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Ovarian cancer is the seventh most commonly diagnosed cancer in women, with the highest mortality rate among female genital cancers. Due to the nonspecific symptoms and the lack of effective screening strategies, ovarian cancer is often diagnosed in an advanced stage of the disease, with a 5-year survival rate of 25%. The efforts of specialists are aimed at identifying screening methods, with the lowest possible rates of false positive or false negative results in order to diagnose the disease at an early stage, when the 5-year survival rate is 92%. In this study we analyzed the incidence of ovarian cancer in the last five years in the Bucharest University Emergency Hospital, being registered 153 cases of ovarian cancer. The aim of this paper is to analyze the correlation between the early diagnosis of ovarian cancer and the long-term prognosis.

Vulvar cancer is a rare malignancy of the genital tract, the fourth most common type in this category. The most common form of the clinical appearance is long-lasting pruritus, a lump or mass on the vulva. Despite its histological type, in most cases, invasive vulvar cancer metastasizes primarily through the lymphatic system. Bone metastases related to gynecological cancers are rare, often underdiagnosed, and have a very poor prognosis. The most common site of metastasis in vulvar cancer is the lung, which is affected in about 45%, followed closely by the liver and brain. Bone metastases are present in about 10% to a quarter of cases. The most common places are the spine, pelvic bone, ribs, skull, limb bones and sternum. The only characteristic of the bone microenvironment is its high sensitivity to endocrine status, as vulvar cancer affects postmenopausal women. Thus, the theory of the protective role of estrogen on bone density and bone metastases remains an open door for future protection and treatment strategies.

A successfully implemented screening program for cervical cancer is essential for detecting cervical intraepithelial lesions which offer the possibility of appropriate management and monitoring, implicitly the limitation of the progression to an invasive form of cancer. For different grades of squamous intraepithelial lesions, the use of vaginal tablets or applicators based on various natural substances as hyaluronic acid, beta-glucan and Coriolus Versicolor is possible with the purpose of expectative management or prior and post excisional intervention. We present the incidence trend of abnormal Pap smear results for the last five years in the University Emergency Hospital of Bucharest, with a summary of the literature regarding the biochemical mechanism of the main natural components from vaginal tablets used in the management of precancerous cervical lesions HPV induced and we share our personal experience with three clinical cases that benefited from this therapy. As there is a therapeutic window between the Pap-smear result, colposcopy and preparing for intervention, local treatment with natural components is a suitable choice as it is easy to use, inexpensive and efficient. The conclusion we reached is that the vaginal treatment with natural substances can be useful in terms of improving the local inflammatory process on the one hand and lubricating and regenerating tissues with the improvement of subsequent procedural performance on the other.

The latest decades are characterized by an enormous progression in the field of human genetics. In consequences, for various phenotypic manifestations, genetic testing could identify a specific underlying cause. An estimated incidence for all types of 18q deletions is one in 55 000 births predominant on females. About 94% of cases with 18q deletion syndrome appearance are de novo, and the remaining 6% are the inherited from a parent carrying a balanced chromosomal translocation. We present the case of a 35-year-old female who was admitted in our Unit for a second ultrasound opinion after being diagnosed at the second trimester scan at gestational age of 21 weeks of pregnancy with multiple brain and heart malformations, having the recommendation for fetal magnetic resonance imaging (MRI). Further investigations included genetic analysis and pathological examination. Major malformations diagnosed and confirmed were agenesis of the corpus callosum, ventriculomegaly with dilated fourth ventricle, partial agenesis of vermis, bilateral anophthalmia with wide nasal base and left cleft lip. Additional, cardiac malformation, with an important ventricular septal defect and overriding aorta were noted. The results of the microarray analysis showed an abnormal fetal karyotype with a loss of 30.5 basis identified in the long arm of chromosome 18. Although most of the cases of 18q deletion are sporadically or de novo, could be cases where the possible existing syndromes can be inherited from a healthy or mild affected parent. Therefore, in order to establish the recurrence risk, parental karyotypes are recommended.

Vascular stress at the level of the uterus-placental unit, with chronic placental ischemia, results in intrauterine growth restriction. Expectation management can be used, when the situation allows, in cases of compensated intrauterine growth restriction. The aim of the present study was to evaluate the neonatal prognosis of preterm births with and without growth restriction and term births with growth restriction in order to improve decisional accuracy regarding the termination of pregnancy. The frequency of term birth infants with low birth weight for gestational age was ~2%. The male sex, predominated only in the group of premature infants with normal weight for the gestational age. The highest frequency of neonatal complications studied occurred in the group of preterm neonates small for gestational age (SGA) with statistical significance obtained for cardiovascular arrest acute respiratory failure, ulcer-necrotic enterocolitis, respiratory distress, cerebral edema, intraventricular hemorrhage, cerebral hemorrhage, pulmonary hemorrhage, neonatal infection, hypoglycemia, retinopathy, anemia, hemorrhagic disease, disseminated intravascular coagulation, disease of hyaline membranes, neonatal sepsis, need for intensive neonatal therapy and death. In conclusion, immediate neonatal adaptation of SGA preterm neonates is more deficient than for preterm neonates with appropriate weight for gestational age; the adaptation of preterm neonates, in turn, is more deficient than term newborns with intrauterine growth restriction. The term newborns with intrauterine growth restriction have a neonatal adaptation comparable to that of the term newborns with weight corresponding to the gestational age.

According to World Health Organization (WHO), fetal death is defined as the death of the fetus prior to its complete expulsion, independent of the duration of pregnancy, thus only ascribing the term stillbirth to fetal deaths in the case of pregnancies after 28 weeks of gestation. The great progress of perinatology care is reflected in a significant reduction in the rate of stillbirths, especially in well-developed countries, with approximately 98% of stillbirth cases now occurring in poor and developing countries. Stillbirth powerfully impacts both the patient and the practitioner. Because nearly half of stillbirth cases result from apparently uncomplicated pregnancies, we considered it critical to review the known predictive markers for intrauterine fetal death. In both preterm and term infants, perinatal mortality is increased in fetuses small for their gestational age, and this risk grows proportionally with the severity of the fetal growth restriction. A protracted first stage of labor has not been associated with an increased risk of perinatal mortality and morbidity, but a prolonged second stage of labor has been associated with mortality and neonatal morbidity characterized by sepsis, seizures, and hypoxic-ischemic encephalopathy. Ultrasound examination of the placenta and the umbilical cord is essential for appropriate pregnancy monitoring. Various findings from ultrasound examination have been related to variable adverse perinatal outcomes, including intrauterine fetal death. After reviewing the evidence for predictors of intrauterine fetal death, we offer a general strategy for reducing the likelihood of stillbirths.

Cord blood collection for stem cell storage remains a popular procedure due to the advantages associated to it. In the last ten years, the therapeutic potential of umbilical cord stem cells was demonstrated in the treatment of bone pathologies, neuropsychiatry, metabolic and genetic diseases. There are several factors with direct influence on the quality and quantity of cord blood collection for stem cell storage. The collection principles should be individualized according to the maternal and fetal characteristics. Furthermore, in the context of COVID-19 pandemic, additional information can be obtained through this procedure. We present a specific case-adapted strategy for the collection of umbilical cord blood and its application in analyzing the transplacental transfer of maternal COVID-19 antibodies after vaccination. We suggest that the informed consent offered to the future parents prior to the procedure should include the history of COVID-19 during pregnancy, the vaccination status of the mother and the gestational age at the time when this event occurred.

Placental site trophoblastic tumour (PSTT) is a very rare and unique form of gestational trophoblastic tumour, representing about 1-2% of all gestational trophoblastic tumours. Usually, the pattern is a slow growing nodule implicating the endometrium and myometrium, accompanied by abnormal uterine bleeding. Three ultrasound types of PSTT are described, but thereis no specific characteristic for diagnosis. We present the case of a patient with an atypical placental site trophoblastic tumour diagnosed two months after a caesarean scar pregnancy. In the presented case there are several particularities, such as the rapid growth and progression of the tumour, the limitation to the myometrium and the difficulty of the differential diagnosis and approach.

Pregnancies complicated with preeclampsia associate a high incidence of intrauterine fetal death, intrauterine growth restriction, premature ruptures of membranes, abruption placentae and prematurity. Understanding the pathogenesis of preeclampsia is mandatory for a correct approach and prevention management of high risk cases. Placental hypoperfusion seems to be a key factor in developing systemic resounding. By placental necrosis and apoptosis, cell-free DNA is released in maternal circulation in early pregnancy, respectively prior 17 weeks of gestation. There is no test, useful in early pregnancy, accurate enough to predict preeclampsia. Various screening test have been proposed in order to predict the development of preeclampsia, but most of them are not sufficiently accurate for general screening. There is a continuous debate regarding the algorithm of administration, doses and timing of low dose aspirin. The initiation moment is crucial, as the administration after the development symptoms and signs of preeclampsia do not interfere with the progression and the severity of the disease. Early initiation of therapy with low dose aspirin, prior the end of the first trimester is important since the pathogenesis mechanisms of preeclampsia take place in the first trimester. The action of acetylsalicylic acid consists in inhibition of COX-1 and COX-2 (cyclooxygenase isoenzymes), necessary for prostaglandin biosynthesis. Preferential inhibition of Thromboxane A2 by low dose aspirin, counterbalance the increased production of thromboxanes characteristic to preeclampsia and modulate the inflammatory process, amplified in pregnant women with preeclampsia.

Methods to prevent the development of pathologies due to placental dysfunctions, such as gestational hypertension and preeclampsia, are the main approaches for obtaining the best maternal and fetal antepartum and postpartum prognosis. During 5 years of study (January, 2015 to December, 2019), the cases of pregnancy and puerperium complicated with pathology due to placental dysfunction were analyzed. The main objective was to determine the magnitude of the impact of thrombophilia on the development of an entity of gestational hypertension disorder. We compared the impact of thrombophilia and its associated complications in patients with gestational hypertension with moderate and severe preeclampsia. Thus, we found obesity, thrombophilia, and underlying cardiac pathology to be significant risk factors for severe preeclampsia. Regarding the comparative analysis of the risk factors and complications associated with patients with mild preeclampsia compared with those with severe preeclampsia, the presence in severe preeclampsia of thrombophilia, endocrine, liver, and cardiac pathology was higher and, a higher rate of complications was observed; complications included fetal death, intrauterine growth restriction (IUGR), prematurity, fetal arrhythmia with acute fetal distress, HELLP syndrome, and placental abruption. Thrombophilia has a significant effect on the development of severe preeclampsia, and oligohydramnios as specific complication of mild preeclampsia. Factors indicating an increased risk of progression from mild preeclampsia to severe preeclampsia are in addition to inherited thrombophilia the underlying pathologies, namely cardiac, hepatic, and endocrine factors.

Human T-lymphotropic virus (HTLV) is considered to be the most highly oncogenic existing virus, being the cause of several fatal diseases such as adult T cell leukemia-lymphoma (ATL) and HTLV-I-associated myelopathy (HAM). The main transmission methods are unprotected sexual intercourse, vertical transmission and breastfeeding and direct exposure to infected blood or tissue. The identification of infected mothers prior to delivery is a highly important step in preventing mother to child transmission. Universal antenatal screening for HTLV is not recommended in Romania, although there are sufficient data demonstrating the risk of vertical transmission. We present the case of an HTLV-1-infected pregnant woman, with an aim to highlight: i) points of strategy for the management of HTLV during pregnancy; ii) the particularities of the course of pregnancy; and iii) the aspects that show the importance of knowing the status regarding the HTLV infection antepartum. The case was particular due to the ascendant proviral load during the pregnancy period, which led to the initiation of antiretroviral therapy and the particular pregnancy outcome with preterm rupture of membranes and fetal growth restriction. According to current recommendations, pregnant women infected with HTLV-1 should be advised to refrain from donating blood, body organs, or other tissues. There is no evidence of the number of individuals infected with this virus in Romania at present, and the diagnosis can only occur by chance. A specific treatment or immunization for HTLV infection does not currently exist, thus preventive methods are the only tool to reduce the prevalence and mortality of this infection.

During pregnancy, maternal diet is a modifiable factor that impacts the birth outcome. Since the nutritional needs of a pregnant women vary during preconception, gestational and breastfeeding period, it is necessary to adapt the diet and lifestyle, optimally under the personalized nutrition guidance of a specialist. High quality research regarding diet during pregnancy remains challenging as nutritional concerns also vary according to religion, financial income, age and education of the pregnant woman, as well as specific traditions of each country, limited number of dietitians with special training in maternal nutrition. The obstetrician usually plays a major role in dietary counselling and the use of nutritional monitoring tools can help identify pregnant women who may be at risk due to an inappropriate diet. The age of the pregnant women can be important when it comes to dietary and lifestyle changes. In this context, we addressed a questionnaire to 100 pregnant women in third trimester of pregnancy in order to evaluate a possible correlation between the age and the dietary behavior and lifestyle of a pregnant woman. Furthermore, the maternal compliance with dietary recommendations in pregnancy and the exposure to various risks due to unhealthy nutrition were also analysed in the study.

The prevalence of pathologies due to placental dysfunction superimposed on pregnancy is constantly increasing. The prognosis of the cases complicated by gestational hypertension is usually good, significantly better compared with that of the cases associating preeclampsia. About half of the cases with gestational hypertension will progress to preeclampsia, the risk of decompensation being inversely proportional to the gestational age of the onset of gestational hypertension. The present study, analyzed the cases of pregnancy and postpartum complicated by pathologies related to placental dysfunction, during a period of 5 years. The risk factors analyzed were the presence of infections during pregnancy, diabetes, thrombophilia, pregnancy obtained by in vitro fertilization, abnormal adherence of the placenta, obesity, multiple pregnancy, the presence of an earlier hepatic, endocrine, renal, cardiac or autoimmune pathology, and the existence of an uterine malformation. Obesity appears with a significantly increased incidence in patients with gestational hypertension and middle preeclampsia. Intrauterine growth restriction appears with a significantly increased incidence in patients with mild preeclampsia. Complications such as prematurity, acute fetal distress and abruption of placentae had a significantly increased incidence in patients with severe preeclampsia. Thus, obese patients have a higher risk of moderate preeclampsia, following gestational hypertension and finally severe preeclampsia.

Preeclampsia is and remains an actual subject of obstetrics regarding the associated immediate high risk of morbidity and mortality for both mother and future risk for cardiovascular disease. Many different strategies to prevent preeclampsia have been studied, but none of the reported results presented a widely effectiveness, until now. Possibility of predicting preeclampsia would have a significant impact in decreasing the incidence of cases with tragic outcome related to this condition. For late-onset preeclampsia there is no prediction method at this time, in this context, the suitable approach is the diagnosis as early as possible in order of a better outcome. Low-dose aspirin (LDA) administrated in the first trimester to patients who are at increased risk for pre-eclampsia is the only drug that has proven benefits for reducing the frequency of this condition and associated adverse outcomes. In terms of prophylaxis with low molecular weight heparin in combination with LDA or as a single treatment, results are controversial, additional studies being required. We intend to summarize the latest proposals regarding the measures that can be taken to prevent maternal and fetal complications that may occur as a result of the development of preeclampsia, methods of early diagnosis and characteristics of atypical forms of preeclampsia.

Currently, Romania ranks first in Europe with regard to cervical cancer mortality. A new solution proposed for optimizing cytology-based screening, before seeing the risk associated with minor abnormalities results, is the use of molecular markers. This study concerns atypical squamous of undetermined significance (ASC-US) results, the grey zone of cytology that hides up to 15% high-grade lesions, to see how dual immunocytochemistry (ICC) staining for p16INK4a∕Ki67 help to better identify and manage high-risk (HR) ASC-US patients. We included and reviewed 183 cases with ASC-US results and p16INK4a∕Ki67 double staining (DS) performed in MICOMI Clinic (Bucharest) during 2014-2016. All patients were referred for colposcopy and biopsy if appreciated as necessary and followed-up at six and 12 months. One DS(+)∕HR human papillomavirus (HPV) negative case was positive for HPV73 Group IIB International Agency for Research on Cancer (IARC). The mean age for ASC-US in our study group was 32 years, with a median of 31 years and 31% of patients were aged 25-29 years. The sensibility of p16INK4a∕Ki67 double immunostaining was 100%, the specificity 88%, the positive predictive value (PPV) was 82%, and the negative predictive value (NPV) was 100%. The use of p16INK4a∕Ki67 ICC test optimizes the medical approach towards screening or monitoring especially in ASC-US HR HPV(+) young patients, unnecessary colposcopies are avoided thus invasive gestures at nulliparous are limited.

Financial inclusion has a significant role in increasing the quality of life of citizens, as it represents the model of access to financial products and services in order to meet their development needs in a sustainable and responsible way. In this article, we are aiming to analyse the educational deficiencies of the Republic of Moldova, resulting in low financial inclusion of the population, as well as to provide certain solutions to increase the level of economic education of the population at different stages of the educational process. The opportunity to study this subject refers to the need to implement various solutions in order to ensure an acceptable level of financial inclusion, which primarily involves the participation of educational institutions in the formation of financial skills and financial literacy. In order to study the subject approached in the article, there were used the following research methods: analysis, synthesis, induction, deduction, comparison, etc. The research results include the selection from the literature of the concepts on financial inclusion, financial education and their importance for the economic development, research on this subject based on the analysis of the education system in the Republic of Moldova and the formulation of the most relevant research findings, resulting in recommendations for actions needed to be implemented actions needed to be implemented in the emerging countries, such as the Republic of Moldova in order to increase the level of financial inclusion.

Endometrial cancer is the most common gynecologic malignancy in developed countries, with an average incidence of 14.7/100,000 women and ranks second place after cervical cancer in developing countries, with an average incidence of 5.5/100,000. The global average incidence in 2012 was 8.2/100,000 women, representing 319 605 cases of cancer of the endometrium. The reported incidence in 2012 of cancer of the endometrium for Romania was 8.46/100000 women, within Europe the same year average was 13.6/100,000 women. In Romania, pick the incidence occurs in the age group 60-64 years (42.8/100,000 women), the cumulative risk being 1%. According to World Health Organization predictive estimates for Romania is expected for 2015 an increase in the number of new cases by 2.92% to 10.07% for 2025 and for 2035 with 15.33%, of whom, under the age of 65 years in 2015 will be 990 new cases, in 2025 will be 986 new cases and in 2035 under this age will be 1027 new cases of cancer of the endometrium. The data for the period 2005-2015 was investigated coming from reports of family doctors, the national registry for cancer and (SIUI). Of the total of admissions for diagnosed endometrial cancer, 10% have affected women under 50 years, and 2.78% women under 40 years. Studying the National Registry for Cancer for 2005-2007, regarding new cases reported by district oncology cabinets, an average number of 108 new endometrial cancer cases/year has resulted and respectively 237 new colorectal cancer cases for women under 50. The total number is significant, representing the patients whose genetic testing is essential for defining an important high risk group for familial cancer, a fact that is universally accepted, the screening which is intended for.

Premature rupture of fetal membranes is associated with a substantial fetal morbidity and mortality. Immediate actions that can improve the future neonatal outcome are the administration of antenatal corticosteroid therapy, infection prophylaxis, tocolytic drugs and insurance of an appropriate neonatal nursery level. One of the essential points in the management of these cases is the attempt to extend as much as possible the gestational age, especially in mid trimester premature rupture of membranes and even more considering that the duration of the latency period inversely correlates with gestational age at membrane rupture. We present the case of a patient aged 41 years admitted as obstetric emergency for suspected leakage of clear fluid in context of dichorionic, diamniotic twin pregnancy, 22 weeks of gestation, obtained by in vitro fertilization due to primary infertility. Under continuous tocolytic and antibiotic treatment, the extension of the gestational age of the first fetus with 5 weeks was successfully obtained. The second fetus was born one week later as a result of the abandonment in utero of the placenta. Complications implied by preterm rupture of membranes in twin pregnancies are significantly influenced by the presence of chorioamnionitis and by placentation. We consider that the prognosis of the second fetus, perfectly normal developed during first 5 years, was positive and significantly influenced by the prolonged gestational age with almost one week.

Two main causes of arterial thrombosis are known: fi rst - atherosclerosis, extensively studied, and the second - atrial fi brillation. The lack of any risk factors and the occurrence at young age of a thrombotic event requires us to investigate possible other conditions, including inherited thrombophilia that is represented by a series of genetic disorders that increase the risk of thromboembolic disease. The role of thrombophilia in the occurrence of arterial thrombosis is inconsequential; this disorder is characterized by the tendency of developing venous thrombosis. We present a rare case of a 29 year old woman that presents an arterial thrombotic event subsequent to the caesarean section. The patient had a positive familial history for thrombotic events and a cavernous sinus thrombosis in personal history. Prophylactic treatment with unfractionated heparin throughout pregnancy was applied. At 31 weeks gestation the patient underwent cesarean surgery for nonreassuring fetal status, 2 weeks fetal intrauterine growth restriction and absent diastolic fl ow of uterine arteries. Three days post operatory arterial thrombosis is suspected. The context that led to this suspicion was paresthesia, color modifi cation of the right leg and abolished popliteal pulse. Angiographic-CT confi rmed the presumptive diagnosis. A cardiovascular, conservatory treatment was successfully applied. Considering the particularities of the presented case we discuss the occurrence of arterial thrombosis postpartum in the context of confi rmed thrombophilia by reviewing the specialized literature.

Bone metastasis is a frequent complication of advanced genito-mammary cancer patients. Skeletal involvement is particularly common in breast cancer. Bone metastases induce a wide range of symptoms, lowering the quality of life and shortening survival. The normal bone remodeling process is deeply affected in all types of metastases: osteolytic, osteoblastic, and mixed. The main mechanisms involved in bone metastatic dissemination are the expression of adhesion tumor molecules and corresponding receptors within bone marrow and bone matrix cells; local growth factors, molecular mechanisms of remodeling the hematopoietic stem cell activity, and alteration of the expression of the post-transcriptional regulatory microRNAs of the gene expression are the new theories developed from recent studies. Abnormalities in the number of copies of the 16q23 gene explain the increased risk of bone metastasis of breast cancer compared to its dissemination to the other organs; the mutual interaction between tumor cells and the bone microenvironment constitutes the element that stimulates both bone destruction and tumor development. Endothelin -1, bone morphogenic proteins, platelet-derived growth factor, Wnt proteins stimulate proliferation and osteoblastic activity. Genomic and proteomic studies underlie the development of new therapeutic agents for the treatment and prevention of bone metastases.

Rationale: Primary myelofibrosis is encountered with the myeloproliferative diseases and is the least prevalent among women of childbearing age. The prognosis is guided by pancytopenia, leukemic transformation and thrombosis which are the dominant complications. Patient concerns: Data regarding protocol management during pregnancy in the context of myelofibrosis are insufficient. Fewer than ten cases have been described until now and half of this cases have resulted in fetal death due to placental infarction during the second and third trimesters. Diagnoses: We present the case of a 34-year-old pregnant woman diagnosed with Jak 2- negative primary myelofibrosis. Personal history did not include miscarriage or stillbirth. Interventions: The patient was previously treated with anagrelide hydrochloride, which was interrupted at 6 weeks of gestation when the pregnancy was confirmed. It was replaced with Interferon-a 3 MU/day. Because of severe thrombocytosis, administration of aspirin 150 mg/day was recommended. Outcomes: The pregnancy was uneventful. The patient was hospitalized at 33 weeks of gestation because of moderate vaginal bleeding and high risk of preterm birth. After a specialized hematological investigation, the treatment with aspirin was replaced with low-molecular-weight heparin 0.6 ml per day. This combined treatment assisted in the natural tendency to lower platelet counts during pregnancy and resulted in stabilization of the hematological status. At 38 weeks of gestation the patient delivered a healthy baby boy via cesarean. He weight 2850 grams and his Apgar score was 9. Anticoagulant and interferon treatments were continued post-partum under hematologist surveillance. Lessons: This case was rare and complex. Because it was related to pregnancy it required continuos collaboration and supervision between obstetrician and hematologist.

The incidence of fetal growth restriction is variable, being known that is more frequent in resource-limited countries. The mechanism of fetal growth restriction is considered to be multifactorial, resulting from a combination of maternal, placental and fetal factors, the uteroplacental insufficiency being the dominant cause. Our purpose in this study was to determine the impact and the incidence of various maternal factors encountered among cases with fetal growth restriction delivered at term. The studied parameters were: the birth weight, the sex of the newborn, the way of delivery, the Apgar score at one minute, the maternal age, the maternal gestation and parity, the presence of presentation dystocia, the pregnancy monitoring by specialist, the presence of infectious factor, the presence of abnormal placental insertion or umbilical cord abnormalities, the status of the fetus and the presence of pregnancy-induced hypertension, preeclampsia or eclampsia. Results. During the 3-year period of the study, there were registered 12987 births in our hospital. The incidence of newborns with low birth weight at term was 1.5%. The average weight at birth was 2302 grams, with the lowest value 1750 grams, and the female fetuses were more affected (57.6%). The incidence of placental condition within the studied group was only 2%; also, the pregnancy-induced hypertension was present only in 6% of cases. Conclusion. Fetal growth restriction requires an accurate diagnosis with a clear distinction of constitutional small fetuses from the abnormal small ones. Ultrasound monitorization is mandatory for the diagnosis and the assessment of the fetal status

The birth, growth, development, reproduction and senescence under physiological conditions can be achieved without diminishing the role of other important aspects that influence them, only with the support of an optimal diet that is a fundamental requirement nowadays, considering that the health and the nutritional status are in a permanent interdependence. The effects of inadequate nutrition reflect on the expression of genes, influencing the development of certain diseases in childhood and adulthood. Knowing the phases of the gestation period in which the need of certain nutrients is increased, and their absence has the most serious impact on fetal growth and development, allows for the adoption in due time of concrete preventive rules. Disorders associated with lipid malabsorption, such as celiac disease, Crohn�s disease, pancreatic insufficiency, cystic fibrosis and cholestatic disease, are associated with low serum levels of 5-hydroxyvitamin D. Vitamin D deficiency in the newborn can express as deficient skeletal homeostasis, congenital rickets and fractures in the early days of life. A low level of vitamin D during pregnancy seems to increase the risk of preeclampsia, intrauterine growth restriction and gestational diabetes, and in the longer term it seems to affect the bone, immune system and general status. The prevalence of hypovitaminosis D is increasing globally, and the effects on pregnancy and neonatal outcome of the vitamin D deficiency and supplementation are a topical issue, which is currently under investigation.