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This research illustrates a complex, observational, longitudinal, comparative and noninterventional biometric study on the evaluation, in dynamics, of stature-weight development, in children with Down syndrome (DS), compared to children with varying degrees of mental retardation (MR), by repeatedly determining their height and weight, as well as by correlating these two parameters, in order to highlight the harmonious or disharmonious aspect of their stature-weight development. For this purpose, from patients’ medical files, we extracted the data regarding the periodic, annual, height and weight determinations of 50 preschoolers and schoolchildren, institutionalized in two Special Schools in Bucharest, which we compared with the standard tables used for Romanian population. The results showed that all children with DS show a disharmonious stature-weight development, with excess weight, as a consequence of both chromosomal trisomy and associated congenital malformations, especially heart malformations. In children with MR, the results showed a great phenotypic variability in terms of their stature-weight development. Thus, there were several cases in which the stature-weight development was harmonious, but, in the vast majority of cases, the results showed the presence of harmonious stature-weight development periods, which alternate with disharmonious stature-weight development periods, with weight surplus or weight deficit, alternation, which can be explained both by the involvement of genetic factors, and especially by the involvement of environmental, exogenous or endogenous factors.

Endometriosis is a disease very common nowadays affecting 1-2% of the female population, by estrogen-dependent mechanism. The identification of mutations in the gene encoding for the FSH receptor (FSHR) has been reported since 1995. Physiology teaches us that follicle-stimulating hormone (FSH) is a hormone that is vital in the steroidogenesis regulation mechanisms, while FSH receptor (FSHR) activation helps to promote folliculogenesis and estrogensynthesis. Therefore, studies to show if there are any correlations between endometriosis and FSHR are acquired. Genotyping of FSHR gene polymorphisms were performed using PCR - Restriction Fragment Length Polymorphism (PCR-RFLP) analysis. We analysed a total of 78 patients, 44 infertile patients with endometriosis and 34 controls (non-infertile, pregnant patients). The endometriosis group included women with diagnosis of endo-metriosis confirmed by laparoscopy and /or laparotomy and histological evidence of disease with the endometriosis staging according to American Society for Reproductive Medicine (ASRM). Corroborated with the severity of endometriosis, A919G and A2039G tests found that 71.4% of the M (GG) results were associated with primary infertility, not statistically significant (p=0.994) and 42.9% of the total M results had moderate or severe forms of endometriosis (p = 0.185). The genetic involvement in different pathologies such as endometriosis, has yet to be understood, but knowing more about its mechanism, will help physician target the disease at a more profound level.

Background There is no clear consensus on the management of caesarean scar pregnancy (CSP), a complex and life-threatening condition. The objective of this study was to present a novel approach to management of CSP that combines medical therapy of multidose methotrexate and mifepristone with active surgical management by uterine curettage and consecutive local haemostasis. Case presentation We report on a prospective case series of six women with first trimester pregnancy, in whom the diagnosis of CSP was confirmed by 2D and color Doppler transvaginal ultrasound and serial hormone chorionic gonadotropin (hCG) testing. Women were between 23 and 36 years old and had at least one previous delivery by caesarean. At admission, gestational age ranged between 6 to 14 weeks, and serum hCG levels between 397 and 23,000 mUI/ml. Upon decision of pregnancy termination, medical management was undertaken in all cases and 1 mg/kg systemic Methotrexate was administered between 1 and 5 daily doses. Mifepristone was part of the treatment in cases with live pregnancy. Surgical management was employed for the cases were an embryo was seen by ultrasound, being prompted by inadequate response to Methotrexate and/or signs of miscarriage with vaginal bleeding. Curettage combined with local isthmic balloon or vaginal pack tamponade prevented further complications. High treatment rates with preservation of fertility was achieved in all patients except one who underwent hysterectomy for invasive placentation. Ultrasound and hCG levels surveillance ensured that the resolution of pregnancy was achieved. Conclusion Women with history of delivery by caesarean section should be carefully monitored in future pregnancies for prompt diagnosis of CSP. Early diagnosis of CSP allows selection of successful conservative therapy. Through this case series we contribute with our experience to the body of knowledge about the management of this serious complication of early pregnancy.

Objectives The purpose of this study was to evaluate the association between the follicle-stimulating hormone (FSH) receptor (c.-29G>A) and FSH beta chain (c.-280G>T) polymorphisms and endometriosis in Romanian women. Material and methods We performed the polymorphic analysis of the FSH receptor gene and FSH beta chain in 44 patients with endometriosis and 34 controls. Genomic DNA was obtained from peripheral blood and polymorphisms were investigated using restriction fragment length polymorphism analysis (RFLP). Results There were no significant differences in genotype frequencies of FSH receptor gene between endometriosis patients and controls. For the heterozygous type of the FSH receptor polymorphism (c.-29G>A) we did not find a significant difference in its frequency between patients with minimal/mild and moderate/severe endometriosis (p = 0.136). Also, the FSH beta chain (c.-280G> T) polymorphism frequency was not significantly associated with the severity of endometriosis (p = 0.966). Conclusions FSH receptor and FSH beta chain polymorphisms do not seem to influence the severity of endometriosis, but they could be correlated with female infertility (primary or secondary), therefore further studies are required to debate this topic.

Human immunodeficiency virus (HIV) is an RNA (ribonucleic acid) virus that causes acquired immunodeficiency syndrome (AIDS). This disease has a major socioeconomical impact. The aim of the present study was to assess the fetal heart structure and function in HIV-positive pregnant women on highly active antiretroviral therapy (HAART). This is a prospective study conducted between January, 2018 and December, 2019. The hearts of fetuses from 14 HIV-positive pregnant women on HAART were assessed. Statistically significant sex-related cardiac changes in HIV-exposed uninfected fetuses of pregnant women on HAART were found. A narrow aorta was detected in female fetuses and a smaller left ventricular transverse diameter in male fetuses. Overall, the myocardial performance index remained unaltered. The impact of antiretroviral therapy on fetal heart seems to be sex-related. Accurate and complete information about the risks and benefits of antiretroviral treatment and management strategies to improve fetal outcomes may also ensure better compliance of the mothers to this treatment.

Association between phenotype and follicle-stimulating hormone (FSH) receptor and FSH beta chain genotype was evaluated in women with ovarian dysfunction. FSH receptor gene single nucleotide polymorphisms (SNPs) were analyzed by restricted fragment length polymorphism (RFLP) technique. Three groups were analyzed: two groups formed of poor responders (women with ovarian dysfunctions caused by endometriosis and patients who underwent ovarian stimulation protocols) and a third good responders group (normal-ovulatory women who gave birth to naturally conceived children). A higher average level of basal FSH values were found in mutants in the A919G/Ala307Thr/rs6165 or A2039G/Asn680Ser/rs6166 tests (7.16±1.09; P=0.659). Anti-mullerian hormone (AMH) below 1.2 ng/ml was associated with a higher frequency of mutations: 33.3% A919G/Ala307Thr and A2039G/Asn680Ser (P=0.137) and also in 66.6% FSH receptor less frequent polymorphism (c.-29G>A) rs 1394205 (P=0.522). The age, day 3 FSH, and AMH levels are widely used to investigate female infertility. However, we have not yet found the ideal biomarker to determine the best outcome and treatment plan for our patients. We cconsider that genetic markers will become the future in the personalization of controlled ovarian stimulation treatment in the upcoming period.

Endometriosis, one of the most common gynecologic pathologies, is defined as an inflammatory, estrogen-dependent disease characterized by the growth of endometrial stroma and glands outside the uterine cavity. It is a multifactorial disease, conditioned by genetic and immune factors and triggered by hormonal and environmental factors. Estrogen receptors (ER) and progesterone receptors (PR) expression is significantly modified in endometriotic tissue, compared to normal endometrium. We performed a prospective study that included 16 patients with endometriosis: 9 patients that underwent progesterone treatment with 0.075 mg desogestrel, daily for 24 weeks prior to the surgical procedure, and 7 patients that did not follow any kind of treatment. The purpose of the study was to evaluate the changes that occurred in the expression of ER, PR, B-cell lymphoma 2 (Bcl-2) and Ki-67 from the endometriotic tissue. Oral 0.075 mg desogestrel administration proved its benefits in the management of endometriomas.

Progesterone is a steroid hormone synthetized from pregnenolone, a derivate of cholesterol, produced by the yellow body of the ovary and by the placenta during pregnancy. It is crucial for the evolution of the pregnancy, from preconception until delivery. It prepares the endometrium for implantation, supresses the immune response, inhibits the myometrium�s contractility and it can also make the myometrium sensitive to the action of beta-mimetic tocolytics. The vaginal administration of progesterone in various doses has proved effective in preventing premature birth in pregnant women with short cervix � 25mm during transvaginal ultrasound exam.

Objectives The objective of this study was to assess the impact of endometriosis on the quality of life. Patients and methods Study group of 205 women, aged between 18-45 years old, hospitalized in the "Cuza-Voda" Hospital of Iasi, between 2013-2015. We used the Fertility Problem Inventory, the Endometriosis Health Profile and the Beck Depression Inventory. Results We first realized a descriptive analyses of patients' health related quality of life - 60% of women reported higher infertility distress associated with relationship issues caused by difficulties to conceive. The descriptive analysis over the quality of life in patients with endometriosis suggests that the high level of stress related factors, are: the loss over the control of the symptoms, dyspareunia and altered emotional status. Regarding the sexual aspect of life, almost a quarter of the women complained about an altered sexual status, due to both fear of failing in conceiving and dyspareunia caused by the endometriosis. The descriptive analysis over the infertility related stress suggests that the factors associated with a high level of stress are: sadness, pessimism, feeling of failure, irritability, lack of confidence, self-hatred and fatigue. Conclusions Patients with endometriosis are dealing daily with a large spectrum of symptoms, including pain, dyspareunia, emotional instability and high levels of stress, which have a negative impact upon the quality of life, by lowering it on different levels. Also, within the present study we showed a significant presence of high infertility stress in patients of all ages that lead to depression and social anxiety.

STUDY QUESTIONWhat is good practice in ultrasound (US), and more specifically during the different stages of transvaginal oocyte retrieval, based on evidence in the literature and expert opinion on US practice in ART?SUMMARY ANSWERThis document provides good practice recommendations covering technical aspects of US-guided transvaginal oocyte retrieval (oocyte pick up: OPU) formulated by a group of experts after considering the published data, and including the preparatory stage of OPU, the actual procedure and post-procedure care.WHAT IS KNOWN ALREADYUS-guided transvaginal OPU is a widely performed procedure, but standards for best practice are not available.STUDY DESIGN, SIZE, DURATIONA working group (WG) collaborated on writing recommendations on the practical aspects of transvaginal OPU. A literature search for evidence of the key aspects of the procedure was carried out. Selected papers (n = 190) relevant to the topic were analyzed by the WG.PARTICIPANTS/MATERIALS, SETTING, METHODSThe WG members considered the following key points in the papers: whether US practice standards were explained; to what extent the OPU technique was described and whether complications or incidents and how to prevent such events were reported. In the end, only 108 papers could be used to support the recommendations in this document, which focused on transvaginal OPU. Laparoscopic OPU, transabdominal OPU and OPU for IVM were outside the scope of the study.MAIN RESULTS AND THE ROLE OF CHANCEThere was a scarcity of studies on the actual procedural OPU technique. The document presents general recommendations for transvaginal OPU, and specific recommendations for its different stages, including prior to, during and after the procedure. Most evidence focussed on comparing different equipment (needles) and on complications and risks, including the risk of infection. For these topics, the recommendations were largely based on the results of the studies. Recommendations are provided on equipment and materials, possible risks and complications, audit and training. One of the major research gaps was training and competence. This paper has also outlined a list of research priorities (including clarification on the value or full blood count, antibiotic prophylaxis and flushing, and the need for training and proficiency).LIMITATIONS, REASONS FOR CAUTIONThe recommendations of this paper were mostly based on clinical expertise, as at present, only a few clinical trials have focused on the oocyte retrieval techniques, and almost all available data are observational. In addition, studies focusing on OPU were heterogeneous with significant difference in techniques used, which made drafting conclusions and recommendations based on these studies even more challenging.WIDER IMPLICATIONS OF THE FINDINGSThese recommendations complement previous guidelines on the management of good laboratory practice in ART. Some useful troubleshooting/checklist recommendations are given for easy implementation in clinical practice. These recommendations aim to contribute to the standardization of a rather common procedure that is still performed with great heterogeneity.STUDY FUNDING/COMPETING INTEREST(S)The meetings of the WG were funded by ESHRE. The other authors declare that they have no conflict of interest.TRIAL REGISTRATION NUMBERNA.ESHRE Pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.

Endometriosis is a multifactorial disease that is manifested by infertility and pelvic pain. The purpose of the study was to evaluate the effect of progesterone treatment on the serum level of osteopontin, a multipotent cytokine, in patients with endometriosis. The study was prospective and we evaluated osteopontin levels that were measured in the serum of 40 patients with endometriosis and 12 healthy women using a standardized Enzyme-Linked Immunosorbent Assay (ELISA) kit. Osteopontin seric levels were lower in endometriosis patients and increased after progesterone treatment. Because of the large dispersion of data even in the control group, we find the association between osteopontin and endometriosis questionable.

Iniencephaly is a rare neural tube defect, characterized by the classical triad of extreme retroflexion of the head, occipital bone defect and variable rachischisis. Its etiology is not fully understood: it might arise due to anomalies of genes controlling the planar cell polarity pathway, affecting the dorso-ventral orientation of the body axis. Risk factors include low socio-economic status and lack of folic acid supplementation. In up to 90% of cases involves female gender. We report a case diagnosed prenatally at 13 weeks by ultrasonography. It was characterized by abnormal shape of the fetus, with no distinct separation between the head and the body, extreme retroflexion of the fetal head, significant shortening of the spine, hypotelorism and holoprosencephaly. Three-dimensional (3D) ultrasound reconstruction evidenced the occiput absence and the same marked retroflexion with lordotic cervical spine, but with clear, distinct, un-fussed vertebrae. The parents opted to have an elective termination of pregnancy. Pathological examination confirmed the diagnosis, showing a perfect correlation with the ultrasound findings. The anomaly is incompatible with life, and early antenatal ultrasound diagnosis is advisable. Suggestive 3D images were helpful for illustrating these issues to the parents during prenatal counseling.

Congenital high airway obstruction syndrome (CHAOS) is a rare disorder defined as any fetal abnormality that obstructs the larynx or trachea. Most cases are sporadic with an unknown incidence. We report a case that was diagnosed prenatally at 21 gestational weeks, which showed a typical CHAOS pattern with expanded hyperechogenic lungs, inverted diaphragms, dilated trachea and ascites. There were no other fetal abnormalities and the karyotype was normal (46xy). The parents opted to have an elective termination of pregnancy. Pathological examination confirmed the diagnosis, showing infraglottic atresia (type II) and complete trachea obstruction. The disease is incompatible with life, and antenatal ultrasound diagnosis is advisable. However, few cases have been reported which managed with neonatal interventions such as ex-utero intrapartum treatment.

Preeclampsia is an obstetric complication that is characterized through hypertension and proteinuria which appear after week 20 of pregnancy, more frequent in the last week before labour. The pregnancy can induce or worsen hypertension; the increase in systolic blood pressure with 30 mmHg and/or the diastolic blood pressure with 15 mmHg represents a risk factor in preeclampsia. The prediction of preeclampsia has a prognostic of over 75% if the data is correlated with the pulsatility index obtained by uterine artery Doppler procedure and is also correlated with the cranio-caudal length of the fetus.

Purpose. The study aims to investigate whether an early diagnostic of pre-eclampsia can be established by evaluating the sensitivity and specificity of sFLT-1 and PlGF biomarkers. Material and method. The assessment of the ratio sFLT-1/PlGF, in correlation with the risk factors shown in routine medical practice, was performed by doing a prospective case control study on a group of 30 pregnant women, 15 of them having high blood pressure with suspicion of pre-eclampsia and the other 15 normal pregnant women, all monitored in the period of time January-May 2013 in the Ambulatory center from “Cuza Vodă” Hospital Iaşi. Results and discussions. The ratio sFLT-1/PlGF was significantly higher for the group of pregnant women with HTA (24,74 vs 124,38) (p=0,030). The cumulation of risk factors: age, mean blood pressure, LDH, GOT/AST, INR , IQ and CRP correlates in a significant way with the sFLT-1/PlGF ratio. It should be noted that sFlt-1/PlGF ratio is the best predictor, but also sFlt-1 is a good predictor of preeclampsia, with an accuracy of 72,3% and 61,6% respectively in comparison with the accuracy of PlGF 30,8%. Conclusions. The values of the ratio are significantly higher for women chronic hypertension or gestational hypertension in comparison with the control group. This fact demonstrates that the ratio sFlt-1/ PlGF is a valuable instrument for differentiating the patients with pre-eclampsia from the ones with other hypertensive conditions that appear in pregnancy. Besides, the study showed that, for the patients diagnosed with pre-eclampsia, the value of the ratio could constitute and element of prognostic regarding the imminent birth. This thing is important especially before week 34 of pregnancy because an early detection of the women with imminent birth risk is essential for reducing perinatal morbidity and mortality.

To support through personal experience the use on a large scale of the modern techniques of correction of the pelvic floor disorders by using polypropylene prosthetic devices. Objectives: To specify the technical details regarding the correct placement of prostheses in feminine genital prolapse. Show the personal casuistry in order to highlight the indications techniques and results of these types of surgeries. Plead for expending the modern techniques in pelvic-perineal floor dysfunctions. Material and Methods: The study was performed between July 2007 and July 2013, in the second surgical Clinic St.Spiridon Hospital Iasi, on 138 cases with different pelvic floor dysfunctions. Different procedures were practiced, isolated or associated, on the patients in the lot, depending on symptoms, the prolapse type and degree, age, local anatomical situation and the existence or absence of sexual life. Thus they were performed: strip urethrocystopexy or “hammock” device, with four arms transobturator - 68 cases; The sacrosciatic posterior colposuspension or the anal levator floor restoration–29 cases; abdominal colpopexy in 41 cases, 18 of which with hysterectomy or resection of residual cervix. In 5 cases a polypropylene mesh implant has been associated with this procedure at anal levator level; and in 11 cases the doctors used a suburethral transobturator vaginal strip for stress urinary incontinence (SUI). The abdominal approach allows the correct path of skeletonization of the internal genitalia and also of the vagina which is turned inside-out like a glove finger, avoiding damage on the ureters and bladder. The vaginal vault is secured to the promontory with a polypropylene device and it ensures the results maintain in time. Results: The treatment of the different pelvic-perineal floor disorders that are associated or not with stress urinary incontinence has benefited lately from new indications and techniques by using different prosthetic devices made of polypropylene, which are especially conceived and placed through minimally invasive procedures. Generally, all the cases had an immediate simple postoperatory evolution with only two haematomas that required surgical evacuation and 3 cases of vaginal mucosa necrosis, one of them requiring the removal of the device implanted. The anatomical and functional results were good. Conclusions: The use of strips, nets and polypropylene devices in correcting different pelvic floor disorders, shows certain advantages, as it is relatively easy tom implement, the hospitalization period is shortened and there are very good results that pass the test of time.

OBJECTIVES The purpose of our study was to assess the factors that may improve the feasibility of routine fetal echocardiography at the time of the first-trimester scan. METHODS In this prospective study, we included 616 healthy singleton fetuses. Examinations were performed transabdominally by a single sonographer at the beginning of his training in first-trimester screening. The fetal heart was examined by high-definition color Doppler imaging to obtain the 4-chamber view, right and left ventricular outflow tracts, and 3-vessel and trachea view. Logistic regression was used to investigate the effect on the ability to visualize different cardiac structures. RESULTS The frequency of successful heart examinations increased significantly with the number of scans performed (P < .05). The sonographer needed 180 examinations before he could successfully examine the heart in at least 80% of cases. Significant factors that increased the probability of adequate echocardiography were the length of the heart examination and the experience of the sonographer (P< .05) but not transducer-heart distance, maternal body mass index, fetal crown-rump length, placenta interposition, or restrictive fetal position. Visualization of the left ventricular outflow tract could be improved by increasing the experience of the sonographer and decreasing the transducer-heart distance. Also, visualization of the 3-vessel and trachea view depended on the length of the heart examination, the experience of the sonographer, an anterior position of the placenta, and a restrictive fetal position. CONCLUSIONS Competence in color flow mapping assessment of the fetal heart at gestational ages of 11 weeks to 13 weeks 6 days is achieved only after extensive supervised training.

Background In Romania, a country with no organized national surveillance program regarding cervical cancer, the early diagnosis of HPV (Human Papilloma Virus) infections is a major requirement, especially in HIV-infected women. The objective of this study was to determine the HPV prevalence and type distribution in young HIV-positive women and to assess the difference in the risk factors for developing cervical cancer compared to those of HIV-negative women. Method We conducted one cross-sectional cohort study from June 2013–September 2014, including 1,032 women: 992 HIV- women who were 36.5 years old (limits: 17 ÷ 84) and 40 HIV + women who were 22.9 years old (limits: 17 ÷ 30) with iatrogenic HIV infected. We detected HPV types with the Linear Array HPV Genotyping test (Roche, Romania). Results DNA/HPV was detected in 18/40 (45%) of the HIV+ patients and in 350/992 (35.2%) of the HIV- patients (OR = 1.5, 95%CI 0.76÷2.96). After age adjustment, the overall HPV prevalence was 51.6% in HIV+ versus 63.2% in HIV- women aged under 25, and 22.2% in HPV+ versus 47.2% in HIV- women aged 25–34. We detect HIV being a risk factor for acquiring multiple HPV type infections (OR = 2.30, 95% CI 0.88÷5.97). The eight most common HPV types (high-risk, and low-risk) for women below age 30, HIV+ / - were: HPV 16, 18, 31, 51, 58, 68, and 6 and 82 respectively. To assess the risk factors of HIV-positive women for acquiring HPV infection, we analyzed the CD4/μL, ARN/HIV copies/μL, the age group, the number of sexual partners, smoking, and the type of HPV infection (single versus multiple infections). We found that the number of sexual partners and smoking are statistically significant risk factors. Conclusion Even though there are no significant differences regarding the prevalence of HPV infection in HIV + versus HIV – patients, multiple infections were more frequent in the first group. In our study group young HIV-infected patients under HAART therapy, high number of sexual partners (more than 3) and smoking were detected to be risk factors. Future organized screening for HPV infection using sensitive and specific methods are necessary at the national level in Romania.

Viral load of high risk HPV types 16 and 18 can be useful biomarkers in detecting women with cervical dysplasia in early stage, prior to development of cervical cancer. Purpose of the study was to assess the clinical utility of viral load determination for HPV 16 and 18 in relation with the severity of cervical dysplasia and the association of classical risk factors. The HPV 16 and 18 positive women were selected from a cohort study, using one HPV DNA test for screening. METHODS: Viral load quantification was performed with Real Time PCR MX3005P. RESULTS: The viral load for HPV 16 was between 3.45 - 7.177 x 106 copies / μl, and 1.138 x 103 to 7.119 x 104 for HPV 18. CONCLUSIONS: Viral load of high risk HPV types seems to be one sensitive and objective biological marker in detecting women at risk for developing cervical cancer. No significant association was fount for the risk factors investigated.

The paper describes a research-development which had the objective to implement and manage the Electronic Patient Record in a multifunctional pilot platform named PROMED. The Electronic Patient Record implemented by PROMED platform is mainly aimed to facilitate both patient and health providers access to the health records and to provide an optimization of diagnostic and decision in healthcare services based on patients' medical history and medical statistics. The project promotes modern information and communication technologies for increasing quality and efficiency of healthcare services in an information based society. The PROMED platform is expected to contribute specifically to the improvement of the healthcare services in Romania by offering a solution for the integration of the main stakeholders involved in national healthcare system: patients, health service providers and public health authorities. The pilot system is first implemented in the "Cuza Voda" Obstetrics and Gynecology Hospital in Iassy, an important universitary and cultural city in the North East of Romania.

We present the ultrasonographic diagnosis at the 19th gestational week in a case of Prune-belly syndrome which consists in abdominal wall distension with deficiency of the abdominal wall musculature, urinary tract abnormalities (specially mega bladder), and in males, cryptorchidism. The pathologic examination found the patient devoid of striated muscles anterior abdominal wall, hypertrophy of the urinary bladder, and urethral atresia. The Prune-belly is accessible to antenatal diagnosis and the variable prognosis does not always justify abortion.

Background Cervical cancer is a major public health problem worldwide. While Romania has the highest incidence of cervical cancer in Europe, the prevalence of HPV has not been evaluated. We report the first data on HPV prevalence and type distribution in Northeast Romania. Methods HPV prevalence and genotype distribution was investigated in 514 consecutively women with or without cervical lesions in Northeast Romania. Genotyping was performed with Linear Array Genotyping/Roche kit. Results In our study group, 192/514 (37.4%) patients were positive for HPV (infected with single and with multiple HPV types). Most frequent types were: 16 (10.5%), 53 (5.44%), 51 (5.05%), 52 (4.08%) 18 (2.91%) and 31 (2.73%). Conclusions Infection with high risk types of HPV is common in Northeast Romania. Enhanced and systematic screening for cervical cancer is needed. Our results call for the implementation of a National HPV vaccine program in Romania.