Treatment of pregnant women with asymptomatic trichomoniasis does not prevent preterm delivery. Routine screening and treatment of asymptomatic pregnant women for this condition cannot be recommended.

Objective To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO4) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP). Study design In a randomized trial of MgSO4 or placebo in women at high risk of preterm delivery, up to three cranial ultrasound were obtained in the neonatal period. Images were reviewed by at least two pediatric radiologists masked to treatment and other clinical conditions. Diagnoses were predefined for intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), intracerebral echolucency or echodensity, and ventriculomegaly. CP was diagnosed at two years by standardized neurological examination. Results Intraventricular hemorrhage, PVL, intracerebral echolucency or echodensity, and ventriculomegaly were all strongly associated with an increased risk of CP. MgSO4 administration did not affect the risk of cranial ultrasound abnormality observed at 35 weeks post-menstrual age or later. However, for the 82% of infants born at <32 weeks gestation, MgSO4 was associated with a reduction in risk of echolucency or echodensity. The reduction in risk for echolucency explained 21% of the effect of MgSO4 on CP (p=0.04), and for echodensity explained 20% of the effect (p=0.02). Conclusions MgSO4 given prior to preterm delivery was associated with decreased risk of developing echodensities and echolucencies at <32 weeks gestation. However, this effect can only partially explain the effect of MgSO4 on CP at two years of age.

No abstract

No abstract

Background Persistent human papillomavirus (HPV) infection is a precursor to cervical and anal dysplasia and cancer. Among HIV+ women, HPV is more difficult to treat. While no national standards exist for anal dysplasia screening, it may be an important tool in reducing anal cancer risk. At an urban university hospital in South Florida, HIV+ women lacked access to screening; thus, a pilot project was initiated. Methods: With support from the university, the hospital and the Florida/AIDS Education and Training Center (AETC), we implemented an anal dysplasia clinic within our existing HIV colposcopy clinic. A video developed by the Pennsylvania/Mid-Atlantic AETC provided anal Pap technique training to Advanced Registered Nurse Practitioners. The protocols for specimen collection included Dacron swabs and Thin Prep® fixative, and cytology samples were read using the Bethesda criteria. AETC funded two gynaecologists to attend ASCCP’s high-resolution anoscopy (HRA) training; Health Resources and Services Administration funded a dedicated colposcope for HRA. Women attending the clinic were offered anal Pap screening with referral to HRA for abnormal results. Results: Anal Pap smears were collected for 124 women between May 2012 and June 2013; 114 (92%) had ASCUS, ASC-H, LSIL or HSIL. Overall, women are receptive to anal Pap screening; however, the no-show rate for follow-up HRA is 64%. Conclusions: Anal pap screening in an existing colposcopy clinic is a feasible model for detecting anal dysplasia and could be replicated for HIV+ women in other locales. Further study should assess the effect of staff engagement and patient education on screening to improve follow-up HRA rates.