MyMedR

The characteristics of normal labour in 977 Malay, Chinese and Indian parturients were established from a retrospective study. Indian babies were found to be significantly smaller than Malay babies which were significantly smaller than Chinese babies (P less than 0-05, P less than 0-05). The mean duration of the first stage of labour taken from the time of admission to the labour ward was 3-4 hours in primiparae and 2-7 hours in multiparae. The mean durations of the second stage of labour were 23-7 minutes and 13-1 minutes respectively. Curves of mean dilatation of cervix and probit analysis at 80% revealed significant differences in the progress of normal labour in primiparae among the three racial groups. The Indian primiparae not only had a slower rate of cervical dilatation but seemed to reach the accelerated phase of dilatation later. No significant differences were noticed in the labours of multiparae.

Matched MeSH terms: Cervix Uteri

Actinomyces-like organisms in the cervical smears of IUCD users

Farida Jamal, Mohd Salleh Mohd Yasin, Zooraidah Zainal, Hamid Arshat

Malays J Reprod Health, 1983 Jan;1(1):55-9.

PMID: 12279890

Matched MeSH terms: Cervix Uteri*

Radical hysterectomy and pelvic lymphadenectomy for early invasive cancer of the cervix - 14-year experience

Sivanesaratnam V, Sen DK, Jayalakshmi P, Ong G

Int. J. Gynecol. Cancer, 1993 Jul;3(4):231-238.

PMID: 11578351

During a 14-year period, 397 radical hysterectomies and pelvic lymphadenectomies were performed for early invasive carcinoma of the cervix. Twenty-one patients were in stage IA2 with lymphatic/vascular channel permeation (5.2%), 340 in stage IB (85.6%) and 34 in early stage 2A disease (8.5%). Eighteen patients (4.5%) were pregnant. Adenocarcinoma comprised 26.9% of cases. The mean operative time was 4.14 h; the intraoperative blood loss was less than 1.51 in 77.3% patients. There was no operative mortality; one patient died 3 weeks after surgery from clostridium difficile enterocilitis. Eleven patients (2.7%) developed venous thrombosis; severe lymphedema occurred in four (1%). The incidence of uretero-vaginal fistula was 0.2% and that of vesico-vaginal fistula 0.5%. Ovarian metastases were noted in 4.3% of cases with adenocarcinoma. Sixty-six patients had positive nodes (16.6%). Five-year survival in patients with more than 2 positive nodes was 68%. The use of adjuvant chemotherapy in patients with 'high risk' factors resulted in survival rates approaching those without risk factors. Neo-adjuvant chemotherapy was used in 10 patients with large bulky tumors; the results were favorable. Recurrences occurred in 47 patients (11.8%); 36 patients have died (9.1%). Age did not appear to influence survival. The overall 5-year survival was 92.2%.

Matched MeSH terms: Cervix Uteri

The effects of oestradiol and relaxin on extensibility and collagen organisation of the pregnant rat cervix

Cheah SH, Ng KH, Johgalingam VT, Ragavan M

J Endocrinol, 1995 Aug;146(2):331-7.

PMID: 7561646

The effects of exogenously introduced oestradiol-17 beta (E) and relaxin (RLX) on cervical extensibility and collagen organisation were tested in rats ovariectomised in late pregnancy. When the cervices were stretched in vitro by 1 mm increments, it was found that those from rats given E alone generated significantly higher tensions than those from control rats, while cervices from rats given both E and RLX had tensions similar to controls. Examination of cervical sections under the light microscope and ultra-thin sections under the electron microscope showed that the collagen fibres in the cervices from E-treated rats were highly organised, whereas those from animals given E+RLX and control animals were disorganised and dispersed. It was concluded that E decreased cervical extensibility, while RLX counteracted the effect of E to maintain a soft and easily extensible cervix.

Matched MeSH terms: Cervix Uteri/anatomy & histology; Cervix Uteri/drug effects*; Cervix Uteri/physiology; Cervix Uteri/ultrastructure

Fulltext A randomised double-blind study of vaginal misoprostol vs dinoprostone for cervical ripening and labour induction in prolonged pregnancy

Lee HY

Singapore Med J, 1997 Jul;38(7):292-4.

PMID: 9339095

Dinoprostone, is presently used in our standard protocol for cervical ripening and labour induction. In search for a cheaper alternative, misoprostol has been found to be a good substitute. In view of the potential saving it might offer, we set out to test its efficacy against the standard dinoprostone.

Matched MeSH terms: Cervix Uteri/drug effects*; Cervix Uteri/physiopathology

Fulltext Colonization and transmission of Ureaplasma urealyticum and Mycoplasma hominis from mothers to full and preterm babies by normal vaginal delivery

Chua KB, Ngeow YF, Lim CT, Ng KB, Chye JK

Med J Malaysia, 1999 Jun;54(2):242-6.

PMID: 10972036

A prospective study was carried out among pregnant women and their newborn babies in the University Hospital, Kuala Lumpur from January 1996 to June 1997. The maternal cervical colonization rates of Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) were found to be 57.5% and 15.8% respectively while the isolation rates from nasopharyngeal secretions of the newborns were 50.8% for UU and 6.6% for MH. The overall transmission rates were 88.4% for UU and 42.1% for MH. There was no significant difference in the transmission rates of either organism from mothers to their respective newborn babies by the maturity of pregnancy. In preterm babies, the nasopharyngeal isolation rates of UU and MH were not influenced by the babies' gestational age and birth weight nor by the maternal history of abortion or parity. However, there was a tendency for UU to persist in the nasopharyngeal secretion of preterm babies especially those of birth weight below 2 kg. None of the babies contaminated with mycoplasmas at birth developed respiratory symptoms during six to eight weeks of follow-up.

Matched MeSH terms: Cervix Uteri/microbiology*

Fulltext Delayed diagnosis of cervical pregnancy: management options

Sivalingam N, Mak FK

Singapore Med J, 2000 Dec;41(12):599-601.

PMID: 11296786

Cervical pregnancy is an uncommon variety of ectopic gestation. The aetiology is obscure. Diagnosis can be missed unless early evaluation is done by experienced personnel utilising pelvic ultrasonography. Three cases of cervical pregnancy managed at this hospital are described illustrating difficulties in early diagnosis and possible association with previous uterine scar and prior curettage of the uterus for retained products of conception. Treatment options vary according to the clinical state of the patient at the time of diagnosis. Non-surgical methods including systemic methotrexate administration in one and surgical evacuation of products of conception with subsequent cervical cerclage in another are discussed. Surgical interventions like total abdominal hysterectomy with internal iliac artery ligation to arrest life-threatening pelvic haemorrhage is also described. Other treatment options include potassium chloride (KCl) alone or in combination with methotrexate.

Matched MeSH terms: Cervix Uteri*

Telomerase activation and human papillomavirus infection in invasive uterine cervical carcinoma in a set of Malaysian patients

Cheah PL, Looi LM, Ng MH, Sivanesaratnam V

J Clin Pathol, 2002 Jan;55(1):22-6.

PMID: 11825919

AIM: Telomerase activity was studied in invasive uterine cervical carcinoma to assess whether it was activated during cervical malignant transformation and to look for a possible association with human papillomavirus (HPV) infection in a set of Malaysian patients.

METHODS: Histologically confirmed invasive cervical carcinoma and benign cervices were assayed for telomerase activity using a commercial telomerase polymerase chain reaction (PCR) enzyme linked immunosorbent assay kit. The same cases were subjected to PCR detection of HPV using type specific (HPV types 6b, 11, 16, and 18) followed by L1 open reading frame (ORF) consensus primers.

RESULTS: HPV was detected in 18 (13 HPV-16, one HPV-6b, four only L1 ORF) of 20 invasive cervical carcinoma and one (only L1 ORF) of 19 benign cervices. Raised telomerase activity (A(450 nm) > 0.215) was detected in 11 cervical carcinomas, with A(450 nm) ranging between 0.238 and 21.790 (mean, 3.952) in positive squamous carcinomas, whereas A(450 nm) was only 0.222 in the one positive adenosquamous carcinoma. Five of 11 cervical carcinomas in stage I, three of six in stage II, both in stage III, and the only case in stage IV showed telomerase activation. Increased telomerase activity was noted in five of the 12 lymph node negative, five of the seven lymph node status unknown cases, and the one case with presumed lymph node metastasis. Ten of 18 HPV positive and one of two HPV negative cervical carcinomas showed telomerase upregulation.

CONCLUSIONS: Telomerase is activated in invasive cervical carcinoma. Although larger studies are needed, there seems to be no clear association between telomerase upregulation and HPV status, although there is a suggestion of increased telomerase activity in squamous carcinomas and late stage disease.

Matched MeSH terms: Cervix Uteri/enzymology; Cervix Uteri/virology

P53 immunohistochemical expression: messages in cervical carcinogenesis

Cheah PL, Looi LM

Pathology, 2002 Aug;34(4):326-31.

PMID: 12190289

AIMS: The pattern of p53 expression was studied in pre-invasive and invasive cervical carcinoma in an attempt to clarify its role in cervical carcinogenesis.

METHODS: A total of 234 invasive cervical carcinomas (152 squamous cell carcinomas, 61 adenocarcinomas and 21 adenosquamous carcinomas) and 16 cervical intraepithelial neoplasia (CIN) I, six CIN II and 25 CIN III were immunohistochemically studied for p53.

RESULTS: p53 was detected more frequently in CIN and invasive carcinoma (100% of CIN I, 74.2% CIN II + III and 70.1% invasive carcinoma) compared with benign cervices (P< 0.001); however, only three squamous cell carcinomas, 11 adenocarcinomas and two adenosquamous carcinomas exhibited p53 expression in >75% of tumour nuclei. Six of the 11 adenocarcinomas and both adenosquamous carcinomas were poorly differentiated compared with one of the three squamous carcinomas. p53 immunoreactive cells were randomly distributed in invasive carcinoma, confined to the lower third of the epithelium in CIN I, reached the middle third in 20% of CIN II and upper third in 16.6% of CIN III.

CONCLUSIONS: Assuming that p53 immunoreactivity indicates gene mutation when the majority (> 75%) of neoplastic cells express p53, p53 mutations would seem uncommon in cervical carcinogenesis. Nonetheless, glandular malignancies, in particular poorly differentiated variants, may show a higher frequency of mutation. p53 was detected more frequently in CIN I compared with CIN II/III and invasive carcinoma which may be due to p53 protein degradation following interaction with high risk human papillomavirus E6 protein in CIN II/III and invasive carcinoma.

Matched MeSH terms: Cervix Uteri/metabolism

Fulltext Malignant mixed mullerian tumour, heterologous in a 66-year-old malay lady - a case report

Rahman MT, Naik VR, Noor SR, Mahmud NM, Isa M

Malays J Med Sci, 2003 Jul;10(2):93-5.

PMID: 23386805

A 66-year-old Malay woman, known hypertensive, presented with post menopausal bleeding associated with clot for three months. She was postmenopausal for last ten years. She also complaints of developing a mass in the abdomen which was growing in size also for last three months. Abdominal examination revealed a twenty week size mass, movable from side to side but unable to get below the mass. Vaginal examination revealed a fleshy fungating mass arising from the uterus coming out through the vagina. Cervix could not be visualized properly. Subsequent histopathology of the removed mass was reported as a Malignant Mixed Mullerian Tumour - Heterologous.

Matched MeSH terms: Cervix Uteri

Endometrial and endocervical secretion: the search for histochemical differentiation

Nieuwenhuizen L, Khalil MK, Venkatesh N, Othman NH

Anal. Quant. Cytol. Histol., 2006 Apr;28(2):87-96.

PMID: 16637511

To determine the ideal histochemical stain to differentiate between non-neoplastic and neoplastic endocervix and endometrium.

Matched MeSH terms: Cervix Uteri/pathology; Cervix Uteri/secretion*

Fulltext Role of mid-trimester transvaginal cervical ultrasound in prediction of preterm delivery

Hebbar S, Samjhana K

Med J Malaysia, 2006 Aug;61(3):307-11.

PMID: 17240581 MyJurnal

Ultrasonographic cervical length assessment is increasingly being utilized clinically to identify women at risk for spontaneous preterm delivery. In a randomised prospective longitudinal study involving 200 women, we measured cervical length and internal os diameter by transvaginal scan at 20 - 24 weeks and analysed their ability to predict preterm birth. The risk of spontaneous preterm delivery increased steeply as cervical length decreased. At cut off value of < or = 2.5cm, the cervical length measurements had sensitivity, specificity, positive predictive value and negative predictive value of 77%, 95%, 56% and 98% respectively. However, internal os diameter lacked sensitivity and specificity. Our data suggests that the duration of pregnancy is directly related to length of the cervix: the shorter the cervix, the greater the chance of preterm delivery.

Matched MeSH terms: Cervix Uteri/ultrasonography*

Ultrasound and clinical predictors for Caesarean delivery after labour induction at term

Tan PC, Suguna S, Vallikkannu N, Hassan J

Aust N Z J Obstet Gynaecol, 2006 Dec;46(6):505-9.

PMID: 17116055

To assess the relationship of ultrasound assessment for amniotic fluid, fetal weight, cervical length, cervical funneling and clinical factors on the risk of Caesarean delivery after labour induction at term.

Matched MeSH terms: Cervix Uteri/anatomy & histology

Fulltext Villoglandular papillary adenocarcinoma of the uterine cervix with lymph node metastasis - a case report and review of the literature

Geok, Chin Tan, Mohd Sidik Shiran, Manickam Swaminathan, Ali Siti Aishah, M.D., Poo, Ling Ong, Mohd Dali Ahmad Zailani Hatta

Medicine & Health, 2006;1(1):85-90.

MyJurnal

Villoglandular papillary adenocarcinoma was first described by Young and Scully in 1989 as a distinct entity with the histological features of exophytic growth proliferation, villous and papillary architecture and mild to moderate nuclear atypia. We report one case of villoglandular papillary adenocarcinoma (VGPA) of the uterine cervix with lymph node metastasis and reviewed the clinicopathological features of six other cases reported in the literature. Our patient is the seventh similar reported cases. They ranged in age from 29 to 54 (mean, 41) years. Five had lymphovascular invasion. All except our patient were treated with radical hysterectomy and radiotherapy. She was followed-up for 7 months and unfortunately died due to chest infection.

Matched MeSH terms: Cervix Uteri

Transvaginal sonographic measurement of cervical length vs. Bishop score in labor induction at term: tolerability and prediction of Cesarean delivery

Tan PC, Vallikkannu N, Suguna S, Quek KF, Hassan J

Ultrasound Obstet Gynecol, 2007 May;29(5):568-73.

PMID: 17444553

To compare transvaginal sonography for cervical length measurement and digital examination for Bishop score assessment in women undergoing labor induction at term, to assess their tolerability (in terms of pain) and ability to predict need for Cesarean delivery.

Matched MeSH terms: Cervix Uteri/anatomy & histology; Cervix Uteri/ultrasonography*

Fulltext Comparison of DR. HPV Chip Kit with hybrid capture II assay for the detection of human papillomavirus in clinical samples: a preliminary study

Rajan S, Shen TH, Santhanam J, Othman NH, Othman N, Hock TT

Trop Biomed, 2007 Jun;24(1):17-22.

PMID: 17568373

Human papillomavirus (HPV) is well known as an etiological factor for the development of anogenital carcinomas. The aim of our study was to compare the performance of USFDA approved Hybrid II (HCII) Assay and recently introduced DR. HPV Chip Kit for the detection of HPV DNA in clinical cervical scrapings from 40 patients. HPV DNA testing was performed using the automated HCII Assay system and DR. HPV Chip Kit. Taking cytological results as gold standard, it was found that HCII was more sensitive (36.4%) than DR. HPV Chip Kit (18.2%) although specificity was 100% with the latter method. In addition, both these molecular methods had comparable negative and positive predictive values. It was concluded that both HCII and DR. HPV Chip Kit have comparable specificity. However, sensitivity for detection of HPV in clinical samples with HCII is almost double as compared to DR. HPV Chip Kit.

Matched MeSH terms: Cervix Uteri/virology

Fulltext Predictors of newborn admission after labour induction at term: Bishop score, pre-induction ultrasonography and clinical risk factors

Tan PC, Suguna S, Vallikkannu N, Hassan J

Singapore Med J, 2008 Mar;49(3):193-8.

PMID: 18362999

Following labour induction at term, 12 percent of neonates can expected to be admitted to the neonatal intensive care unit. We aimed to evaluate the Bishop score, pre-induction ultrasonography (US) assessment of amniotic fluid, foetal weight and cervical length, and pre-induction and intrapartum risk factors as predictors of neonatal admission.

Matched MeSH terms: Cervix Uteri/ultrasonography

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