Colposcopic findings and intraepithelial neoplasia in diethylstilbestrol-exposed offspring

Article Abstract:

Diethylstilbestrol (DES) was a drug used between 1950 and 1975 to prevent miscarriages. Daughters of women who were prescribed DES were later found to have abnormal changes in the cells of the vagina, uterus and cervix. In the Netherlands 12 centers were developed for the identification, examination and management of DES-exposed women. The DES clinics were equipped with colposcopes, a large microscope which sits a few inches away from the opening of the vagina and is used to visualize the cells of the vagina and cervix. The use of colposcopes to evaluate DES-exposed women and the incidence of related complications were evaluated. Of the 224 women studied, 30 percent had structural changes in the vagina and cervix and 65 percent had changes in the cells lining the vagina (epithelial cells). Vaginal adenosis, abnormal growth of vaginal gland tissue, was found in 22 percent of the patients with epithelial cell changes. Only half of the patients with abnormal colposcopic findings had low-grade abnormal cell growth, or intraepithelial neoplasia, confirmed by biopsy. Women not exposed to DES were not included in the study. Therefore, it is unclear whether DES-exposure was responsible for the abnormal tissue changes. Colposcopic evaluation must be performed by highly skilled practitioners to avoid unnecessary biopsies in DES clinics.

Health aspects, Usage, Netherlands, Endoscopes, Diethylstilbestrol, Colposcopes

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Identification of patients with persistent trophoblastic disease by means of a normal human chorionic gonadotropin regression curve

Article Abstract:

A normal human chorionic gonadotropin (hCG) regression curve was constructed for use in identifying patients with persistent trophoblastic disease. Trophoblastic disease refers to a group of placental disorders including hydatidiform mole and cancer of the chorion. Following the evacuation of a hydatidiform mole, hCG levels are monitored for signs of persistent trophoblastic disease. A steady rise or plateau in the regression curve of hCG is generally taken as sign that chemotherapy should be initiated. However, there is no commonly accepted definition of how long it takes for hCG levels to normalize following a molar pregnancy. An hCG regression curve was constructed from data obtained in the 25 weeks following removal of hydatidiform mole in 130 women. hCG levels from 77 women who had persistent trophoblastic disease were then compared to the normal regression curve. In 71 (92%) of the women, hCG levels differed significantly from those of the normal regression curve.

Measurement, Chorionic gonadotropin, Chorionic gonadotropins, Molar pregnancy, Hydatidiform mole

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Intraperitoneal serous adenocarcinoma: A critical appraisal of three hypotheses on its cause

Article Abstract:

Discussing the serous ovarian, fallopian tube, and peritoneal adenocarcinomas remarkably similar, both in morphology, as well as in their clinical behavior. It is concluded that the fallopian tubes play a major role in the development of female serous cancer.

Care and treatment, Risk factors, Adenocarcinoma, Women patients, Fallopian tube diseases

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