Comparison of cases with and without acute liver injury in pregnant women with SARS-CoV-2 infection; obstetric and neonatal outcomes.

Background and objective: The effect of SARS-CoV-2 infection on the liver during pregnancy and the impact of SARS-COV-2-related liver injury during pregnancy on obstetric and neonatal outcomes are not yet clear. The aim of this study was to determine the clinical features of pregnant women at risk of liver injury and to investigate the effect of liver dysfunction on obstetric and perinatal outcomes. Methodology: Pregnant women who were followed up and treated at Selcuk University Medical Faculty Hospital and diagnosed with COVID-19 were determined retrospectively. All pregnant women whose PCR test results were positive between March 1, 2020 and July 31, 2022 were included. A total of 96 PCR positive pregnant women were included in the study. The patients were divided into two groups as those with and without liver damage. Both groups were compared in terms of obstetric and neonatal outcomes. Results: While liver damage findings were observed in 34.4% of the 96 pregnant included in the study; No liver damage was observed in 65.6% of the patients. White blood cell, neutrophil, ferritin, D-dimer, troponin, C-reactive protein, systemic immune-inflammation index, interleukin-6, alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase levels were higher in patients with liver injury compared to pregnant women without liver injury. Prematurity, premature rupture of membranes, preterm premature rupture of membranes, preeclampsia and fetal death were observed relatively more in the patient group with liver injury, there was no statistical significiant difference between the groups in terms of these complications. Unfortunately, maternal death occurred in four mothers with liver injury and in one patient without liver injury. Birthweight, APGAR scores and obstetric complication rates were similar between two groups. Conclusion: Our study showed that pregnant patients with liver damage had worse inflammatory response than those without liver damage. Women with elevated liver enzymes tend to have severe disease, but obstetric and perinatal outcomes were similar between groups with and without liver damage.

An analytical cross-sectional study: determining gestational age using fetal clavicle length during the second trimester.

PURPOSE: To investigate the correlation between fetal clavicle length and gestational age in pregnant patients from 14 and 27 weeks of gestation. METHODS: This was a retrospective cross-sectional study of patients from 14 and 27 weeks of gestation. Ultrasonographic measurements such as abdominal circumference (AC), femur length (FL), humerus length (HL), clavicle length (CL), head circumference (HC), biparietal diameter (BPD), estimated fetal weight (EFW), and transverse cerebellum diameter (TCD) were made and compared. RESULTS: A total of 552 patients were evaluated in our clinic and CL was measured properly and successfully in all fetuses. Fetal AC, FL, HL, CL, BPD, HC, EFW and TCD measurements were significantly and strongly correlated with gestational week, and Pearson's correlation values were 0.964, 0.965, 0.959, 0.965, 0.951, 0.917, 0.925, and 0.954, respectively (p < 0.001). In the regression analysis equation, gestational week = 0.894 + CL × 0.961. CONCLUSION: There was a significant positive correlation between fetal CL (mm) and gestational week. We suggest that the 1 mm = 1 week rule can be used for patients with anomalies of the cerebellum and vermis, as well as for patients with unknown last menstrual period.

Could interleukin-33 and its suppressor of tumorigenicity 2 (ST2) receptor have a role in cervical human papillomavirus (HPV) infections?

Why most women can clear human papillomavirus (HPV) infections while others can develop permanent infections. The stimulation of immunotolerance of the immune system of the host by the persistent HPV infection may be the answer to this question. Interleukin-33 (IL-33) may play a role in the pathogenesis of HPV infection, this hypothesis was thought to be due to the rapid release of IL-33 from damaged cells following tissue damage, necrosis, and activation of the inflammasome. Thus, in this study, the role of IL-33/suppressor of tumorigenicity 2 (ST2) was emphasized in HPV positive and HPV negative cervical tissues. A total of 80 were assessed. The reduced levels of IL-33 and ST2 are associated with cervical HPV infections. There was a statistically significant 42% positive correlation between IL-33 and ST2 in the HPV-positive group. Surprisingly, our data showed no significant difference between the expression levels of IL-33 or ST2 and working status, type of delivery, pre- and post-operative pathology, cigarette, educational status, locality, birth control method, gynecological, and colposcopic findings. We found that as a result of our study; low IL-33 and ST2 levels were associated with HPV infections.

Effect of lycopene on oxidative ovary-damage induced by cisplatin in rats.

The anti-cancer drugs, particularly those used in reproductive period, may cause several complications such as ovarian insufficiency and infertility. The mechanism of action of cisplatin toxicity on the ovaries is not fully described. However, further production of free oxygen radicals and reduced production of antioxidants are thought to have an effect on the occurrence of cisplatin toxicity. The aim of this study was to investigate the effects of lycopene on cisplatin-induced ovary-damage, oxidative stres and histological changes in rats. Albino Wistar female rats were randomly divided into three groups. The control group (Group 1) received sunflower oil; animals in Group 2 received only cisplatin; one hour of lycopene pre-treatment was applied to the animals in Group 3 before administration of cisplatin. Cisplatin (5 mg/kg/day) was intraperitoneally injected as a single dose and lycopene (0.5 mg/kg/day) was administered by gavage. Biochemical and histopathological methods were utilised for evaluation of the oxidative ovary-damage. There was an increase in the levels of malondialdehyde, while total glutathione, glutathione reductase, and superoxide dismutase were decreased in Group 3, but it is observed that these ratios are reversed in the Group 1 and in the Group 2. Lycopene had protective effect against cisplatin-induced ovary-damaged.

The effect of resveratrol on oxidative ovary-damage induced by methotrexate in rats (Resveratrol oxidative ovary-damage).

Methotrexate (MTX) is a commonly used folic acid antagonist for the treatment of neoplasia and some autoimmune diseases. Resveratrol has important anti-inflammatory, antioxidant and immunomodulatory properties. The aim of this study was to investigate the effects of resveratrol on MTX-induced ovary-damage and oxidative stress in rats. We hypothesized that supplement of resveratrol could counteract MTX-induced cytotoxicity in rat ovary. Albino Wistar female rats were randomly divided into three groups: Healthy control (HC), resveratrol + methotrexate (RMTX) and methotrexate (MTX) group. Their ovaries were removed. Biochemical and histopathological methods were utilized for evaluation of the oxidative ovary-damage. MDA was found to be higher but tGSH and SOD were lower in the ovarian tissue of the rat group administered MTX, but it is observed that these ratios are reversed in HC and in RMTX groups. MTX treatment induced ovary damage and especially pre-treatment with resveratrol provided protective effect against this MTX-induced ovary-damaged.

Does myo-inositol oxygenase, the only enzyme to catalyze myo-inositol in vivo, play a role in the etiology of polycystic ovarian syndrome?

In polycystic ovary syndrome (PCOS), myo-inositol (MI) supplements have shown many beneficial effects. In this study, therefore, we aimed to investigate the serum level of myo-inositol oxygenase (MIOX), which is the only enzyme catalyzing MI in vivo, in patients with PCOS. Serum MIOX enzyme levels and other laboratory parameters were compared between sixty patients, who were diagnosed with PCOS for the first time, and sixty healthy individuals at similar age and sex. MIOX serum levels were not different between two groups (p = 0.7428). MIOX median and 95% CI were 19.4 and 10.6-39.1 in the control group and 16.4 and 7.6-46.2 in the patient group respectively. Demographic data, biochemical and hematological parameters, hormone parameters were not different except from the lymphocyte count between the two groups. Lymphocyte count was higher in the patient group. Although the ratio of LH/FSH was higher in the patient group, it was not statistically significant. Our results suggest that serum MIOX levels do not change in PCOS. It was, therefore, concluded that MI deficiency observed in PCOS was not related to the level of MIOX enzyme which cleaves MI.

The effect of rutin on ovarian ischemia-reperfusion injury in a rat model.

The effect of rutin on ovarian ischemia-reperfusion (I/R) injury was investigated in this experimental study. Eighteen Wistar albino female rats were divided into three groups as follows: I/R group (IRG; n = 6), 50 mg/kg rutin + I/R group (RG; n = 6), and a healthy control group scheduled for a sham operation (SG; n = 6). 2 h of ischemia and following 2 h of reperfusion were created in the IRG and RG by using a torsion model involving atraumatic vascular clips. Rutin, a flavonoid glycoside, was injected intraperitoneally at the dose of 50 mg/kg to RG group 1 h before reperfusion. Then, rats were euthanized and their ovaries were removed for biochemical and histopathological examination and also assessment of the gene expressions. IRG group had a significant increase in malondialdehyde (MDA) levels, in the expressions of tumor necrosis factor alpha (TNF-α) and interleukin 1 beta (IL-1ß), and also in the activity of cyclooxygenase 2 (COX-2) unlike the significant decrease in total glutathione (tGSH) levels and the activity of COX-1 when compared to the SG group. However, rutin significantly decreased MDA levels, the expressions of TNF-α and IL-1ß, and also the activity of COX-2 while it increased significantly tGSH levels and the activity of COX-1 in the RG group in comparison with the IRG group. Rutin ameliorated the I/R-induced ovarian injury in rats via its possible antioxidative and anti-inflammatory effects.

The Effect of the 50 g Glucose Challenge Test on The Thiol/Disulfide Homeostasis in Pregnancy.

AIM: A 50 g glucose challenge test (GCT) is recommended for screening all pregnant women for gestational diabetes mellitus. In this study, the effect of GCT on the thiol/disulfide balance was investigated. METHODS: One-hundred women that underwent a 50 g GCT at 24-28 weeks of gestation (63 positive and 37 negative results) were evaluated in terms of thiol/disulfide in serum samples at test hours 0 and 1. RESULTS: Compared to the baseline values (hour 0), after the glucose load (hour 1), the thiol and native thiol/total thiol (p < 0.0001) of the GCT-positive women were reduced whereas the values of glucose, disulfide, disulfide/native thiol, disulfide/total thiol (p < 0.0001) and total thiol increased (p = 0.018). CONCLUSION: In GCT-positive pregnant individuals, the glucose load increases oxidative stress by changing the thiol/disulfide homeostasis. Such an effect is not observed in healthy pregnancies.

Role of lymphadenectomy in disease-free and overall survival on low risk endometrium cancer patients.

OBJECTIVES: Evaluation of the effect of lymphadenectomy in disease-free and overall survival on the low risk corpus cancer. MATERIAL AND METHODS: Between 1994 and 2012, a total of 257 patients with endometrioid type, grade 1 or 2, myometrial invasion < 1/2, no intraoperative evidence of macroscopic extrauterine spread was treated surgically. Pelvic lymphadenec-tomy was performed in 184 cases, and not performed in 73 cases. RESULTS: There was no difference between two groups about tumor sizes. Also lymphovascular space invasion and histo-logic grade of two groups were similar. Omission of LA did not worsen DFS and OS in early stage low risk corpus cancer. CONCLUSIONS: Patients who have low risk corpus cancer, can be treated optimally with hysterectomy only.

Prognostic factors of primary fallopian tube carcinoma.

AIM OF THE STUDY: Fallopian tube cancer is very rare in the literature and so there are not enough data about the therapeutic approaches. The approaches are generally determined in accordance with the data obtained from ovarian cancer. Many prognostic factors have been investigated in an effort to better estimate patient outcome. Stage, age, and residual tumor after surgery are consistently important prognostic factors. In this study, we aimed to evaluate the prognostic factors and survival rates of primary fallopian tube cancer (PFTC), which is rare among gynecological cancers. MATERIAL AND METHODS: Thirty-eight patients with a diagnosis of PFTC were identified through the gynecologic oncology service database of our Research and Training Hospital in the period 1995-2013. Clinicopathological and surgical data were collected. All patients were evaluated for survival and disease-free survival between the dates specified. RESULTS: A significant relationship and correlation was found between optimal surgery and life expectancy. Better results were obtained in patients treated with optimal surgery. The survival probability was found to be higher in patients with lower CA-125 levels and serous histologic type adenocarcinoma. CONCLUSIONS: Stage is one of the factors affecting the survival probability. We determined that the pathological type of tumor, the diameter of residual tumor remaining after surgery, tumor grade, preoperative CA-125 levels and presence of ascites affect the survival probability.

The effect of diabetes on ovaries in a rat model: the role of interleukin-33 and apoptosis.

Interleukin-33 (IL-33) is a novel cytokine involved in diabetes mellitus (DM) but its role in diabetic ovarian injury is unknown. As IL-33 is modulated by apoptosis, we aimed at investigating the effect of diabetes on ovaries in terms of evaluating apoptosis and IL-33 in a rat model. In this prospective experimental study, 16 female, nonpregnant Sprague-Dawley albino rats (12 weeks, 220-240 g) were randomly divided into two groups. Group 1 included eight healthy nondiabetic rats as controls and group 2 included eight rats in which diabetes was induced by intraperitoneal (i.p) injection of streptozotocin (STZ). After overt DM occurred (blood glucose >400 mgr/dl), all animals were euthanized and blood samples were collected by cardiac puncture for biochemical analysis. Bilateral oophorectomy was performed for histopathological examination. Serum levels of IL-33 and ovarian IL-33 and caspase-3 immunoexpressions were assessed. Immunoexpressions of caspase-3 and IL-33 were significantly higher in ovarian stromal cells of the diabetic rats compared to the controls. Also, in diabetic group, serum IL33 levels were significantly higher than the control group. In conclusion, increased IL-33 was observed both in serum and ovaries of STZ-induced diabetic rats as well as increased apoptosis in these diabetic rats. IL-33 may contribute to the apoptosis in diabetic ovarian injury.

Serum levels of soluble interleukin-2 receptor in association with oxidative stress index in patients with different types of HPV.

OBJECTIVES: The aim of this paper is to determine the oxidative-antioxidative status and levels of soluble interleukin-2 recep-tor (sIL-2R) in serum of patients with different types of HPV infections and to compare it with patients who are negative for HPV. MATERIAL AND METHODS: A total of 80 women were divided into three groups as follows: Group 1 consisted of 25 women who were positive for HPV types 16 or 18; Group 2 consisted of 25 women who were positive for other types of HPV includ-ing type 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 or 68; Group 3 consisted of 30 patients who were negative for HPV as a control group. Serum sIL-2R and plasma oxidative stress index (OSI) were analyzed. RESULTS: Serum sIL-2R levels were significantly higher in group 1 compared to group 2 and 3. OSI was found significantly increased in groups 1 and 2 compared to group 3. Also, we found a weak positive correlation between IL-2R and OSI. CONCLUSION: sIL-2R and oxidative stress may have a role in HPV infection, especially in case of high-risk types.

Outcomes of the patients diagnosed incidentally appendicitis during cesarean section.

OBJECTIVES: Appendicitis is the most common condition leading to an intraabdominal operation for a non obstetric problem in pregnancy and diagnosis of appendicitis is complicated by the physiologic and anatomic changes that occur during pregnancy. Although a surgical procedure carries the risk of fetal loss or preterm delivery, delay in diagnosis also increases the risk of complications in both mother and fetus. In this report we present our experience and analyze clinical characteristic and the pregnancy outcomes of appendicitis diagnosed incidentally during cesarean in the third trimester. MATERIAL AND METHODS: The study population consisted of 23 pregnant women who were diagnosed incidentally with appendicitis during cesarean at Erzincan University Hospital between 2015 and 2016. RESULTS: Appendectomy was performed on 23 patients during a caesarean section performed for any reason. The mean dia-meter of appendix was 7.82 ± 1.85 mm. The mean operation time was 67.39 ± 18.94 SD and antibiotic therapy was given to all patients. Postoperative complications were noted in 4 (17.4%) patients. Wound infection was seen in 4 (17.4%) patients, the other 19 patients revealed no postoperative complications. The mean of APGAR score of newborns in the postoperative period was 8.26 ± 0.86 SD and no complications were observed in both mothers and newborns. Histopathology of the specimen confirmed acute appendicitis in 23 (100%) cases. CONCLUSIONS: Acute appendicitis is a challenging diagnosis in the pregnant patient; however, early surgical intervention should be performed with any suspicion. The type of surgery depends on the surgeon's preference and experience.

Estimation of the prevalence and distribution of HPV genotypes and identification of related risk factors among Turkish women.

AIM OF THE STUDY: The present study aims to estimate the prevalence and distribution of HPV genotypes and identify related risk factors among Turkish women. MATERIAL AND METHODS: 11 624 Turkish women attending our gynaecological clinic and expressing a desire for access to cervical cancer screening were assessed during the years 2014-2016. Cervical specimens were collected and transported using the HC2 HPV DNA Collection Device (consisting of a cervical brush and digene Specimen Transport Medium). RESULTS: Among these 11 624 individuals, positive HPV test results were obtained for 325 (2.79%), and negative results were observed for 11 299 (97.2%). The vast majority of patients were between the 3rd and 5th decades and the mean age of the patients was 44 ±9.12 (range 27-66). Among the HPV-positive women, 205 were positive for a single HPV type (205/325 = 63.1% of HPV infections; 205/11624 = 1.76% of all samples) and 120 were positive for multiple types (120/325 = 36.9% of HPV infections; 120/11624 = 1.03% of all samples). The four most prevalent high-risk types were HPV 16, 31, 51 and 52, with frequencies of 11.25%, 7.83%, 6.06% and 3.16%, respectively. CONCLUSIONS: There appears to be geographic variation in the distribution of HPV genotypes. In this study, the four most prevalent high-risk types were HPV 16, 31, 51 and 52, with frequencies of 11.25%, 7.83%, 6.06% and 3.16%, respectively.

Urodynamic assessment of short-term effects of pelvic radiotherapy on bladder function in patients with gynecologic cancers.

OBJECTIVES: To determine the short-term effects of adjuvant or primary curative radiotherapy (RT) on the urinary system in women with gynecologic cancer. MATERIAL AND METHODS: This is a prospective, concurrent cohort study including 55 patients with gynecologic cancer who were divided into three groups. Group 1 included 10 patients who were administered adjuvant RT following a radical hysterectomy (RH); Group 2 included 36 patients who were administered adjuvant RT following a type 1 hysterectomy and Group 3 included 9 patients who were administered primary curative RT. Urogynecologic assessments were carried out on patients before and six months after the treatment. RESULTS: Compared to pretreatment, no significant differences were observed in any of the three groups after treatment in terms of incontinence, first urge to urinate, normal urge to urinate, severe urge to urinate and changes in residual urine volumes. There was a significant decrease in maximal vesical pressure after treatment in Group 1 and Group 3. The maxi-mum detrusor pressure decreased significantly in Group 1. The post-treatment decline in bladder capacity in Group 1 and Group 2 was also significant. CONCLUSIONS: RH and pelvic RT cause lower urinary system dysfunction. Especially patients who receive primary curative RT and patients who are administered RT after RH, where more pelvic denervation occurs, are at higher risk due to high doses of RT.

Assessment of clinicopathological features, evaluation of treatment, and prognosis of clear cell and serous papillary endometrial carcinoma.

OBJECTIVES: We aimed to evaluate and compare the clinical and pathological features, diagnosis, treatment, and prognosis of uterine papillary serous carcinoma (UPSC) and clear-cell carcinoma (CC). MATERIAL AND METHODS: Thirty-four patients who were operated on for UPSC and CC carcinoma at the Izmir Tepecik Research and Teaching Hospital, between January 1983 and December 2014, were included. Patients were evaluated for the following factors: age, gravidity, parity, preoperative CA-125, tumor size, myometrial and lymphovascular invasion, lymph node tumor metastasis, presence of atypical cells in peritoneal cytology, pathology results, operation types, whether or not they received postoperative adjuvant therapy, prognosis, and death rate. RESULTS: The stage of the disease was the main factor affecting disease-free and the overall survival. Cisplatin-based chemotherapy was partially effective in patients with postoperative recurrence, while postoperative adjuvant radiotherapy proved to be more effective in preventing relapse. CONCLUSION: The studied parameters generally were concordant with the literature but, due to the relatively small sample size, more comprehensive and multicenter studies are needed to generate valid results.

Retrospective evaluation of clinical and pathological features, as well as diagnostic and treatment protocols of primary vaginal malignancy.

OBJECTIVES: Our study aimed to determine the epidemiological characteristics and diagnostic and treatment protocols of primary vaginal carcinoma. Also, we compared the clinical and pathological features of primary vaginal carcinoma which intersect with cervical and vulvar carcinomas. MATERIAL AND METHODS: Sixteen patients with primary vaginal carcinoma, admitted to the Department of Gynecologic Oncology, Izmir Tepecik Training and Research Hospital between January 1983 and December 2012, were evaluated retrospectively. FIGO (International Federation of Gynecology and Obstetrics) Surgical staging was performed. The SPSS (Statistical Package for Social Sciences) program was used for statistical analyses. RESULTS: The histological distribution of the 16 patients with primary vaginal carcinoma was as follows: 9 patients (56.3%) with squamous cell carcinoma (SCC), 5 (31.3%) with rhabdomyosarcoma, and 2 (12.5%) with adenocarcinoma. CONCLUSION: The stage of the disease was found the be the main factor affecting the survival.

Uterine Collagen Cross-Linking: Biology, Role in Disorders, and Therapeutic Implications.

Collagen is an essential constituent of the uterine extracellular matrix that provides biomechanical strength, resilience, structural integrity, and the tensile properties necessary for the normal functioning of the uterus. Cross-linking is a fundamental step in collagen biosynthesis and is critical for its normal biophysical properties. This step occurs enzymatically via lysyl oxidase (LOX) or non-enzymatically with the production of advanced glycation end-products (AGEs). Cross-links found in uterine tissue include the reducible dehydro-dihydroxylysinonorleucine (deH-DHLNL), dehydro-hydroxylysinonorleucine (deH-HLNL), and histidinohydroxymerodesmosine (HHMD); and the non-reducible pyridinoline (PYD), deoxy-pyridinoline (DPD); and a trace of pentosidine (PEN). Collagen cross-links are instrumental for uterine tissue integrity and the continuation of a healthy pregnancy. Decreased cervical cross-link density is observed in preterm birth, whereas increased tissue stiffness caused by increased cross-link density is a pathogenic feature of uterine fibroids. AGEs disrupt embryo development, decidualization, implantation, and trophoblast invasion. Uterine collagen cross-linking regulators include steroid hormones, such as progesterone and estrogen, prostaglandins, proteoglycans, metalloproteinases, lysyl oxidases, nitric oxide, nicotine, and vitamin D. Thus, uterine collagen cross-linking presents an opportunity to design therapeutic targets and warrants further investigation in common uterine disorders, such as uterine fibroids, cervical insufficiency, preterm birth, dystocia, endometriosis, and adenomyosis.

The struggle against endometrial cancer: ten years of experience of a tertiary center.

OBJECTIVES: We aimed to investigate the clinical and pathological factors of our patients who were diagnosed with endometrial cancer in terms of prognosis. With this study, we present our 10 years of surgical experience in endometrial carcinoma cases. MATERIAL AND METHODS: Four hundred twelve patients with endometrial carcinoma who applied to our center between 2010-2019 and that we followed up were evaluated retrospectively. RESULTS: Most of the tumors were low-grade endometrioid malignancies. Non-endometrioid types accounted for 12.1% of cases. Lymph node dissection was performed in 395 of 412 patients (95.9%). 66 (16.01%) of the 412 patients died during the follow-up period in the study sample. Higher OS and DFS rates were associated with endometrioid histological types, FIGO stage, absence of lymphovascular space invasion, lower grade and less than 50% myometrial invasion (p < 0.05). 5-year OS at stage 1, 2, 3, 4 was found as 88.9 ± 2.2%, 65.5 ± 10.8%, 49.4 ± 0.79% and 23.7 ± 0.97% respectively. 5-year DFS at stage 1, 2, 3, 4 was found as 84.1 ± 2.6%, 65.5 ± 10.8%, 47.7 ± 0.78% and 23.7 ± 0.97% respectively. In univariate analysis, Age, tumor histology, FIGO stage, histological grade, LVSI, positive peritoneal cytology, cervical involvement, myometrial invasion and not receiving adjuvant therapy were defined as prognostic factors. CONCLUSIONS: Age, grade, FIGO stage, myometrial invasion, histological type, LVSI involvement, cervical involvemet, positive peritoneal cytology and not receiving adjuvant therapy are important prognostic factors for progression-free survival and overall survival in patients diagnosed with endometrial cancer.

Cervical dysplasia after renal transplantation: A retrospective cohort study.

OBJECTIVE: Since the first days of organ transplantation, it has been accepted that solid transplant recipients have a high risk of developing cancer. Chronic immunosuppression and environmental factors play a role in cancer development in recipients. In the present study, we tried to evaluate the cumulative incidence of cervical dysplasia after renal transplantation, risk factors for disease development, and the time until high-grade dysplasia occurred. MATERIALS AND METHODS: A total of 50 patients with renal transplantation who presented for gynecologic follow-up was included in the study. The medical records of the patients were reviewed until the last clinical visit, their demographic characteristics, transplant history, gynecologic history, and gynecologic examination results (cervical cytology and histology reports) were reviewed. RESULTS: Of the 50 women in the study population, 29 (58%; 95% confidence interval: 8.8-15.9) developed cervical dysplasia after the first transplant at a median follow-up of 7.8 (range: 4.6-12.9) years. Twenty-one women with benign cervical cytology before transplantation had evidence of low-grade intraepithelial lesions + after transplant (47% of these were within 2 years after transplant). During the follow-up, 8 women (18.2%) were diagnosed as having high-grade intraepithelial lesions + (within 5 years after transplantation). CONCLUSION: Renal transplant patients were found to have higher abnormal cervical cytology and histology rates than the normal population.