Background:There are limited data and guidance from the UK on borderline nuclear change in endocervical cells (BNCs). The objective of this study is to determine the clinical outcome of women with BNCs, to determine the accuracy of colposcopy and propose a more robust management algorithm.Methods:This is a retrospective review of all BNC referrals between January 2006 and December 2011 at the Northumbria Healthcare Trust. Histological diagnosis was based on high-grade histology (CIN 2 or worse). Any high-grade histology in the first year of follow-up was included in the final diagnosis.Results:Of the 9001 new referrals, 167 women had BNCs. Thirty-seven (22%) were diagnosed with high-grade histology on initial assessment. Sixty women had satisfactory and negative colposcopy, out of which 7 (12%) were detected with high-grade histology/cytology in the first year of follow-up. Overall, 50 high-grade histology (30%), including two invasive carcinomas were detected.Conclusions:Current follow-up of BNCs relies heavily on colposcopic assessment. A significant proportion of women with negative colposcopy was found to have high-grade histology in the first year of follow-up. We propose a more robust management algorithm to lower the probability of missed high-grade histology in this subgroup of women.

Introduction Hypertension in pregnancy is still a major risk factor for maternal and fetal morbidity all over the world. Changes in coagulation tests are seen in patients with pre-eclampsia and is important to understand its significance in planning management of patients with pre-eclampsia. Objective The objective of this study was to evaluate the clinical utility of coagulation screen in clinical management of patients with preeclampsia. Materials and Methods This was a retrospective cohort study of women with hypertension in pregnancy during the period from January 2008 to July 2009 in West Cumberland Hospital. These women were evaluated for severity of pre-eclampsia and also for any coagulation abnormalities (prothrombin time, partial thromboplastin time and fibrinogen). Results 104 women were included in the study. Thrombocytopenia (platelets <150 000) is one of the indicators of severity of disease. Using thrombocytopenia as a indicator of severity of the disease, coagulation screen had a sensitivity of only 4%. Also coagulation screen is more expensive and time consuming compared to determination of platelet count. Thus coagulation screen should not be considered as a first line investigation of women with normal platelets in pre-eclampsia.

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