A. Rosen

Die Konisation in der Gravidität und deren Bedeutung für den weiteren Schwangerschaftsverlauf

The influence of cold knife conisation on further progression of pregnancy was analysed in 28 patients, who underwent the operation during pregnancy. 13 women were operated on within the first 16 weeks of gestation (group I) and were compared to 15 patients, where conisation was done in the 17th week or later (group II). In the first group, deliveries were found in the 39th week of pregnancy compared to 34 weeks in the second group (p.05). A statistical significant difference concerning the further duration of pregnancy after conisation was found: 25 weeks in group I vs. 11 weeks in group II (p. 0012). There was no difference, however, in radicality whether conisation was done in early or late pregnancy. Our final conclusion is, that a preterm delivery occurs significantly more often in women who underwent conisation after 16th week of gestation.

Die Konisation beim Zervixkarzinom im Stadium Ia

Between 1975 and 1988, a total of 78 patients suffering from cervical cancer stage Ia were treated by conisation based on a positive smear. According to FIGO, these 78 patients consisted of 53 (67.9%) stage Ia1 and 25 (32.1%) stage Ia2 cases. Complete removal of the tumour by conisation was achieved in 51 patients. In 23 cases (29.5%) the margin of resection was reached by a carcinoma in situ, in 4 cases (5.1%) invasive carcinoma was found. Conisation was not followed by further surgery in 10/51 patients with complete tumour removal. One patient (1/23) with incomplete removal underwent surgery elsewhere. In the other 67/78 patients following hysterectomy, the pathologist diagnosed three cases of cervical cancer, 11 cases of carcinoma in situ and 53 cases (67.9%) without pathological findings. Carcinoma in situ after hysterectomy was found in only 2 cases (4.9%) with primarily free resection margins of the conus. Among the 27 patients with carcinoma in situ or invasive carcinoma reaching the conus margin, 9 cases of carcinoma in situ and 3 invasive carcinomas were diagnosed histologically after hysterectomy and one patient underwent surgery elsewhere. In this study, the value of conisation as single therapy of cervical cancer stage Ia1 and stage Ia2 with good prognosis (depth of infiltration of < 3 mm and no invasion of blood vessels) is discussed and the importance of thorough and exact histological examination is emphasised.

Pregnancy following prostaglandin F2 alpha treatment of tubal pregnancy

We report on a successful pregnancy after prostaglandin F2 alpha treatment for tubal pregnancy. Laparoscopic instillation of prostaglandin F2 alpha was performed in 14 cases; we had to laparotomise in only 2 cases.