This is the published version of a paper published in Clinical Microbiology. Citation for the original published paper (version of record):Larsson, P-G., Poutakidis, G., Adolfsson, A., Charonis, G., Pasi, B. et al. (2016) Treatment of bacterial vaginosis in early pregnancy and its effect on spontaneous preterm delivery and preterm rupture of membranes. AbstractBackground: This study was conducted to investigate whether screening and treatment of bacterial vaginosis (BV) in early pregnancy reduces the risk of spontaneous preterm delivery or preterm premature rupture of membranes (PPROMs).
Background: Bacterial vaginosis (BV) is a risk factor for premature birth and group B streptococci (GBS) colonizing the vagina are etiological agents of neonatal infections. Significant growth of GBS in the vagina has been assumed to be detectable through urinary culture. The aim was to investigate the correlation between BV and the presence of GBS in qualitative vaginal or quantitative urinary culture, since this could predict a higher risk for perinatal morbidity. Design and setting: A consecutive prospective study of women in early pregnancy included 3101 women between 2007 and 2010, in a region of south-western Sweden. Methods: Vaginal and urine samples were obtained from women in early pregnancy at maternity health care clinics. BV was diagnosed according to the Ison/Hay classification. GBS in urine were detected in amounts as low as 100 CFU/ml. Vaginal culturing for GBS was obtained from a selected group of 481 women. Results: There was no difference in the prevalence of GBS in the urine among women with BV compared with women with lactobacilli flora (OR 0.7; 95% CI 0.4-1.1). Vaginal presence of GBS was found among 17.3% of women with BV and among 23.5% of women with lactobacilli flora (OR 0.7; 95% CI 0.3-1.4). Among the 105 women who had vaginal GBS, the urine culture of GBS was positive in only 21.9% of cases. Conclusions: Even though women with BV. have much higher concentration of bacteria in the vagina, they do not necessarily have more GBS in the vagina or urine. The modest correlation between positive vaginal culture and positive urine culture of GBS question the value of urinary culture for detection of vaginal GBS.
Objectives: To evaluate the sensitivity and accuracy of the HPV DNA test in conjunction with Thinprep cytology test as a screening method of human papillomavirus (HPV) infection. Method: In our retrospective study, 158 women with age group 21-70 years having positive thin cytology test were recruited. A computerized search identified patients with ASCUS, LSIL, HSIL in Thinprep test results and high risk HPV DNA testing and cervical biopsy results of these patients. Results: Out of 158 patients, HPV DNA tests were positive in 52 (32.9%) and negative in 106 (67.1%). High grade CIN and Carcinoma Cervix were commonly associated with ASCUS and HSIL as CIN I, II-III, III, Carcinoma Cervix, were 53.6%, 24.3%, 22.2% and 15% respectively for ASCUS (n=67); and 0%, 63.2%, 77.8%, 75% for HSIL (n=49). HPV DNA positive extremely favors CIN II-III, III and cervical cancer as Human Papilloma Virus DNA test were positive in 22 (78.6%) out of 28 cases of CIN I, 36 (97.5%) out of 37 cases of CIN II-III, 9 (100%) out of 9 cases of CINIII and 4 (100%) out of 4 cases of cervical cancer. There was significant correlation of TCT with HPV, age and CIN (P<0.0001). HPV DNA was common in increasing age group as compared to young age (21-30 years, n=39 [46.2%] vs. 61-70 years, n=4 [100%]). Conclusion:Combined thin cytology test along with HR HPV DNA test has great value in determining high grade of cervical intraepithelial neoplasia and cervical neoplasia. Keywords: Human papilloma virus, cervical intraepithelial neoplasia, squamous intraepithelial neoplasia, atypical squamous cells thin cytology test © 2013 Shrestha et al; licensee Herbert Publications Ltd. This is an Open Access article distributed under the terms of Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0). This permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. IntroductionThe concept of preinvasive disease of the cervix was introduced in 1947, when it was recognized that epithelial changes could be identified that had the appearance of invasive cancer but were confined to the epithelium [1]. Subsequent studies showed that these lesions, if left untreated could progress to cervical cancer [2]. Improvements in cytologic assessment led to the identification of early precursor lesions called dysplasia, a name that acknowledges the malignant potential of these lesions. The concept of cervical intraepithelial neoplasia (CIN) was introduced in 1968, when Richart suggested that dysplasias have the potential for progression [3]. The criteria for the diagnosis of intraepithelial neoplasia may vary according to the pathologist but the significant features are cellular immaturity, cellular disorganization, nuclear abnormality, and increased mitotic activity. The extent of the mitotic activity, immature cellular proliferation, and nuclear atypia identifies the degree of neoplasia. If the presence of mitoses and immature cells is limited to the lower third of the epithelium, the lesi...
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