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Endometriosis is a benign chronic disease with a major impact on a woman's quality of life, mainly due to painful physical symptoms. Endometriosis is also a common cause of infertility caused by low ovarian reserve, distorted pelvic anatomy, and severe local inflammation with a direct negative impact on the quality of oocytes, embryos, and endometrium. We conducted a retrospective study between January 2019 and December 2023, including women with a history of surgery for endometriosis who underwent in vitro fertilization (IVF) to achieve pregnancy. Their reproductive outcome was compared with a group of patients with documented tubal obstruction. The aim of our study was to identify the factors associated with a positive impact on the pregnancy rate, specifically age, anti-Mullerian hormone (AMH), ovarian stimulation protocol, and types of gonadotropins used. We analyzed a group of 175 patients with endometriosis compared with 189 patients with tubal obstruction. The average age was similar between the two groups but with a difference in the average AMH value (1.63 ± 1.09 ng/mL vs. 2.55 ± 1.67 ng/mL). The most utilized ovarian stimulation protocol in both groups was the short gonadotropin-releasing hormone (GnRH) antagonist. The clinical pregnancy rate was 27.2% in the endometriosis group and 54.7% in the tubal obstruction group. Our study revealed that treatment with corifollitropin alfa in the endometriosis group was associated with a higher clinical pregnancy rate. AMH and age proved to be significant independent factors for the reproductive outcome. [ABSTRACT FROM AUTHOR]

Endometriosis is a common cause of infertility among reproductive-age women. A low ovarian reserve is associated with the presence of endometriotic cysts, and this is accentuated even more after surgery. Patients with a history of endometrioma are a special category of poor ovarian reserve requiring in vitro fertilization (IVF). The aim of this retrospective study was to evaluate the characteristics and outcome of ovarian stimulation and embryo transfer in women with a history of ovarian surgery for endometrioma compared with a control group with tubal factor infertility. A total of 146 patients had previous laparoscopic cystectomy for endometrioma (group A) and their IVF results were compared with 136 patients with documented tubal obstruction (group B). In both groups, the most frequently used ovarian stimulation protocol was the short antagonist in 84.24% versus 80.88%. The number of stimulation days was between 6 and 15 days in the two groups with a mean value of 12.76 days in group A and 9.47 days in group B. The clinical pregnancy rate was 26.77% in the endometrioma group and 39.68% in the tubal obstruction group. Patients with a history of endometrioma are less likely to conceive than those with tubal obstruction despite having similar ovarian reserve and stimulation results. [ABSTRACT FROM AUTHOR]

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Copyright of Obstetrică şi Ginecologie is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Obstetrică şi Ginecologie is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Obstetrică şi Ginecologie is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A lot of methods have been used to evaluate the lower uterine segment after cesarean section: hysterography of the uterine scar, pelvic examination, amniography, x-ray pelvimetry and ultrasonography. The present study consisted of 275 secondiparous with the gestational age between 36 and 38 weeks. All recruited patient were evaluated by transvaginal ultrasound in order to characterize the lower uterine segment (LUS). LUS thickness was measured as the distance between the two calipers placed at the urinary bladder - myometrium interface and at the myometrium - chorioamniotic membrane interface. The appearance of the LUS where classified into three categories, where class I and II are considered non-dehiscent and class III was considered dehiscent. Therefore, the intraoperative assessment results included 19.6% patients in class III (dehiscent LUS, uterine content visible) and 80.4% patients in class I and II (non-dehiscent LUS). In the intraoperative non-dehiscent group 25.8% patients were included in class I (normal, well-developed LUS) and 54.6% were included in class II (thin LUS, uterine content not visible). The results showed that at a LUS thickness less than 2 mm carries a higher risk for dehiscence (incomplete uterine rupture) than those with a thickness more than 2 mm. [ABSTRACT FROM AUTHOR]

Cystic hygroma represents a fluid accumulation in different structures, often cephalic, on the left side, with an incidence of 1/6000-1/16,000. Karyotype anomalies are found in 20-75% of cases, most frequently Turner, Down, Klinefelter, Edwards and Patau syndromes. Subchromosomal abnormalities include Noonan syndrome, Fryns syndrome, multiple pterygium syndrome and achondroplasia, and also maternal alcohol consumption. We report a series of cases diagnosed in the first trimester with cystic hygroma and their genetic determinacy. The first patient was diagnosed at 11.6 weeks of gestation with a large cystic lesion sheltering the entire fetus, with omphalocele, AVSD and arthrogryposis. The patient decided the termination of pregnancy and the karyotype confirmed the Down syndrome. The second patient, having a term birth by caesarean section followed by five first-trimester miscarriages, presented at 8.5 weeks of gestation, with an ultrasound image of large cystic hygroma causing double contour suggestive for fetal hydrops and no fetal heartbeat. The abortion product karyotype revealed Turner syndrome. Couple karyotyping and genetic counseling were recommended, showing a 46,XX/47,XXX mosaicism in the mother, respectively an addition in the 9th pair of chromosomes in the father – 46,XY,add(9)(p12), for which arrayCGH was recommended in order to detect a possible chromosomal balanced translocation, which was ruled out. The third patient, with history of two early pregnancy miscarriages and two failed IVF procedures, presented with a spontaneous 11.6-week pregnancy showing cystic hygroma, medium size omphalocele, micrognathia and hypoplastic nasal bone. The parents decided the termination of pregnancy and the karyotype revealed trisomy 18. The fourth patient was diagnosed in the first trimester with a large left laterocervical cystic mass, consistent with lymphangioma. The follow-up showed normal development and amniocentesis revealed a normal karyotype. An appropriate weight neonate was born at 38 weeks by caesarean section, with a good postnatal transition, expecting removal surgery of the cervical lymphatic cyst sized 12 cm. We suggest a significant association between cystic hygroma and karyotype anomalies, stronger in patients with obstetrical failure history, validated by invasive genetic testing. [ABSTRACT FROM AUTHOR]

Cystic hygroma represents a fluid accumulation in different structures, often cephalic, on the left side, with an incidence of 1/6000-1/16,000. Karyotype anomalies are found in 20-75% of cases, most frequently Turner, Down, Klinefelter, Edwards and Patau syndromes. Subchromosomal abnormalities include Noonan syndrome, Fryns syndrome, multiple pterygium syndrome and achondroplasia, and also maternal alcohol consumption. We report a series of cases diagnosed in the first trimester with cystic hygroma and their genetic determinacy. The first patient was diagnosed at 11.6 weeks of gestation with a large cystic lesion sheltering the entire fetus, with omphalocele, AVSD and arthrogryposis. The patient decided the termination of pregnancy and the karyotype confirmed the Down syndrome. The second patient, having a term birth by caesarean section followed by five first-trimester miscarriages, presented at 8.5 weeks of gestation, with an ultrasound image of large cystic hygroma causing double contour suggestive for fetal hydrops and no fetal heartbeat. The abortion product karyotype revealed Turner syndrome. Couple karyotyping and genetic counseling were recommended, showing a 46,XX/47,XXX mosaicism in the mother, respectively an addition in the 9th pair of chromosomes in the father – 46,XY,add(9)(p12), for which arrayCGH was recommended in order to detect a possible chromosomal balanced translocation, which was ruled out. The third patient, with history of two early pregnancy miscarriages and two failed IVF procedures, presented with a spontaneous 11.6-week pregnancy showing cystic hygroma, medium size omphalocele, micrognathia and hypoplastic nasal bone. The parents decided the termination of pregnancy and the karyotype revealed trisomy 18. The fourth patient was diagnosed in the first trimester with a large left laterocervical cystic mass, consistent with lymphangioma. The follow-up showed normal development and amniocentesis revealed a normal karyotype. An appropriate weight neonate was born at 38 weeks by caesarean section, with a good postnatal transition, expecting removal surgery of the cervical lymphatic cyst sized 12 cm. We suggest a significant association between cystic hygroma and karyotype anomalies, stronger in patients with obstetrical failure history, validated by invasive genetic testing. [ABSTRACT FROM AUTHOR]

Background. We define deep endometriosis as the peritoneal invasion of endometrial tissue more than 5 mm in depth. Frequently affected areas include the rectovaginal septum, the rectus, the sigmoid colon, the urinary bladder and the ureters. Usual symptoms include cyclical or noncyclical abdominal pain, infertility, dysmenorrhea, dysuria and dyschezia. The diagnosis is obtained mainly clinical, laparoscopy being considered the gold standard, since the direct visualization of the lesions is possible, as well as correlation with the histopathological examination. The treatment can be medical or surgical. Setting aside the established indications for surgery – unresponsive pain and infertility, there are certain aspects that need to be considered more thoroughly, such as the progressiveness of the disease, as well as the functional impact on the affected organs. Materials and method. We present a systematic review in which we included articles regarding the surgical treatment of deep endometriosis and the right time when surgery is indicated. We will also present several cases of severe deep endometriosis, in order to emphasize the progressive character of the disease and the consequences of late surgical treatment. Results. Endometriosis should be viewed as a chronic disease which affects the quality of life. Certain localizations of the disease can lead to irreversible damage, going as far as organ function loss. For example, parametrial nodules can obstruct the ureter, develop ureterohydronephrosis and lead to kidney failure. Intestinal endometriosis can cause bowel obstruction, as well as the destruction of the nervous plexus within the intestinal wall, that will lead to functional disturbances. The goal of laparoscopic surgery in deep endometriosis is to completely excise the lesions, reducing the risk of recurrence and reintervention as much as possible. Conclusions. The surgical treatment of deep endometriosis is a challenging task. The failure of treatment is correlated with the surgeon’s experience, case complexity and the anatomical localization of the disease. Endometriosis is a chronic disease and the goal of surgery is to stop the lesional progression and to restore the normal anatomy and function. [ABSTRACT FROM AUTHOR]

Cystic hygroma or lymphangioma was first described in 1843 and represents a lesion that can occur in any anatomical structure of the fetus, but is most frequently found in the cephalic region (75%), especially on the left side of the body. The incidence of the condition is reported as ranging from 1/6000 to 1/16,000 cases. Karyotype abnormalities are found in 20-75% of cases, the most frequently involved conditions being Turner, Down, Klinefelter, Edwards and Patau syndomes. Other nonchromosomal abnormalities associated with cystic hygroma are Noonan, Fryns, multiple pterygium syndomes and achondroplasia. Also, an important association between maternal alcohol consumption and this condition has been observed. We present a series of four cases diagnosed in the first trimester with cystic hygroma and their genetic determinance. The first patient, aged 42, IG, IP, was diagnosed at 11.6 weeks of gestation with a large cystic hygroma covering the entire fetus, omphalocele, atrio-ventricular septal defect, and arthrogriposis. The patient decided to terminate the pregnancy and the karyotype of the abortion product revealed Down syndrome. The second patient, aged 33, VIIG, IIP, with a personal history of a term birth by caesarean section followed by five misscariages in the first trimester, presented at 8.5 weeks of gestation an ultrasound aspect of large cystic hygroma causing double contour suggestive for fetal hydrops and no fetal heartbeat. The karyotype of the abortion product revealed Turner syndrome. Couple karyotyping and genetic counselling were recommended, showing a 46,XX/47,XXX mosaicism in the mother, respectively an addition in the 9th pair of chormosomes in the father – 46,XY,add(9)(p12), for which arrayCGH was recommended in order to detect a possibile chromosomal balanced translocation. The third patient, aged 38, IIIG, IP, with a personal history of two first-trimester misscariages and two failed IVF procedures, presented with a spontaneous pregnancy. At 11.6 weeks of gestation, the ultrasound revealed cystic hygroma, medium size omphalocele, microgratia and small nasal bone. The parents decided pregnancy termination and kayrotyping, which is still in progress. The fourth patient, aged 32, IG, IP, was diagnosed in the first trimester with a large latero-cervical cystic mass, consistant with a lymphatic cyst. The periodic follow-up showed no other abnormalities, and amniocentesis revealed a normal fetal karyotype. The neonate was born at 38 weeks of gestation by caesarean section and presented a normal weight and good adaptation to neonatal life, being programmed for surgery in order to remove the left sided cervical lympahtic cyst sized 12 cm. In conclusion, our small number of cases of fetuses with cystic hygoma suggests a relatively high association with genetic defects, especially in patients with personal history of obstetrical failure, which justifies us to recommend in these cases the genetic testing. [ABSTRACT FROM AUTHOR]

The abdominal cerclage is a therapeutic procedure that performs a reliable cervical canal obliteration in specific selected cases. The abdominal cerclage is indicated for cervico-isthmic incompetence in patients who had repeatedly failed transvaginal cerclage, and also in those with anatomical abnormalities represented by a very short or absent cervix due to congenital or surgical conditions. The paper aims to present a series of eight cases in which abdominal cerclage was performed. The abdominal cerclage can be performed through open abdominal route or laparoscopic. The procedure can be practiced prophylactically before conception or during pregnancy, in the first trimester of gestation either prophylactically, or as an emergency solution for imminent abortion. The abdominal cerclage is a safe procedure, with an excellent fetal outcome, and is an alternative treatment for cervico-isthmic incompetence. The advantages of the abdominal cerclage are represented by the placement of the cerclage tape in close proximity of the internal os, the absence of a foreign body in the vagina (that could cause infection), decreased risk of suture migration, and the ability to keep the suture in place for future pregnancies. The abdominal cerclage is the only therapeutic solution in patients with a history of recurrent abortions resulting from failed transvaginal cerclages, as well as in patients with very short or absent cervix. [ABSTRACT FROM AUTHOR]

We present a rare case of postpartum umbilical cord hematoma with unknown cause in a term newborn. The neonate was born by caesarean section indicated for failure of medical induction of labour in a 28-year-old primipara with a 41-week pregnancy. The mother did not suffer from any pathology throughout gestation, presenting a morphologically normal foetus and negative urine and cervical cultures. She delivered a 3690-gram male newborn, with an Apgar score of 9 at one minute and 10 at five minutes, following an uncomplicated caesarean section. The newborn presented good postnatal adaptation, and breast alimentation was initiated in the first day of life. The C-reactive protein (CRP) of the newborn was negative and his evolution was favourable in the first two days of life. In the third day of life, the neonate presented swelling of the umbilical cord stump, with a dark-red coloration, suggestive for hematoma. Antibiotic prophylaxis and local antiseptic therapy were initiated, CRP was repeated and bacteriological samples were collected, the results being negative. After two days of local antiseptic treatment, the umbilical stump fell and the umbilicus presented normal appearance. The evolution of the neonate was good, and he was discharged in the fifth day of life. The mother did not present any sign of infection or thrombosis, with a physiological recovery. The particularity of the case is represented by the rarity of the pathology, until present only a few cases of umbilical cord haematoma being described in the specialty literature. The etiology in this case is idiopathic, the infectious, malformative, thromboembolic and mechanical causes being ruled out. The only risk factor in our case could be represented by the advanced gestational age (41 weeks of pregnancy), which could explain partially the frailty of the umbilical cord vessels. [ABSTRACT FROM AUTHOR]

Objective. The aim of this paper is to present the authors' experience and to evaluate the effectiveness of laparoscopic colorectal resection in cases with deep infiltrating endometriosis, as well as the impact on the quality of life, symptomatology and digestive symptoms. Materials and method. During June 2017 until January 2019, a number of 120 patients underwent laparoscopy for deep infiltrative endometriosis. Fourty-two patients with deep endometriosis were included in the study - all the patients included in the study completed a questionnaire on the symptoms of preoperative endometriosis and quality of life (Questionnaire SF-36), and completed the preoperative evaluation (MRI, transvaginal ultrasound, endo-rectal ultrasound, HidroColo-CT). The status and quality of life were assessed postoperatively. The gynecological and digestive symptoms, as well as the rate of perioperative complications were also evaluated. The laparoscopic surgery was performed by the same surgical team in all cases. Results. Twenty patients (47.62%) benefited from laparoscopic segmental rectosigmoid resection with end-to-end mechanical anastomosis. Twenty-one patients (50%) with deep endometriosis benefited from laparoscopic excision of deep endometriosis nodules. The average age of patients was 34 years old. The laparotomy conversion rate was null. Following surgery, a significant improvement in dysmenorrhea, dyspareunia, chronic pelvic pain, defecation pain, and lower abdominal pain was noted. In cases of deep endometriosis and colorectal resection, an improvement in the quality of life score assessed by the SF- 36 questionnaire was observed. One patient (2.38%) refused the colorectal resection for objective reasons. The rate of postoperative complications was 2,38 % (a reintervention at 5 days postoperative for a ileostomial protection in a patient that underwent two intestine resections). The rate of hemoperitoneum, rectovaginal fistula, uroperitoneum and pelvic abscess was null. Conclusions. Laparoscopic segmental colorectal resection for endometriosis significantly improves the quality of life and the gynecological and digestive symptoms. However, women should be informed about the risk of complications, including rectovaginal fistula. The need for adherence to a national guide on the therapeutic conduct in deep endometriosis cases and the standardization of treatment allow us to achieve satisfactory results in terms of improving the quality of life in patients with colorectal resection. The preoperative investigations allow for surgical planning and the formation of a multidisciplinary team for the correct management and the complete excision of endometriotic lesions. [ABSTRACT FROM AUTHOR]

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Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)