Efficacy of transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial invasion in patients with endometrioid endometrial cancer: a prospective comparative study.

BACKGROUND: We compared the accuracy of preoperative transvaginal ultrasound (TVUS) versus magnetic resonance imaging (MRI) for the assessment of myometrial invasion (MI) in patients with endometrial cancer (EC), while definitive histopathological diagnosis served as a reference method. PATIENTS AND METHODS: Study performed at a single tertiary centre from 2019 to 2021, included women with a histopathological proven EC, hospitalized for scheduled surgery. TVUS and MRI were performed prior to surgical staging for assessment MI, which was estimated using two objective TVUS methods (Gordon's and Karlsson's) and MRI. Patients were divided into two groups, after surgery and histopathological assessment of MI: superficial (≤ 50%) and deep (> 50%). RESULTS: Sixty patients were eligible for the study. According to the reference method, there were 34 (56.7%) cases in the study with MI < 50%, and 26 (43.3%) with MI > 50%. Both objective TVUS methods and MRI showed no statistical significant differences in overall diagnostic performance for the preoperative assessment of MI. The concordance coefficient between both TVUS methods, MRI and histopathology was statistically significant (p < 0.001). Gordon's method calculating MI reached a positive predictive value (PPV) of 83%, negative predictive value (NPV) of 83%, 77% sensitivity, 88% specificity, and 83% overall accuracy. Karlsson's method reached PPV of 82%, NPV of 79%, 69% sensitivity, 88% specificity, and 80% overall accuracy. Accordingly, MRI calculating MI reached PPV of 83%, NPV of 97%, 97% sensitivity, 85% specificity, and 90% overall accuracy. CONCLUSIONS: We found that objective TVUS assessment of myometrial invasion was performed with a diagnostic accuracy comparable to that of MRI in women with endometrial cancer.

Pregnancy outcome in women who survived genital or extragenital cancer.

Aim To investigate clinical and obstetrical characteristics, an outcome and a prognosis for pregnant women with diagnosed and treated genital or extragenital cancer and their newborns. Methods This retrospective cohort study included pregnant and childbearing women with a history of cancer diagnosed before pregnancy during the period between 1 January 2014 and 31 December 2018. Data related to the course of pregnancy and childbirth were collected from medical records (mothers' disease history and partogram). The analysis covered clinical and histopathological characteristics of cancers, type of the treatment (surgery, chemotherapy, radiotherapy), demographic data, obstetric characteristics, comorbidities of women, and outcome of the newborns. Results The study recorded 18 414 deliveries, of which 30 (0.16%) were pregnancies in women who had been diagnosed and treated earlier for genital or extragenital cancer. The average age of the women at the time of delivery was 29.43±5.97 years. There were six (20%) women with genital and 24 (80%) with extragenital cancer. The most frequent extra genital cancer was Hodgkin lymphoma, in eight (26.6%) cases; ovarian cancer was the most frequent genital cancer, in four (13.3%) cases. The average time span from the cancer diagnosis and start of the treatment to the delivery was 59.2±44.4 months (5 years) (range 12 months - 15 years). Two (6.6%) women died. Conclusion Our data demonstrate a favourable obstetric and neonatal outcome for women who have survived cancer.

Pregnacy and Delivery in a Patient After Tetralogy of Fallot Surgery Being Undergone.

AIM: The aim of the paper is to present the risk of pregnancy for mother and her child in a young patient who had a surgery to repair Tetralogy of Fallot (ToF), who gave a birth to her firstborn by having a cesarean section. CASE REPORT: 23 years old patient, in 28 weeks of pregnancy was admitted to the clinic due to her medical record. She did not have any subjective complaints. She had two surgeries to repair ToF. After the surgery, she had residual ventricular septal defect (VSD). She had her first surgery 20 years ago (she was 3 years old), and second 7 years ago (she was 16). She had regular check-ups since, and her heart condition was unchanged. Due to her heart surgeries and VSD, a cardiologist indicates that she should deliver by having a c-section when she is 36 weeks pregnant. The patient's heart condition was stabilized and the patient was sent home. She was recommended to have her cardiologist check up on her as she leaves the hospital and to have a gynecological examination in 6 weeks. CONCLUSION: It can be concluded that team work and prenatal care, in most cases, lead to delivery without complication, both for mother and fetus.