Ananya Trongpisutsak, Patou Tantbirojn and Ruangsak Lertkhachonsuk
Vulvar lesion is one of the common gynecologic problems.
To assess the proportion of vulvar premalignant and malignant lesions in overall vulvar specimens and to evaluate the clinicopathologic features of each vulvar lesion in King Chulalongkorn Memorial Hospital (KCMH).
Pathological microscopic slides and medical records of the patients who underwent vulvar-related operations between January 1, 2002 and December 31, 2015 were reviewed. Patients’ clinical characteristics and pathologic features were evaluated and analyzed.
A total number of 700 patients were included. The proportion of malignant and premalignant lesions in overall vulvar specimens were 16.3% and 8.4%, respectively. Squamous cell carcinoma was the most common malignant vulvar lesion (48.2%), whereas vulvar intraepithelial neoplasia 1 (VIN1) (33.9%) was the most common lesion in the premalignant group. On multivariate analysis, four clinical factors were significantly associated with malignancy risk: increased parity (odds ratio [OR] 1.19, P = 0.010), large tumor size (OR 2.00, P < 0.001), lesion at clitoris (OR 16.67, P = 0.002), and erythematous lesion (OR 2.41, P = 0.026).
The proportion of malignant and premalignant lesions in overall vulvar specimens was 24.7% in KCMH. Increased parity, large tumor size, clitoris-located lesion, and erythematous lesion were associated with increasing malignancy risk.
Kamonlapat Wijuckhapan, Patou Tantbirojn and Vorapong Phupong
Histopathology shows that 49.8% of women with preterm labor between 23–32 weeks of gestation had histological chorioamnionitis (HCA), but there is poor correlation between HCA and clinical diagnosis of chorioamnionitis. Cervical swab culture is used as a standard tool for evidence of infection.
To determine the relationship between cervical swab culture and placental histological evidence of amniotic fluid infection in preterm labor.
Retrospective observational review of cervical swab culture and placental pathology of women presenting to labor rooms of King Chulalongkorn Memorial Hospital.
We identified 104 patients with preterm labor and intact membranes from January 2012 to May 2013. Amniotic fluid infection detected by placental pathology was present in 10 patients, while a positive cervical culture was present in 12. There was only one patient that showed a positive result for both cervical swab culture and HCA. In patients with HCA, acute chorioamnionitis was present in 7 of 10 cases. Fetal inflammatory response was noted in only one case. There was no significant correlation between cervical swab culture and evidence of amniotic fluid infection in placental pathology (P = 0.87, odds ratio 0.84, 95% confidence interval 0.1 to 7.27).
There was no significant relationship between evidence of amniotic fluid infection in placental pathology and cervical swab culture or clinical signs of chorioamnionitis in preterm labor with intact membrane. However, because of some limitations in this study, the role of cervical swab culture in preterm labor remains inconclusive and more study is needed for clarification.