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Copyright of Obstetrică şi Ginecologie 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 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 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.)

Classically fetal heart evaluation is mandatory in the second trimester of pregnancy. Recent data suggest that the diagnosis of congenital heart disease is feasible in the first trimester (FT) of pregnancy, especially for trained examiners. In this pictorial essay we aim to illustrate in detail the particularity of the FT heart evaluation: the specific ultrasound techniques including practical tips for the basic and extended first trimester fetal heart evaluation protocol. The diagnosis is possible by the use of a variety of ultrasound techniques (B mode, CFM, Bidirectional Doppler, STIC, TUI) using the transabdominal/transvaginal probes. An abnormal FT heart scan requires second trimester reassessment. Unfortunately, not all cardiac disease can be potentially diagnosed in the first trimester. Based on their own experience the authors recommend that heart examination in the FT should be attempted in all fetuses, even in low risk pregnancies, using at least the basic Doppler examination protocol. [ABSTRACT FROM AUTHOR]

Copyright of Obstetrică şi Ginecologie 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 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.)

Uterine adenomyosis, characterized by the ectopic presence of endometrial tissue in the myometrium, has a significant impact on the quality of life of reproductive aged women. Therefore, its prompt diagnosis is essential for symptom relief, but it is often established histologically, after hysterectomy. Noninvasive diagnostic methods have started to gain ground recently, but research is still ongoing. Transvaginal ultrasound (TVUS) has proven itself an essential diagnostic tool, but is less accurate than magnetic resonance imaging in differentiating adenomyosis from uterine leiomyoma. In order to increase the accuracy of the method, the combined use of TVUS and elastography has been attempted, with strain elastography showing promising results. Biomarkers such as interleukin 6, tumour antigens, circulating endometrial cells or microRNAs could represent novel diagnostic tools, but still require further validation in larger-based population studies. Conclusions. The diagnosis of adenomyosis is still challenging, with novel imaging and serological methods emerging as future potential noninvasive assets. Further research is necessary to warrant their diagnostic utility, as well as their capacity of distinguishing adenomyosis from other benign uterine pathologies. [ABSTRACT FROM AUTHOR]

Copyright of Obstetrică şi Ginecologie 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.)

After the first detection of cell-free DNA (cfDNA) in the maternal plasma in the 70s, no one could imagine the tremendous impact of this discovery on the clinical practice. The present article aims at analyzing the actual knowledge about cfDNA from the clinician point of view. In the first part, the origin, kinetics and metabolization of cfDNA are explained. Afterwards, the major applications and limitations of cfDNA are presented. A vast part of the review is dedicated to the different techniques used for trisomy and sex chromosome detection and to their performance. The current international and local guidelines are presented at the end of the article. [ABSTRACT FROM AUTHOR]

This document is an editorial from the journal "Obstetrică și Ginecologie." It discusses various topics related to obstetrics and gynecology that have a direct impact on daily activities and patient health. The article highlights the repercussions of maternal obesity on pregnancy, the fetus, and the newborn, emphasizing the importance of addressing this transgenerational impact through active preconception and prenatal interventions. The editorial also mentions advancements in fundamental research that have led to personalized treatment approaches for endometrial cancer based on molecular characteristics. Additionally, it discusses the management of uterine fibroids during pregnancy and the dynamic field of urogynecology. The editorial concludes by inviting readers to share their opinions on optimizing the legislative framework for medical practice and malpractice insurance coverage. [Extracted from the article]

Background: Bioresonance therapy is a holistic physical method used in the treatment of various diseases. Aim of the study: The aim of the present paper was to evaluate the effect of bioresonance therapy in patients with recurrent major depressive disorder and with mild or moderate depressive episodes, respectively, without any other pharmacological, psychological, or other type of treatment. Methods: We selected 40 patients diagnosed with recurrent depressive disorder and bioresonance therapy as the only treatment. Assessment of the level of depression was achieved by measuring the biorhythm with the bioresonance device and by applying the Hamilton Depression Inventory questionnaire, with 17 items, at the beginning and the end of five weeks of treatment. Results: We identified a statistically significant decrease in depression levels as quantified by the HAM-D 17 scale, between the initial and final phase of therapy (p = 0.0001). Conclusions: Our results suggest that bioresonance therapy can decrease the level of depression in patients with recurrent depressive disorder, with mild and moderate depressive episodes.

Obese pregnant patients (BMI>30) raise particular problems to the obstetrician. The existence of uncontrolled diabetes before pregnancy increases the risk of developing congenital anomalies. Ultrasound examination in the first trimester by transabdominal route is possible and the pregnancy can be confirmed, but the use of the transvaginal probe is an opportunity for morphological ultrasound of the first trimester being extremely important, often the examination allowing the confirmation of anatomical details that are difficult to visualize later at the second-trimester morphological ultrasound. Serum screening tests has a low performance in this category of patients. Conducting invasive tests (biopsy of chorionic villi, amniocentesis) raises additional technical problems. In addition, noninvasive NIPT tests are performing worse in this category of patients, with the amount of free DNA being low. In conclusion, despite the technical progress made, obese patients still pose a challenge for the gynecologist. [ABSTRACT FROM AUTHOR]

Introduction. The postnatal period is for a woman a time of great vulnerability to become mentally unwell, and postpartum mood disorders are likely exacerbated by the COVID-19 pandemic. This retrospective study aims to understand the impact of social support on mental health of patients who gave birth during the COVID-19 pandemic. Method. The participants were 163 women (19-40 years old) recruited from hospital to complete an online survey between May and July 2021.We assessed depression, anxiety and perceived stress using validated questionnaires. Social support was assessed in relation to mental health. Results. Linear regression analysis identified that social support has been a small predictor, explaining 10% of the variation (β=-32, ρ<00.1) in postnatal depression scores, 19% of the variation in anxiety scores (β=-44, ρ<00.1), and 5% of the variation in perceived stress scores (β=-234, ρ<00.3). Conclusions. This study shows that social support had a small impact on the mental health of the patients who gave birth during the COVID-19 pandemic. Contrary to expectation, social support was found not to be a significant predictor of postnatal depression, anxiety and perceived stress. [ABSTRACT FROM AUTHOR]

Introduction. Neonatal asphyxia is one of the main causes of mortality in the neonatal period. The diagnosis and classification of perinatal asphyxia and hypoxicischemic encephalopathy are not consistant: cord-pH, Apgar score (SA), BE (basic excees), lactate, neurological evaluation like clinical neurological scores, an EEG/ EEG early neuroimaging mostly used for diagnosis: Sarnat-Score (+EEG) + neurological exam. There is no consens about which are the best diagnostic approaches and predictors for later neurodevelopmental outcome: Apgar, clinical neurological examination, blood values (pH, BE, LDH, lactate, troponin, S-100, NSE), EEG/EEG, cerebral ultrasound, Doppler, MRI (Magnetic Resonance Imaging), NIRS (Near-InfraRed Spectroscopy)? Neonatal encephalopathy is a condition characterized by brain malfunction, occurring in association with deficient oxygenation. The surveillance and management of these newborns remain among the greatest challenges for the neonatologist. Objective. The authors tried to evaluate the relationship between the trend of serum biomarkers and neuroimaging findings in newborns with neonatal asphyxia. Methodology. The study group included 23 term neonates with perinatal asphyxia exposed to therapeutic hypothermia in a third-level neonatal care unit in Cluj-Napoca, Romania. We performed head ultrasonography on the first, third and tenth days of life. MRI is done on the tenth day of life. We quantified the severity of cerebral lesions on MRI using the injury scoring system proposed by Trivedi et al., in five regions of the brain. We evaluated the dynamics of: Astrup parameters, LDH (lactate dehydrogenase), renal function, TGO, TGP (transaminases). All newborns were monitored continuously using NIRS. All patients had the informed consent signed. All data were analyzed with the SPSS programme. Results. The group had a gestational age of 39.22±1.77 weeks of gestation and weighted 3,292.61±504.77 g. The values of Apgar score (SA) improved significantly from 2.48 to 5.47 at 10 minutes (p<0.000). There seems to be a significant negative correlation between the SA at 1, 5, 10 minutes with the Sarnat stage and the severity of lesions on MRI, the SA at 1 minute having the highest correlation (r=0.731). Lactate value positively correlated with Sarnat stage on the first day. On the second and third days, we found a correlation between lactate value and the intensity of cerebral lesion found on MRI (r=0.616 and r=0.620). On the fourth day, the value of lactate significantly correlated with the IR from the head ultrasound in addition to MRI findings and Sarnat stage. The intensity of cerebral lesions also correlated with LDH, CK-MB, creatinine, TGO, and TGP in the three days of life. rSO2 was correlated with Sarnat stage on the first and second days of life (r=0.495 and r=0.518). Conclusions. Our study confirms the SA and pH value on the first day of life as predictors of cerebral lesions. LDH, CK-MB, creatinine, TGO and TGP values on the first and third days could qualify as predictors for the intensity of cerebral lesions in the newborn with neonatal asphyxia. No markers analyzed can be used as predictors for death. [ABSTRACT FROM AUTHOR]

Fetal ovarian cysts represent the most frequent abdominal pathology diagnosed in utero, especially in the third trimester of pregnancy. The cysts based on their ultrasound appearance are considered simple if they are unilocular with a thin wall and a diameter inferior to 2 cm. The complex cyst is multilocular and it can have thick walls, multiple septae, a heterogeneous aspect and usually a diameter superior to 2 cm. Fetal MRI can be useful for the diagnosis of complex cysts, but is more important for excluding other cystic intrauterine pathology. The intrauterine management is individualized based on the ultrasonographic appearance and the gestational age. The follow-up is the rule for the unilocular simple cysts. The management of the complex cysts is delicate, the most important factor being the gestational age. Some authors propose the intrauterine aspiration for all fetal ovarian cysts in order to prevent the most frequent complications, torsion or rupture. The vaginal delivery is possible in the absence of other obstetrical indications for caesarean delivery, except for large compressive ovarian cysts. The ultrasound is mandatory postanatally; some cysts may resorb spontaneously, but in particular situation surgery is required immediately or later in the early neonatal period. In the second part, we aim to present some cases from our service - First Clinic of Obstetrics and Gynecology, Cluj-Napoca - and their prenatal and postnatal management [ABSTRACT FROM AUTHOR]

The authors present their experience in ultrasound patterns of primary and recurrent endometrioma and correspondence with histopathological results, using 2D and color Doppler ultrasound examination. Cases of primary and recurrent endometriomas, as well as other false positive diagnosis are presented. The presence of the peripheral, healthy ovarian tissue, is the principal difference between the primary endometrioma and their recurrence. The arousal of papillary projections or solid-type echostructure decreases the likelihood of an endometrioma without histological atypia. Postmenopause modifies the ultrasound features of endometrioma by decreasing homogeneity and echogenicity. [ABSTRACT FROM AUTHOR]

Evaluarea complexă a stării embrio-fetale în protocoalele actuale a fost deplasată către vârste tot mai mici ale sarcinii. Acest fapt este datorat progreselor tehnologice în imagistică, progreselor în tehnicile genetice și progreselor în embriologie. Scopul acestor evaluări este de a cunoaște cât mai precoce calitatea embrionului și de a declanșa rapid secvențele de diagnostic dacă se identifică anomalii. Deoarece 80-90% dintre malformații apar în absența oricărui factor de risc al părinților, unica metodă de screening este examinarea ecografică. Ecografia de la 11-14 săptămâni permite analiza morfologiei fetale precoce, depistarea sindroamelor polimalformative, screeningul pentru aneuploidii și screeningul unor patologii obstetricale (nașterea prematură, preeclampsia, IUGR). Limitele acestei ecografii decurg din dezvoltarea unor structuri fetale după 16-20 de săptămâni, din faptul că este operator dependentă și deoarece există patologii malformative evolutive, cu apariție in trimestrul II tardiv și III (cardiace, cerebrale și renale). [ABSTRACT FROM AUTHOR]

Uterine leiomyomas are common benign uterine tumors but by contrast, their acute complications are very rare. We present an unusual case of 38-year-old woman that came to the emergency department with acute abdominal pain. The ultrasound revealed hemoperitoneum, a uterus with two intramural fibroids and a tender inhomogeneous pelvic mass that seems to connect with the uterus. Computer tomographic (CT) examination raised the suspicion of a degenerated fibroid and hemoperitoneum. Emergency laparotomy was performed: the hemoperitoneum was determined by a degenerated fundal subserosalfibroid. Myomectomy was subsequently carried out. Even though this condition is extremely rare, every clinician has to bear in mind that acute fibroid complications can be a potential cause of acute abdominal pain that requires immediate surgery. The imagistic tools, ultrasound and CT are extremely helpful for the diagnosis.Due to its relative rarity in the second part of the article we have performed a review of the existing literature regarding the acute complications of fibroid torsion. [ABSTRACT FROM AUTHOR]

Hepatic steatosis is a condition frequently encountered in clinical practice, with potential progression towards chirrhosis and hepatocellular carcinoma. Ultrasonography (US) is one of the noninvasive imaging techniques used in the diagnosis of steatosis. We will review the US diagnostic criteria, the US performance in the diagnosis and grading of hepatic steatosis, the US steatosis models, but also its limitations in the diagnosis of steatosis. In addition, we will discuss 2 modern methods of assessing hepatic steatosis using ultrasounds, namely the computerized processing of data forming the US image and the controlled attenuation parameter measured with unidimensional transient elastography. [ABSTRACT FROM AUTHOR]

Breast cancer diagnosed during pregnancy is at increasing incidence due to the increased frequency of obesity, the postponement of the first pregnancy to later decades of life and the advances of diagnostic techniques. Clinical and imaging diagnosis is difficult during gestation due to adaptive changes of the maternal organism , the mammary glads in particular. Furthermore, the therapeutic approach is limited both by the possible side effects on the fetus and by the skepticism of the couple over these therapeutic regimens.The present paper aims to review the main diagnostic steps to confirm pregnancy associated breast cancer, as well as the therapeutic possibilities during this period, related to the potential adverse effects concerning pregnancy. [ABSTRACT FROM AUTHOR]

Aim: To asses the cardiac morphology and functional changes specific for newborns from intrauterine growth restriction (IUGR) pregnancies.Material and Method: A cohort of IUGR infants were evaluated by serial echocardiographies at delivery and at the first and six months follow-ups. IUGR newborn delivery status was compared to that of newborns in the control group according to gestational age (AGA).Results: Left heart measurements were significantly lower in IUGR newborns compared to AGA babies. Left ventricular size increased at follow-up inthe IUGR group (p<0.05). Systolic dysfunction (the myocardial performance index (MPI)> 0.47) was identified in 40% of the neonates in the IUGR group (16/40), respectively 4.76% in the control group. IUGR neonates had a significantly increased proportion of systolic malfunction (p=0.004).Conclusion:  IUGR patients had reduced left ventricle dimensions compared to AGA babies. The MPI stands out as a marker of leftheart function in newborns. Systolic dysfunction was a hallmark of the cardiac adaptation in IUGR neonates. [ABSTRACT FROM AUTHOR]

Krukenberg's tumor diagnosed in pregnancy is an uncommon situation that raises both diagnosis and medical management issues. We performed a review of the existing literature regarding this pathology, diagnostic means and therapeutic approaches, motivated by a case in our own practice. A 35-year-old primigravida was diagnosed with an adnexal mass during the first trimester prenatal ultrasound. Ultrasound revealed a 10 cm right adnexal mass with multiple septae, richly vascularized, whose presence and characteristics were confirmed by magnetic resonance imaging. Due to the progressively increasing tumor size, laparoscopy was performed with right adnexectomy and peritoneal biopsies. Histopathology diagnosed a metastatic ovarian tumor from a mucinous colorectal adenocarcinoma. After delivery the patient was further investigated and diagnosed with sigmoid cancer. Even though ovarian cancer in pregnancy is rare, adnexal ultrasound is mandatory when scanning during the first trimester to rule out the presence of associated fallopian or ovarian masses.