Objective: This study was conducted in order to assess the prevalence of different cervicovaginal infections during pregnancy.Materials and methods: Totally 110 healthy pregnant women with complaints of vaginal symptoms in their third trimester of pregnancy were checked for vaginal candidiasis, bacterial vaginosis, vaginal trichomoniasis, streptococcus b hemoliticus, gonorrhea, syphilis, and infection by chlamydia trachomatis and HIV.Results: Among 110 studied women and mostly nullipara, the mean age was 25.2 years. All of them had at least one symptom including discharge, itching or burning of vagina. Among them 39 (35.5%) had vaginal and endocervical infection identified by laboratory tests including candidiasis 26.4%, bacterial vaginosis 8% and streptococcus b hemoliticus 5.3%. Gonorrhea and trichomoniasis were not seen. Three of the patients had positive IgG antibody for chlamydia trachomatis. None of them had serological positive test for syphilis and HIV.Conclusion: Symptomatic pregnant women need to be actively searched for infections. Besides speculum examination as an easy to carry out clinical test and if needed laboratory exams must be used to choose the best treatment.

Introduction & Objective: Cervicovaginal infections, affecting millions of people throughout the world annually, are among: the most prevalent infections in clinical medicine. This study was undertaken to analyze the frequency of infections due to tricomonas vaginalis, candida albicans and gardnerella vaginalis through cytological smears. Materials & Methods: A group of 1942 women were studied from October 1999 to September 2000. They referred to 1 health and therapeutic centers for routine pap smear. After collecting the data, they were analyzed using SPSS software. Results: 802 (41.3) of the subjects lived in rueral areas and 1140 (58.7%) of them Jivedin urban areas. 255 (13.3%) had 1 candidiasis, 82 (4.22%) had gardnerella vaginalis and 37 (1.9%) had tricomoniasis. The effect of age, contraception methods and other factors were studied. Results showed that there was a significant difference between infections of age and contraception methods (p<0.05). Conclusion: It can be concluded that cytological smears can be used for cervicovaginal infection diagnosis but it is necessary to add other diagnostic methods.

Introduction & Objective: Cervicovaginal infections are the most common causes of reffereing to clinics and health centers. The primary aim of present study was to determine the prevalence of genital infections in Pap smear specimens and its relationship with varriables such as age and contraceptive methods.Materials & Methods: This was a cross-sectional study that carried out in 2010 in Ahvaz, Iran. The number of 1353 Pap smear reports were selected from Ahvaz pathology laboratories using cluster sampling. Data were analyzed using chi square and ANOVA tests in SPSS. Results: The results of study showed that the prevalence of cervicovaginal infections was 10.4 on which, 8.2% of them were candida, 1.4% was trichomonas and 0.8% was gardnerella. In 87.3% of cases various degrees of inflammation of 1+ to 4+ grades were reported. There was no relationship between age and cervical infection or inflammation. There was no significan relationship between infection' type and inflammation rate and age. There was significant correlation between contraceptive methods and reports of cervicovaginal infections and inflammation.Conclusion: The cervicovaginal infections have association with use of contraceptins. For prevention of recurrent infections and precancerous cervical changes, women with risk factors for cervical cancer are recommended to make informed choices about contraceptive methods.

Background and Aim: Today, several viruses that are responsible for the development of approximately 15% of all human tumors have been characterized.Human T cell leukemia/lymphoma virus type1 (HTLV-1) , one of the human retroviruses which causes Adult T cell leukemia and Tropical spastic myelopathy, is also associated with other diseases and cancers in humans. This virus is endemic in Khorasan province.Considering the association of HTLV-1 with cervicovaginal cancers and the endemic prevalence of the virus in Khorasan, this study was designed to investigate the presence of HTLV-1 genome in the tissue specimens of cervicovaginal cancers.Materials and Methods: In this cross sectional and historical prospective study, all archived tissue specimens of cervical and vaginal cancers, diagnosed in a 20 year period (1983-2003) in the Pathology Department of Imam Reza Hospital of Mashhad were elicited and restudied microscopically .Thirty two tissue specimens were tested by PCR, using Tax, Pol and LTR primers and resulted data were analysed by Z test.Results: The results showed that most of the patients were in their fourth or fifth decades of life; about one decade younger than the other worldwide reports. Squamous cell carcinoma (SCC) was the most frequent histological subtype. In all tissue specimens studied by PCR method, genome of HTLV-1 was not detected.Conclusion: Despite the endemic prevalence of this virus in Khorasan, no association was noted between HTLV-1 and cervicovaginal cancers in studied Iranian women.

BACKGROUND: Vagina like all other mucosal organs owns its especial bacterial/microbial flora. Though may be pathogen in other circumstances, members of vaginal normal flora do not cause disease on healthy vaginal mucosa. In this study, we tried to determine the relationship between microscopic findings on Methenamine silver stained cervicovaginal smears and clinical symptoms.METHODS: A total of 389 cervicovaginal smears were examined cytologically from April to August 2005, among which 103 satisfactory smears of patients who were normally menstruating were subsequently selected. The originally Papanicolaou– stained smears were stained with Methenamine silver method. The cervicovaginal flora in symptomatic and asymptomatic patients was classified into four groups. The relationship between the type of genital flora and the presence of Candida or Actinomyces spp was also determined. Data were analyzed with SPSS software using Chi–square test.RESULTS: In 103 evaluated patients, 46 (44.7%) were symptomatic and the rest were asymptomatic. The most prevalent genital microbial flora in both symptomatic (21.7%) and asymptomatic (37.9%) patients was type II (Lactobacilli). Microbial frequency differences were significant for types II (P=0.034) and III (P=0.039) in both groups. Coexistence of microbial flora of type I (P = 0.02) and type IV (P=0.033) with Candida was statistically significant. Coexistence of all types of microbial flora with Actinomyces was not proved significant.CONCLUSIONS: Symptomatic women, except those with potential pathogens, tend to have Lactobacillus flora. Therefore, it is advisable that all Lactobacilli types be investigated through microbiological methods in symptomatic patients. In silver stained slides, there was a clear relationship between the type of vaginal microbial flora and the presence of Candida spp.

Introduction: The image analysis methods are auxiliary methods of pathological diagnosis, which can increase the accuracy and speed of evaluation of the samples. Materials & Methods: This cross-sectional study was performed on 50 samples of cervicovaginal smear cytology from Pathology Department of Ghaem Hospital, Mashhad, Iran. Firstly, samples were divided into four diagnostic groups, including reactive epithelial changes, normal, low-grade squamous intraepithelial lesion (LSIL), and high-grade squamous intraepithelial lesion (HSIL) using Bethesda method. Afterwards, the images of cytology slides were prepared using an Olympus microscope imaging system and Olympus DP3 image. The next step included the analysis of factors, such as the area and the perimeter, gray value of cells. Findings: The mean values of cell area were statistically different among the normal, LSIL, HSIL groups (P>0. 01). The mean values of the circular index for three groups were not statistically different (P=0. 151). The mean scores of gray value were significantly different between the normal and HSIL groups in terms (P=0. 00), meaning that intensity of the color was higher in the nucleus of the HSIL group. This means that cells appear darker in the HSIL group (P>0. 01). Discussion & Conclusions: The obtained results of the study indicated that an image analysis could extract useful information from digital images related to cytology of cervical smear. The findings of the four diagnostic groups, namely reactive epithelial changes, normal, LSIL, HSIL were in line with those of pathologists’ eye evaluation.

Introduction: Preterm labor affects the new born exuberance in multiple aspects such as increasing the risk of very low birth weight infants, intrapartum hypoxia and birth trauma, the sequelae of intrauterine growth retardation, respiratory distress syndrome, necrotizing enterocolitis, intracranial hemorrhage and septicemia. So prevention of preterm labor can be effective in decreasing of these complications. Our study focused on the cervicovaginal levels of Beta-HCG in order to determine its predictive value in preterm labor.Methods: In this case-control study, we determined the Beta-HCG concentration in the cervicovaginal secretions of 87 pregnant women of whom 55 had preterm labor in their medical history (cases) and 32 of them didn’t have such medical history (controls) since 2006 to 2008 in 22 Bahman hospital affiliated to Islamic Azad university in Mashhad. After explaining the procedure and the potential benefits of the study, we obtained cervicovaginal samples at 28, 30, 32, 34, 36 weeks of gestation and labor time for measuring the Beta-HCG by ELIZA test. The data were analysed by statistical program of SPSS version 15, first the data were checked by Glumogroff and Smearnoff tests for being normal, then t-test and nonparametrical tests like mean whitney were used for normal and abnormal cases, respectively. Significance level of the tests was considered less than 0.05.Results: Among the 55 pregnant women (cases), 12 (21.9%) had preterm labor however none of the other 32 pregnants with no past history of preterm labor (controls) had preterm delivery (0.0%). The mean maternal age in this study was 24.55±5.57. In all, the median concentration of Beta-HCG in cervicovaginal secretions of the women at high risk of preterm labor (81.067mIU/ml) showed no statistically significant difference with that control normal risk group pregnant women (78.872mIU/ml and p>0.05). But there was statistically significant difference between the 12 high risk women who had preterm labor (92.098 mIU/ml) and the remaining 43 high risk women who had normal labor (75.492mIU/ml) in 28, 30, 32 and 34 weeks of gestation (p>0.05).Conclusion: Cervicovaginal Beta-HCG concentration is a good predictor of preterm delivery in patients with high risk of preterm labor.

Congenital absence of the vagina with variable uterine development known as Mullerian agenesis or Mayer-Rokitansky-Kuster-Hauser syndrome. Cervicovaginal agenesis in the presence of normal uterus is very rare. Conservative surgery has recently been suggested in patients with congenital cervicovaginal atresia in order to relieve the symptoms and maintain fertility. A 13-year-old female referred to a pelvic floor clinic, because of primary amenorrhea and severe cyclic pelvic pain. Ultrasonography revealed a large amount of blood accumulation in the uterine cavity, and also, the cervicovaginal agenesis was reported. Both ovaries were normal. A neovagina was created by dissection of the space between the bladder and rectum. Under ultrasonography guidance, two Pezzer catheters were inserted between uterine ending and neovagina, so the catheters kept the canal patent, a soft mould was applied to prevent the vaginal stricture. Cervicovaginal agenesis, accompanied by normal functional endometrium, is a rare but challenging Mullerian anomaly in the case of surgical treatment. One of the successful conservative treatment in a fully educated patient is the vaginal reconstruction and uterovaginal anastomosis by stenting and continues the application of vaginal mould.

Background: Preterm delivery is one of the important problems in obstetrics and finding a way for its prediction and prevention has always been under investigation.Materials and Methods: This study carried out to determine whether human chronic gonadotropin (HCG) detected in cervicovaginal secretion of patients with symptoms suggestive of preterm labor is a predictor of preterm birth, and to determine the cut-off values for HCG in prediction of delivery before 37 weeks of pregnancy. 150 pregnant women with gestational age 24-34 weeks and diagnosis of preterm labor and intact membrane were enrolled to the study. The patients were allocated in two groups and HCG in cervicovaginal secretion was measured in all of them. The patients were followed until their delivery and were divided in two groups. Seventy-one cases delivered after 37 weeks of pregnancy (term) and 79 before 37 weeks (preterm). The amount of HCG in cervicovaginal secretion of the two groups was compared.Results: Mean concentration of HCG in cervicovaginal secretion in term group was 7.9±34.1 miu/ml and in preterm group 61.12±66.84 miu/ml which was statistically significant (p<0.001) A. significant positive correlation was found between the cervical HCG concentration, gestational age at the time of sampling (p<0.01, r=0.2), cervical dilatation(p<0.001, r=0.54) and cervical effacement (p<0.001, r=0.43), and a significant negative correlation between the cervical HCG concentration, gestational age at the time of delivery (p<0.001, r=0.4). The cut-off value for cervical HCG concentration, its sensitivity, specificity, positive and negative predictive values and accuracy for determination of delivery before 37 weeks of pregnancy were 9.5 miu/ml, 92.4% (95%CI=83.6-96.9), 87.3% (95% CI=76.8-93.7), 89%, 91.27% and 90%, respectively. However, these characteristics for HCG concentration of 10.5 miu/ml were 79.7% (95%CI=68.9-87.6), 93% (95%CI =83.7-97.4), 92.6%, 80.5% and 86% respectively, and for HCG concentration of 13.5 miu/ml were 73.4% (95% CI=62.1-82.4), 98.6% (95%CI=93.1-99.9), 98.3%, 76.9% and 85.3% respectively.Conclusion: Quantitative HCG concentration measurement from cervicovaginal secretions may be a useful predictor of preterm birth in symptomatic patients. This test has the advantage of low cost and wide availability.