الفهرس 
Servicovaginal Epithelium During Pregnancy and PuerperiumOnly 14 pages are availabe for public view
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Abstract
Five hundred successive pregnant women attending
the antenatal clinic of Ilenha university ho s plt a I were
screened clinically cytologically colposcopically
and pathologically for evidence of specific infections
and other pathological lesions in the lower genital
tract.
By cytological methods that included ; wet smear •
methylene blue stained smear and Papanicolaou stained
smear six types of specific infections of the lower
genital tract were diagnosed. Candida albicans was
detected in 140 cases ( 28%) Trichomonas vaginalis
in 22 cases ( 4.4%) C n rd ne rc Ll a vaginal is in 95 cases
( 19%) Chlamydia trachomatis in 2 cases ( 0.4% )
herpes simplex virus in 4 cases ( 0.8% ) and condyloma
accuminata in 9 cases ( 1.8% ).
Clinical judgment alone was found to be
unsatisfactory in diagnosing these specific infections
of the lower genital tract. The simple cytologic
methods used in this study could accurately identify
the causative agent which is the basis for proper
management of these infections.
Methylene blue stained smears and wet smears
were more reliable in the diagnosis of infections caused
by candida albicans Gardnerella vaginal is and
Trichomonas vaginalis than Papanicolaou stained smears •
but. for the highest yield all three methods were
indicated. These three types of infections constituted
94.5% of specific infections detected in this study.
However Papanicolaou stained smears could diagnose
infections caused by Chlamydia trachomatis herpes
simplex virus and human papillomavirus ( condylomaL.-20iJaccuminata).
less common Althoughas they those types of constituted only infections were
5.5% of cases with specific infections yet they are more hazardous
to the mother and the foetus.
Col po scopic examination revealed non-specific appearances in patients with infections caused by candida
albicans Gardnerella vaginalis and c h I amydia trachomatis. Colposcopic examination revealed true
erosion , which is characteristic of herpetic cervicitis, Moreover col po scopic herpes simplex virus examination revealed in only one infection. out of the 4 CDses with specific appearances namely double capillaries and
colpitis macular is in 95% of cases with Trichomonas vaginalis infection. Also it revealed colposcopic
appearances characteristic of condylomatous lesions
in 8 cases out of 9 cases with cytologically condyloma accuminata. Moreover by the diagnosed aid of types flat condyloma ( 5 classified cases )colposcopy the into 3 distinct
condylomatous lesions were
exophytic condyloma
colpitis ( 2 cases( 3) .cases )from the and condylomatous results mentioned
above we can conclude that when diagnosis of specific
infections of the lower genital tract is considered,
cytology is superior to colposcopy.
Pregnancy provides a suitable occasion for routine
screening for cervical carcinoma.
Routine cytology revealed dyskaryosis in 10
cases , only 8 of them proved to have CIN on pathological
evaluation while the remaining 2 cases were chronic
non-specific cervicitis.
Routine colposcopy revealed abnormal colposcopic
findings in 30 cases 25 cases inside the T. Z. and
5 cases outside the T.Z.. Pathological evaluation
of colposcopically directed punch biopsies from these
areas with abnormal colposcopic findings revealed CIN
in 11 cases ( all inside T.Z.) acanthotic epithelium
in 17 cases ( 13 inside T.Z. and 4 outside T.Z. ) and
chronic non-specific cervicitis in 2 cases ( one inside
T.Z. and one ouside T.Z. ).
It was observed that cases with CIN were almost
asymptomatic and
20 to 30 years.
in 4 cases wi th
72.7% of them were in the age group
Associated infections were encountered
CIN as; T.V. in one case, HSV in one
case, condyloma accuminata in 2 cases.
Cytology showed a false-negative rate of 27.3%
and a false-positive rate of 20%.
Correlation between cytologic and colposcopic
findings in the 11 cases with pathologically diagnosed
CIN showed that cytology revealed dyskaryosis in only
8 cases while colposcopy revealed atypical
transformation zone ( ATZ ) in 11 cases. So we
think that as far as diagnosis of CIN is considered ,
colposcopy is superior to cytology.