Coriocarcinoma gestacional primario de cuello uterino. Presentación de un caso

Choriocarcinoma represents a type of malignant tumor of gestational trophoblastic disease. It can develop after a molar pregnancy, miscarriage, normal or ectopic pregnancy. Generally its seat site is the uterine body; infrequent places such as the cervix have been described. We report the case of a 37-year-old patient is reported, VI gestations IV deliveries I cesarean section I molar pregnancy, with abnormal uterine bleeding, which is referred to the Hospital Oncology Service. On gynecological examination, an exophytic mass is observed in the cervix. A biopsy was taken that reported: Gestational choriocarcinoma and plasma levels of β-hCG were verified: 13805 IU / L. A total abdominal hysterectomy was performed with preservation of the ovaries. It was concluded as stage I of the International Federation of Gynecology and Obstetrics and 8, according to the score of the World Health Organization (ST I: 8), for which adjuvant was indicated. Currently no evidence of disease. Keywords: Choriocarcinoma, gestational trophoblastic disease, cervix.

Human Papillomavirus Prevalence and Genotype Distribution Landscapes in Shannan City, Tibet Tibetan Autonomous Region, China

Background: Data regarding human papillomavirus (HPV) prevalence and genotype distribution are limited in Shannan City, Tibet Tibetan Autonomous Region, China. The purpose of this study is to provide reliable data for guiding women in Shannan City in cervical cancer screening and HPV vaccine innoculation. Methods: HPV testing was performed on women aged 16 to 109 years (mean age 44.03 ± 9.25 years) from Shannan City in 2019 and 2020, which was implemented technically by gynecological examination, vaginal discharge smear microscopy, cytology, and HPV detection. The overall prevalence, age-specific prevalence, and genotype distribution were analyzed. Results: A total of 48,126 women received HPV testing, of which 3,929 were detected human papillomavirus. The HPV-positive rate was 8.16% (3,929/48,126), and the highest prevalence was in the ≤ 25-year-old age group (12.68%). After the age of 25, the prevalence rate decreased rapidly, and then slowly increased from 7.49% in the 46-55 age group to 9.82% in the ≥ 66 age group, showing a “U-shaped” pattern. The positive prevalence of HPV 16 or 18-only was 1.43%, that of other HPV genotypes except HPV 16 or 18 was 6.39%, and mixed HPV infections including HPV 16 or 18 was 0.34%. Conclusions: The HPV infection rate in Shannan city is rather low, and the age-specific prevalence of HPV infection presents a “U” curve, suggesting the importance of screening among younger women and the necessity of detection among older women.

Prevalence of Uterine Fibroids in Women in Eastern Siberia: A Cross-Sectional Study

The objective of this study was to determine uterine fibroids (UF) prevalence in the unselected (medically unbiased) female population in the Eastern Siberia region, Russia, and to evaluate the significant risk factors. Methods and Results: The study included 2389 women aged from 18 to 80 yrs (mean age of 42.8±11.9 yrs). Subjects were evaluated consecutively by means of questionnaires, anthropometry, vital signs, gynecological examination, and pelvic ultrasound. We demonstrated 26.41% UF prevalence in the unselected female population from Eastern Siberia. We found that the single nodules predominate among all fibroids, with the types 3–5 and the size of either ≤1 cm or ≥4 cm as the most frequent variants. Our study confirmed that the prevalence of fibroids increases with age. The incidence of fibroids is significantly lower in women with the age at menarche of 15 years. We also have found that a BMI of more than 25 kg/m2, more than 4 pregnancies, and late menopause are risk factors for the development of fibroids.

Psychological Cognition of Women of Childbearing Age on the Use of Cosmetics During Pregnancy

Objective: To investigate the psychological cognition of women of childbearing age on the use of cosmetics during pregnancy, so as to provide guidance for women of childbearing age to correctly use cosmetics during pregnancy. Methods: A total of 180 women of childbearing age who underwent gynecological examination in Dezhou People’s Hospital from October 2020 to October 2021 were selected as the research subjects. Questionnaires were used to investigate the psychological cognition of women of childbearing age on the use of cosmetics during pregnancy. Results: Among the 180 women of childbearing age, 48 (26.67%) felt that cosmetics cannot be used during pregnancy, 60 (33.33%) felt that it did not matter, and 72 (40.00%) agreed that cosmetics can be used during pregnancy. In addition, urban women, highly educated women, unmarried women, and enterprise employees agreed with the use of special cosmetics for pregnant women or the selective use of cosmetics during pregnancy. Conclusion: Most women of child-bearing age felt that cosmetics can be used during pregnancy; this cognition is related to their education level, occupation, and registered residence.

Progesterone Concentrations during Canine Pregnancy

Pregnancy and lactation are amongst the most challenging times of a bitch’s life. Most studies focusing on the endocrinological aspect of pregnancy consider only a small number of animals. The aim of this study was to evaluate progesterone (P4) concentrations in a large number of bitches during early, mid and late pregnancy. In total, 126 bitches of various breeds were recruited following a thorough clinical and gynecological examination during estrus. Blood samples were collected three times (T1–T3) during pregnancy or from non-pregnant dogs in diestrus, and P4 was measured via chemiluminescence. At T1 (11–19 days post-ovulation (dpo)), serum P4 concentrations were 30.23 ± 6.65 ng/mL and 28.45 ± 6.26 ng/mL, at T2 (23–32 dpo) they were 22.73 ± 6.27 ng/mL and 22.59 ± 5.77 ng/mL and at T3 (52–60 dpo) they were 6.68 ± 2.18 ng/mL and 3.17 ± 2.26 ng/mL, in pregnant (n = 98) and non-pregnant (n = 23) dogs respectively. The P4 concentrations differed significantly between pregnant and non-pregnant animals at the last examination (p ≤ 0.001). In the context of hypoluteoidism, the gathered data yielded interesting results. Overall, 28 out of 98 pregnant bitches showed a greater decline (>15 ng/mL) in P4 concentrations from early to mid-pregnancy, and 56 bitches showed P4 concentrations lower than deemed adequate (>20 ng/mL at T1 and T2, >5 ng/mL at T3) according to existing recommendations. Despite not being supplemented with P4, none of those animals suffered from abortion or preterm delivery. Considering that supplementation of P4 can entail considerable risks for the bitch and the puppies, more research on P4 concentration patterns, diagnosis of hypoluteoidism and treatment indications and options is indicated.

Surgical lysis of nerve entrapment caused by retroperitoneal fibrosis/adhesions; two case reports and a literature review

Introduction: Retroperitoneal fibrosis (adhesions) in the pelvic area is rare and not well known in gynecology. However, their presence can cause compression neuropathy leading to severe pain symptoms involving the lower extremities. A neuropelveological approach can be applied in dealing with such cases in diagnosis and management. Objective: To demonstrate neurolysis of sacral nerves in patients with retroperitoneal fibrosis (adhesions). Case presentations: Case 1: A 43-year-old gravidity 1 parity 1 female patient with known endometriosis presented with dysmenorrhea, dyspareunia, and left-sided sciatica. Gynecological examination revealed a rectovaginal nodule and full obliteration of pouch of Douglas. Robot-assisted laparoscopic sacral neurolysis and dissection of pouch of Douglas with rectal nodule shaving was performed. The patient was symptom free 6 months postoperatively. Case 2: A 49 years old gravidity 2 parity 2 female patient presented with severe pain on the left groin and leg, dysuria, and constipation, which required frequent manual evacuation of the feces. The begin of her symptoms coincided with a previous laparoscopic total hysterectomy, where she experienced postsurgical hemorrhage. Laparoscopic sacral neurolysis with adhesiolysis was performed. The patient was symptom free 6 months postoperatively. Conclusion: Pelvic retroperitoneal fibrosis (adhesions) are rarely encountered in gynecology. However, they should be included in differential diagnosis in patients presenting with pelvic pain accompanied by lower extremity pain, urinary, and/or bowel symptoms. Since presurgical diagnosis of fibrosis (adhesions) is hard with visualization techniques such as transvaginal ultrasound or magnetic resonance imaging, a thorough neuropelveological examination can be helpful in such cases.

LEIOMYOMA TYPES, INCIDENCE AND CLINICAL PRESENTATION - A STUDY AT A TERTIARY CARE HOSPITAL

A cross sectional studywas conducted over a period of 15 months from 1st Jan 2020 to 31st March 2021 at Malla Reddy Hospital,a tertiary care hospital. To study the incidence of fibroids according to FIGO categorization and their clinical presentation. 38 confirmed cases of fibroid uterus in the age group 20 – 60 attending gynecology OPD were interviewed and subjected to regular gynecological examination, PAP smear, dilatation and curettage procedures. Based on the studies, 60% of these patients were subjected to total abdominal hysterectomy as a part of treatment and the intra operative findings of the specimens were noted. The leiomyomas were classified according to the histopathological and ultrasonographic findings based on FIGO categorization. Highest incidence was seen 41 to 45 years age (52.6%). Incidence of Leiomyoma types according to FIGO subclassification system were found to be Type0=5%, Type1=5%, Type2=5%, Type3=13%, Type4=30%, Type5=13%, Type6=18.6%, Type7=3.3% and Type8=5%. Multiple fibroids were more common than single fibroids. Posterior location fibroids were more common than anterior. Most common symptom was menorrhagia (73.6%) followed by spasmodic dysmenorrhea (47.3%) and metrorrhagia (26.3%), infertility and symptoms of anemia. Most common sign was pallor (58%) followed by mass per abdomen (18.4%). Incidence of associated pathology of adenomyosis (18%) ovarian cysts (8%), endometrial polyps (8%), myxoid degeneration (2.6%). The results of our study matched the existing studies.

THE SITUATION OF PRATICE CERVICAL CANCER PREVENTION AMONG REPRODUCTIVE AGE WOMEN AND HAVING GYNECOLOGICAL EXAMINATION AT LAM DONG GENERAL HOSPITAL

Objectives: The aims of this study to assess the practice of preventing cervical cancer of 15 - 49 years old and having gynecological examination women at Lam Dong General Hospital. Research method: A cross-sectional description. Interviewed practice about cervical cancer prevention of 400 women. Results: Over the course of the study, 400 women showed the number of women who had not been vaccinated is still high at 85.5%, the rate who had not been screened for cervical cancer is 62.3%. Based on the results of the study, we recommend that reproductive age women should be communicated more frequently about HPV vaccination and periodic cervical cancer screening to prevent cervical cancer.

Effect of Retained Placenta And Clinical Mastitis On Reproduction Parameters, Immune Response And Steroidogenic Receptors Gene Expression In Postpartum Crossbred Crossbreed Dairy Cows

The purpose of this study was to evaluate the effect of retained placenta (RP) and clinical mastitis (CM) on the reproductive efficiency of crossbred dairy cows during the postpartum period and to investigate the effect of them in some innate immune system indicators. For this, in the first experiment a total of 232 crossbred dairy cows were evaluated and divided into three groups as: healthy control, RP and CM. The incidence of RP and CM was evaluated after parturition until 30 days postpartum (DPP) and reproductive rates were measured. In experiment 2, 30 crossbred dairy cows were divided into three groups as in Experiment 1. Between 40 and 50 DPP, clinical, gynecological examination and endometrial cytobrush were performed to evaluate subclinical endometritis and gene expression of interleukin- 1β (IL-1β), interleukin-6 (IL-6), chemokine ligand -5 (CCL5), estrogen α (ESR1) and progesterone (PGR) receptors by qRT-PCR analysis. In Experiment 1, the conception rate at 1st AI was lower in RP and CM groups and pregnancy rate at 150 days decreased in cows with CM. Calving-to-1st AI interval and days open were shorter in healthy cows. In Experiment 2 the occurrence of subclinical endometritis was 26.7% and was higher in cows with RP and CM. The expression of IL-1β was increased in RP and CM groups, while IL-6 was less expressed in RP group. The chemokine CCL5, ESR1 and PGR were similar between groups. In conclusion, cows with RP and CM had their reproductive efficiency negatively affected and had they initial pro-inflammatory response improved by the increase of IL-β, while, IL-6 was lower in animals with RP probably because it was evaluated later in the postpartum.