Objective: To determine whether the measurement of beta-human chorionic gonadotropin (β-hCG) levels in vaginal fluid is useful for the diagnosis of premature rupture of membranes (PROM). Material and Methods: A total of 92 pregnant women between 24and 40 weeks gestation participated in this study. The patients with fluid leaking from the vagina were designated Group 1, the patients with no fluid leaking from the vagina were Group 2, and those with a suspicion of fluid leaking from the vagina were classified as Group 3. Irrigating the posterior vaginal fornix with 5 mL sterile saline was used to measure β-hCG levels of the patients. Receiver operator curve (ROC) analysis was used to determine the cut-off value for a positive diagnosis. Results:The β-hCG levels of vaginal fluid were measured as 20.5±25.0 mIU/mL, 254.6±346.8 mIU/mL, and 74.3±100.8 mIU/mL in Group 1, Group 2, and Group 3, respectively. Vaginal β-hCG level was higher statistically significantly in Group 2 than Group 1 and 3 (p<0.001). 100 mIU/mL was accepted as a cut-off value by using the receiver operating characteristic curve. According to 100 mIU/mL, sensitivity, specificity, positive predictive and negative predictive values were calculated as 71.2, 100, 100, and 65.1%, respectively. Conclusion:The study showed that the measurement of β-hCG level in vaginal washing fluid is an efficient and easy diagnostic test for predicting the amount of fluid leaking from the vagina. However, due to the low negative predictive value of the test, it would not be convenient in daily practice. (J Turkish-German Gynecol Assoc 2013; 14: 201-4) Key words: Beta-human chorionic gonadotropin, premature rupture of membranes, diagnosis Received: 01 June, 2013 Accepted: 19 September, 2013 Amaç: Erken membran rüptürünün tanısı için vajinal sıvıda beta-human koryonik gonadotropin (β-hCG) seviyesinin ölçümünün yararlı olup olmadığını belirlemek. Gereç ve Yöntemler:Gebeliğin 24-40. haftaları arasında olan toplam 92 gebe bu çalışmaya dahil edildi. Vajinadan sıvı geldiği görülen hastalar Grup 1, vajinadan sıvı gelmeyenler Grup 2 and şüpheli sıvı gelişi olan hastalar Grup 3 olarak sınıflandırıldı. Hastaların vajinal sıvıdaki β-hCG seviyelerinin ölçümü için posterior vajinal fornixin 5 mL salin ile elde edilen yıkantı suyu kullanıldı. Receiver operator curve (ROC) analizi yapılarak doğru tanı için gereken eşik seviye belirlendi. Bulgular:Vajinal sıvıda β-hCG seviyesi Grup 1 için, 20.5±25.0 mIU/mL, Grup 2 için 254.6±346.8 mIU/mL, Grup 3 için 74.3±100.8 mIU/mL olarak ölçüldü. Vajinal β-hCG seviyesi Grup 2 de Grup 1 ve 3'ten istatistiksel olarak daha yüksek bulundu (p<0.001). ROC analizi eğrisi kullanılarak eşik seviye 100 mIU/mL olarak kabul edildi. 100 mIU/mL eşik degree göre; sensitivite, spesifite, pozitif ve negatif prediktif değerler sırasıyla %71.2, %100, %100 ve %65.1 olarak hesaplandı. Sonuç:

Nabothian cysts are common and silent retention cysts of the uterine cervix with no particular intervention required. It is quite rare to reach a size of more than 4 cm and it is a diagnostic dilemma to differ it from adenoma malignum. We report a case of a woman with 38 weeks of gestation presented to the maternity unit with labour pain and protruding cystic mass (60x70 mm) out of the vagina. Simple drainage was performed to allow the vaginal delivery. She delivered 4130 grams, 9-10 Apgar, male baby by spontaneous vaginal delivery. The patient's and the newborn postpartum course was uneventful. Gynaecologic examination revealed a persisting cystic mass in the cervix (40x50 mm) two months after the delivery. We performed a total excision of the cyst to confirm the pathologic diagnosis. This paper is the first report of nabothian cysts obstructing labour passage. In the view of this case, we aimed to discuss cervical cystic masses and a review of the literature.

Our results showed that adenomyosis is significantly associated with lower stage in endometrial cancer that may suggest a possible limiting effect on endometrial cancer spread. In addition, despite similar rates in disease-free survival and endometrial cancer-related death, overall survival rate was significantly higher in the presence of adenomyosis and might be considered as a good prognostic factor for endometrial cancer.

Our study demonstrated that a cancer antigen 125 level ≥ 35 is the only independent prognostic factor for both progression-free survival and overall survival in patients aged ≤40 years with endometrial cancer.