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Over the last two decades, obesity and overweight have increased significantly, becoming public health problems worldwide. Data from literature show a continuous increase in the prevalence of the two entities, which results in an increasing number of overweight or obese patients who reach the reproductive age and become pregnant. Pregnancies in obese or overweight patient are the new challenges that obstetricians have to face. This review is based on publications that were found on PubMed, with a special attention to the review articles, cohort studies and randomized trials. Obesity and overweight can affect both getting and maintaining a pregnancy. The chances of obtaining a pregnancy decrease linearly by 4% for every 1 kg/m² gained, starting from a Body Mass Index (BMI) of 29 kg/m². The prevalence of fetal malformations is also increased in overweight or obese patients, the risk raising proportionally with the severity of obesity. These endemic diseases are also associated with certain maternal complications. A 10% increase in weight during pregnancy compared to pregestational BMI has been shown to be a factor that increases the risk by about 10% for the occurrence of hypertension and gestational diabetes, respectively. Newborns are also affected by these pathologies. Newborns in obese mothers have an increased percentage of adipose tissue, and studies have shown that there is an association between maternal adiposity and fetal weight at birth. The interventions in lifestyle and nutrition during pregnancy did not have an important effect on reducing the incidence of maternal and fetal complications. Therapeutic strategies are needed for normalizing body weight before pregnancy because reducing BMI has benefits for both mother and fetus. [ABSTRACT FROM AUTHOR]

Objective. The etiology of embryonic demise is multifactorial, with chromosomal abnormalities being the most common (40%). The purpose of this study is to evaluate the correlation between a serum biomarker, inhibine A, and an ultrasonographic parameter, the distance between yolk sac (YS) and embryo (DYSE), in assessing the prognosis of pregnancy evolutivity in the first trimester. Method. The study is a case-control prospective analysis that includes two groups of patients: 81 patients with first-trimester pregnancy in evolution, and 89 patients with embryonic demise, all of the patients having amenorrhea between 6 and 11 weeks. The endovaginal ultrasonographic exploration was performed to evaluate the distance between the lower pole of the embryo and the yolk sac. From each subject enrolled in the study, 20 ml of blood was collected for inhibin A dosing. Results. Regarding the DYSE in the case group, lower values were observed compared to the control group, the difference being statistically significant. In the statistical analysis of serum inhibin A values, statistically significant differences were observed between the two groups (p<0.05). Conclusions. DYSE has a high positive predictive value in identifying pregnancies with potentially reserved evolutivity, this study demonstrating that a DYSE<3 mm may lead to an unfavorable evolution of pregnancy. The low serum level of inhibine A is associated with an increased rate of non-viable embryos. [ABSTRACT FROM AUTHOR]

Introducere. Diagnosticul prin RMN al endometriozei are la bază trei semne înalt sugestive: T2 shading (scăderea intensității semnalului pe secvența T2 comparativ cu secvența T1), T2 dark spots (indicator de hemoragie cronică) și, mai nou, secvența de difuzie cu harta ADC (apparent diffusion coefficient), care măsoară gradul de restricție al mișcării browniene a moleculelor de apă libere. Studiile recente sugerează însă posibilitatea apariției acestor semne frecvent și în cazul chisturilor hemoragice. Metodologie. S-a analizat baza de date a Departamentului de radiologie și imagistică din cadrul Spitalului Clinic Judeţean de Urgenţă Cluj-Napoca și s-au luat în studiu șase paciente cu endometrioză confirmată și trei paciente cu chisturi hemoragice. Protocoalele de examinare utilizate sunt: Axial T1 FSE, TR 470.0, TE 12.5; Axial T1 FSE FS, TR 593, TE 12.5; Sagital T2 PROPELLER (TR 6374, TE 107); Axial T2 focus, spaceing 0, TR 6823, TE 100; Difuzie (DWI axial) contrast LAVA-FLEX (TR 6.3, TE 4.2). S-au efectuat măsurători cantitative bazate pe hărțile ADC calculate la 10-6 mm2/sec a leziunilor folosind un ROI (region of interest) de 10 mm2 centrat pe zona cu hiposemnal franc. Rezultate. Valorile ADC în cazul endometriozei (1100) au fost mai mici decât în cazul chisturilor hemoragice (1800). T2 shading a fost prezent la trei din şase paciente cu endometrioză, respectiv la una din trei paciente cu chist hemoragic. T2 dark spot s-a regăsit la cinci din şase paciente cu endometrioză, versus una din trei paciente cu chist hemoragic. Concluzii. Cele trei semne RMN aduc argumente valoroase în favoarea diagnosticului endometriozei fără a putea însă stabili diagnosticul de certitudine, care trebuie confirmat prin EHP. [ABSTRACT FROM AUTHOR]