European journal of obstetrics, gynecology, and reproductive biology
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Oct 2018
The predictive value of sentinel node biopsy in early breast cancer after neo-adjuvant chemotherapy: A prospective study.
A sentinel Node (SN) has replaced axillary lymph node dissection (ALND) in patients with clinically node negative axilla (cN0). SN after Neo-adjuvant chemotherapy (NACT) is feasible but not accurate in clinically node positive (cN1-3) patients. The goal of this study is to determine the negative predictive value (NPV) of SN in cN0 breast cancer after NACT. A secondary endpoint is to determine if ALND can be avoided after NACT regardless of the pre-treatment clinical staging of the axilla, in case of a normalization of the 18F-fluoro-2-deoxy-glucose positron emission tomography scan (PET-CT scan). ⋯ A SNB should become the standard after NACT if case of a cN0. If after NACT the PET CT has normalized, no ALND should be performed if the SN is negative.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Oct 2018
Multicenter Study Comparative StudyMidtrimester transvaginal ultrasound cervical length screening for spontaneous preterm birth in diamniotic twin pregnancies according to chorionicity.
To compare the mean transvaginal ultrasound (TVU) cervical length (CL) at midtrimester screening for spontaneous preterm birth in asymptomatic monochorionic diamniotic versus dichorionic diamniotic twin pregnancies STUDY DESIGN: This was a multicenter retrospective cohort study. Study subjects were identified at the time of a routine second trimester fetal ultrasound exam at 18 0/7-23 6/7 weeks gestation. We excluded women that received progesterone, pessary, or cerclage. Distribution of CL was determined and normality was examined. Mean of TVU CL were compared between monochorionic diamniotic and dichorionic diamniotic pregnancies. The relationship of TVU CL with gestational age (GA) at delivery and incidence of spontaneous preterm birth (SPTB) at different TVU CL cut offs were assessed. Incidence of short TVU CL, defined as TVU CL ≤30 mm, was also calculated in the two groups. ⋯ Monochorionic diamniotic twin pregnancies had a higher rate of spontaneous preterm birth than dichorionic diamniotic pregnancies. The higher rate of spontaneous preterm delivery in monochorionic pregnancies is associated with lower midtrimester TVU CL when compared to dichorionic pregnancies.