Prenasal thickness to nasal bone length ratio: effectiveness as a second or third trimester marker for Down syndrome.

OBJECTIVE: To assess the value of the prenasal thickness to nasal bone length ratio (PT/NBL) for detecting trisomy 21 (T21) after the first trimester. METHOD: Two examiners blinded to fetal T21 status retrospectively measured prenasal thickness (PT) and nasal bone length (NBL) of T21 and control fetuses at 15-36 weeks' gestational age on two-dimensional images from all T21-screening ultrasounds from November 2010 to April 2013. ROC curve analysis and its diagnostic values determined the best cut-off value for the ratio. Interobserver reproducibility was assessed. RESULTS: Good quality ultrasound profile images were available for 26 fetuses with T21 compared to 91 normal fetuses. The median PT/NBL ratio was 1.28 for T21 and 0.73 for control fetuses (p<0.0001). The PT/NBL ratio performed significantly better (AUC 0.99; 95%CI 0.97-1) than either PT (0.82; 0.73-0.91) or NBL (0.91; 0.85-0.98). The optimal PT/NBL ratio cut-off was 0.98, with a sensitivity of 88.5% [76.2-100%] and a specificity of 100%. Interobserver variability was low. CONCLUSION: The PT/NBL ratio is a strong marker for detecting T21 in the second and third trimesters, significantly more effective than either indicator alone.

[Role of endocervical curettage in the screening for cervical cancer: apropos of a series of 31 cases]. / Place du curetage endocervical dans le dépistage du cancer du col: à propos d'une série de 31 cas.

We present a study of 31 cases of pathologic cervical smear with an inconclusive colposcopy. The aim of this study was to compare the results of the cervical smear, colposcopy, cervical biopsy, endocervical curettage and conization. The endocervical curettage is a valuable complement to the colposcopy, especially in the case of an inconclusive colposcopy.

[Value of biological glue in CO2 laser conization. Experience with 32 cases]. / L'apport de la colle biologique à la réalisation de la conisation au laser CO2. Expérience à partir de 32 cas.

The effects of the use of biological glue in the crater that is left after CO2 laser conisation was studied in a series of 32 cases and compared with a previous study carried out using the same technical methods by the same surgeons. The use of biological glue has as its aim to improve capillary haemostasis after conisation; and so increasing the security of leaving these conisation craters in order to improve the chance of normal morphology later. Biological glue has furthermore never given a febrile reaction, nor has it ever increased the likelihood of scar stenosis. Biological glue however is just an extra method of helping normal morphological healing with a good transformation zone and retaining fertility. When conisation is carried most extensively (in particular as far as depth is concerned) and with the use of powerful laser beams, the application of biological glue seem to guarantee most forms of postoperative haemostasis and good healing.