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Rationale: The extent of pregnancy in adolescents and young adults, especially in low and middle‐income countries, is a source of increasing concern given its social and economic impact. Aims and Objective: We hypothesized that there would be correlations between female patients becoming pregnant at a young age and practices such as harmful alcohol misuse, cigarette smoking, and drug use, the use of toxic substances, low educational attainment, and an essential absence of health care seeking about the outcome of adolescent pregnancies. Methods: We performed a prospective cross‐sectional study of patients who gave birth between August and November 2017 at St. Pantelimon Emergency Hospital in Bucharest, Romania. Seventy‐four patients aged 14 to 20 years, with a mean maternal age of 18.07 years, were enrolled in the study and answered a 15‐item questionnaire about their social, educational, and medical background. Results: Fifty‐three patients (71.6%) gave birth by caesarean section and 21 (28.3%) by vaginal delivery. Notably, patients aged 14 to 16 years had a lower rate of caesarean delivery compared with those aged 17 to 20 years. Moreover, 83.0% of the caesarean sections and 76.1% of the vaginal deliveries were at term. With reference to age and type of delivery, women are more likely to give birth by caesarean section at any age group (the association is not statistically significant at P < .05), except for the age of 15 years (five out of six patients in our sample had a spontaneous birth). Smoking was the most common risk behavior in the sample (45.9%, n = 34), followed by alcohol consumption (17.5%, n = 13) and drug use (5.40%, n = 4). Conclusions: A high percentage of caesarean delivery was reported, particularly in patients aged >17 years. The percentage of female participants who underwent a caesarean delivery for their second pregnancy was significantly higher than compared with primipara participants. Patients receiving consistent antenatal care visits compared with those who did not monitor their pregnancy did not differ in the likelihood of undergoing a caesarean section. [ABSTRACT FROM AUTHOR]

The study that implicates vitamin D in playing a role in fertility is compelling, and it is backed up by sound hypothesis. Nevertheless, further research needs to be assess for the health benefits and reaching appropriate levels. This could represent a starting point of a new domain which could find simple approaches to improve health. Notwithstanding fertility benefits, patients should have vitamin D supplementation for health benefits, including pregnancy health, bone health and chronic disease risk reduction. This review is based on the results of clinical trials and studies published in medical journals and database from the moment it was first acknowledged until nowadays. We aim to present the evolution of the perspective on the subject and the new findings surrounding it. Vitamin D has its well-known function in calcium and phosphorus hemostasis, and its deficiency is predominant in high-risk populations, but the prevalence among healthy or asymptomatic adults is not well defined. Several theories and hypothesis have been launched over the last years regarding the etiology of vitamin D deficiency, none of them being flawless or able to explain the entire panel of symptoms. Taken into consideration the insufficiency of vitamin D which could have implications also in infertility, especially in young fertile women, the newest research could lead to new supplementation of vitamin D in the treatment of both women and male infertility management. [ABSTRACT FROM AUTHOR]

Patient admitted to the hospital with the diagnosis of threatened abortion at 25 weeks gestation is diagnosed intraoperatively with late second trimester tubal pregnancy. The misdiagnosis is made because of the rarity of advanced tubal pregnancy and the lack of early first trimester ultrasound examination and proper prenatal care. The patient was managed surgically and recovered uneventfully. [ABSTRACT FROM AUTHOR]

We reported a 54-year-old patient with a complete hydatidiform mole invasive in myometrium. This diagnostic was suggested by irregular vaginal haemorrhage, amenorrhea and reduced nausea. The paraclinical investigations which suggest the diagnosis were: pelvic ultrasound and level of serum beta-human chorionic gonadotropin (β-hCG). Endovaginal ultrasound revealed enlarged uterus volume, with diameter of 12/15/8 cm, and the presence of multiple nodular formations located intramural and subserosal and a mass with Doppler rich blood supply through myometrium and endometrium. The level of β-hCG was 28099.00 mIU/L. The treatment was abdominal hysterectomy and bilateral salpingo-oophorectomy. Anatomopathological report revealed a complete invasive mole and endometrial polyp. After the surgical intervention the patient was treated with methotrexate as prophylactic chemotherapy recommended by oncologists because of the invasive character of mole and age of patient. The complete invasive mole is a benign tumor that is characterized by abnormal proliferation of trophoblast and is locally invasive. Developing pregnancy rate in perimenopause period is very rare and most of the pregnancies that occur at this age are abnormal, spontaneous abortion occurring most often. We choose to report this case to emphasize that this condition can occur in a relatively advanced age, especially during perimenopause period. [ABSTRACT FROM AUTHOR]

Introducere. În ultimul deceniu au fost recunoscute mai multe sindroame neoplazice ereditare ce pot determina cancere în sfera ginecologică. Medicii specialiști ginecologi sunt primii care iau contact cu aceste paciente cu risc crescut și sunt nevoiți să recunoască și să trateze specific aceste cazuri prin măsuri de reducere a riscului bolii și prin screening. Metode. Deși majoritatea neoplasmelor sunt caracterizate prin apariția sporadică, la pacientele care au mutații genetice specifice crește incidența apariției acestora. Astfel, identificarea acestor paciente cu antecedente familiale sau personale de sindroame neoplazice trebuie să ridice suspiciunea unei mutații genetice și trebuie să conducă la investigații suplimentare. O situație aparte o reprezintă pacientele cu antecedente semnificative, dar cu screening genetic negativ, acestea putând fi încadrate în categoria de risc crescut și vor beneficia de consiliere individualizată. Beneficiul screeningului în cancerul mamar pentru pacientele cu risc crescut este bine cunoscut, dar în cazul cancerului de ovar și de endometru, ghidurile naționale de screening nu sunt la fel de eficiente, cu toate acestea fiind obligatorie respectarea acestora. După identificarea pacientelor ce pot beneficia de pe urma tratamentului specific, se poate opta pentru terapie medicamentoasă, chirurgicală sau ambele. Este esențial de luat în calcul raportul risc/beneficiu al tratamentului ales. Discuții. Standardul de aur pentru reducerea riscului de neoplazie al pacientelor aflate în grupa de risc crescut pentru sindroame neoplazice este managementul chirurgical. Astfel, mastectomia profilactică bilaterală și salpingoooforectomia profilactică bilaterală, salpingectomia profilactică bilaterală, asociate sau nu cu histerectomia, sunt opțiuni terapeutice acceptate pentru pacientele cu risc crescut de a dezvolta cancer mamar, ovarian sau uterin și ulterior pentru a facilita terapia de substituție hormonală. Concluzii. Identificarea pacientelor cu risc crescut pentru dezvoltarea neoplasmelor cu caracter ereditar în sfera ginecologică poate salva viața acestora, prin reducerea specifică a factorilor de risc. [ABSTRACT FROM AUTHOR]