RESUMO
OBJECTIVES: To study the prevalence of high-grade cervical intraepithelial neoplasia (CIN 2-3) during pregnancy and compare the rates of persistence, progression and regression of CIN 2-3 by colposcopically guided biopsy during pregnancy with respect to the postpartum period. Also to assess biopsy results during pregnancy and postpartum in relation to histopathology after treatment of lesions. POPULATION: Pregnant women with a histological diagnosis of CIN 2-3 confirmed by colposcopically guided biopsy during pregnancy. METHODS: Between 1989 and 2008, 11 700 pregnant women had cytologic and simultaneous colposcopic examinations during pregnancy. A colposcopically guided biopsy was performed when colposcopically suspicious high-grade lesions were detected, regardless of cytological results. Women with a histopathological diagnosis of CIN 2-3 during pregnancy were re-evaluated by colposcopically guided biopsy and treated during the postpartum period. RESULTS: CIN 2-3 was diagnosed in 56 of 11 700 (0.48%) pregnant women by biopsy. Thirty women complying with the protocol were assessed postpartum by histopathological studies, of whom 70% exhibited persistence, 13.3% progression and 16.7% regression of CIN 2-3. Twenty-nine were diagnosed by conization and one by colposcopically guided biopsy during the postpartum period, which revealed invasive cervical carcinoma. CONCLUSIONS: Due to the high rates of CIN 2-3 persistence during the postpartum period, we suggest that all patients in whom CIN 2-3 was diagnosed during pregnancy are biopsied and treated if necessary during the postpartum period, with at least a two-year follow-up control to prevent lesion recurrence.
Assuntos
Colo do Útero/patologia , Regressão Neoplásica Espontânea , Complicações Neoplásicas na Gravidez/patologia , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/patologia , Biópsia , Distribuição de Qui-Quadrado , Colposcopia , Conização , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Gradação de Tumores , Invasividade Neoplásica , Período Pós-Parto , Gravidez , Complicações Neoplásicas na Gravidez/epidemiologia , Complicações Neoplásicas na Gravidez/cirurgia , Prevalência , Estudos Retrospectivos , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/cirurgia , Displasia do Colo do Útero/epidemiologia , Displasia do Colo do Útero/cirurgiaRESUMO
OBJECTIVE.: To evaluate the sensitivity and specificity of the score and each one of the clinical criteria (pH, potassium hydroxide (KOH) test for amines, and clue cells) in relation to the Amsel's method. MATERIALS AND METHODS.: One hundred ninety vaginal exudates from pregnant women were studied from April to August 1997. The patients were examined in the Lower Genital Tract and Colposcopy Clinics of the Obstetrics Division at the University Hospital de Clínicas at the University of Buenos Aires, Argentina.The diagnosis of bacterial vaginosis (BV) was made by the presence of three or more of the following criteria: homogeneous vaginal discharge, pH >/= 4.5, positive KOH test for amines, and microscopic presence of clue cells. We also used the microscopic observation of coccobacilli forms in Gram stain (Nugent's method), diagnosing BV with a score >/= 7. RESULTS.: Nugent's method showed a sensitivity of 97% and specificity of 98%. The presence of clue cells showed a sensitivity of 92% and specificity of 97%. The sensitivity of the pH and KOH test for amines was 87% and 81%, whereas the respective specificity was 45% and 99%. CONCLUSIONS.: Because Nugent's method showed a very good specificity and sensitivity, it can be used as another method in the diagnosis of BV. The presence of clue cells diagnosed BV with better sensitivity and specificity than the other clinical criteria. In this way, we recommend the microscopic exam by Gram stain, using Nugent's method or the presence of clue cells, for diagnosing BV.
RESUMO
En el presente trabajo se describe el abordaje interdisciplinario de la adolescente embarazada, su pareja y su familia, en la forma que se lleva a cabo en la División Obstetricia a cargo del Prof. Dr. Avelino D. Barata del Dpto. de Tocoginecología del Hospital de Clínicas "José de San Martín" de la Universidad de Buenos Aires y Programa de Adolescencia del Hospital y se expone el marco conceptual del Equipo de Salud, en el cual se encuadra nuestra atención
Assuntos
Humanos , Feminino , Adolescente , Gravidez , Cuidado Pré-Natal/normas , Gravidez na Adolescência/psicologia , Assistência Perinatal/normas , Pai/psicologia , Saúde Materno-Infantil , Parto , Pais Solteiros/psicologiaRESUMO
En el presente trabajo se describe el abordaje interdisciplinario de la adolescente embarazada, su pareja y su familia, en la forma que se lleva a cabo en la División Obstetricia a cargo del Prof. Dr. Avelino D. Barata del Dpto. de Tocoginecología del Hospital de Clínicas "José de San Martín" de la Universidad de Buenos Aires y Programa de Adolescencia del Hospital y se expone el marco conceptual del Equipo de Salud, en el cual se encuadra nuestra atención (AU)