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Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(4):201-206
, , , , , To evaluate recurrence rates and risk factors among women with stage IA1 cervical cancer without lymph vascular space invasion managed conservatively.
retrospective review of women with stage IA1 squamous cervical cancer who underwent cold knife cone or loop electrosurgical excision procedure, between 1994 and 2015, at a gynecologic oncology center in Southern Brazil. Age at diagnosis, pre-conization findings, conization method, margin status, residual disease, recurrence and survival rates were collected and analyzed.
26 women diagnosed with stage IA1 squamous cervical cancer without lymphovascular space invasion underwent conservative management and had at least 12 months follow-up. The mean follow-up was 44.6 months. The mean age at diagnosis was 40.9 years. Median first intercourse occurred at age 16 years, 11.5% were nulliparous and 30.8% were current or past tobacco smokers. There was one Human immunodeficiency virus positive patient diagnosed with cervical intraepithelial neoplasia grade 2 at 30 months after surgery. However, there were no patients diagnosed with recurrent invasive cervical cancer and there were no deaths due to cervical cancer or other causes in the cohort.
Excellent outcomes were noted in women with stage IA1 cervical cancer without lymphovascular space invasion and with negative margins who were managed conservatively, even in a developing country.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(4):201-206
, , , , , To evaluate recurrence rates and risk factors among women with stage IA1 cervical cancer without lymph vascular space invasion managed conservatively.
retrospective review of women with stage IA1 squamous cervical cancer who underwent cold knife cone or loop electrosurgical excision procedure, between 1994 and 2015, at a gynecologic oncology center in Southern Brazil. Age at diagnosis, pre-conization findings, conization method, margin status, residual disease, recurrence and survival rates were collected and analyzed.
26 women diagnosed with stage IA1 squamous cervical cancer without lymphovascular space invasion underwent conservative management and had at least 12 months follow-up. The mean follow-up was 44.6 months. The mean age at diagnosis was 40.9 years. Median first intercourse occurred at age 16 years, 11.5% were nulliparous and 30.8% were current or past tobacco smokers. There was one Human immunodeficiency virus positive patient diagnosed with cervical intraepithelial neoplasia grade 2 at 30 months after surgery. However, there were no patients diagnosed with recurrent invasive cervical cancer and there were no deaths due to cervical cancer or other causes in the cohort.
Excellent outcomes were noted in women with stage IA1 cervical cancer without lymphovascular space invasion and with negative margins who were managed conservatively, even in a developing country.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):237-243
DOI 10.1590/S0100-72031998000500002
We analyze prospectively the existence of a relationship between the mother's glycemic control, in the first half of pregnancy, and the occurrence of abnormal fetal cardiac abnormalities, in pregnant women with diabetes mellitus. In 127 pregnant women, the level of glycosylated hemoglobin was determined on the first visit during prenatal care. Nine patients had type I diabetes, 77 type II and 41 gestational diabetes mellitus (GDM). All mothers were submitted to detailed fetal echocardiography, during the 28th ± 4.127 week of gestation. In 31 (24.4%) of the 127 fetuses cardiac anomalies were detected. In 10 (7.87%) an isolated cardiac anomaly was identified. Mean HbA1c in the group of pregnant women without cardiac anomalies (5.64%) was statistically different from the group with anomalies (10.14%) (p<0.0001). The receiver-operator characteristic, representing the balance between sensitivity (92.83%) and specificity (98.92%) in the diagnosis of structural cardiac abnormalities, showed a cut-off point at the 7.5% HbA1c level. In nine of ten fetuses with structural cardiac anomalies, the maternal level of HbA1c was higher than 7.5%. The difference between means of the groups with and without myocardial hypertrophy diagnosed as isolated anomaly (MCHP) was not statistically significant, when considering both type II diabetes and GDM subgroups. In conclusion, levels of HbA1c higher than 7.5% were associated with most cases of echocardiographycally diagnosed structural cardiac anomalies. On the other hand, this test was not useful to discriminate conceptus with MCHP.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):237-243
DOI 10.1590/S0100-72031998000500002
We analyze prospectively the existence of a relationship between the mother's glycemic control, in the first half of pregnancy, and the occurrence of abnormal fetal cardiac abnormalities, in pregnant women with diabetes mellitus. In 127 pregnant women, the level of glycosylated hemoglobin was determined on the first visit during prenatal care. Nine patients had type I diabetes, 77 type II and 41 gestational diabetes mellitus (GDM). All mothers were submitted to detailed fetal echocardiography, during the 28th ± 4.127 week of gestation. In 31 (24.4%) of the 127 fetuses cardiac anomalies were detected. In 10 (7.87%) an isolated cardiac anomaly was identified. Mean HbA1c in the group of pregnant women without cardiac anomalies (5.64%) was statistically different from the group with anomalies (10.14%) (p<0.0001). The receiver-operator characteristic, representing the balance between sensitivity (92.83%) and specificity (98.92%) in the diagnosis of structural cardiac abnormalities, showed a cut-off point at the 7.5% HbA1c level. In nine of ten fetuses with structural cardiac anomalies, the maternal level of HbA1c was higher than 7.5%. The difference between means of the groups with and without myocardial hypertrophy diagnosed as isolated anomaly (MCHP) was not statistically significant, when considering both type II diabetes and GDM subgroups. In conclusion, levels of HbA1c higher than 7.5% were associated with most cases of echocardiographycally diagnosed structural cardiac anomalies. On the other hand, this test was not useful to discriminate conceptus with MCHP.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(8):459-463
DOI 10.1590/S0100-72031999000800006
SUMMARY Purpose: to examine the response of the fetal heart rate (FHR) and middle cerebral artery resistance (MCA PI) to vibratory stimulation (VAS) in normal human fetuses. Methods: when the fetuses were without activity (in apnea and without corporal movements), we obtained baseline measurements of MCA PI and FHR before and after the application of a 3-sec vibratory acoustic stimulus. Real time ultrasonography with pulsed wave and color Doppler imaging was used for the execution of the study. The VAS was performed using a bicycle horn with 400 to 4000 Hz and sound pressure was 65 to 110 dB. Results: the FHR before VAS was 139 ± 3.14 bpm and after VAS was 153 ± 7.23 bpm (p<0.0001). The MCA PI rate before VAS was 1.84 ± 0.07 and after VAS was 1.56 ± 0.04 (p<0.001). In all cases we observed a fetal response with vigorous corporal movements, FHR rise and MCA PI reduction after VAS. Conclusions: we conclude that VAS, in human fetuses near term, for 3 sec as described in this study, determines some response, with increase in FHR and corporal movement and MCA PI reduction. Although we have a tendence to say that VAS determines fetal cerebral flow increase, these data do not allow such clinic interpretation.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(8):459-463
DOI 10.1590/S0100-72031999000800006
SUMMARY Purpose: to examine the response of the fetal heart rate (FHR) and middle cerebral artery resistance (MCA PI) to vibratory stimulation (VAS) in normal human fetuses. Methods: when the fetuses were without activity (in apnea and without corporal movements), we obtained baseline measurements of MCA PI and FHR before and after the application of a 3-sec vibratory acoustic stimulus. Real time ultrasonography with pulsed wave and color Doppler imaging was used for the execution of the study. The VAS was performed using a bicycle horn with 400 to 4000 Hz and sound pressure was 65 to 110 dB. Results: the FHR before VAS was 139 ± 3.14 bpm and after VAS was 153 ± 7.23 bpm (p<0.0001). The MCA PI rate before VAS was 1.84 ± 0.07 and after VAS was 1.56 ± 0.04 (p<0.001). In all cases we observed a fetal response with vigorous corporal movements, FHR rise and MCA PI reduction after VAS. Conclusions: we conclude that VAS, in human fetuses near term, for 3 sec as described in this study, determines some response, with increase in FHR and corporal movement and MCA PI reduction. Although we have a tendence to say that VAS determines fetal cerebral flow increase, these data do not allow such clinic interpretation.
