Abstract Background Severe perineal lacerations represent a significant complication of normal labor with a strong impact on quality of life. Objectives To identify factors that lead to the ...occurrence of severe perineal lacerations. Search strategy We searched MEDLINE, Scopus, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, Google Scholar and reference lists from all included studies. Selection criteria We included prospective and retrospective observational studies. Data collection and analysis Predetermined data were collected and analyzed with the Mantel–Haenszel fixed-effects model or the DerSimonian–Laird random-effects model. Main results The meta-analysis included 22 studies (n = 651 934). Women with severe perineal tears were more likely to have had heavier infants (mean difference 192.88 g 95% CI, 139.80–245.96 g), an episiotomy (OR 3.82 95% CI, 1.96–7.42), or an operative vaginal delivery (OR 5.10 95% CI, 3.33–7.83). Epidural anesthesia (OR 1.95 95% CI, 1.63–2.32), labor induction (OR 1.08 95% CI, 1.02–1.14), and labor augmentation (OR 1.95 95% CI, 1.56–2.44) were also more common among women with perineal lacerations. Conclusions Various factors contribute to the occurrence of perineal lacerations. Future studies should consistently evaluate all examined parameters to determine their possible interrelation.
Cervical cancer incidence is tightly linked to HPV infection, and particularly virus types 16 and 18 cause the majority of cases presenting with pre-cancerous stages of cervical intraepithelial ...neoplasia (CIN). Structural and functional information concerning HPV proteins can offer novel insight into the mechanism(s) of cancer progression in the cervical epithelium. Recently, novel structural determinants of the interactions of viral proteins with their targets in keratinocytes have been elucidated. These exciting findings open the way for the development of targeted anti-oncogenic therapies, and may eventually allow the introduction of novel approaches for a rational cervical cancer treatment.
Purpose
To evaluate the tumor’s volume and intratumoral vascularization with 3D vocal power Doppler ultrasound in patients with stage 1B1 cervical cancer.
Methods
This was a prospective study on ...patients with cervical cancer and stage 1B1 disease, which took place between 2012 and 2015. All women had an initial 2D ultrasound examination for the estimation of the tumor volume. Following this, 3D volumes of the cervix were acquired and were further analyzed using the Virtual Organ Computer Aided Analysis (VOCAL) program. In the selected volume, the vascular pattern (linear or complex vascularization) was also examined. The ultrasonographic findings were compared to the histological ones following surgery.
Results
Twenty-seven patients were included. The average cervical tumor volume measured by the 2D ultrasound and 3D VOCAL-PD were 3.14 and 3.08 cm
3
, respectively. Both 2D and 3D VOCAL-PD overestimated the tumor staging. Further analysis showed a statistically significant superiority of 2D ultrasound over 3D VOCAL-PD for tumors equal or smaller than 2.5 cm
3
with linear vascularity (
p
< 0.001), while for tumors of larger volume with complex vascularization, a statistically significant superiority of 3D VOCAL-PD was confirmed (
p
< 0.001).
Conclusions
3-D VOCAL-PD is extremely accurate and superior to 2D ultrasound for the estimation of tumor volume and vascularization when it is more than 2.5 cm
3
and has a complex vascularization in patients with stage 1B1 cervical cancer.
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