OBJECTIVE: Cervical cancer contributes to a significant global health burden with room for improvement of primary prevention methods. This study aimed to determine the prevalence of Turkish women with abnormal cytology and their management by comparing results from repeat cytological analysis with close follow-up and colposcopy. METHODS: A retrospective evaluation of 8738 women who underwent Pap smears at a single institution during 2011 was performed. Either repeat cytological analysis or colposcopic biopsy was used for follow-up evaluation of women who had abnormal index cytology. RESULTS: From the 8670 women, 8259 of had normal cytology results (95.3%) and 411 women had abnormal cytology (4.7%) in the index Pap smear. The frequency of initial abnormal cytology was 65% (n=267), 27% (n=111), 3.4% (n=14), 2.4% (n=10), 1.9% (n=8), and 0.3% (n=1) for atypical squamous cell of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), ASC cannot exclude high-grade intraepithelial lesion (ASC-H), high-grade SIL (HSIL), atypical glandular cells (AGC), and invasive cancer, respectively. Of the 267 women with initial ASCUS, 108 (40.4%) underwent repeat cytology analysis, 84 (31.5%) underwent colposcopic biopsy, and 75 (28.1%) were lost to follow-up. On histopathology, 8.3% (n=7) of patients had cervical intraepithelial neoplasm 2 (CIN2) on colposcopy. Of 60 women with LSIL that underwent colposcopic biopsy, 13.3% (n=8) had CIN2/3. CONCLUSION: The results of the study suggest that routine cytological follow-up may be an appropriate method in the management of ASCUS instead of immediate colposcopy while immediate colposcopy cannot place repeat cytology for LSIL in developing countries.

The purpose of the study is to determine the prevalence preeclampsia and to evaluate the maternal and the fetal adverse outcomes in the severe and the early-onset preeclampsia subgroups. Hundred and sixteen pregnant women with preclampsia who gave birth in an academic tertiary health centre were included in this study. The preeclampsia rate was 1.4 per 100 singleton births for three years (1.5/100 in 2012 and 1.3/100 in both 2013 and 2014 in this study). The rates of severe and early-onset preeclampsia were found as 0.5 and 0.4 per 100 singleton births in this three years period. Adverse maternal outcomes occurred in 18 cases. Maternal mortality occurred in 1 case. In severe preeclampsia (PE), the mean gestational age (33. week) , birth weight (1935 g) and Apgar score at 5th minute at delivery (6.8 points) were calculated. In severe PE, the admission rate to Neonatal Intensive Care Unit (NICU) and neonatal mortality rate were 67 % and 24%, respectively. In the early-onset preeclampsia, the mean birth weight and 5th min-Apgar score at delivery were found as 1454 g and 5.4 points, respectively. The admission rate to NICU and neonatal mortality rate were 91% and %30 in earlyonset PE, respectively. The rate of severe PE in the early-onset PE was 59%. The women with severe preeclampsia had the highest antihypertensive drug prescribing rate (41%) at discharge. Preeclampsia, particularly early-onset and severe preeclampsia require special attention of the healthcare providers.

Borderline ovarian tumours (BOTs) are characterised histologically by a low degree of cellular proliferation and nuclear atypia in the absence of infiltrative growth or stromal invasion. Surgical treatment has been a crucial component of BOT therapy. Surgical decisions are established intraoperatively via the frozen section. We evaluated the accuracy of frozen section diagnosis. The rate of correct diagnosis, underdiagnosis and overdiagnosis of BOTs with frozen sections was 78%, 17% and 5%, respectively. The sensitivity and positive predictive values for the diagnosis of BOTs with frozen sections were 82.3% and 93.3%, respectively. The positive likelihood ratio was 0.82 (95% CI: 0.85-0.96). The histological classification of BOTs had a significant effect on the accuracy of diagnosis (p = 0.001). Frozen section diagnosis is not suitable to be considered as the gold standard for a definitive diagnosis. Clinicians should be aware that using frozen sections is insufficient for the accurate staging of BOTs.

Highlights Vaginal schwannoma. Vaginal epithelioid MPNST. Malignant peripheral nerve sheath tumors. Vaginal cancer. Spindle-to-epithelioid tumor.

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