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The aim of this study is to establish morphological, histological and ultrasonographic (US) correlations in the placenta of type 2 diabetes. This is a multicenter case-control study conducted on a lot of 21 selected cases diagnosed with type 2 diabetes, analyzed over a two year period. The clinical characteristics of the patients in the study group are represented by the average age of 34 years and diabetes associated with preeclampsia, hypertension, diabetic neuropathy, urinary infections, obesity or history of infertility. All the patients in the study group are Caucasian. US assessment of placental characteristics in our series revealed increased placental thickness from the second trimester and placentomegaly at the end of the third trimester. Immature appearance of placenta has been observed. Gross analysis of maternal and fetal surfaces of the placentas revealed basal plate and subchorionic fibrin depositions, placental infarction or intervillous thrombosis. Preconceptional glycemic control and its support during gestation are essential for pregnancy outcome. US findings have as a background the morphological changes. From morphological perspective there is about a combination of anomalies, otherwise unspecific which, in terms of association with various comorbidities could define a placental diabetic pattern. [ABSTRACT FROM AUTHOR]

Complex and modern obstetric medical care provides a constant improvement for the pregnancy prognosis. Thus, young women with an undiagnosed pathology become pregnant and, during pregnancy, the previously undiagnosed pathology, without any clinical signs and symptoms, becomes present during pregnancy, having an unfavorable impact on the fetus and the health state of the pregnant woman. The gestational syndromes during pregnancy influence the woman's health state over a long period of time and the quality of the conception product. The recommendation, performance of laboratory tests and imagistic investigations at the right time during pregnancy, as well as a correct interpretation of their results, may prevent the onset of catastrophic occurrences including fetal death in utero and/or maternal death. We report the case of a 30-year old primigesta, primipara (IGIP) patient with a singleton, naturally obtained pregnancy, severe preeclampsia, severe IUGR and thrombophilia. [ABSTRACT FROM AUTHOR]

The aim of the research was to assess the outcome of persistent (=two years) low-grade cervical intraepithelial neoplasia (CIN 1) medicated with loop electrosurgical excision procedure (LEEP). An analysis of 38 topics with persistent biopsy-confirmed CIN 1 diagnosed after low-grade squamous intraepithelial lesion (LSIL) or atypical squamous cells of undetermined significance (ASC-US) on Pap test and treated using LEEP was performed. Post-LEEP follow-up were scheduled in 6 months, 1 year, and yearly thereafter: cytology, colposcopy, and plasma diagnostic examinations. There were 38 LSIL patients treated with LEEP conization. About 6 patients were excluded from the study due to subsequent hysterectomy and 2 patients never attended the follow-up schedule in the rest. The remaining 30 patients were retrospective studied for the incidence of recurrent rate. The mean age of the patient was 44 years. About 50% of patients were multiparity and nearly one - third used oral contraceptive pill. The results of this study suggest that the incidence of CIN 2+ lesions during follow-up of persistent biopsy-confirmed CIN 1 after ASC-US/LSIL treated by LEEP is very low. [ABSTRACT FROM AUTHOR]

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We report the case of a 37-year old primigesta, primipara (IGIP) patient with a singleton, naturally obtained pregnancy, diagnosed with type I diabetes mellitus from the age of three, carrier of an insulin pump for 11 years. The patient was diagnosed in adolescence with with a tumor of the ischio-rectal fossa with multiple attempts of excision which failed due to the particular situation of the tumor. Ultrasound examination diagnosed in the first trimester of pregnancy a voluminous right ovarian cystic tumor. The patient presented pregnancy-induced hypertension starting with 28 gestational weeks. Maternal-fetal and obstetric management assumed sequential ultrasound examination, ovarian tumor and maternal blood pressure drug control, and also the surgical management of the ischio-rectal tumor. Cesarean section was performed at 38 gestational weeks, outcoming with a live fetus, normal weight, good neonatal progression and favorable postoperative progression of the mother. In this case report, we emphasize the fact that in pregestational diabetes mellitus and pregnancy-induced hypertension, constant glycemic control, performed by the insulin pump, prior and during gestation, and the maternal blood pressure control are essential for maternal-fetal outcome. [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]

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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.)

Introduction. Ovarian tumor formations represent a common pathology in gynecology. They are divided into malignant, benign, secondary and borderline ovarian tumors. The benign tumors develop locally, starting with the ovarian follicles, the luteal body etc. Malignant tumors are formations that can invade locally and disseminate at distance. Premalignant tumors are tumor formations that present a high risk for malignant transformation, without having to invade other organs. Materials and method. The study included 30 patients, 10 patients with benign ovarian cysts, 10 with borderline ovarian tumors and 10 with malignant ovarian tumors. The patients were between 19 and 72 years old, diagnosed and treated in the Clinic of Obstetrics-Gynecology II of the County Clinical Emergency Hospital of Craiova, between 2015 and 2019. The pieces obtained postoperatively were introduced in paraffin and studied from the histological and immunohistochemical point of view. The blocks resulted were sectioned using the microtome, the sections were applied on simple smears for the classical histological stains Hematoxylin-Eosin (HE)/Trichromic Masson (TM) and on smears with Poly-L-lysine for immunohistochemical stains. The antibodies used were as follows: anti-estrogen receptor (ER), anti-progesterone receptor (PR), anti-Cytokeratin 7 (CK7), anti-Cytokeratin 20 (CK20), anti-Ki67, anti-B Cell Lymphoma (BCL2), anti-Cluster of differentiation (CD34), and anti-cancer antigen 125 (CA125). Results. The classic HE and TM stains demonstrated the presence of cystic structures, while by means of immunohistochemistry we showed that these tumors are of ovarian epithelial type, being positive for CK7 and negative for CK20, making the differential diagnosis with a possible metastasis from the level of the digestive tube. Estrogen and progesterone receptors are present in the structure of these glands, influencing the therapeutic conduct. Cellular antiapoptotic genes were positive in the hyperplastically/neoplastically transformed areas, while cell proliferation was intensely positive in the malignant areas. Vascularization was intense especially in cases diagnosed with borderline tumors. Conclusions. The surgical intervention and the subsequent histopathological examination provide actual data regarding the diagnosis of tumor certainty, helping to establish the long-term prognosis and the application of other types of treatment. [ABSTRACT FROM AUTHOR]

Introduction. There are several strains of human papillomavirus (HPV) and 14 of them have been associated with cervix cancer. High-risk strains cause most cervix cancer and preneoplastic lesions. Preneoplastic cervical lesions can be treated, and HPV infection may disappear under the action of the inflammatory system in a few months or up to two years. Persistent infections can turn the normal cervix into a pathological one. Materials, method and results. The 32-year-old patient presented to the ambulatory service for vaginal dyspareunia and minimal vaginal bleeding after sexual contact. The speculum examination revealed an exocervix increased in volume, presenting lesions, slightly bleeding upon touch. Samples were collected for the Pap smear in liquid environment. The result of the Pap smear revealed the presence of abnormal squamous cells (ASC-H) and HPV genotyping detected strains 42 and 59. The product was also sampled for the CIN Tech 2++ test, which was positive in rare epithelial cells. Colposcopy with biopsy was performed. Following the colposcopy and the histopathology results, the existence of cervical changes (cervical intraepithelial neoplasia CIN 1, 2) was demonstrated in an area of pavementous transformation, and electroresection with diathermy snare was decided. The excised fragments were subjected to microscopic study. By using immunohistochemistry, we demonstrated that 2/3 of the thickness of the epithelium was positive in the reaction with anti-Ki67 and anti-p16 antibodies, (CIN 1 – positive reaction with anti-Ki67 antibody in the basal layer; CIN 2 – positive reaction in the basal layer and in the intermediate layers). Also, in the classical stains we noticed the asynchronism between the nucleus and the cytoplasm in the dysplasically transformed areas. The patient was periodically monitored to avoid relapse. Conclusions. HPV infection may influence the transformation of normal cervical cells into preneoplastic or malignant transformation cells. The early detection and treatment of these modifications can cease pathological evolution and save lives. [ABSTRACT FROM AUTHOR]

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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]

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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.)

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]

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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]

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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.)

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.)

Imagistica prin rezonanţă magnetică (IRM) fetală este o metodă complementară imagistică pentru evaluarea fetală, ecografia fiind modalitatea de screening în imagistica obstetricală. IRM fetal este o metodă neiradiantă, cu rezoluţie superioară a ţesuturilor moi, fără limite în ceea ce priveşte obezitatea, poziţia fetală sau restricţii de vizualizare a craniului fetal datorită structurilor osoase. IRM oferă reconstrucţii şi imagini multiplanare într-un câmp vizual mare, facilitând examinarea feţilor cu anomalii complexe, precum şi a întregului corp fetal. IRM fetal poate fi utilizat, teoretic, în orice moment al perioadei gestaţionale dacă raportul risc/beneficiu justifică examinarea, iar celelalte metode de investigaţie neiradiante sunt inadecvate. Totuşi, este prudent să se aştepte până în săptămâna 17-18 de gestaţie din cauza posibilei afectări a organogenezei din primul trimestru de sarcină şi a limitelor actuale ale IRM fetale create de dimensiunea redusă fetală şi mişcarea excesivă a feţilor. În conformitate cu Colegiul American de Radiologie (ACR) şi Societatea de Radiologie Pediatrică (SPR), recomandările IRM fetal sunt vaste, cele mai frecvente indicaţii fiind afecţiunile neurologice. IRM este frecvent utilizat pentru a investiga substratul etiologic al ventriculomegaliei şi anomaliile morfologice care nu sunt diagnosticate prin utilizarea ecografiei, precum disgeneziile de corp calos, malformaţii ale dezvoltării corticale şi anomalii ale fosei posterioare. IRM poate detecta defectele de tub neural şi poate localiza mielomeningocelul în eventualitatea unei intervenţii chirurgicale. Protocolul de examinare trebuie adaptat patologiei suspectate şi vârstei gestaţionale. În sarcina multiplă, IRM fetal oferă o alternativă complementară ultrasonografiei pentru diagnostic, având indicații în diferite malformaţii congenitale asociate gestației multifetale, în naşterea prematură, moartea fetală intrauterină, anomalii de creştere intrauterină, sindromul transfuzor-transfuzat, sindromul de perfuzie arterială inversă și mai ales în cazul gemenilor conjuncţi. Imagistica prin rezonanţă magnetică fetală este o metodă complementară imagistică pentru evaluarea sarcinii, ecografia fiind modalitatea de screening pentru evaluarea anomaliilor fetale. [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.)

The paper aims at analyzing the histopathological modifications induced by the amniotic infection on present fetal membranes and in the absence of clinical signs of chorioamnionitis. Such an evaluation is important in the context of postpartum fetomaternal complications. The objective was to determine the relation between the microbial invasion in the amniotic cavity and the severity of inflammatory lesions of the placenta, of the membranes and the umbilical chord.