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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.)

Objective. Ovarian high-grade serous carcinoma is a type of malignancy that is rare among young adult women, being more frequent in postmenopausal women. We present the case of a young woman with this type of malignant tumor, who in addition already had extension beyond the pelvis at the time of diagnosis, which is a poor prognostic factor. Case report. We repot the case of a 36-year-old woman who was admitted in our hospital with pelvic pain and ascites and also with suspicion of peritoneal carcinomatosis. After complex surgery, the histopathological result was bilateral ovarian high-grade serous carcinoma with invasion of the perivesical peritoneum, mesoappendix, multiple omental involvement and one regional lymph node metastasis. Afterwards, she was submitted for oncologic treatment. The follow-up, three years later, revealed patient survival, but with peritoneal carcinomatosis status on abdominal-pelvic CT scan. Discussions. Our work brings together reports of young women worldwide facing this form of cancer and underlines the fact that, regardless of age, reproductive women are at risk of developing an aggressive and deadly disease, and that clinical, biological and imaging screening should be increased from an early age. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study is a retrospective analysis of the spectrum of ovarian tumors: statistics, epidemiology and pathological features, based on one-year experience in our hospital. Materials and method. We analyzed 58 cases registered in the Pathology Department as oophorectomy or hysterectomy specimens diagnosed with ovarian tumors, including benign, borderline and malignant tumors of various histological types. Results. Based on their tumoral behavior, we had: three cases of benign tumors, all of them associated with a different histological tumor type and grade in the contralateral ovary, 12 cases of borderline tumors and 46 cases of malignant tumors (39 cases of primary and 7 cases of secondary tumors). The most frequent histologic type was represented by highgrade serous carcinoma (37.9%). 85.7% of the secondary tumors were endometrial carcinomas extensions. Rare primary ovarian tumors were represented by: adult granulosa cell tumor, clear cell carcinoma, mixed serous-mucinous carcinoma and undifferentiated pleomorphic sarcoma (1.72% for each type). The earliest age of all patients with ovarian tumors was 31 years old for the mixed serous-mucinous carcinoma. Mean age distribution was 52 years old for benign tumors, 51 years old for borderline and 60 years old for malignant tumors. Conclusions. Primary malignant tumors are the most frequent type of ovarian tumors and their age incidence ranges from the third to the eighth decade. The majority of secondary ovarian tumors are of endometrial origin. [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 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.)

Borreliosis is one of the most common diseases transmitted by ticks. Clinical diagnosis is difficult due to non-specific symptoms and the fact that usually the patient does not remember when he was bitten by a tick, especially since the skin lesion, erythema migrans, is inconstant. We report the case of a 33-year-old patient, secundigesta, secundiparous, who attended her obstetrician during the 22nd week of pregnancy for fatigue and the appearance of erythematous lesions on the posterior region of her left calf. Following clinical and para-clinical examination she was diagnosed with borreliosis. Rapid antibiotic treatment was indicated. The evolution of pregnancy was normal. No fetal malformations were detected. At 39 weeks of pregnancy she delivered by cesarean section due to uterine rupture imminence a healthy male, weighing 3450 g, IA = 9. The impact of Lyme disease on pregnant women is difficult to assess. Maternal and fetal prognosis seems to be favorable if the diagnosis is established rapidly and an appropriate antibiotic therapy is indicated. [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.)

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]

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.)

Congenital infections are a well-known cause of intrauterine fetal death and also of peri- and postnatal morbidity. Also, the malformative potential is well documented. Trans-placental infection of viruses, even in a subclinical phase of the maternal infection, can determine sever congenital syndroms. Even non-specific echographic anomalies may indicate a congenital infection. However, some echographic anomalies are specific for congenital syndromes. This is why establishig a fast and correct diagnosis of congenital infection is a dezideratum of the modern obstetrician. Ultrasound assessment is a key element in establishing the diagnosis and in follow-up of patients with congenital infections. [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.)

The vulnerability of adolescent girls to contact HPV is caused by several factors. These include: greater exposure to HPV through the risky sexual behavior, lack of immune memory and high rates of squamous metaplasia. Detecting HPV in teenage girls is most commonly associated with normal cytology. The incidence varies between 12-56% in women under 21 years, while in those over 35 years old ranges between 2-7%. Environmental factors, such as sexually transmitted infections or semen itself, may induce inflammation, repair and metaplasia favoring HPV infection. HPV vaccination should respect the principles of bioethics as a first key element in the relationship with the patient and an accurate, complete and efficient counseling. The arrangements in the prevention of infection are quite clearly established and include: educating teenagers and young people about HPV, counseling on the benefits of abstinence, delay in initiation of sexual intercourse, limiting the number of sexual partners. Histology but not cytology is the basic criterion for decision on uterine cervix surgery in adolescents. The decision regarding the surgical intervention on uterine cervix in teenage girls is always the exception. It is essential that young girls should be vaccinated prior to onset of sexual activity, and as a result, many of high degree precancers could be prevented, maximizing the effect of vaccines. For teenagers who have already begun their sexual life, the vaccine can still be effective and it is recommended because they will not be infected with HPV types protected by the vaccine. [ABSTRACT FROM AUTHOR]

Vesicoureteral reflux (VUR), the retrograde flow of urine from the bladder upward toward the kidney, is diagnosed commonly following an urinary tract (UTI). The VUR key to diagnosis is to maintain an adequate index of suspicion for a UTI. A voiding cystography (VCUG) is required to confirm the diagnosis. The goal of management is to prevent renal parenchimal injury, although many patients have renal scarring at the time of diagnosis. Many patients who have low - or moderate grade reflux experience spontaneous resolution whith continous antibiotic chemoprophilaxis. Surgery may be required in patients who have grade IV-V reflux, persistent high-grade reflux or febrile breakthrough infections or who are not compliant with medications. [ABSTRACT FROM AUTHOR]

Introduction. Spina bifida is a non-lethal foetal anomaly, but the prognostic, the evolution and life quality of the foeti born with this malformation implies limb paralyses, severe neuro-motor dysfunctions, urinary and fecal incontinence etc. The cranial and cerebral ultrasound signs in the spina bifida aperta have a sensibility of over 99%, being sometimes the first element which draws the attention on a possible defect of the neural tube. The study evaluates the indirect cerebral and cranial signs, for the spina bifida aperta diagnostic without as sociated genetic syndromes, during the second trimester of pregnancy. Material and method. The thesis analyses a number of 17 cases diagnosed with spina bifida aperta, in three prenatal diagnostic centres, in two years' time, 2013- 2014. The ultrasonographic examination was performed by ob serving the ISUOG guides for the foetal neurosonography. The ultrasonographic signs and the parameters included in the stu dy were: the biparietal diameter, the cranial circumference, the flattening of the frontal bones, the transverse cerebellar com pression, the ventriculomegaly, the obliteration of the cisterna magna. The foetal karyotype was performed in all ca ses. Results. Spina bifida aperta in the cases with normal foe tal karyotype. The sign of fruits: 94.11%. The CM obliteration: 88.23%. The ventriculomegaly: 70.58%. The decrease of BPD: 64.7%. Low cranial circumference: 41.17%. Cerebellar anomaly on the whole - 16 cases. The therapeutic interruption of the pregnancy was performed in 16 cases, 1 case evolved on term with the informed counselling of the parents. Conclusions. The secondary ultrasound markers represent indirect diagnostic elements, but many times very precise in spina bifida aperta. The sign of fruits or the ventriculomegaly are in many cases the first element which draws the attention on the ultrasound screening in the second trimester of pregnancy. The ultrasound 3D/4D be come almost indispensable for the foetal neurosonography. [ABSTRACT FROM AUTHOR]

Acute abdomen during pregnancy is a plurietiological, pathological entity that evolves rapidly, with increased morbidity and mortality of both mother and foetus. We report the management of two cases, with history of hysteroscopic procedures: a patient aged 35 years diagnosed with advanced abdominal pregnancy and a pregnant I gesta, I para, 29 weeks of gestation, with uterine rupture of a apparent intact uterus. The uterine scar caused by hysteroscopic procedures is a potential risk factor for the occurrence of advanced abdominal pregnancy and uterine rupture, two entities of acute abdomen during pregnancy. Unfortunately, the diagnosis and treatment of these conditions are not standardized. Therefore the management of a patient with ectopic abdominal pregnancy and uterine rupture patients with abdominal or uterine rupture is a real challenge for the obstetrician. [ABSTRACT FROM AUTHOR]

The vanishing twin syndrome is part of the much more complex notion of death of a foetus in utero, but it expressly refers to the succumbing and disappearance of one or more embryos or foeti, in the environment of a multiple pregnancy, during the first trimester of pregnancy. The embryo-foetal disappearance can be due to some genetic causes, anatomic anomalies, placenta insufficiency, anomalies of the umbilical cord, infections or related maternal pathological situations such as high blood pressure and diabetes. The article proposes the presentation of this particular situation of the multi-foetal pregnancy, in terms of the diagnostic, the conduct and the obstetrical prognostic, presenting the experience of its own cases and the existing data in the specialty literature. [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 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.)

Diabetes is the most common medical complication associated with pregnancy. During pregnancy complicated with maternal diabetes (DM), the placenta suffers certain pathological, functional and structural changes. DM was correlated with a rapid progressive microangiopathy and this, in turn, may be associated with capillary hypertension and changes in capillary permeability. The objective of the study is to identify the clinical correlations with influence on gestation in general, and on the placental structure in particular, in pregnancy associated with type 1 (T1DM), type 2 (T2DM) and gestational diabetes mellitus (GDM). The impact of the clinical conditions associated with DM on placenta has been analyzed and correlated with the ultrasound (US), morphological, histological and immunohistochemical study of the placental structure. Preexisting maternal hypertension, preeclampsia and obesity were the main associated conditions. The US examination of placental characteristics revealed an increase in placental thickness in the second trimester. The macroscopic analysis showed that the placentas of women with diabetes are heavier. Gross pathological analysis of maternal and fetal surfaces of placentas revealed subcortical or basal plaque fibrin deposition, and placental infarction or intervillous thrombosis. From the microscopic point of view, the findings include fibrinoid necrosis, intervillous fibrosis, focal hyaline degeneration, villous immaturity, chorangiosis, placental calcifications, placental infarction or decidual vasculopathy. Maternal hypertensive disorders amplify the spectrum of morphological changes in the placenta. Placental immaturity and villous capillary dysfunction are characterized by increased angiogenesis and enhanced vascular permeability. The diabetic placenta does not show specific changes, but different associations may be a diabetic pathological pattern influenced by associated conditions, especially preeclampsia, obesity, dyslipidemias and the lack of euglycemia during pregnancy. [ABSTRACT FROM AUTHOR]

Introduction. Adenomyosis is a benign pathology defined by the presence of endometrial glands in the miometrium, accompanied by chronic pelvic pain, infertility and vaginal bleeding. It is a hormonal dependent condition and is common in reproductive age. Adenomyosis areas differ from the normal endometrium by increased local production of estrogen or prostaglandins and resistance to progesterone action. Materials and method. The study included 23 patients, aged 26-52 years old, diagnosed with adenomyosis. Postoperatively obtained specimens were included in paraffin and studied histologically and immunohistochemically. The blocks were cut by the microtome, the sections were applied on simple slides for histological staining of Hematoxylin-Eosin and on Poly-L-lysin slides for the immunohistochemical stains. The antibodies were: anti-estrogen receptors (ER), anti-progesterone receptors (PR), anticytokeratin 7 (CK7), anti-cytokeratin 20 (CK20). Results. Classical Hematoxylin-Eosin staining showed the presence of mono-layered, cylindrical glandular epithelial tissue in the structure of the myometrium, and with immunohistochemistry we showed that these glands were of endometrial origin, being CK7-positive and negative at CK20, making a differential diagnosis with an eventual metastasis from the digestive tract. The receptors for estrogen and progesterone are present in the structure of these glands. Conclusions. Adenomyosis is a benign pathology diagnosed with certainty by histopathological examination. Receptors for estrogen and progesterone are features for endometrial tissue, and cytokeratins make the differential diagnosis with digestive epithelium. [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.)

Moartea fetală in utero este mult mai frecventă în sarcina multiplă, comparativ cu sarcina unică. Mai mult, moartea in utero a unuia dintre feți ridică probleme legate de etiologie, interrelație maternofetală și feto-fetală. La fel ca și în multe alte circumstanțe ale sarcinii multiple, corionicitatea are un rol decisiv. Datorită anastomozelor vasculare și a circulației interfetale partajate specifice placentației monocorionice, moartea in utero a unuia dintre feți, prin fluctuațiile hemodinamice interfetale subsecvente, este responsabilă pentru aproximativ 20-40% dintre anomaliile care apar la fătul supraviețuitor. Moartea fetală unică prezintă un risc de 20% pentru encefalomalacia multichistică și naștere prematură a supraviețuitorilor în sarcina monocorionică. Anomaliile cerebrale ale fătului supraviețuitor sunt atribuite mai multor mecanisme, cel mai important fiind cel hipoxic-ischemic, conducând în final la hemoragii intraventriculare și leucomalacie periventriculară. Șocul hipovolemic pe care îl resimte fătul supraviețuitor reprezintă un mecanism important, de asemenea. Conform acestei teorii, fătul decedat acționează printr-un efect de robinet asupra supraviețuitorului, care practic sângerează spre fătul decedat, lipsit de rezistență vasculară. Acest sindrom transfuzional rapid se realizează prin intermediul anastomozelor superficiale arterio-arteriale și veno-venoase. Managementul morții in utero a unuia dintre feți în sarcina multiplă este net diferențiat prin problematica legată de corionicitate. Dacă în sarcina multiplă bicorionică atitudinea este în principiu mai limpede și se bazează în special pe managementul expectativ conservator și evaluarea fetală sistematică, fiind evident supusă riscului de avort sau naștere prematură, în sarcina monocorionică această atitudine este mult mai complexă. Dacă evenimentul fatal al unuia dintre feți survine în cel de-al doilea trimestru de sarcină, supravegherea ultrasonografică a fătului supraviețuitor este esențială, decizia intervenției elective este sensibilă, iar prognosticul este inevitabil supus hazardului. [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.)

Introducere. Boala Lyme (borelioza) este o patologie infecţioasă multisistemică produsă de spirochete din genul Borrelia spp., care sunt transmise de la animal la om prin înţepătura de căpuşe. România se regăseşte în aria de răspândire a acestei boli, existând zone cu caracter endemic, infecţia apărând în anumite perioade de vârf pe parcursul anului. Borelioza nu se manifestă imediat şi nu apare la toţi cei înţepaţi de căpuşe, astfel încât foarte multe cazuri rămân nedescoperite sau, din cauza faptului că aceasta poate mima simptomatologia altor boli, diagnosticul este dificil de efectuat. La gravide, boala Lyme este destul de rară, dar transmiterea transplacentară, deşi controversată şi nedemonstrată pe deplin, se pare că este posibilă în cazul în care pacienta nu este tratată. Complicaţiile fetale sunt redutabile, de la malformaţii cardiace complexe până la avort sau moarte intrauterină. Cu toate acestea, sunt puţine cazuri descrise în lume de boală Lyme în sarcină şi lucrări despre consecinţele ei asupra fătului. De aceea, considerăm utile prezentarea unui astfel de caz şi atenta urmărire a sarcinilor cu borelioză. Material şi metodă. Raportăm cazul unei gravide, IIG, IIP, care se prezintă la medicul ginecolog în săptămâna a 22-a de sarcină, având o leziune eritematoasă suspectă în context epidemiologic sugestiv pentru borelioză. În continuare, se efectuează consulturi de specialitate (dermatologie şi boli infecţioase) pentru realizarea unor diagnostice de excludere. Ulterior, testele serologice relevă rezultat echivoc al Ac IgM anti-Borrelia spp., ceea ce complică şi mai mult diagnosticul. Gravida este tratată în acelaşi timp pentru infecţie de tract urinar, sarcina fiind atent monitorizată atât ecografic, cât şi clinic şi paraclinic, pentru depistarea posibilelor complicaţii materno-fetale. Rezultate. Contextul clinic şi epidemiologic sugestiv pentru borelioză, rezultatele serologice controversate ale testelor ELISA şi confirmate prin PCR, asociate cu prezenţa concomitentă a unor infecţii de tract urinar, au determinat specialiştii să recomande gravidei tratament antibiotic. În aceste condiţii, evoluţia sarcinii este favorabilă, cu atenta supraveghere a mamei şi a fătului. Pacienta naşte prin operaţie cezariană, la termen, un făt viu, normoponderal, sănătos. Lăuza şi nou-născutul au fost testaţi imediat după naştere pentru borelioză, fătul neprezentând răspuns imun. Placenta a fost atent analizată prin examen histopatologic, fără a se decela modificări, excluzându-se astfel transmiterea transplacentară a spirochetelor. Concluzii. Diagnosticul diferenţial al bolii Lyme la gravidă trebuie făcut cu mare atenţie, ţinând cont de particularităţile imunologice şi de reacţiile fals-negative şi fals-pozitive datorate altor patologii. În general, pacientele primesc antibioterapie pentru alte infecţii genitourinare, care de cele mai multe ori tratează şi infecţia transmisă de căpuşă. Cu toate acestea, anamneza corectă, identificarea eritemului migrator şi informarea pacientelor asupra riscurilor bolii Lyme sunt esenţiale pentru identificarea şi tratarea la timp a unei infecţii cu potenţial malformativ şi consecinţe nefaste în sarcină. [ABSTRACT FROM AUTHOR]

Este unanim recunoscut la ora actuală faptul că studiile epidemiologice, clinice și moleculare converg spre ideea clasificării adenocarcinoamelor endometriale în cel puțin două subclase: tipul I - în care tumorile sunt adenocarcinoame endometroide și probabil mucinoase, în timp ce tipul II include formele de carcinoame seroase sau cu celule clare. Patologia malignă a endometrului reprezintă cea mai frecventă neoplazie invazivă a tractului genital feminin. Majoritatea acestor cazuri sunt reprezentate de adenocarcinomul endometrioid (sau de tip I), care este cel mai comun tip histologic. În cazul tipului I de carcinoame, gradingul histopatologic este de mare importanță în stabilirea prognosticului și, în multe cazuri, a conduitei terapeutice. Majoritatea pacientelor solicită consultul de specialitate în momentul apariției hemoragiei pe cale vaginală, cel mai important simptom al acestei palologii, iar tumoarea este de obicei limitată la corpul uterin la momentul diagnosticului. Factorii de risc ai cancerului endometrial includ, în mare, obezitatea și vârsta avansată. Alți factori care influențează riscul sunt: sindromul ovarelor polichistice, terapia estrogenică, în special la menopauză, menarha devreme, menopauza precoce, istoric de infertilitate, nuliparitatea, neregularitățile menstruale, rasa albă, tratamentul cu tamoxifen, diabetul, hipertensiunea arterială, boli ale vezicii urinare, contracepție orală combinată pe termen lung și fumatul. Există numeroase studii, în ultimele două decenii, cu privire la carcinomul endometrial, însă la fel de adevărat este și faptul că s-au înregistrat modificări semnificative în modelele de distribuție a caracteristicilor patologice, în cadrul acestor entități cu variabilitate destul de amplă. Carcinomul endometroid de tip mucinos reprezintă 1-2% dintre cancerele endometriale, având un aspect mucinos ce cuprinde mai mult de jumătate din tumoare și fiind denumit generic aspect focal. Scopul acestui studiu este de a stabili corelații imagistice, morfologice și de patologie chirurgicală privind diagnosticul, conduita terapeutică și prognosticul tumorilor uterine din categoria adenocarcinomului endometrial endometroid. [ABSTRACT FROM AUTHOR]

Introducere. Rutina practicii clinice obstetricale și materno-fetale presupune evaluarea ultrasonografică a structurii placentare pe toată durata gestației, prin tehnica standard 2D, dar și prin tehnici 3D şi Doppler avansate. Scopul studiului este de a realiza corelații sistematice între placentația anormală evaluată ultrasonografic și diagnosticul morfopatologic al acestei structuri gestaționale. Material și metodă. Cercetare multicentrică terțiară ce include un număr de 734 de sarcini neselectate, diagnosticate ultrasonografic cu anomalii placentare sau ale membranelor fetale, în intervalul 2012-2017. Evaluarea ultrasonografică a fost urmată de studiul morfopatologic al acestor structuri. Intervalul de examinare a variat între 11 (+4) şi 38 (+5) săptămâni gestaționale. Studiul include 722 de sarcini unice și 12 sarcini multiple. Diagnosticul ultrasonografic a inclus evaluare transabdominală, transvaginală sau mixtă. Rezultate. Corelații ultrasonografice şi morfopatologice au fost observate pentru: infarcte placentare - 75 de cazuri (10,21%), anecogenități placentare - 17 (2,31%), placenta circummarginata - 42 (5,72%), tumori placentare - 7 (0,95%), placenta praevia - 24 (3,26%), hematom retroplacentar - 51 (6,94%), benzi amniotice - 31 (4,22%), placentă hiperaderentă (accreta, increta, percreta) - 28 (3,81%), placentă molară - 27 (3,67%), lobulație anormală - 42 (5,72%), abruptio placentae - 9 (1,22%). Concluzii. Un număr semnificativ de anomalii placentare pot fi detectate ultrasonografic chiar din primul trimestru de sarcină. Examinarea 2D standard este esențială pentru diagnostic, dar tehnicile 3D şi Doppler avansat completează și susțin evaluarea ultrasonografică. Anumite structuri anatomice macroscopice ale placentei au expresie ultrasonografică evidentă și bine definită, aducând detalii pentru prognosticul materno-fetal. Există un număr semnificativ de anomalii fetale, structurale sau funcționale, unele cu implicare sindromică, a căror identificare ultrasonografică trebuie să conducă spre examinarea morfopatologică a structurii placentare. Anumite anomalii de placentație detectate ultrasonografic pot atrage atenția asupra necesității diagnosticului prenatal invaziv. [ABSTRACT FROM AUTHOR]

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Ultrasonografia (US) poate aduce informații utile în diagnosticul incontinenței urinare de efort (IUE) prin evaluarea morfologică a vezicii urinare, uretrei, dar și a statusului și mobilității uretro-vezicale. Din punct de vedere morfologic, uterul și pereții vaginali prolabați reprezintă mesagerii defectelor anatomice. Examenul clinic evaluează defectul herniar și gradul de prolabare. Important pentru un tratament corect este conținutul sacului herniar și mecanismul de apariție al prolapsului. US poate aduce date cu privire la conținutul sacului herniar, poate explica simptomele - dificultăți de evacuare vezicală, rectală, IUE - și orientează asupra defectelor anatomice. Soluțiile de diagnostic US în IUE sunt reprezentate de ecografie transperineală (translabială)- TPUS, ecografie transvaginală - TVUS sau ecografie endoanală - EAUS. Evaluarea US în IUE urmărește: măsurarea volumului urinar rezidual, grosimea detrusorului, dinamica colului vezical, prezența cistocelului, integritatea uretrei, mase tumorale sau diverticuli. US introitală (sondă de 5 MHz) poate diagnostica elongația de col sau colpocelul - corpul uterin retroversat ce ocupă sacul herniar posterior. EAUS și 2D/3D TPUS sunt complementare în evaluarea compartimentului posterior. Reperele US ale compartimentului posterior sunt: centrul tendinos perineal - formă triunghiulară, ușor hiperecogen, situat anterior de sfincterul anal; septul rectovaginal - aspect hiperecogen între peretele vaginal (hipoecogen) și musculara rectală și unghiul ano-rectal - între axul longitudinal al canalului anal și peretele rectal posterior. Concluzii. US este neinvazivă versus cistouretrografie/defecografie, cost-eficientă comparativ cu RMN în dinamică, permite evaluarea în timp real a planșeului pelvic, oferind date de anatomie funcțională sau evaluarea poziției și dinamicii meșelor de polipropilenă. US este utilă în evaluarea preoperatorie prin posibilitatea aprecierii conținutului sacului herniar și a corelației defect anatomic - simptome. US contribuie la evaluarea rezultatelor postterapeutice, a poziției meșelor sintetice și la verificarea efectului lor funcțional. US devine un element important atât în diagnosticul IUE, permițând aprecierea morfologică și dinamică a tractului urinar inferior, cât și în evaluarea preoperatorie pentru stabilirea conduitei chirurgicale. [ABSTRACT FROM AUTHOR]

Introducere. Sindromul de dilatare a tractului urinar fetal (SDTU) cuprinde dilatarea limitată la pelvisul renal, calice și/sau uretere. Vezica urinară poate fi dilatată, de asemenea. SDTU are o incidență de 1-5%, fiind mai frecvent la sexul masculin (2:1). Studiul are ca scop evidențierea aspectelor de diagnostic ultrasonografic (US), evaluarea prognosticului și managementul pre- și postnatal al SDTU. Material și metodă. Studiu multicentric pe o perioadă de doi ani. Sarcini unice cu SDTU diagnosticat ultrasonografic (US). SDTU a fost evaluat atât prin US 2D, dar și prin tehnici de reconstrucție 3D, TUI și Doppler. Rezultate. Diagnosticul US - distensia pelvisului renal cu sau fără dilatație caliceală. Pelvisul renal este măsurat anteo-posterior în planul transversal. Criteriile de diagnostic pentru SDTU în trimestrul al doilea - ușor (4-7 mm), moderat (7-10 mm), sever (>10 mm); în trimestrul al treilea - ușor (7-9 mm), moderat (9- 15 mm), sever (>15 mm). În cele mai multe cazuri, SDTU este o constatare izolată. AFI este de obicei normal. Concluzii. SDTU este o constatare comună, de obicei tranzitorie, dar există un risc semnificativ de patologie renală, în special prin dilatarea progresivă sau severă, caliectazii sau dilatare ureterală. Dacă SDTU este diagnosticat în al doilea trimestru, se recomandă reevaluare în ultimul trimestru pentru a identifica hidronefroza persistentă sau agravarea acesteia. Cele mai comune etiologii sunt: hidronefroza, obstrucția joncțiunii uretero-pelvice și refluxul vezicoureteral. Toate acestea sunt de obicei tranzitorii. Este recomandată US renală postnatal. Profilaxia infecției urinare neonatale poate fi necesară. 25% dintre cazuri necesită intervenții chirurgicale. [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.)