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This implementation research examines the feasibility of training health care workers at grassroot level in Vietnam to perform visual inspection with acetic acid as a regular screening service for cervical cancer at commune health stations (CHSs). Employing a two-phase design, the study trained 36 nurses working at CHSs to do VIA screening method in the first phase. In the second phase, evaluation on the capacity of those trained to do VIA method as well as client's satisfaction with VIA services performed in CHSs setting was done among 380 clients. Results indicated that within a short time, CHS nurses can be trained to perform VIA correctly (80.6% felt confident to perform VIA and 75% was able to perform test efficiently). All clients showed high level of satisfaction with VIA services provided at CHS setting. This implementation research provided evidences that VIA screening services performed by local midwives/nurses at grassroots level can be an optimal solution to deal with both the raising burden of cervical cancer and the current concern of shortage of well-trained doctors in low resource setting areas. It also gave some important lessons for health care managers on how to sufficiently integrate cervical cancer screening in low resource settings. [ABSTRACT FROM AUTHOR]

Objective: To analyze a case of heavy uterine bleeding in adolescence caused by an arteriovenous malformation (AVM) in Hanoi Obstetrics and Gynecology Hospital, Vietnam., Methods: We observed a case of a 14-year-old girl, without vaginal sexual intercourse experience, having heavy uterine bleeding caused by AVM. She underwent a laparoscopic operation at the hospital for vascular lesions in the uterine anterior wall, which caused an internal hemorrhage of 1500 ml blood loss into the peritoneal cavity. Three years later, this patient was hospitalized twice for massive vaginal bleeding., Results: Results of ultrasound and magnetic resonance imaging indicated a uterine intramural mass with enlarged vessels connecting to the endometrial cavity. A pelvic digital subtraction angiography was performed and showed profuse bleeding from a ruptured branch of the left uterine artery. This artery was embolized at Bach Mai hospital and the bleeding was stopped. The patient had stable health and normal menstrual periods after 4 months of follow up., Conclusion: Abnormal mass with dilated vessels in the myometrium in a patient experiencing heavy uterine bleeding is an exclusive sign of uterine vascular malformation and can be treated by angioembolization., (© 2021 International Federation of Gynecology and Obstetrics.)