PubMed · 14053459
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R H KAUFMAN. 1963. CERVICAL CONIZATION.. https://pubmed.ncbi.nlm.nih.gov/14053459/
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OBJECTIVE: Vaginal childbirth is a risk factor for female pelvic organ prolapse and stress incontinence. Imaging studies have suggested that vaginal delivery leads to increased anterior vaginal wall mobility. The authors intended to define the relationship between antepartum pelvic organ mobility and delivery-related changes in these parameters. STUDY DESIGN: Prospective observational clinical study conducted on 200 nulliparous women recruited from antenatal clinic. Patients were assessed by translabial ultrasound in late pregnancy and 2-5 months postpartum. RESULTS: Vaginal childbirth resulted in highly significant changes to all parameters used to describe pelvic organ mobility. These alterations were more marked in those women with limited pelvic organ mobility prior to childbirth, and these negative correlations were highly significant (anterior compartment r=-0.519, P<0.0001, central compartment r=-0.539, P<0.0001, posterior compartment r=-0.604, P<0.0001). CONCLUSIONS: Women with little pelvic organ mobility before childbirth appear to be those that show most marked delivery-related changes.
Recent advances in fiber optics, sources and detectors, imaging, and computer-controlled instrumentation have stimulated a period of unprecedented growth in the development of photonics technologies for a wide variety of diagnostic and therapeutic clinical applications. These include the application of quantitative optical spectroscopy and imaging for the detection of precancerous lesions in the uterine cervix, a topic of interest at the Second International Conference on Cervical Cancer, which was held April 11-14, 2002. Investigators have applied the Littenberg method of emerging technology assessment to new optical methods used to detect cervical neoplasia. Currently, such technologies as fluorescence spectroscopy (the combination of fluorescence and diffuse reflectance spectroscopy), tri-modal spectroscopy, and light-scattering spectroscopy that probe the spectral characteristics of tissue are being investigated. Optical technologies that create images of subcellular structure without biopsy subsequent to pathology that currently are under investigation include in vivo confocal imaging and optical coherence tomography. Numerous small studies have demonstrated the potential of these optical technologies. What remains to be elucidated are the fundamental biophysical origins of variations in remitted optical signals between normal and dysplastic tissue. Large multicenter randomized controlled trials are needed to confirm the detection and imaging capabilities of optical technology. Furthermore, the development of contrast agents that could boost detection with these technologies is needed, and basic biologic characterization of signals should be pursued. Applying the Littenberg assessment will help ensure that superior, not simply alternative, technologies are implemented.
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