Background and Objectives: Cervical ectopic pregnancy is one of the rarest forms of ectopic pregnancy. We present a single center case series of 10 cases of cervical ectopic pregnancy, where 3 patients underwent small-caliber hysteroscopy as a single treatment method.Methods: This was a retrospective study of women treated at our medical center with the diagnosis of cervical ectopic pregnancy from January 1, 2018 to December 31, 2020. Patient characteristics, medical history, obstetric history, diagnostic methods were collected. Small-caliber hysteroscopy treatment was performed in 3 patients and 7 patients underwent dilation and curettage (D&C).Results: We identified 10 patients diagnosed with cervical ectopic pregnancy who were treated at our center. Ultrasonography was used to diagnose all cervical ectopic pregnancies Three patients underwent small-caliber hysteroscopy as a single treatment option, while D&C was performed in 7 patients. Patients who underwent small-caliber hysteroscopy had a median gestational age at diagnosis of 7 weeks and initial b HCG < 10,000 mIU/ mL. These patients had shorter hospital stay and a lower estimated blood loss than patients who underwent D&C. Conclusions:In our experience, small-caliber hysteroscopy is a safe and effective single treatment option for cervical ectopic pregnancy, but requires a skilled and experienced gynecologist.

Epitheliod trophoblastic tumor (ETT) account for only 1–2% of all the cases of gestational trophoblastic neoplasia (GTN), with a reported mortality rate of 10–24%. ETT is derived from chorionic type intermediate trophoblastic cells, which appears to be the reason for the only slightly elevated βhCG levels in these patients. We present a case of a 42-year-old patient who was admitted to the clinic eight months after Caesarean delivery, for irregular vaginal bleed with normal values of beta-human chorionic gonadotropin (βhCG). A 6 × 5 cm hematoma was evacuated from the isthmic uterine segment during the operation, and the histopathological exam of the tissue surrounding the hematoma revealed ETT. There were no metastatic lesions on the thoracal, abdominal, and pelvic CT. The second ultrasonographic exam revealed tumefaction of 5 cm at the site from the previous surgical procedure. Color Doppler imaging revealed no central nor peripheral blood flow. The patient underwent a total abdominal hysterectomy with bilateral adnexectomy without adjuvant chemotherapy. This appears to be one of the shortest intervals from the anteceded gestational event until the diagnosis of this tumor, along with the absence of the significant ultrasonographic feature of the ETT-peripheral Doppler signal pattern. We underline that, even with normal values of βhCG, irregular vaginal bleeding following the antecedent gestational event should always arouse suspicion of GTN.

Introduction. Invasive mole, a form of gestational trophoblastic neoplasia (GTN), is defined as penetration of molar tissue into the myometrium and/or presence of extra-uterine metastases. An invasive mole arising from a complete hydatiform mole is more common than an invasive mole arising from the partial hydatiform mole. Dilatation and uterine evacuation and/or curettage (D&E/C) is the first step in managing molar pregnancy.Uterine perforation is the most serious complication of this procedure. A less common one is the false passage. Cases report. A 47-year-old woman was referred to our Clinic under the suspicion of GTN, with elevated serum hCG levels. Intraoperatively, a softened uterus with trophoblastic tissue arising from the uterine perforation was observed. Histopathological exam (HPE) of tissue obtained from hysterectomy confirmed an invasive mole as a result of uterine perforation made during D&E/C. A 32-year-old woman with vaginal bleeding, nausea, and high levels of serum hCG levels was admitted to our Clinic. After four D&E/C, and persistently high levels of serum bhCG levels, explorative laparotomy has been performed. A false passage created during D&E/C with necrotic and molar tissue was observed. The partial hydatidiform mole was confirmed by the HPE.Conclusion This is the second reported case in the literature of postmolar GTN as a result of iatrogenic perforation of the uterus, and also the first described case of postmolar GTN arising from a false passage, created as an iatrogenic complication of D&E/C. A national survey of iatrogenic events during the treatment of GTD is needed since these events could completely change the therapeutic strategies in managing GTD.

Detectable serum levels of beta subunit of human chorionic gonadotropin (βhCG) in nonpregnant, perimenopausal women bring confusion in both clinician and patient and could lead to unnecessary diagnostic and therapeutic procedures. A 45‐year‐old woman with the continuous elevation of βhCG underwent hysteroscopy, two laparoscopic surgeries, two explorative uterine cavity curettages and three cycles of cytostatic therapy. No ultrasonographic, macroscopic or histological signs of pregnancy, both uterine and ectopic or gestational trophoblastic disease were found. Both radiographic and computed tomography reports ruled out the presence of a nongynecological neoplasm. All recommended steps were taken for confirmation or ruling out the possibility of heterophile antibodies interference, but the results were not absolute. Finally, the referent laboratory confirmed the presence of the antibodies, but their exact type remains unknown. This case underlines the importance of the universally accepted protocol in the cases of persistent βhCG elevation in nonpregnant, perimenopausal women.

Introduction/Aim: Occupational exposure makes health workers m vulnerable and at high-risk for COVID-19 infection and major psychological disturbance. Fear from the unknown, anxiety for close family and friends, rapid exhaustion of protective equipment, direct contact with infected patients, in combination with media-provoked panic, create a considerable psychological burden in healthcare workers. The aim of this study was to assess mental health of medical and non-medical staff of a university gynecology and obstetrics clinic during COVID-19 epidemic in Serbia. Methods: The study was conducted from 1st to 31st of May 2020 through 160 online questionnaires distributed among the staff of Obstetrics and Gynecology Clinic Narodni front. This online survey consisted of two sections: one included questions related to demographic characteristics, medical history, behavior and habits during the COVID-19 pandemic, while the other comprised questions included in Depression, Anxiety and Stress Scale 21 (DASS-21). Results: Among 118 employees who had participated in the study, depression, anxiety, and stress were present in 35.6%, 40.7%, and 27.1% participants. Participants with lower education had higher total DASS, depression, anxiety, and stress scores compared to participants with higher education. Non-medical staff had significantly higher total DASS and anxiety scores than medical staff. Participants with lower education and married subjects were more likely to have anxiety and depression symptoms. Conclusion: Apart from medical staff, non-medical personnel and their mental status should not be neglected, and we believe that future studies related to the psychological impact of public health emergencies, should include this group.