Objective: The aim of this study is to assess the correlation between transabdominal and transvaginal ultrasound measurements of the cervix in pregnancy. If transabdominal ultrasound measurement of cervical length is found to provide effective information, it could be used in patient counselling and when making clinical decisions. Material and Methods:One hundred and twenty seven pregnant patients between 18-26 weeks of pregnancy were enrolled in this prospective study for measuring cervical length, both by transabdominal and transvaginal ultrasound scan after bladder emptying. Transabdominal and transvaginal measurements were compared and correlated. Results:In patients with transvaginal ultrasound scan (TVS) cervical length ≤32 mm, TVS cervical length was found to be shorter than by transabdominal ultrasound scan (TAS). Most of these patients needed >3 cm of vertical pocket of urine in the bladder for adequate visualisation of the cervix. In patients with TVS cervical length >32 mm, the TVS measurement of the cervix was longer than the TAS measurement of the cervix. In these patients, the cervix could be seen by TAS when there was either ≤3 cm vertical pocket of urine in the bladder or an empty bladder. Statistical tests showed that there is a significant difference between TAS and TVS cervical measurements and that there is a significant association between these two measurements. Conclusion:Most of the patients needed variable degrees of bladder filling for adequate visualisation of the cervix. Although minimal bladder filling does not influence TAS measurements of cervical length, moderate fullness of the bladder does cause an apparent increase in TAS measurements of cervical length. If the cervical length is ≥30 mm by TAS, regardless of urine content in the bladder, the patient can be assured vis a vis their risk of preterm labour as far as cervical length is concerned. However, in patients with TAS cervical measurement <30 mm and where the bladder needed a moderate amount of urine for adequate visualisation of the cervix, TVS cervical measurement may be close to the critical value of 25 mm. These patients need to be counselled and offered TVS for better assessment of cervical length. (J Turkish-German Gynecol Assoc 2013; 14: 225-9) Key words: Cervical length, transabdominal sonography, transvaginal sonography Received: 10 July, 2013 Accepted: Sonuç:Hastaların çoğunda serviksin yeterli görüntülenmesi için çe-şitli derecelerde mesane dolumu gerekliydi. Minimal mesane dolumunun servikal uzunluk TAS ölçümlerini etkilememesine rağmen, mesanenin orta derece dolgunluğu servikal uzunluk TAS ölçümlerin-de belirgin bir artışa neden olmaktadır. Servikal uzunluk TAS ile ≥30 mm ise, mesanedeki idrar içeriğine bakmaksızın, servikal uzunluk söz konusu olduğu sürece hastanın erken doğum riski ile karşı karşıya olduğundan emin olunabilir. Bununla birlikte, TAS serviks ölçü-mü <30 mm olan hastalarda ve serviksin yeterli görüntülenmesi için mesanede orta derecede idrar miktar gerekli olduğunda, TVS servikal ölçümü 25 ...

Cancer of the uterine cervix (CACX) is one of the most common carcinoma affecting women worldwide. During treatment, histologically lymph node (LN) metastasis and presence of HPV DNA in blood plasma act as a major prognostic factor. Despite the lack of apparent LN involvement, some early-invasive CACX patients have shown recurrences and poor survival. This is suggestive of undetected early dissemination of cancer cells characterized by presence of HPV DNA in histologically non-metastatic LNs which finally progresses into histologically visible metastasis. This present study investigated the status and origin of HPV genome during early dissemination by molecular analysis in primary tumor (PT), histologically non-metastatic pelvic lymph nodes (LNs) and blood plasma (BP) of same patient. First, CACX patients showing signs of early dissemination was identified by detection of HPV in PT (n = 22) and their corresponding histologically non-metastatic pelvic LNs (n = 45) and BP (n = 18) followed by typing of HPV16/18. This was followed by comparative analysis of the physical, copy number and methylation (enhancer/early/late) status of HPV16 genome present in LNs and BP with that of PT. Our study revealed for the first time that the HPV16 genome were frequently present in the integrated form though the copy number was low in both non-metastatic LNs and BP. However, the methylation pattern of PT was discordant with that of corresponding LNs and BP in majority of the cases. Critical assessment of HPV16 profiles established that the presence of hrHPV may be due to the early dissemination of PT cells having significant pathological implications.

Aim:To review the effects of selective fetal reduction in trichorionic triplet pregnancy with focus on risk of miscarriage and preterm delivery in Indian women and thus provide local data for counseling the prospective parents in similar situation. Materials and methods:This retrospective study reviewed the pregnancy outcome of 32 sets of triplet pregnancies following fetal reduction. All mothers had trichorionic triplet pregnancy with three live fetuses at 10 to 11 weeks of gestation. One to two milliliter ml of 10% potassium chloride (KCl) was injected into the heart of the target fetus to achieve asystole. Results:The miscarriage (pregnancy loss before 24 completed weeks) rate in our study was 3.12%. The delivery in our study at ≤32 and ≤35 weeks were 6.45 and 51.61% respectively. The mean gestational age (mean ± SD) of the mothers was 242.58 ± 12.93 days. Regarding the birthweight of neonates, 5.08% babies were <1500 gm, 89.83% were between 1500 and ≤2500 gm and 5.08% were > 2500 gm. The mean birth weight (mean ± SD) of the babies was 1921.18 ± 339.78 gm. There was no neonatal death in this cohort. Conclusion:Our study results, when compared with 'expectant management' group of two European studies as there was no control in our study, appeared significantly better in terms of gestational age at delivery and neonatal birth weight.Selective fetal reduction remains an effective option to Indian women with trichorionic triplet pregnancy.

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