplasia and accuracy of frozen section pathological examination in this context: A multicenter study

Objective: To estimate the accuracy of frozen pathological analysis in patients preoperatively diagnosed with endometrial atypical complex hyperplasia (ACH) and to develop a model predicting the probability of the presence of endometrial carcinoma in ACH. Methods: Patients (n = 128) who underwent total hysterectomies because of diagnoses of ACH were evaluated at four tertiary centers. Results: Diagnoses made using frozen sections and permanent sections were in good agreement (k = 0.61, p 12 mm). The AUC of this score was 0.793, and the score afforded 80.9% sensitivity, 70.3% specificity, a 75.3% positive predictive value, and a 76.4% negative predictive value, when a score of 5 was used as a cutoff. Conclusions: Patients with ACH should be evaluated by gynecological oncologists and intraoperative frozen section analysis should be performed by pathologists specializing in the evaluation of gynecological malignancies, because ACH is closely associated with endometrial cancer (EC). Our novel preoperative scoring system may aid in the detection of patients at increased risk of EC and thus guide general gynecologists. © 2014 S. Karger AG, Basel

The impact of surgical staging on the prognosis of mucinous borderline tumors of the ovaries: A multicenter study

Background/Aim: The purpose of this study was to prove the effect of complete surgical staging of patients with mucinous borderline ovarian tumors (mBOTs) especially appendectomy on progression-free survival (PFS) and overall survival (OS). Patients and Methods: The database of 14 gynecological oncology departments from Turkey and Germany were comprehensively searched forwomen who underwent primary surgery for an ovarian tumor between January 1, 1998, and December 31, 2015, and whose final diagnosis was mBOT. Results: A total of 364 patients with mBOT with a median age of 43.1 years were included in this analysis. The median OS of all patients was 53.1 months. The majority of cases had Stage IA (78.6%). In univariate and multivariate analyses, radical surgery, omentectomy, appendectomy, lymphadenectomy, and adding adjuvant chemotherapy were not independent prognostic factors for PFS and OS. Furthermore, FIGO stage (?IC vs. <IC), radical surgery, and staging surgery were not independent risk factors for recurrence of mBOTs. Finally, abnormal macroscopic appendix and FIGO stage (?IC vs. <IC) were independent risk factors for appendiceal involvement (p=0.032). Conclusion: Patients with conservative surgery do not have higher recurrence rates. Fertility-sparing surgery should be considered in the reproductive age group. Detailed surgical staging including lymphadenectomy, appendectomy, and omentectomy does not have an impact on survival rates

ANALYSIS OF MUCINOUS BORDERLINE OVARIAN TUMORS: A MULTICENTER STUDY

WOS: 00042323520409