Search

Advancements in ultrasound technology and the integration of cell-free DNA testing into standard prenatal screening services have made it more feasible to identify fetal sex at an early stage. Fetal sex determination through sonography relies on different factors, depending on the gestational stage. In the late second trimester, it is determined by directly visualizing the external genitalia. However, in the late first and early second trimesters, it primarily relies on the direction of the genital tubercle, known as the sagittal sign. Other sonographic landmarks, like the fetal scrotum, midline raphe of the penis, labial lines, uterus, descended testis, and the direction or origin of the fetal micturition jet in males, can aid in the fetal sex determination accuracy. However, malformed external genitalia can lead to inaccurate results. This article focuses on the sonographic determination of fetal sex during the late first trimester, early second trimester and late second trimester, utilizing both transvaginal and transabdominal ultrasound techniques. Additionally, we explore various elements that have contributed to the precision of fetal sex determination. While ultrasound examination of the external genitalia is typically sufficient, there are certain situations where it becomes crucial to identify the internal genitalia for precise prenatal diagnosis and thorough counseling. This paper aims at reviewing these situations in which the evaluation of the external genital organs is necessary, as well as the ways in which ultrasound can be used in the diagnosis of genital malformations. [ABSTRACT FROM AUTHOR]

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.)

Pregnancy is a period characterized by numerous alterations of the body, to provide a proper environment for newborn development and growth and optimal conditions for the natural delivery. The changes that take place at the musculoskeletal system are subsequent to the increase in the ligament laxity secondary to hormonal changes, especially relaxin, and due to weight gain, which is predominantly distributed at the abdominal level, with the anteriorly movement of the center of gravity. The curvatures of the spinal column changes, with the accentuation of the lumbar lordosis and compensatory modifications at cervical and thoracic levels in order to facilitate the ambulation of the pregnant woman with a minimum risk of falls. The pelvic girdle adapts for natural delivery, with higher diameters due to an increased mobility in the sacroiliac and pubic articulations. Hydro saline retention may be accompanied by edema and secondary compression of the nervous structures, determining paresthesia and pain. It is important to know how these mechanisms work, because the common element is pain, which leads to invalidation and a decrement of the life quality, to provide with an adapted management, especially because the therapeutic resources are limited in pregnancy. [ABSTRACT FROM AUTHOR]

Lactation provides for the newborn the proper quantity and quality of food. There are no alimentary restrictions for the mother in the lactating period, but in case of complications such as obesity or gestational diabetes, nutrition counseling is necessary. The milk demand of the infant dictates the mother’s capacity of milk production and is influenced by age, growth rate and by any other medical conditions. Breastfeeding offers optimal nutritional intake, even when the mother’s food intake is limited, except for the case when the mother has a chronically deficient diet. Energy requirement depends on maternal age, weight, height and level of physical activity, alongside the necessary elements for milk synthesis. The micronutrients and macronutrients requirements depend on the maternal nutritional status, the mobilization of tissue deposits and on their rate in milk secretion, in order to provide a proper growth and development of the newborn. Weight gain or loss in lactation is similar as in nonpregnant women, but weight loss after pregnancy is influenced by factors such as weight before pregnancy, age, parity, race, smoking status, the amount of physical exercises and if the mother returns to work outside her home. Special situations such as multiple gestations, obesity or recent bariatric surgery require support and encouragement for a proper breastfeeding. [ABSTRACT FROM AUTHOR]

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.)

Intrauterine growth restriction or fetal growth restriction represents a fetal incapacity of achieving its entire growth potential in intrauterine life, as a result of maternal, fetal and/or placental causes, from hypertension, autoimmune diseases, drug consumption, hereditary thrombophilia to genetic syndromes, intrauterine infections, umbilical cord anomalies or placental insufficiency. The ultrasonographic evaluation of the fetus with intrauterine growth restriction identifies an estimated fetal weight or a fetal abdominal circumference below the 10 th percentile for gestational age; a severe fetal growth restriction is defined as an estimated fetal weight below the 3rd percentile. The Delphi consensus managed to classify fetal growth restriction as early, being diagnosed under 32 weeks of gestation, respectively late, after 32 weeks of gestation. Up to 10% of pregnancies are complicated by fetal growth restriction, which are then considered high-risk pregnancies for the morbidity and mortality risk carried for the fetus, requiring an accurate diagnosis of the cause, intensifying the fetal monitoring and timing the birth, in order to deliver the fetus in safe conditions. This paper proposes an algorithm for an initial evaluation of fetal growth restriction, with the aim of simplifying the medical approach when encountering a fetus with intrauterine growth restriction, in order to improve morbidity and mortality rates among pregnancies complicated by fetal growth restriction. [ABSTRACT FROM AUTHOR]

Transvaginal ultrasound and serum concentration of human chorionic gonadotropin are the main methods of prognostic evaluation of early pregnancies. Although these pregnancy investigation methods have proven their benefits, the interpretation is fundamental for a correct diagnosis, in order to avoid interventions that may affect pregnancies that would normally have had a physiologic course, as well as to apply an appropriate management in the case of nonviable pregnancies. Recent studies have shown the need to adopt rigorous criteria that minimize false positive results and thus decrease the frequency of diagnostic errors. Over time, a series of ultrasound features have been described which have proven effective in predicting nonviable pregnancies in the first trimester (cranio-caudal length in relation to the presence or absence of cardiac activity, yolk sac diameter, gestational sac diameter in relation to presence or absence of embryo with cardiac activity, embryonic heart rate, subchorionic hematoma etc.). In the context of the new prospects for the development of artificial intelligence softwares, the present work focuses on the description of the precise ultrasonographic aspects aboded by the latest studies that propose certain cut-off values dependent on the gestational age of the ultrasound parameters in the first trimester, increasing the sensitivity and the specificity of ultrasound in the diagnosis of nonviable early pregnancies, thus aiming to improve the reproductive prognosis of couples with recurrent abortions. [ABSTRACT FROM AUTHOR]

During pregnancy, gestational diabetes is the most common metabolic disorder, characterized by altered glucose tolerance. The prevalence of gestational diabetes is increasing, which is linked to the rise in maternal obesity rates in recent years. Despite numerous large-scale studies on the topic, there is still ongoing debate about the screening and treatment of gestational diabetes. The fetal and neonatal complications associated with gestational diabetes include fetal macrosomia, hyperinsulinemia, hypoglycemia, hypocalcemia, neonatal hyperbilirubinemia, increased risk of respiratory distress, and shoulder dystocia, especially in macrosomic babies. Additionally, children born to diabetic mothers are at a higher risk of developing obesity and diabetes in adolescence and adulthood. Maternal complications of gestational diabetes include an increased risk of developing hypertensive syndromes and the likelihood of requiring a caesarean section. Screening and treatment of gestational diabetes are crucial in ensuring healthy outcomes for both mother and child. In this article, we will explore the importance of early detection and effective management of gestational diabetes, highlighting the benefits of timely intervention, and the potential risks of untreated gestational diabetes. Furthermore, we will present the latest international guidelines and recommendations for the screening and management of gestational diabetes. [ABSTRACT FROM AUTHOR]