Concurrent endometrial carcinoma in hysterectomy specimens in patients with histopathological diagnosis of endometrial hyperplasia in curettage specimens.

OBJECTIVES: The purpose of this study was to appraise the presence of Endometrial Carcinoma (EC) sequence in patients undergoing hysterectomy for Endometrial Hyperplasia (EH). MATERIAL AND METHODS: Eighty-two patients undergoing hysterectomy with the indication of EH based on endometrial curettage between January 2009 and December 2013 were analyzed respectively All patients with a diagnosis of EH were investigated for age, parity history of diabetes mellitus and hypertension. The histopathology of the hysterectomy specimens were compared with their curettage specimens. RESULTS: A total number of 82 women; 48 (58.5%) postmenopausal and 34 (41.5%) premenopausal were determined to have EH on histopathological evaluation of endometrial tissues obtained by endometrial curettage performed for evaluation of various bleeding abnormalities. Mean-age of patients was 54.6?8.7. Among 82 patients found to have EH on curettage specimens 39 had EC on hysterectomy specimens (39/82. 47.5%). Consequently we determined well differentiated endometrial adenocarcinoma in 66% (35/53) of the patients with hyperplasia with atypia (17/35. 48.5% Grade 1 and 18/35.51.4% Grade 2) and 13.7% (4/29) hyperplasia without atypia (4/4.100% Grade 1). CONCLUSIONS: Postoperative diagnosis of endometrial pathology might be different from that of preoperative especially in cases with complex EH with atypia. Our study indicated that most of women diagnosed preoperatively with Atypical endometrial hyperplasia (AEH) may have a cancer at final examination of hysterectomy specimens. It may be useful to operate patients with AEH in specific centers because of invasive endometrial cancer risk in final histopathological evaluation.

Prevalence of and influencing factors for chronic headaches among pregnant women.

OBJECTIVE: To determine the prevalence of headaches and their influencing factors among pregnant women. METHODS: A cross-sectional study was conducted from January 3 to April 29, 2005, with 1357 women receiving routine pregnancy check-ups at the obstetric clinics of the community health institutions of Kayseri, Turkey. A structured questionnaire and the Zung Depression Scale were used to collect data. RESULTS: Overall, 24.6% (95% confidence interval, 22.3%-26.9%) of the participants had headaches before pregnancy, whereas only 17.9% (95% confidence interval, 15.9%-20.1%) had headaches during pregnancy. Although the headache prevalence was lower during than before pregnancy, it was high among the participants aged 35 years or older, those who received help in their housework, and those who were multiparous. Moreover, the Zung depression score was significantly high among those experiencing headaches. CONCLUSION: The significant decrease in headache prevalence observed during pregnancy may be the result of a pregnancy-specific hormonal status. However, the most significant factors influencing the frequency of headaches in the participants were related to their socioeconomic status and the severity of depression.

Surgical management of intra-abdominal mislocated intrauterine devices.

OBJECTIVE: We report on our experience in surgical treatment of patients with intra-abdominal intrauterine devices (IUDs). MATERIAL AND METHODS: A total of 10 patients were retrospectively analyzed. Diagnosis was based on gynecologic examination, transvaginal sonography, and abdominal X-ray. RESULTS: All of the IUDs were inserted by trained midwives, either in the puerperal period (n=3) or within 1 year after puerperium (n=7). Five women were asymptomatic at the time of diagnosis, three were pregnant and two complained of pelvic pain. Eight patients were managed by laparoscopy, whereas laparotomy was required in two. Abscess formation was present in two cases. The postoperative course was uneventful in all patients. CONCLUSION: A missing string during gynecologic examination is the first sign of an intra-abdominal IUD in all cases. Transvaginal sonography should be combined with abdominal X-ray to reach a definitive diagnosis. Laparoscopic treatment may be appropriate in most of the cases.