4 research outputs found
Does uterine position affect pain intensity during outpatient diagnostic hysteroscopy?
No full textObjective: To assess the impact of uterine position on pain intensity during outpatient diagnostic hysteroscopy. Materials and Methods: Retrospective data from 312 diagnostic hysteroscopy patients were evaluated. Pain was measured using a 10-cm visual analog scale (VAS). Analyses were performed to determine associations between uterine position [anteverted-anteflexed (AA), anteverted-retroflexed (AR), retroverted-anteflexed (RA), retroverted-retroflexed (RR)], and pain intensity during the procedure (VAS > 3 vs. VAS ≤ 3). Patient characteristics and clinical variables were evaluated using univariate and multivariate analysis. Results: Logistic regression analysis revealed no association between uterine position and pain intensity during outpatient diagnostic hysteroscopy [AA uterus, adjusted odds ratio (AOR) = 0.82, confidence interval (CI): 0.39–1.72; AR uterus, AOR = 0.65, CI: 0.25–1.71; RA uterus, AOR = 1.37, CI: 0.38–4.84; RR uterus, AOR = 0.84, CI: 0.22–3.17]. Conclusion: The present data suggest that uterine position does not affect pain intensity during diagnostic hysteroscopy
Nitric oxide metabolite levels and assessment of cervical length in the prediction of preterm delivery among women undergoing symptomatic preterm labor.
No full textOBJECTIVE: To evaluate the diagnostic accuracy of measuring cervical length (CL) in combination with cervical and plasma nitric oxide metabolite (NOx) levels to identify women undergoing preterm labor (PTL) who will deliver preterm. METHODS: A hospital-based prospective cohort study of 730 women undergoing spontaneous PTL between 24 and 33weeks+6days of pregnancy was conducted. Measurement of cervical and plasma NOx levels and ultrasonographic assessment of CL were performed to find the best model to predict preterm delivery (PTD). Optimal cut-off values were calculated by receiver operating characteristic (ROC) curve analysis. Logistic regression analysis and rank correlation tests were also performed. RESULTS: CL of 15mm or less, cervical NOx levels greater than 87.6μmol/L, and plasma NOx levels greater than 123μmol/L (P<0.0001) were the only factors significantly associated with PTD within 7days of sampling. This combined model provided high diagnostic accuracy (sensitivity 80.0\%; specificity 99.2\%). Both cervical and plasma NOx levels were negatively correlated with CL (r=-0.453, P<0.0001 and r=-0.362, P<0.0001, respectively). CONCLUSION: Combined measurement of CL and levels of cervical and plasma NOx could help identify women undergoing symptomatic PTL who are at increased risk of PTD
Age-related changes in the diagnostic assessment of women with severe cervical lesions
No full textObjectives To evaluate the effect of age on the diagnostic assessment of women with severe cervical intraepithelial neoplasia (CIN).Methods This retrospective observational study included 338 consecutive women with a diagnosis of CIN3 on cone specimen. Patients were divided into three groups according to age: = 50 years (Group C). Clinical and colposcopic variables were compared, and human papillomavirus (HPV) genotype distribution was measured.Results The most common HPV genotype was HPV-16 (63.65%), followed by HPV-33 (7%), HPV-18 (6.2%), and HPV-31 (5.4%). The rate of the following high-grade lesion predictors was lower in Group C than in Groups A and B: HPV-16 infections (55.9% vs. 75% vs. 70.9%, respectively, p = 0.022); high-grade colposcopic impression (29.4% vs. 51.8% vs. 51.7%, respectively, p < 0.0001); and high-grade cytological changes (30.9% vs. 56.2% vs. 45.4%, respectively, p < 0.025). An endocervical lesion location was more frequent in Group C than in Groups A and B (55.6% vs. 6.8% vs. 11.8%, respectively, p < 0.0001).Conclusion Women aged 50 years and older with CIN3 showed a significant reduction of high-grade lesion predictors along with physiological confounding cervical changes (transformation zone type 3 and endocervical lesion location). The diagnostic work-up of cervical lesions in older women should provide their potential consideration as a special population
Diagnostic accuracy of endometrial thickness for the detection of intra-uterine pathologies and appropriateness of performed hysteroscopies among asymptomatic postmenopausal women
No full textObjective: To measure the diagnostic accuracy of endometrial thickness for the detection of intra-uterine pathologies among asymptomatic postmenopausal women, and to test the diagnostic accuracy and appropriateness of performed hysteroscopies.Study design: Prospective study of 268 asymptomatic postmenopausal women with endometrial thickness >= 4 mm referred to diagnostic hysteroscopy. The diagnostic accuracy of various endometrial thickness cut-off values was tested. Histological and hysteroscopic results were compared to measure the diagnostic accuracy of outpatient hysteroscopies.Results: No endometrial thickness cut-off values had optimal diagnostic accuracy [positive likelihood ratio (LR+) >10 and negative likelihood ratio (LR-) = 8 mm (LR+ 10.05 and LR- 0.22). An endometrial thickness cut-off value >= 10 mm did not miss any cases of endometrial cancer. The success rate of diagnostic hysteroscopy was 89%, but 97% of these revealed a benign intra-uterine pathology. The diagnostic accuracy of hysteroscopy was optimal for all intra-uterine pathologies, except endometrial hyperplasia (LR- 0.52).Conclusion: Using an endometrial thickness cut-off value >= 4 mm, only 3% of performed hysteroscopies were useful for the detection of pre-malignant or malignant lesions. Despite the finding that endometrial thickness did not show optimal diagnostic accuracy, using the best cut-off value (>= 8 mm) may be helpful to decrease the number of false-positive results. No cases of endometrial cancer were diagnosed in asymptomatic postmenopausal women with endometrial thickness <10 mm. (C) 2014 Elsevier Ireland Ltd. All rights reserved
