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The purpose of this review is to draw attention to the importance of early diagnosis in cases of clinically significant fetomaternal hemorrhage, which is a rare but important condition to consider in the diagnosis of fetal distress. Unfortunately, since the signs of fetomaternal hemorrhage are nonspecific and the majority of cases occur spontaneously, without prior trauma or other condition, a high degree of suspicion from the clinician is necessary to establish the early treatment. The use of paraclinical tests, such as Kleihauer-Betke test and flow cytometry, is necessary to identify the passage of fetal erythrocytes into the maternal circulation. The determination of the most efficient and accessible method of diagnosis is imperative. The proposed diagnostic algorithm presented in this article can help standardize the diagnostic process of fetomateral hemorrhage, making it more efficient and precise. [ABSTRACT FROM AUTHOR]

The management of prelabor rupture of membrane (PPROM) is one of the most discussed issues in perinatal medicine. The guidelines recommend to manage the pregnancy expectantly whenever this is possible, taking into account certain factors, such as gestational age, presence or absence of maternal/fetal infection, presence or absence of labor, fetal presentation, fetal well-being, and cervical status. Our objective is to demonstrate the benefits of expectantly management. We undertook a retrospective observational analytical study in which we included PPROM pregnancy between 2015 and 2020. We followed the evolution of premature newborn using several parameters (neonatal death, respiratory distress syndrome, hypoxia, intraventricular hemorrhage, hypoglycemia, necrotizing enterocolitis, neonatal sepsis), originated from both PPROM pregnancies that were managed expectantly and PPROM that were delivered short time after admission. In PPROM pregnancies managed expectantly we included the patients to whom there had been administrated tocolysis, corticosteroids and antibiotics, so the delivery was postponed. We observed a significant decrease in neonatal complication in pregnancies that were prolonged. We concluded that the expectantly management of pregnancies with preterm prelabor rupture of membrane leads to a statistical benefit, decreasing the incidence of fetal and maternal complications. [ABSTRACT FROM AUTHOR]

Brest cancer represents the most common cancer worldwide, being the second deadliest cancer in women. There is no doubt regarding the importance of breast cancer screening. Mammography represents the primary imaging technique used to detect suspicious lesion for breast cancer. This imagistic method has been found to decrease the mortality related to breast cancer. Mammography may detect evidence of cancer one and a half to four years before cancer becomes clinically obvious. Patients with breast tissue augmentation need a routine screening mammography in order to evaluate the native breast tissue. The indications for breast cancer screening are the same as in women without implants, the only difference being that women with breast implants should be approached differently from a clinical point of view. Standard imaging technique for this type of patients involves four sections in alternative of the usual two sections per breast. In conclusion, women with breast augmentation should not be neglected and should undergo breast cancer screening alongside the targeted population, even though the required technique is more laborious and requires a more experienced eye. [ABSTRACT FROM AUTHOR]

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]