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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.)

(1) Background: Endometriosis is a widespread gynecological condition that causes chronic pelvic discomfort, dysmenorrhea, infertility, and impaired quality of life in women of reproductive age. Clinical examination, transvaginal ultrasonography (TVS), and magnetic resonance imaging (MRI) are significant preoperative non-invasive diagnosis procedures for the accurate assessment of endometriosis. Although TVS is used as the primary line for diagnosis, MRI is commonly utilized to achieve a better anatomical overview of the entire pelvic organs. The aim of this systematic review article is to thoroughly summarize the research on various endometriosis diagnosis methods that are less invasive. (2) Methods: To find relevant studies, we examined electronic databases, such as MEDLINE/PubMed, Cochrane, and Google Scholar, choosing 70 papers as references. (3) Results: The findings indicate that various approaches can contribute to diagnosis in different ways, depending on the type of endometriosis. For patients suspected of having deep pelvic endometriosis, transvaginal sonography should be the first line of diagnosis. Endometriosis cysts are better diagnosed with TVS, whereas torus, uterosacral ligaments, intestine, and bladder endometriosis lesions are best diagnosed using MRI. When it comes to detecting intestine or rectal nodules, as well as rectovaginal septum nodules, MRI should be the imaging tool of choice. (4) Conclusions: When diagnosing DE (deep infiltrative endometriosis), the examiner's experience is the most important criterion to consider. In the diagnosis of endometriosis, expert-guided TVS is more accurate than routine pelvic ultrasound, especially in the deep infiltrative form. For optimal treatment and surgical planning, accurate preoperative deep infiltrative endometriosis diagnosis is essential, especially because it requires a multidisciplinary approach. [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 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 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 presence of intrauterine polypoid masses is a frequently encountered gynecologic pathology, usually associated with abnormal bleeding and infertility. We investigated a series of 857 consecutive patients with polypoid uterine masses that showed great histological variability. Although most lesions are benign lesions, the incidence of neoplastic lesions that can manifest macroscopically as polypoid masses increase with age. Heterogeneity of histopathological aspects of endometrial polypoid lesions requires a thorough differential diagnosis. [ABSTRACT FROM AUTHOR]

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]

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.)

Introduction. The uterine malformations are caused by deficitary development of the müllerian ducts during the embryological life. With a prevalence of 1-6% in the general population, they result in an abnormal uterine cavity, which has a negative impact on fertility. The most frequent uterine malformations are represented by the septated arcuate and bicornuated uterus and result from an incomplete absorption of the müllerian ducts. Often, the differentiation between these pathologies through imagistic techniques can be troublesome. The new ASRM classification comes with remarks in this regard. The aim of the treatment is the restoration of the uterine cavity, since the reconstruction of the normal uterine anatomy is key to a better reproductive function. Materials and method. This poster describes a clinical case of uterine malformation in a 33-year-old patient with infertility, showing the diagnostic and therapeutic protocol, as well as the impact over fertility. Results. Using 3D US and ASRM criteria, the correct diagnosis of septate uterus could be placed. Hysteroscopic resection of the septum and the restoration of the uterine cavity allowed the implantation of an embryo via IVF. Conclusions. The treatment gold standard of uterine malformations is represented by hysteroscopy, which has a low risk of postoperative complications and leads to an improvement of the reproductive function. Applying the ASRM criteria, a correct diagnosis can be made with ease, allowing for the most effective treatment protocol to be followed. [ABSTRACT FROM AUTHOR]

Introduction. Endometriosis is a common gynecological condition among women of childbearing age, associated with chronic pelvic pain, dysmenorrhea, infertility and impaired quality of life. Although the internationally accepted gold standard is the diagnostic laparoscopy, the preoperative noninvasive diagnosis methods – clinical examination, transvaginal ultrasound and magnetic resonance imaging (MRI) – are an important step in the correct preoperative diagnosis of endometriosis. The aim of this paper is to determine the ideal method of preoperative noninvasive diagnosis depending on the symptoms and location of endometriosis lesions, whether clinical examination and transvaginal ultrasound are sufficient or when MRI examination is necessary. Methodology. We performed, on a group of 96 patients diagnosed with endometriosis, imaging examination by transvaginal ultrasound and MRI before the surgical treatment of the lesions, with the collection of biological samples for histopathological examination. The results obtained after the intervention were observed, comparing the lesions identified preoperatively with those excised during surgery. Results. MRI provides accurate information for the staging of deep endometriosis, especially when the case does not allow a transvaginal ultrasound examination – it is limited by chronic pelvic pain, virgo intacta or obese patient. MRI is used when the clinical examination and ultrasound do not identify lesions in symptomatic patients (parametric lesions, uterosacral ligaments). The association of MRI increases the sensitivity of transvaginal ultrasound in the diagnosis of endometriosis in these cases (70.3% compared to 11.3%). Large endometriosis lesions that can be easily identified on clinical examination and ultrasound do not require MRI (rectal nodules d≥2 cm, endometriomas d≥4 cm). For intestinal endometriosis, MRI and ultrasound have similar efficiency (83.78% and 87.75%). Discussion and conclusions. Although it is not a routine investigation in all patients suspected of having endometriosis, MRI is effective in identifying the lesions. It is necessary for the gynecologist to request an MRI investigation when the transvaginal ultrasound is insufficient or cannot be performed. The methods depend on the experience of the gynecologist and radiologist in making a preoperative assessment of the lesions, so that the surgical treatment is performed in the most complete way possible. [ABSTRACT FROM AUTHOR]

Cervical carcinomas can be prevented by detecting and treating precancerous lesions early. Although the cytological screening has decreased the incidence worldwide, the results obtained must be integrated in a clinical context in order to avoid false-positive diagnoses. Persistent infection with high-grade HPV is the leading cause of preneoplastic and neoplastic lesions. Although the Babeş-Papanicolaou cytological examination, performed both conventionally and liquid-based, is the most efficient method in terms of quality/price ratio, and the histopathological examination is often considered the gold standard, in some cases there are inconsistencies between the two. In our study, we aimed to retrospectively evaluate Babeș-Papanicolaou smears and post-biopsy results in order to determine the incidence of false-positive and false-negative cases. [ABSTRACT FROM AUTHOR]

High-grade squamous intraepithelial lesion (HSIL) includes the entities formerly called intraepithelial cervical neoplasia (CIN 2, CIN3), moderate and severe dysplasia, and in situ carcinoma. Although not all high-grade lesions will progress to cancer, HSIL is considered a preneoplasic lesion. The aim of our study was to compare colposcopy changes associated with the diagnosis of HSIL (high-grade squamous cervical lesion) cytologically and histologically confirmed and the role of the interprofessional team in the prompt evaluation and management of these lesions. We evaluated cytological/ histological diagnoses of HSIL and colposcopic diagnostic elements. The cytological and histological diagnoses were reported according to the Bethesda system. Out of the total of 1180 PAPS collected in 2020, a number of 27 presented HSIL results, these being the ones evaluated in the present paper. [ABSTRACT FROM AUTHOR]

Introduction. Endometriosis of the abdominal wall is a condition defined by the presence of endometrial tissue in the subcutaneous adipose tissue and in the muscles of the abdominal wall. The diagnosis can be difficult due to the fact that the symptoms are not specific. The patients present with catamenial abdominal pain and palpable abdominal tumor. Endometriosis of the abdominal wall usually affects women of fertile age and most commonly occurs on the post-caesarean scar. The diagnosis can be made by ultrasound or magnetic resonance imaging, correlated with medical history and clinical examination. The treatment of choice is surgical resection of the endometrioma. Methodology. During 2019 and 2020, 146 patients diagnosed with endometriosis were treated in our clinic. Eleven of these cases were diagnosed and treated for abdominal wall endometrioma. Results. 16.06% of the patients diagnosed with endometriosis were diagnosed with abdominal wall endometrioma. Of the 11 cases of parietal endometriomas, 45% also associated deep endometriosis lesions of the pelvic peritoneum, unilateral or bilateral endometriotic cysts, deep endometriosis nodules in the parameters or uterosacral ligament or intestinal nodules. The average age of patients was 35 years old. The results of the histopathological examination confirmed in all cases the diagnosis of parietal endometriosis. In two of the 11 patients with abdominal wall endometrioma, polypropylene mesh was used to close the aponeurotic defect. Conclusions. Endometriosis of the abdominal wall is usually manifested by palpable tumor formation accompanied by cyclic abdominal pain. Ultrasound together with a correct clinical examination and the patient’s history can guide the diagnosis. MRI is nonspecific but it can help diagnose node extension and the deep pelvic endometriosis lesions. In our experience, abdominal wall endometriomas occur quite frequently, with or without deep endometriosis. The number of cases diagnosed with parietal endometriosis is increasing, in line with the increase in the number of caesarean sections. [ABSTRACT FROM AUTHOR]

Objectives. This case report serves the purpose of evaluating the efficiency of an alternative treatment for the women who are suffering from vulvodynia. Materials and method. After the correct diagnosis of a iatrogenic hemivulvodynia with vaginal atrophy and vaginismus, we applied different solutions for the treatment of a patient, and we observed whether the symptomatology subsided or disappeared. We used different treatments, such as laser therapy for vaginal atrophy, non-linked hyaluronic acid for vaginal dryness, external personalized creams with anesthetics, antidepressants (amitriptyline) and antispastics (baclofen) for vulvodynia, and botulinum toxin injections in different sites for vaginismus and vulvodynya. Results. Every treatment method that we applied to the patient had a benefit for her well-being, but the most satisfying result came after the pudendal nerve block with botulinum toxin. Conclusions. Pudendal nerve block with botulinum toxin is an efficient treatment for vulvodynia. [ABSTRACT FROM AUTHOR]

Mesenchymal tumors of the uterus represent a high number of routine practice in gynecological pathology, and the pathology is heterogenous, with diagnostic challenges. There is a large variation in clinical, pathological and prognostic patterns of these entities, smooth muscle and endometrial stromal constituting the majority of the group. Although histopathological slides are the gold standard and sometimes enough for the diagnosis of mesenchymal uterine tumours, difficult cases need ancillary tests. A large panel of immunohistochemical antibodies provides more information. We present the algorithm used for the differential diagnosis between uterine smooth muscle tumors, endometrial stromal tumors, UTROSCTs, PEComas, and the most frequently used imunohistochemical markers. [ABSTRACT FROM AUTHOR]