Cytohistological discrepancies of cervico-vaginal smears and HPV status

Objectives: Discrepancies between abnormal cervical cytology or high-risk human papillomavirus (HR-HPV) status (cytolo-gy negative/HPV positive) and subsequent histological findings are a common occurrence. After using co-testing, the dis­crepancies between the HR-HPV status and cervical cytology have become an issue. In this study, we aimed to determine the characteristics of women with a discrepancy between histology and cytology/HR-HPV status, in terms of diagnosis, review and identification. Material and methods: A total of 52 women, patients of the University Hospital between 2013–2015, with cytohistologi­cal or HR-HPV status discrepancy were recruited for the study and retrospectively analyzed. The cytological samples were liquid-based Pap smears, classified according to the 2001 Bethesda system. The HR-HPV status was identified using the Hybrid Capture 2 HR-HPV DNA assay. The histological samples were obtained by cervical biopsy as well as large loop exci­sion of the transformation zone (LLETZ). Results: A cytohistological discrepancy was demonstrated in patients with (-)cytology/HR-HPV(+), ASCUS, LSIL, ASC-H, HSIL, AGC-NOS: 17.3%, 23.07%, 26.9%, 9.5%, 17.3% and 5.7%, respectively. When the degree of atypia in cytology increases, the concurrency of cervical cytology with biopsy also increases. A positive HR-HPV co-test result (19/24, 79.1%) was observed in nearly all CIN2 ≥ (+) cases. Our study emphasizes the significance of HR-HPV testing to determine CIN2 ≥ (+) cases, even in the presence of a normal cytological result. Conclusions: In case of cytohistological or HR-HPV discrepancies, a careful review of the HR-HPV status and the degree of cytological atypia should be performed before further intervention

The Applicability and Use of Doppler Ultrasonography in The First Trimester

In contemporary obstetrics, the idea of “the pathological processes which are apt to cause complications or diseases at the later stages of pregnancy or even at the postnatal period could be revealed in early pregnancy weeks is spreading. Most researchers are readily willing to use all available means of technology to detect the pathologies which could develop in the early weeks of pregnancy. Along with the first trimester screening tests, the importance and application fields of the first trimester doppler ultrasonography is frequently discussed. This review will discuss shortly the first trimester screening tests and then will focus on the advantages and applicability of the first trimester doppler ultrasound as mentioned in the current literature

Prenatal Diagnosis of Megacyst In Early Pregnancy: A Case Report

A case with an incidental ultrasonographic finding of a megacysty in the 14th week of pregnancy, leading to an early diagnosis of Trisomy 18 is presented. An 18-year-old primigravida attending to outpatient clinic for her routine antenatal check up at the 14th week of her pregnancy was observed to have a fetus with a 12 mm bladder. There were no other apperant major organ or system abnormalities. Under the guidance of current literature, the family was counseled by obstetrics and genetics departments, and a chorion villus sampling was adviced. The result of the CVS was reported as Trisomy 18. The family’s wish of termination of the pregnancy was evaluated and the medical abortion with misoprostol induction was achieved. When evaluating and screening an early pregnancy with ultrasound for fetal abnormalities, the size of the fetal bladder should be evaluated carefully and megacystic cases should be kept in mind with the possibility of chromosomal abnormalities

A Historical Technique for Replacement of Postpartum Uterine Inversion: A Case Report

Acute puerperal uterine inversion is an unpredictable life threatening obstetrical complication. The etiology is unknown; but, traction of the umbilical cord before detachment of placenta and application of pressure over fundus are blamed and considered as risk factors. We are reporting a case of uterine inversion in which the uterus could not be replaced manually due to cervical constriction ring, and in which the uterus had to be replaced using a method described originally by Spinelli