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Evaluation of Pap Smear and Colposcopy at first three months of pregnancy

تقييم لطاخة عنق الرحم وتنظير عنق الرحم المكبر عند الحوامل في الأشهر الثلاثة الأولى من الحمل

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 Publication date 2014
and research's language is العربية
 Created by Shamra Editor




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This research was carried out in the Department of Obstetrics and Gynecology in Alassad Hospital of Tishreen University in Lattakia in the period between 5th of Jan 2012 to 1st of Aug 2013. The sample tested was divided into two groups: 100 pregnant women, and 50 not pregnant. The study showed that the ratio of the sensitivity of Pap test in pregnancy was 100%, and its quality was 76.74%. The Compatibility with overall histological diagnosis was 79.38%. However, the ratio of the sensitivity of Colposcopy was 90.91% and its quality was 76.74%. The Compatibility with overall histological diagnosis was 78.35%. Thus we conclude that both Pap Smear and colposcopy are safe and good scanning tools. They can be used in the preliminary prognosis for carcinomatous and precarcinomatous tumors through the duration of pregnancy.


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Research summary
أجري هذا البحث في قسم التوليد وأمراض النساء في مشفى الأسد الجامعي في اللاذقية، وشمل 150 سيدة، منهن 100 سيدة حامل و50 سيدة غير حامل. هدفت الدراسة إلى تقييم حساسية ونوعية لطاخة عنق الرحم وتنظير عنق الرحم المكبر خلال الأشهر الثلاثة الأولى من الحمل. أظهرت النتائج أن حساسية لطاخة عنق الرحم في الحمل بلغت 100% ونوعيتها 76.74%، بينما كانت حساسية التنظير 90.91% ونوعيته 76.74%. نسبة التوافق بين اللطاخة والتشخيص النسيجي النهائي بلغت 79.38%، وبين التنظير والتشخيص النسيجي النهائي 78.35%. خلصت الدراسة إلى أن كلا الطريقتين آمنتان وفعالتان في الكشف المبكر عن الآفات السرطانية وما قبل السرطانية خلال الحمل.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة لأنها تسلط الضوء على أهمية الفحص المبكر للآفات السرطانية وما قبل السرطانية عند الحوامل، مما يساهم في تحسين نتائج العلاج وتقليل معدلات الوفيات. ومع ذلك، يمكن أن تكون هناك بعض التحفظات حول العينة المدروسة، حيث أن عدد السيدات الحوامل وغير الحوامل قد لا يكون كافياً لتعميم النتائج على جميع الفئات السكانية. كما أن الدراسة اعتمدت بشكل كبير على خبرة الأخصائيين في تفسير النتائج، مما قد يؤدي إلى تباين في النتائج بين مختلف المراكز الطبية. من المهم أيضاً النظر في تأثير العوامل الاجتماعية والاقتصادية على نتائج الفحص، وهو ما لم يتم تناوله بعمق في هذه الدراسة.
Questions related to the research
  1. ما هي نسبة حساسية لطاخة عنق الرحم خلال الحمل وفقاً للدراسة؟

    نسبة حساسية لطاخة عنق الرحم خلال الحمل بلغت 100%.

  2. ما هي نسبة التوافق بين نتائج التنظير المكبر والتشخيص النسيجي النهائي؟

    نسبة التوافق بين نتائج التنظير المكبر والتشخيص النسيجي النهائي بلغت 78.35%.

  3. ما هي الأداة الأكثر حساسية وفقاً للدراسة، لطاخة عنق الرحم أم التنظير المكبر؟

    لطاخة عنق الرحم كانت الأداة الأكثر حساسية بنسبة 100% مقارنة بالتنظير المكبر بنسبة 90.91%.

  4. ما هي التوصيات الرئيسية التي خلصت إليها الدراسة؟

    التوصيات الرئيسية تشمل إشراك لطاخة عنق الرحم والتنظير المكبر في اختبارات المسح الأولي لجميع السيدات الحوامل، إقامة ندوات تثقيفية لنشر الوعي الصحي، وتوسيع برنامج المسح الوطني للكشف عن الآفات السرطانية وما قبل السرطانية في عنق الرحم.


References used
BEREK,J. Berek & Novaks Gynecology. 14th Edition, Lippincott & Wilki ns , California USA , 2008, pp.576-578
Jean-Jacques Baldauf, Michel Dreyfus, Jean Ritter, Emile Philippe, European Journal of Obstetrics & Gynecology and Reproductive Biology, Colposcopy and directed biopsy reliability during pregnancy: a cohort study,Volume 62, Issue 1, September 1995, Pages 31–36 www.Scienc Direct.com
JOANNA, M. CAIN; HEXTANNGAN;SUZANNE,GARLAND; THOMAS, WRIGHTAND FIGO WORKING GROUP ON COMBATING CERVICALCANCER.Control of cervical cancer: Women's options and right. August 2009, Pages 141-143.>www.scienceDirect.com
Wright Jr TC, Cox JT, Massad LS, Twiggs LB, Wilkinson EJ, for the 2001 ASCCP-sponsored Consensus Conference. Consensus Guidelines for the Management of Women with Cervical Cytological Abnormalities and Cervical Cancer Precursors. Part I: Cytological abnormalities. JAMA 2002;287(18):2120-2129
Jones WB, Shingleton HM, Russell A, Fremgen AM, Clive RE, Winchester DP, Chmiel JS. Cervical carcinoma and pregnancy. A national patterns of care study of the American College of Surgeons Cancer. 1996; 77(8):1479-88
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Mankind is still suffering from many diseases , and with the development of civilization there are many diseases that appear with different clinical types , but tumors, especially malignant , are still very important. Cervical cancer is the secon d common cancer in women , as it is the cause of more than 200.000 deaths annually. Hence the importance of early detection of cervical cancer and of decreasing mortality.
Cervix cancer is one of the most important gynecological cancers ,which is possible to be reduced by using early precancerous detecting technics . Objective : The aim of the study is to highlighten the colposcopy as a device for early detection o f precancerous lesions in the cervix , and compare the results with histopathology .
Ectopic Pregnancy: Avery rare case of cornual pregnancy The statement dexcribes a very rare case of ectopic pregnancy "Cornual pregnancy" which unusually had continued to full term. The case had been diagnosed after the laparatomy during cesarean section which had been achieved in very difficult circumstances, because the hemorrhage was very heavy. The author could deliver a healthy fetus, save the patient's life, and save her uterus and fertility.
Cancer is generally causing a second death after heart and blood vessels in the developed countries diseases is cervical cancer, the second most common cancer among women in developed and developing countries and is considered the early detection o f cervical cancer is a very important factor in the increase cure rate and the rate of survival, and the most important ways screening Pap smear to detect abnormal changes in cervical tissue and recommended to initiate it every three years for women in the age of sexual activity and is an easy and inexpensive and painless, and high sensitivity and contributes to reducing the burden treatment and reduce the deaths and morbidity rate., according to several studies there are many obstacles that prevent it, including the lack of information,, difficulty of access to hospitals, pain, cost, side effects, feeling of shame and embarrassment of procedure, lack of encouragement by the health team, or the husband, not feeling any symptoms paid to conduct the examination, and the fear of discovery of the cancer . the importance of this study was to find out the obstacles that limit the conduct smear screening in the Syrian society and propose appropriate solutions in addition to that not conducted any study in this area in Syria this research was conducted on a sample of 100 married woman of tishreen University Hospital in Latakia in manner convenient sampling. The results showed that the majority of respondents (80%) did not undergo the smear examination, and that the majority of the respondents (93.75%) who did not undergo the smear examination was due to the lack of women's problem to have, and it was the reason (75%) of cases they fear the cancer is detected and 85% of them feel ashamed and embarrassed of the vote and (12.5%) do not have the time to conduct and (62.5 %) they believe that the procedure is painless and (90%) was the lack of encouragement from the doctors and nurses and the proportion (87.5%) was the lack of information about the procedure, Therefore proposed design and implementation of educational programs about the importance , benefits and methode of screening.
The research was conducted in the department of obstetrics and gynecology at Al-Assad university hospital in Lattakia in the period between (1/1/2014) – (30/6/2015). The study included (100) patient, who submitted to colposcopy and Papanicolaou smear to detect the effect of early marriage (early onset of sexual activity) on colposcopic and cellular finding in cervix . The results in (early married women) group (50) patient were compared to control group from patients who (not early married women)group (50) patient. We found that there was important difference in the rate of abnormal colposcopic findings : This rate in early married women was (26%) and in the second was (12%). We also found that there was important difference in the rate of abnormal cellular findings: This rate in early married women was (18%) and in the second was (8%). This assure the effect of early onset of sexual activity (early marriage) on colposcopical and cellular finding in cervix with assuring on the importance of frequent colposcopy and Papanicolaou smear test.

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