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To assess the frequency of multiple thrombophilia-associated mutations and polymorphisms in a selected population of high-risk pregnancies.

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Holoprosencephaly is a brain abnormality resulting from an incomplete cleavage of the prosencephalon during early embryogenesis. Uncontrolled maternal diabetes mellitus is one of the strongest human teratogens and the most well-known cause of holoprosencephaly. We report a rare case of holoprosencephaly in a male fetus in a preexisting diabetic pregnancy. The diagnosis of the holoprosencephaly was established by ultrasound scan and MRI data. [ABSTRACT FROM AUTHOR]

Fertility preservation in cancer patients is currently based on either assisted reproductive technology or fertility-sparing surgery. Loss of fertility may be caused by excisional surgery associated with an adnexal or uterine pathology or secondary to gonadal insufficiency caused by chemotherapy or radiation. The counseling of these patients is very important, being carried out jointly by the oncologist, gynecologist, and reproductive medicine specialist. Reproductive surgery usually requires avoiding laparotomy to significantly reduce the formation of adhesions and trauma or tissue damage. This is done using standard laparoscopic surgery or robotic surgery (computer-assisted laparoscopy), a method increasingly used and accessible to all specialists who want to maintain the fertility of their patients with various oncological diseases. [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.)

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 Obstetrică şi Ginecologie is the property of Societatea de Obstetrica si Ginecologie 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.)

Preeclampsia is an important health problem with a higher prevalence in the adolescent population. Furthermore, preeclampsia causes adverse maternal and neonatal outcomes. Newborns can be affected by preeclampsia, resulting in lower birth weight or Apgar score, the need for neonatal intensive care, or prematurity. All these complications are also associated with adolescent pregnancies, and together with preeclampsia, it can determine poorer neonatal outcomes. The aim of the study was to compare the neonatal outcomes of adolescents and adults with preeclampsia. We analyzed data on all the newborns of adolescents with preeclampsia (n=12) who delivered at the Department of Obstetrics and Gynecology of University Emergency Hospital in Bucharest between January 1st, 2019, and December 31st, 2019 and compared it with data from 12 aleatory newborns of adults diagnosed with preeclampsia. The prevalence of preeclampsia was higher in the adolescent population compared with the adult one. The weight of newborns was lower among adolescents with preeclampsia. There were no significant differences in Apgar scores between the two groups. Preterm delivery was more frequent in adolescent patients with preeclampsia. Preeclampsia is an additional risk factor for adolescent pregnancy, but it is also a severe materno-fetal complication for this population. [ABSTRACT FROM AUTHOR]

Copyright of Obstetrică şi Ginecologie is the property of Societatea de Obstetrica si Ginecologie 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.)

Objectives. The prevention of preterm birth is one of the highest priorities for international obstetric research. This study aimed to evaluate the maternal factors that may influence the pregnancy outcomes in order to assess the fetal outcomes. The main parameters analyzed were the variables newborn’s Apgar score at 1 minute and Apgar score at 5 minutes. Materials and method. This is designed to be a retrospective, observational and non-randomized study on a sample of 30 pregnant women with ruptured membranes, diagnosed and treated in the Department of Obstetrics and Gynecology of the Bucharest University Emergency Hospital, Romania, between May 2021 and October 2021. We used two simple and multiple univariate linear regressions to achieve the main objective. The dependent variable used the APGAR score at 1 minute and the APGAR score at 5 minutes. Results. We obtained significant results regarding the impact of CRP, leukocytes count at admission, mode of delivery, presence of chorioamnionitis, funisitis, and male sex of the newborn on neonatal outcome. Conclusions. These results support further research in developing feasible multivariable prediction models in women with preterm rupture of membranes below 34 weeks of gestation. These models can help clinicians manage low- or high-risk pregnant women efficiently. [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.)

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 Obstetrică şi Ginecologie is the property of Societatea de Obstetrica si Ginecologie 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 Societatea de Obstetrica si Ginecologie 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.)

Placenta accreta spectrum (PAS) disorders, comprising placenta accreta, increta and percreta, are associated with serious maternal morbidity and mortality. The incidence of PAS has increased in the recent years due the rising numbers of caesarean section births, but it is linked also to uterine surgeries like myomectomy, history of placenta accreta in previous pregnancy, and endometrial curettages. At the University Emergency Hospital Bucharest, due to access to transcatheter arterial embolization, we treat first-trimester caesarean scar pregnancy either diagnosed in our department or referred from different centers by the following algorithm: uterine artery embolization followed by safe aspiration. For cases of advanced pregnancies with PAS that come to our setting, we start to complete, preferably as early as the second trimester, the checklist required for a programmed caesarean section performed by a multidisciplinary team, including oncological gynecological surgeons in our department, urology specialist, and with a thorough intensive care preparation. The psychological support and the continuous counseling are performed as needed due to the continuous requirements of reassurance of the patient. We present a series of cases of caesarean scar pregnancies in order to underline the various ultrasonographic aspects of the early first trimester. We consider of utmost importance the early diagnosis and management of these cases that should not be missed in order to avoid future morbidity and mortality. We also present the ultrasonographic aspects of advanced pregnancies where PAS was identified and the management algorithms that we use in the treatment of these life-threatening obstetrical emergencies. [ABSTRACT FROM AUTHOR]

The genesis of neural tube defects (NTD) is poorly understood. The most prevalent types of NTDs are anencephaly, encephalocele and spina bifida. Craniorachischisis totalis (anencephaly with total open spina bifida) is the most severe form of neural tube defects. The concomitant presence of omphalocele was rarely described in the literature. We report a case of a secundigravida, 38 years old, who had a history of premature birth due to cervical incompetence, BMI=30, with hypothyroidism, revealing an embryo with craniorachischisis totalis together with omphalocele, diagnosed during a first-trimester ultrasound at 11 weeks of gestation. We discussed the implications of the diagnosis with the family and proceeded to pregnancy termination. Karyotyping was performed on the aborted product of conception, revealing trisomy 18. The folate level in the mother’s blood showed an above the normal level, thus the lack of folic acid could not be linked to NTD. This case highlights the importance of the first-trimester ultrasound in the diagnosis of severe malformations, together with the genetic diagnostic testing of the fetus. The right diagnosis is crucial for future prenatal investigation and counseling. [ABSTRACT FROM AUTHOR]

Introduction. In the general population, the risk of ovarian cancer is 1.31%, while in patients with ovarian endometriosis, the risk of ovarian cancer rises to 1.8%. Endometriosis shares common pathological mechanisms with cancer: abnormal tissue multiplication, the presence of local and distant implants, resistance to apoptosis and invasion of other tissues. Regarding the histopathological subtypes, it is known that the endometrioid and the clear cell carcinoma prevail among ovarian cancers. This association with malignancy of a condition otherwise considered benign should be acknowledged in order to properly advise the patients with endometriosis. Studies have shown that tumor volume is linked to the malignancy association risk and the advanced age (over 50 years old) is a significant risk factor also. Materials and method. We present two cases of ovarian endometriosis associated with ovarian cancer that were admitted to the Obstetrics and Gynecology Department of the Bucharest University Emergency Hospital in 2020 and 2022. The ages of our patients were 33, respectively 32 years old, with large tumors, first with a long history of chronic pain, and the second with acute complains, and both underwent surgery, the definitive histopathological report revealing the association of ovarian carcinoma. We present the cases’ evolution starting from the initial symptoms, imaging studies and laboratory results, treatment planning, surgical approach and findings, surgical and oncological follow-up. Furthermore, for endometriosis associated ovarian cancer, we discuss several favorable prognostic factors, such as early stage at diagnosis, low-grade disease, endometrioid or clear cell histology, resulting in low invasiveness and slow growth. Conclusions. We recommend that, despite being low, the malignancy risk in cases of ovarian endometriosis should be considered during patient counselling. [ABSTRACT FROM AUTHOR]

Introduction. Neurofibromatosis is a multiorgan affecting genetic disorder with multiple implication in a pregnancy course. Most frequent pregnancy-related complications in this background are first-trimester spontaneous abortion, stillbirth, intrauterine growth restriction and a high rate of caesarean section. Becker nevus syndrome is typically characterized by the presence of circumscribed cutaneous hamartoma, hyperpigmented and hypertrichotic, along with unilateral breast hypoplasia, muscle, skin and/or skeletal abnormalities. The association between these two disorders is an extremely rare event. Moreover, pregnancy in the context of these two disorders overlapped is an exceptional entity. Case presentation. We present the case of a 24-year-old primiparous gravida, 25 weeks of gestation, who was admitted to our clinic for a multidisciplinary approach in the context of severe deformation of the cervical-thoracic-lumbar spine, in “C” shape, associated with multiple café-au-lait spots, suggestive for neurofibromatosis type 1, and an asymptomatic large hyperpigmented and hypertrichotic lesion in the lumbar region, clinically indicating Becker nevus syndrome. Conclusions. The course of this case was clearly a challenge, being a unique case in terms of reports in the specialized literature, both nationally and internationally. [ABSTRACT FROM AUTHOR]

Brain cancer during pregnancy is an unusual event with a poor resolution due to its signs and symptoms that can be confounded with those of pregnancy. Complications like infections and hemorrhages can occur due to multiple tumoral surgeries and these may represent another risk factor and can increase the morbidity and mortality. One of the most important facts we noticed in our two cases we encountered is that both patients were very young (25 years old and, respectively, 26 years old) and both were pregnant when the diagnosis was established. The histopathological exam revealed different results, as one had glioblastoma and the other had anaplastic oligodendroglioma. The last one needed multiple intervention due to complications. In both cases, the newborns had a favorable evolution and the patients started radiotherapy after delivery. [ABSTRACT FROM AUTHOR]

Acute fatty liver of pregnancy is a potentially fatal condition, with an incidence of 1 in 15,000 pregnancies. The reported associated maternal and perinatal mortality exceeds 70%. With prompt and correct diagnosis and management, this percentage decreases to about 20%. The diagnosis may be challenging due to nonspecific clinical presentation, therefore the best approach remains the exclusion of the most common liver diseases in pregnancy. We report a case of acute fatty liver of pregnancy in a 38-year-old secundiparous patient, with 36 weeks of gestation, diagnosed with postpartum dilated cardiomyopathy after her first pregnancy, who presented with severe jaundice, nausea, vomiting, liver enzymes increased over a hundred times and severely increased direct and indirect bilirubin values. The prompt diagnosis and the multidisciplinary approach led to a successful outcome of this case. [ABSTRACT FROM AUTHOR]

Background. Lynch syndrome (LS former known as HNPCC) is a subject of interest for gastroenterologists and other specialties. The design of a multidisciplinary center for Lynch syndrome requires not only equipment but also the existence of a complex team of specialists who are trained to possess expertise in this field. Aim. In order to design the project, we started a colorectal cancer prevalence study among patients who present themselves in a university emergency hospital. The purpose of the study was to characterize epidemiologically and clinically the cases of colorectal cancer diagnosed and treated in our hospital and to highlight among them the potential cases of LS. This study represents only one part of the prevalence study of digestive or gynecological tumors that may present the defining elements of LS. Methods. We performed an observational, retrospective study in a single tertiary center were the complete diagnosis and treatment is recommended by the tumor board team. The board's goal is to determine the best possible cancer treatment and care plan for an individual patient. The complete medical files of the patients discharged with CCR diagnosis confirmed by biopsies were collected and analyzed, on a period of one year before (2019), during (2020-2021) and a year after (2022) pandemic time. From the total number of patients discharged with CCR, we chose those younger than 50 years old, for whom we searched the medical records if they fulfill the Amsterdam criteria. All patients underwent pathological examination and IHC. Those who presented microsatellite instability MSI, were registered to undergo genetic tests to identify the possible presence of LS. Results. from 1850 CCRs discharged patients who performed histological examination and IHC (2019-2022), 165 (8.91%) were under 50 year old at diagnosis and 24 of them (14,4%) had MSI high on IHC. Of these, only 3 patients fulfill the family history for LS. For all 24 patients we recommend genetic testing in order to confirm the specific mutations. From 165 patients, we lost for follow-up 18 (10.9%) Conclusions. The design of a multidisciplinary center for LS is feasible, under the premise that the data collection methodology is homogenous and the patients go through the diagnostic and follow-up protocol under the coordination of a team of specialists in genetic syndromes. The high percentage of patients with MSI on IHC offers the opportunity to diagnose those with genetic LS by complete family history anamnesis and genetic testing. [ABSTRACT FROM AUTHOR]