Cell salvage for the management of postpartum haemorrhage.

Rationale: Postpartum haemorrhage (PPH), defined as a blood loss of 500 mL or more within 24 hours of birth, is the leading global cause of maternal morbidity and mortality. Allogenic blood transfusions are a critical component of PPH management, yet are often unfeasible, particularly in resource-poor settings where maternal morbidity is highest. Autologous cell salvage in the management of PPH has been proposed to combat limitations in access to allogenic blood and potential transfusion-related risks.

A Rare Case of Low-Grade Appendiceal Mucinous Neoplasm Presenting As Mucinous Vaginal Discharge.

Appendiceal mucinous neoplasms (AMNs) are rare tumors that often present with non-specific symptoms, posing diagnostic challenges. This report aims to emphasize the importance of considering AMNs in the differential diagnosis of atypical pelvic symptoms, especially when initial evaluations suggest gynecological issues. A 56-year-old female with a past medical history of hyperlipidemia and a total vaginal hysterectomy performed over 20 years prior for abnormal uterine bleeding due to fibroids presented to her gynecologist with a three-week history of vaginal discharge and pelvic pain.

Cervical Inspection With AAVI and Cryotherapy on HPV-Diagnosed Women in Windhoek, Namibia.

In 2018, the Ministry of Health and Social Services (MoHSS) introduced acetic acid visual inspection (AAVI) screening program and treatment of cervical precancers with cryotherapy in replacement of Pap smear intervention in Namibia. The study examines the effective use of AAVI-and-cryotherapy treatment on HPV-diagnosed women. Female patients of the reproductive age (20-49 years) group visiting 2 Namibian healthcare facilities for AAVI and cryotherapy treatment were investigated using a cross-sectional approach.

Human papillomavirus genotype and cycle threshold value from self-samples and risk of high-grade cervical lesions: A post hoc analysis of a modified stepped-wedge implementation feasibility trial.

Background: Human papillomavirus (HPV) testing of self-collected vaginal samples has potential to improve coverage of cervical screening programmes, but current guidelines mostly require those HPV positive on a self-sample to attend for routine screening.

Methods And Findings: A pragmatic modified stepped-wedge implementation feasibility trial was conducted at primary care practices in England. Individuals aged 25 to 64 years who were at least 6 months overdue for cervical screening could provide a self-collected sample.

Evaluation of the cervical liquid-based cytology sample as a microbiome resource for dual diagnosis.

Cervical cancer, which is mainly caused by oncogenic human papillomavirus subtypes, remains a significant global health challenge. Recent studies have indicated a connection between cervical cancer and the uterine microbiome, underscoring its importance. This study explored the potential of liquid-based cytology (LBC) samples, which are typically used for cytological analysis, in investigating the cervical microbiome.

Clinical Performance of OncoPredict HPV Screening Assay on Self-Collected Vaginal and Urine Specimens Within the VALHUDES Framework.

The introduction of self-sampling in cervical cancer screening has raised the importance of HPV test validation on self-collected samples. This study aimed to evaluate the clinical accuracy of the OncoPredict HPV Screening (SCR) assay on self-collected vaginal and first-void urine (FVU) samples, relative to cervical specimens, using the VALHUDES Framework. FVU and vaginal self-samples followed by a clinician-collected cervical brushing were collected from 500 women referred to colposcopy and tested using OncoPredict HPV SCR assay.

Call to Action: Advocating for Alternatives to Cervical Cytology.

The decline in cervical cancer incidence in the United States has not been uniform and has been influenced by access to care. Hence, we must explore cervical cancer screening routes that do not require a provider visit. This commentary is a call to action that highlights alternatives to cervical cancer screening, specifically the use of self-collected vaginal samples for testing and urine human papillomavirus (HPV) testing.

Efficacy and Safety of Focused Ultrasound Treatment for High-risk Human Papillomavirus Infection-related Cervical Intraepithelial Neoplasia Grade 2 in Nulligravidae Women: A Retrospective Study.

Objective: This retrospective study aimed to investigate the efficacy and safety of focused ultrasound (FU) treatment for high-risk human papillomavirus (HR-HPV) infection-related cervical intraepithelial neoplasia grade 2 (CIN2) in nulligravidae under 35 y old, while also assessing pregnancy outcomes post-treatment.

Methods: Nulligravid patients aged 18-35 y with histologically confirmed CIN2 and HR-HPV infection were included in the study. We collected demographics, pertinent medical history, HPV genotypes and cervical length at baseline.

[Validity of visual inspection with acetic acid versus cervical cytology].

Background: Precancerous lesions, conditions associated with exposure to human papillomavirus (HPV), threaten women's health at different stages of life, from adolescence to old age. It has been observed that a low-cost strategy, such as visual inspection with acetic acid (VIA), reveals cervical lesions, while establishing interventions that allow modifying the course of the disease, thus improving women's quality of life.

Objective: To determine the validity of VIA in comparison with cervical cytology for the detection of precancerous lesions.

Conservative Resolution of a Vesicovaginal Fistula Including Laser Therapy in a Patient Who Underwent Recurrent Surgery After Prior Radiotherapy for Endometrial Cancer.

Background: Isolated vaginal vault recurrence of endometrial cancer can be treated with rescue radiotherapy. However, in previously irradiated patients, surgical resection can be considered the treatment of choice. Vesicovaginal fistulas (VVFs) sometimes complicate the surgical intervention because of the presence of massive ischemia and fibrosis of pelvic tissue from previous irradiation.

Comparison of tissue damage and inflammation for robotic laparoscopy and conventional laparoscopy in early endometrial cancer.

Introduction: This study was to analyze the dynamics of tissue damage and inflammatory response markers perioperatively and whether these differ between robotic laparoscopy and conventional laparoscopy in early endometrial cancer.

Methods: In a randomized controlled trial conducted at SHANGHAI FIRST MATERNITY and INFANT HOSPITAL, eighty women with early-stage, low-risk endometrial cancer were randomly assigned to receive either robotic or conventional laparoscopy. Blood samples were collected at admission, immediately before surgery, 2 h after surgery, 24 h after surgery, 48 h after surgery, and 1 week after surgery.

Cervical cancer screening preference among Inuit women in Nunavik, Quebec.

Self-sampling for oncogenic human papillomavirus (HPV) offers an alternative to the Papanicolaou (Pap) test for cervical cancer screening. We aimed to assess Inuit women's cervical cancer screening preferences. Eligible Inuit women aged between 25 and 65 in 2022-2023 were given the choice between self-sampling, sampling performed solely by the nurse or the Pap test and were administered a questionnaire on screening preference.

Cervical cancer screening: efficacy of PAX1 and JAM3 methylation assay in the triage of atypical squamous cell of undetermined significance (ASC-US).

Background: Atypical squamous cells of undetermined significance (ASC-US) often present diagnostic challenges with cytology-based results, leading to potential underdiagnosis or overdiagnosis. An effective triage method is essential for managing these cases to reduce unnecessary referrals and treatment.

Methods: A total of 322 women diagnosed with ASC-US were tested for HPV-DNA and the PAX1 and JAM3 methylation (PAX1/JAM3) test in the study.

Robot-assisted radical cystectomy with neobladder diversion in females: Safety profile and functional outcomes.

Objective: Radical cystectomy (RC) is a standard treatment for localized muscle invasive bladder cancer and high-risk or very high-risk non-muscle invasive bladder cancer not responding to adequate endovesical therapy. In women, traditionally RC is performed with hystero-adnexectomy and resection of the anterior vaginal wall, often resulting in sexual disorders. Vaginal-sparing techniques have been developed to improve functional outcomes.