Search

The spectacular evolution of the ultrasound equipment and techniques has allowed the assessment of the fetal heart increasingly earlier during the gestation, as well as the diagnosis of the fetal abnormalities in the first trimester of pregnancy. Transvaginal ultrasound and transabdominal ultrasound are used in early fetal echocardigraphy. Studies have shown that the heart defects diagnosed early in gestation are more complex and have a high degree of association with chromosomal abnormalities, compared to those diagnosed in the second trimester of pregnancy. There are many studies on the correlation between the increase in the nuchal translucency (NT) and congenital heart defects, NT being one of the most frequently studied and efficient screening parameters in maternal-fetal medicine. The morphology of the umbilical cord can be assessed in the first trimester of pregnancy by colour Doppler examination. Numerous anomalies associated with single umbilical artery are described. The principles of fetal echocardiography in the first trimester are similar to those of the morphological examination in the second trimester of pregnancy, with certain peculiarities and differences. The complete examination of the fetal heart, with minimal false results, can be done under the conditions of a trained and experienced examiner within the range of 12-13 gestational weeks. The examination route must be adapted to the particularities of the case. Early fetal echocardigraphy should be recommended only in the presence of a precise medical indication. [ABSTRACT FROM AUTHOR]

Gestational diabetes is a form of diabetes that starts during pregnancy and although is an affection which may regress after birth, it leaves its mark on the health of the mother and fetus in the perinatal period, but also on long-term and appropriate treatment initiated at the onset of the disease can reduce its effects. It is defined as carbohydrate intolerance of varying degrees of severity, occurring during pregnancy and that can complicate it (i.e. by increasing the risk of preeclamplsia, polyhydramnios, macrosomia, respiratory distress, hypoglycemia, hypocalcemia and hyperbilirubinemia and neonatal injury at birth). Although the diagnostic criteria varies from one guideline to another, the oral glucose tolerance test remains the gold standard method for the diagnosis of gestational diabetes. Underlying this article we have found significant studies and guidelines related to gestational diabetes published in PubMed and Cochrane databases. Gestational diabetes may be associated with repeated miscarriages, still births, pregnancy-induced hypertension, preeclampsia, premature detachment of the normally inserted placenta, trauma at birth, postpartum bleeding and infection immediately postpartum. Increased risk of maternal complications also increases the risk of premature births. The only modifiable factor in the emergence of all these complications is obesity. Gestational diabetes is a pathology that requires a multidisciplinary team and close monitoring of perinatal complications of pregnancy, in order to prevent and reduce these complications, both on short and long term. [ABSTRACT FROM AUTHOR]

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]

The transition made by the newborn when pass through intra-uterine medium to a new world, will determinate new changes of the immune system against harmful environment. These changes can renders newborns to many pathogens which could lead to some pathologies like pre-term delivery. The immune system works with adaptive immunity response which requires previous contact with antigens and with innate system response without requiring immune experience. Therefore, a better understanding of the cell mechanisms of the immune system which start to develop from newborn to childhood and then adulthood will help physicians to improve the sites of different infections during this period of life. This review focuses mainly on the role of T and B-cells activation in newborns, innate and adaptive immunity, and the changes from newborn to childhood and adulthood. [ABSTRACT FROM AUTHOR]

Pelvic organ prolapse (POP) represents a risk in women who undergo surgical intervention such as histerectomy. In order to treat it, many surgeons started to use grafts implants in reconstruction of the pelvis. The latest studies showed the development of new grafts era, supporting its beneficial effect for the patients. In this respect, the treatment should be individualized and in particular cases the use of grafts should be taken into consideration. When comparing the graft with native tissue repair, the application of surgery on POP have been shown similar anatomical restoration, and grafts were attributed more complications, especially in the transvaginal implant. Although nowadays grafts represent the best tool for prolapsed repair, the ideal implant has not yet been developed. The present review tries to explain the role of synthetic or biological grafts and the therapeutic approaches of the POP. [ABSTRACT FROM AUTHOR]