European consensus statement on expert colposcopy McGee, A.E.; Alibegashvili, T.; Elfgren, K. ...
European journal of obstetrics & gynecology and reproductive biology,
11/2023, Letnik:
290
Journal Article
Recenzirano
Odprti dostop
Following the publication of the European consensus statement on standards for essential colposcopy in 2020, the need for standards relating to more complex and challenging colposcopy practice was ...recognised. These standards relate to colposcopy undertaken in patients identified through cervical screening and tertiary referrals from colposcopists who undertake standard colposcopy only.
This set of recommendations provides a review of the current literature and agreement on care for recognised complex cases. With good uptake of human papillomavirus (HPV) immunisation, we anticipate a marked reduction in cervical disease over the next decade. Still, the expert colposcopist will continue to be vital in managing complex cases, including previous cervical intraepithelial neoplasia (CIN)/complex screening histories and multi-zonal disease.
To provide expert guidance on complex colposcopy cases through published evidence and expert consensus.
Members of the EFC and ESGO formed a working group to identify topics considered to be the remit of the expert rather than the standard colposcopy service. These were presented at the EFC satellite meeting, Helsinki 2021, for broader discussion and finalisation of the topics.
The agreed standards included colposcopy in pregnancy and post-menopause, investigation and management of glandular abnormalities, persistent high-risk HPV+ with normal/low-grade cytology, colposcopy management of type 3 transformation zones (TZ), high-grade cytology and normal colposcopy, colposcopy adjuncts, follow-up after treatment with CIN next to TZ margins and follow-up after treatment with CIN with persistent HPV+, and more. These standards are under review to create a final paper of consensus standards for dissemination to all EFC and ESGO members.
European consensus statement on essential colposcopy Redman, C.W.E.; Kesic, V.; Cruickshank, M.E. ...
European Journal of Obstetrics & Gynecology and Reproductive Biology,
January 2021, 2021-Jan, 2021-01-00, 20210101, 2021-01, Letnik:
256
Journal Article
Recenzirano
Odprti dostop
This European consensus statement on essential colposcopy provides standards for the general colposcopist seeing women referred for colposcopy with an abnormal cervical screening test (including ...cytology and HPV tests) or with a clinically suspicious cervix. The article gives guidance regarding the aims and conduct of colposcopy. Recommendations are provided on colposcopy technique, the management of common colposcopy issues, treatment and follow-up of after treatment of CIN or early stage cervical.
Colposcopists should make an informed decision on the management of each individual that is referred and organize appropriate follow-up. Cervical cancer is still a major health issue and the quality of care can only improve if there is a structured guidance for women with an abnormal smear or suspicious cervix.
IUGR currently constitutes one of the most complex issues of modern obstetrical and perinatal sciences, its incidence constantly increasing and influencing wellbeing indicators at birth.
The aim
of ...the study was to establish the role of USG exam and Doppler velocimetry in IUGR diagnosis.
Materials and methods:
The respective study has been undertaken on a sample of 310 pregnant women, diagnosed with IUGR, between 37–41 gestational weeks. The causes of IUGR were: maternal diseases (67.10±2.67%), oligoamnios (63.5±2.32%), hypertensive disorders in pregnancy (23.2±2.38%), anemia (80.3±2.26%) etc.
Results:
The use of ultrasonography have determined fetal growth anomalies in 268 cases (86.50±2.10%) – EFW, AC, FL, BPD, HC under the 10th percentile. The IUGR was confirmed in 67.54±3.49% cases, at the repeated USG exam (after 14 days), these children have been born by caesarean section. In 47.45±2.84% cases uterine and umbilical Doppler was pathological. In 9 cases the Arbeille index <1 have been determined. There have been established beyond doubt the estimative value, the diagnosis value and the high correlation rate (r=1.00) of the paraclinic diagnosis methods and the degree of fetal suffering.
Conclusion:
The research has made possible the development of a hierarchy IUGR assessment methods early in the pregnancy (28–32 weeks), most effective being the USG exam, followed by Doppler velocimetry that represents a complementary, however important and necessary, diagnosis means. It has been stressed upon the need to use in utero growth curbs and the percentile concept.
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