Placenta accreta is a significant obstetric complication in which the placenta is completely or focally adherent to the myometrium. The worldwide incidence of placenta accreta spectrum (PAS) is increasing day by day, mostly due to the increasing trends in cesarean section rates. The accurate and timely diagnosis of placenta accreta is important to improve the fetomaternal outcome. Although standard ultrasound is a reliable and primary tool for the diagnosis of placenta accreta, the absence of ultrasound findings does not preclude the diagnosis of placenta accreta. Therefore, clinical evaluation of risk factors is equally essential for the prediction of abnormal placental invasion. Pregnant women with a high impression or established diagnosis of placenta accreta should be managed by a multidisciplinary team in a specialist center. Traditionally, PAS has been managed by an emergency obstetric hysterectomy. Previously, few studies suggested a satisfactory success rate of conservative management in well-chosen cases, whereas few studies recommended delayed hysterectomy to reduce the amount of bleeding. The continuously increasing trends of PAS and the challenges for its routine management are the main motives behind this literature review.
Background: Cervical cancer is one of the commonest cancers among women which cause morbidity and mortality worldwide. Though, it is a preventable disease, most of the women with cervical cancer present in advanced stage due to lack of knowledge about the disease and screening among general population. The objective was to assess the level of knowledge and explore attitude towards cervical cancer screening among female nursing staff.Methods: A cross sectional, questionnaire based study was conducted on 34 female nursing staff in a tertiary care hospital of Uttarakhand, India in the month of January 2015. With the help of predesigned questionnaire, information was collected regarding demographic profile, knowledge about cervical cancer and attitude towards screening techniques.Results: In this study, 79% of the respondents had knowledge about screening methods for cervical cancer and 91% had knowledge about HPV vaccine. Though 82% of them were aware of pap smear and 89% had good attitude towards it, 85.29% respondent knew about colposcopy as one of the screening technique for cervical cancer. None of the respondent had undergone a pap smear themselves.Conclusions: The study showed that, female nursing staff had average knowledge and positive attitude towards cervical cancer screening. They were not aware of the routine screening guidelines and had limited understanding of different types of cervical cancer screening techniques. Hence, it is recommended that routine training should be given on regular basis to all the health care providers.
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