Characterization of genomic changes in the cervical pre-cancerous lesions and tumors induced by different types of human papillomaviruses.

Cervical carcinoma is the second most common malignancy among women in both incidence and mortality. Although much is known about the etiology and treatment of cervical cancer, the role of genetic alterations in the multistep pathway of cervical tumorigenesis is largely unknown. The aim of this study was to characterize the genomic changes in the cervical pre-cancerous lesions and tumors, induced by different types of human papillomaviruses.

[BENEFITS AND RISKS AT IMPLEMENTATION OF PROPHILACTIC VACCINES FOR CERVICAL CANCER].

The aim of this review is to present the benefits and risks of the implementation of prophylactic vaccines for cervical cancer. The classical understanding of human papilloma virus (HPV) infection and its role for the cervical oncogenesis, as well as, the place of prophylactic HPV vaccines are discussed. Results concerning the effectiveness of vaccines 10 years after their introduction and data about their safety are presented.

[CONSERVATIVE MANAGEMENT OF PLACENTA ACCRETE DURING VAGINAL DELIVERY].

Conservative management of placenta accrete consists in leaving the entire placenta accreta in situ after vaginal delivery of the fetus. This behavior requires active monitoring the vital signs of mother, genital status and paraclinical indicators for an extended period after birth. Monitoring is suspended after full absorption of the placenta.

[IS THERE A PLACE FOR VIA AND VILI IN OUR PRACTICE].

Unlabelled: The aim of this review is to discuss the possibilities and disadvantages of the techniques for visual inspection of the uterine cervix with acetic acid (VIA) and with Lugol's iodine (VILI) for early detection of cervical neoplasia. Efficient cervical screening method, approved in practice, is cytology--PAP smear. The lack of organized screening program in Bulgaria is the reason why a lot of cases of cervical cancer are missed or diagnosed late.

[CLINICAL PERFORMANCE OF DIFFERENT METHODS FOR CERVICAL SCREENING].

Unlabelled: Cervical cancer is a serious medical and social issue as it affects women at active age and it is diagnosed too late. In Bulgaria morbidity and mortality show continuous increasing trend. The aim of this study is to compare the clinical performance of cytology and other alternative methods for cervical screening that could be used to assess the the cervix.

[TREATMENT WITH INO OF INFANTS WITH PPHN.].

PPHN is a life threatening disease that appears as a result of high pulmonary vascular resistance and persistent right to left shunt across foramen ovale and ductus arteriosus. The treatment of PPHN is complex and often ineffective. iNO is important part of the pathogenetic treatment of the disease.

[BOWEL ENDOMETRIOSIS - CASE OF RECTAL LOCALISATION.].

Endometriosis is a relatively common disease which rarely involves the bowel, and even more rarely occurs with intestinal obstruction. Gastrointestinal tract is involved in 3 to 37% of women with endometriosis such as the frequency is highest in the rectum and the sigma (72%), small intestine (7%), cecum (3.6%) and others.

[PROLONGED RETAINED PLACENTA ACCRETA IN THE UTERUS AFTER VAGINAL DELIVERY (A CASE REPORT AND REVIEW OF LITERATURE)].

A case of prolonged retention in the uterus of placenta accreta after vaginal delivery is reported in the paper. The patient was 20 years old G3, P0 with two pregnancy terminations on request. She was admitted to the obstetric department of a regional hospital one day after the EDD with irregular contractions and non reassuring CTG.

[Histological subtypes of ovarian carcinoma and their importance for clinical prognosis].

Ovarian cancer is one of the most common and most lethal cancers. For Bulgaria (2012) it occupies third place in the structure of gynecological malignancies with a share of 22.6 percent, while regarding mortality is at first place with 35.

[Types of hospital property and the relative rate of cesarean section occurrence].

Aim: To determine the influential significance of types of hospital property over methods of delivery and other related medical issues

Methods And Materials: The research includes 61 662 deliveries over the period of 01.01.2013-31.

[Significance of some colposcopy signs as a marker for severity of histologic atypia].

We present the latest revision of colposcopic terminology accepted by IFCPC. The differences from the previous revision are represented. Colposcopic atypia encompasses a wide range of changes in the cervical mucosa.

[Case of intrauterine retardation and fetal death during labor].

The case concerns to a 37 years old pregnant woman with a history of three miscarriages. Ultrasound biometry in early pregnancy corresponds to the term calculated according the last menstrual period (LMP). At 37 week of gestation was determined retardation of 5 weeks.

[MANAGEMENT OF PLACENTA ACCRETA, DIAGNOSED BEFORE BIRTH].

The optimal management of placenta accreta and until now remains unclear. The reasons for this are a rarity of this condition and the considerable heterogeneity of the group under the term "placenta accreta." Total hysterectomy during caesarean section is the most common approach to a known placenta accreta.

[Causes of stillbirths according to the period of pregnancy].

Introduction: Stillbirths represent 50% of all perinatal mortality and remain significant and unanswered problem.

Objective: To investigate the causes of stillbirths in term and preterm fetuses and place of intrauterine growth retardation in the pathogenesis of antenatal death.

Materials And Methods: The study was retrospective for the period 2008 to 2013, covers 217 cases of stillbirths in University Hospital "Maichin dom" Sofia.

[New colposcopic terminology: Rio de Janeiro--2011].

The purpose of this work is to review the new colposcopic classification of the International Federation for Cervical Pathology and Colposcopy (IFCPC) from 2011 and the possibilities for its application in diagnostic and treatment processes and research. It fulfills the necessity for a modern and widely applicable nomenclature of the findings and it is based on the latest knowledge in this area. Colposcopic terminology of the vagina, as part of the pathology of the lower genital tract, is included as well, while the vulva and perineum terminology is not yet finally adopted.

HPV prevalence and type distribution in women with normal or abnormal Pap smear in Bulgaria.

Human papillomavirus (HPV) is a well-known pathogen for lower genital tract neoplasias, yet little is known regarding HPV prevalence in Bulgaria. The aim of this study was to investigate the prevalence of HPV DNA and to determine HPV types distribution among women with normal and abnormal cytology. Cervical smears with different cytological diagnoses were collected from 355 Bulgarian patients.

[110 years--University Obstetrics and Gynecology Hospital "Maichin dom"].

The first specialized Obstetrics and Gynecology Hospital in Bulgaria was founded based on the idea of Queen Maria Luisa (1883). Construction began in 1896 and the official opening of the hospital took place on November 19, 1903. What is unique about the University Obstetrics and Gynecology Hospital "Maichin dom" is above all the fact that the Bulgarian school of obstetrics and gynecology was founded within its institution.

[Screning study on pregnant women and neonatal infection with streptococcus agalactiae (group B streptococci)].

We report the results of a screening study on pregnant women and early onset neonatal group B streptococcal infections in Sofia, Bulgaria, July 2009-July 2010. Women were studied for risk factors at delivery, intrapartum antibiotic prophylaxis (lAP) and outcome for the newborns. All GBS positive women who had risk factors at delivery gave birth to newborns with neonatal infection despite the IAP given in 50% of the cases.

[Pregnancy and malignant diseases. Part V. Some rare gynecological tumors during pregnancy].

Neoplasia of the vagina, endometrium and fallopian tube have low frequency in pregnant women and in the literature have been reported occasionally. Symptoms of cancer during pregnancy is often ignored by patients and physicians, leading to delayed diagnosis. This publication examines some characteristics of clinical course and management of cases of pregnancy combined with such tumors.

[Diagnostic value of TruScreen, cytology and colposcopy].

Unlabelled: The aim of this study was to compare the diagnostic value of TruScreen with that of already approved in practice methods for detection of precancerous conditions of the cervix. This study reviewed 301 patients; for analysis were included 260 women aged from 16 to 69 years, mean 35.82 years.

[Application of the RNA-based HPV test in the diagnostics of cervical epithelial changes].

Unlabelled: Our purpose was to investigate the diagnostic value of the RNA-based HPV test (NucliSENS EasyQtm HPV) which utilizes NASBA technology for determination of the expression of E6/E7 of five high-risk HPV types (16, 18, 31, 33 u 45).

Methods: Two hundred women aged 16 to 61 (mean 34.44) were prospectively studied.

[Pregnancy and malignant diseases. Part III--. Vulvar cancer].

Vulvar cancer is among the rarest gynecological tumors. It is extremely rare in pregnant women. In the scientific literature, data has been recorded for no more than 50 cases of vulvar cancer during pregnancy.

[Influence of obstetric factors on the quality of cord blood units collected for allogeneic transplantation].

Umbilical cord blood (CB) as a source of haematopoietic stem cells for allogeneic transplantation has many advantages over bone marrow and peripheral blood, however, a main limitation to its use in clinical setting is cell numbers. This study aimed to assess the impact of mother/neonatal factors on the quality of CB units, collected for allogeneic transplantation. We analyzed 33 CB units collected in University Hospital of Obstetrics and Gynaecology "Maichin dom" and donated to the National public bank for stem cells, University Hospital "Alexandrovska", Sofia.