Does a diagnosis of atrophic vaginitis on Papanicolaou test signify the presence of inflammation?

Heller, Debra S.; Weiss, Gerson; Bittman, Sara; Goldsmith, Laura T.

doi:10.1097/gme.0000000000000393

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…Although reporting the presence of inflammation and microorganisms in the Pap test may lead to unnecessary treatment and interventions [47], our data seem to indicate that reporting vaginal infectious conditions and inflammation on Pap smear analyses should be done systematically. For AV, however, Pap readings are not properly validated to provide a full diagnosis, but inflammatory cells can be easily recognised and graded [48,49], at least on conventional Pap smears. Hence, specific Pap test criteria for the diagnosis of AV, inflammation and BV should be developed and advocated, also for the new, liquid-based cytology testing.…”

Section: Discussionmentioning

confidence: 99%

Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities

Vieira‐Baptista

Lima-Silva

Pinto

et al. 2016

Eur J Clin Microbiol Infect Dis

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The purpose of this investigation was to evaluate the impact of the vaginal milieu on the presence of abnormal Pap smears and a positive human papilloma virus (HPV) test. A cross-sectional study was conducted between June 2014 and May 2015, evaluating the vaginal discharge by fresh wet mount microscopy and comparing these data with Pap smear findings. Wet mount slides were scored for bacterial vaginosis (BV), aerobic vaginitis (AV), presence of Candida and Trichomonas vaginalis. Cytologic evaluation was done on all Pap smears according to the Bethesda criteria. The cobas© HPV Test (Roche) was performed for HPV detection. A total of 622 cases were evaluated. The mean age of the patients was 41.6 ± 10.65 years (range 21-75). Eighty-three women (13.3 %) had a cytology result worse than low-grade squamous intraepithelial lesion (LSIL). When comparing this group with the one with normal or minor [atypical squamous cells of undetermined significance (ASC-US) or LSIL] Pap smear abnormalities, there were no differences in the presence of Candida (32.5 % vs. 33.2 %, p = 1.0), absence of lactobacilli (38.6 % vs. 32.5 %, p = 0.32) or BV (20.5 % vs. 13.2 %, p = 0.09). On the other hand, moderate or severe inflammation (msI) (41.0 % vs. 28.8 %, p = 0,04), moderate or severe AV (msAV) (16.9 % vs. 7.2 %, p = 0.009) and msAV/BV (37.3 % vs. 20.0 %, p = 0.001) were more common in women with such major cervical abnormalities. No significant association was found between deviations of the vaginal milieu and high-risk HPV infection. The presence of msI or msAV, but not BV, is independently associated with an increased risk of major cervical cytological abnormalities, but not with HPV infection.

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Section: Discussionmentioning

confidence: 99%

Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities

Vieira‐Baptista

Lima-Silva

Pinto

et al. 2016

Eur J Clin Microbiol Infect Dis

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“…Leukocytes were counted using haematoxylin-eosin-stained specimens. We counted leukocytes in three high power fields (HPFs), and the average was calculated in each case [25].…”

Section: Study Proceduresmentioning

confidence: 99%

Risk factors for spontaneous miscarriage above 12 weeks or premature delivery in patients undergoing cervical polypectomy during pregnancy

Fukuta

Yoneda

et al. 2020

BMC Pregnancy Childbirth

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Background: It currently remains unknown whether the resection of cervical polyps during pregnancy leads to miscarriage and/or preterm birth. This study evaluated the risk of spontaneous PTB below 34 or 37 weeks and miscarriage above 12 weeks in patients undergoing cervical polypectomy during pregnancy. Methods: This was a retrospective monocentric cohort study of patients undergoing cervical polypectomy for clinical indication. Seventy-three pregnant women who underwent polypectomy were selected, and risk factors associated with miscarriage above 12 weeks or premature delivery below 34 or 37 weeks were investigated. A multivariable regression looking for predictors of spontaneous miscarriage > 12 weeks and PTB < 34 or 37 weeks were performed. Results: Sixteen patients (21.9%, 16/73) had spontaneous delivery at < 34 weeks or miscarriage above 12 weeks. A univariate analysis showed that bleeding before polypectomy [odds ratio (OR) 7.7, 95% confidence interval (CI) 1.6-37.3, p = 0.004], polyp width ≥ 12 mm (OR 4.0, 95% CI 1.2-13.1, p = 0.005), the proportion of decidual polyps (OR 8.1, 95% CI 1.00-65.9, p = 0.024), and polypectomy at ≤10 weeks (OR 5.2, 95% CI 1.3-20.3, p = 0.01) were significantly higher in delivery at < 34 weeks than at ≥34 weeks. A logistic regression analysis identified polyp width ≥ 12 mm (OR 11.8, 95% CI 2.8-77.5, p = 0.001), genital bleeding before polypectomy (OR 6.5, 95% CI 1.2-55.7, p = 0.025), and polypectomy at ≤10 weeks (OR 5.9, 95% CI 1.2-45.0, p = 0.028) as independent risk factors for predicting delivery at < 34 weeks. Polyp width ≥ 12 mm and bleeding before polypectomy are risk factors for PTB < 37 wks. Conclusions: Our cohort of patients undergoing polypectomy in pregnancy have high risks of miscarriage or spontaneous premature delivery. It is unclear whether these risks are given by the underlying disease, by surgical treatment or both. This study establishes clinically relevant predictors of PTB are polyp size> 12 mm, bleeding and first trimester polypectomy. PTB risks should be exposed to patients and extensively discussed with balancing against the benefits of intervention in pregnancy.

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Vaginal Neoplasia

Heller

2024

Gynecologic and Obstetric Pathology

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Does a diagnosis of atrophic vaginitis on Papanicolaou test signify the presence of inflammation?

Cited by 4 publications

References 3 publications

Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities

Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities

Risk factors for spontaneous miscarriage above 12 weeks or premature delivery in patients undergoing cervical polypectomy during pregnancy

Vaginal Neoplasia

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