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Parvovirus B19 (B19V) infection is the cause of erythema infectiosum, or the "fifth disease", a widespread infection, potentially affecting 1–5% of pregnant women, in most cases without significant damage to the pregnancy or fetus. It follows a seasonal variation, with a higher prevalence in temperate climates, mainly in late winter and early spring. Women at increased risk include mothers of preschool and school-age children, and those working in nurseries, kindergartens, and schools. Vertical transmission occurs in 33% to 51% of cases of maternal infection. Parvovirus infection is an important cause of fetal perinatal infection resulting in increased morbidity through the development of fetal anemia, heart failure, and non-immune hydrops. A comprehensive literature review was conducted using PubMed, Cochrane Library, and Google Scholar, focusing on publications from the last 10 years and prioritizing studies related to parvovirus B19 infection in pregnancy. We summarized the existing data in the literature on the effects of parvovirus B19 infection during pregnancy and weighed if there is a need for screening in pregnant patients. Routine screening for parvovirus B19 infection can be considered in communities where infection is common, there is occupational exposure, or during endemic periods, with the reason being that accurate identification and treatment of fetuses affected by congenital B19V infection have been shown to improve perinatal outcomes. [ABSTRACT FROM AUTHOR]

Infertility is usually defined as “failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse”, but in couples with advanced female age (>35 years), most practitioners initiate diagnostic evaluation after failure to conceive within 6 months. The ovarian factor is a key element in the evaluation of infertile patients. Ovulatory defects are present in 40% of infertile women and in approximately 15% of couples with infertility. The World Health Organization (WHO) classifies ovulation disorders into three groups: Group I - hypothalamic pituitary failure (hypothalamic amenorrhea or hypogonadotrophic hypogonadism), Group II - hypothalamic-pituitary-ovarian dysfunction (predominately polycystic ovarian syndrome) and Group III - ovarian failure. At ovarian level, within the process of ovulation, there is a micro folicullar stage of development (the anomalies of this stage are divided into two groups - micropolycystic ovaries and multifolicullar ovaries) and a macro follicular stage (with three different types of anomalies: macropolicystic ovaries, functional ovarian cysts and LUF syndrome). All of these anomalies can be assessed today using ultrasound techniques, especially transvaginal ultrasound. The term “ovarian reserve” has been used to describe the capacity of ovaries to respond to stimulation with gonadotropins and therefore to predict the fertility potential. There are 4 morphological markers used to appreciate the ovarian reserve: ultrasound evaluation of antral follicles, measurements of ovarian volume, average ovarian diameter and the evaluation of blood flow al the level of the ovarian stroma. Ultrasound examination plays a key role within the evaluation of the ovarian structure by being able to asses the ovulation/dysovulation processes and other causes of ovarian infertility (endometrioma, tumors). [ABSTRACT FROM AUTHOR]

1. Second Department of Obstetrics and Gynecology, County Emergency Clinical Hospital Cluj-Napoca; “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania 2. Department of Neonatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania between 2019 and 2021. Materials and method. We reviewed data concerning pregnancy and births in adolescent mothers, aged 12 to 17 years old, who were admitted in our clinic from 2019 to 2021. Aside from age, we collected data regarding socioeconomic status, education, pregnancy-associated complications, way of delivery, parity and perinatal complications. Conclusions. Our findings strongly suggest that adolescent pregnancy is associated with environmental characteristics. [ABSTRACT FROM AUTHOR]

Vaccination against human papillomavirus (HPV) was introduced into clinical practice as the most effective strategy for primary prevention of cervical cancer and HPV-induced benign or premalignant lesions. It has been demonstrated that not only adolescents but also adults respond positively to vaccine immune stimulation. A history of abnormal Pap test and genital warts or HPV infection may reduce the efficacy of vaccination, but does not contraindicate it. HPV vaccination increases the magnitude and quality of natural immunity. Radical treatments of cervical lesions do not ensure the elimination of HPV infection. Using the vaccine without the surgical removal of the HPV lesion is useless. However, combining surgical treatment and HPV vaccination can play a crucial role in reducing recurrences. Evidence supports the fact that universal vaccination, of both men and women, from adolescence to 45-50 years old, would represent the optimal modality to control HPV infection-related diseases. [ABSTRACT FROM AUTHOR]

The incidence of cervical cancer in Romania is three times higher than in the rest of the European Union, and the mortality rate of such a pathology is the highest of all the European countries. Since cervical cancer can be prevented in approximately 80% of the cases through screening programs, it is necessary to determine and implement optimal screening and triage strategies. Traditionally, cervical cancer screening was based on cervical cytology, specifically Pap smears, but nowadays, given the fact that persistent infection with HPV high-risk types leads to cervical cancer, HPV testing becomes a logical alternative. The screening for HPV infection can be accomplished by self- or provider-collected HPV testing, within a primary or secondary HPV screening program. Several studies have shown that combining HPV testing with Pap smears saves additional years of life while also being cost-efficient. Implementing sustainable prevention programs that use HPV testing along with Pap smears can result in decreased incidence and mortality rates from cervical cancer, as long as the appropriate HPV testing method is chosen for each given category inside the general population. Knowing the relevance of each HPV testing method leads to cost-efficient prevention programs that patients are more likely to follow-up. [ABSTRACT FROM AUTHOR]

Since 1989, when first commercial 3D ultrasound device became available, new possibilities were identified for the accurate visualization of anatomic fetal structures, with high technological precision and incredible satisfying esthetical features. Still, 3D ultrasound is not a routine evaluation since it requires expensive ultrasound devices and trained personnel. Several advantages of 3D ultrasound can be stated such as: complex assessment of fetal anatomic structures, accurate surface analysis of defects or volumetric measuring of organs. Storage of scanned volumes and images allows the later processing of data without the presence of the patient, as well as data transfer and analysis via telemedicine. The aim of this article is to review the current applications offered by 3D ultrasound in prenatal evaluation and to identify how this technology can became part in future pregnancy surveillance. As accessibility to 3D ultrasound becomes widely available and the interest of medical professionals continues to increase, a comprehensive ultrasound follow-up of the pregnancy without using this technology seems unlikely. Most likely, 3D ultrasound evaluation will not be included in the minimal requirements for obstetrical ultrasound, but an accurate, modern prenatal diagnosis is unimaginable without 3D. [ABSTRACT FROM AUTHOR]

Adnexal masses are frequently detected by ultrasound and pose diagnostic problems, because sometimes benign and malignant characteristics overlap. MRI is preferred as a second imaging method for the evaluation of an insufficiently defined adnexal mass, in order to provide the best care. Magnetic resonance imaging allows more accurate and complete diagnosis and staging than ultrasound, especially in cases of deep pelvic endometriosis. In addition, MRI can identify implants at sites difficult to access by laparoscopy. The first-line examination of pelvic venous insufficiency, frequent in multiparous women, is ultrasound and Doppler, but MRI, which is less invasive than venography, allows even a 3D study of pelvic varicose veins. In assessing the pelvic diaphragm, ultrasound and MRI are comparable and demonstrate a moderate value. Non-visualization of ovaries by ultrasound and magnetic resonance-guided focused ultrasound in the non-invasive treatment of uterine fibromas represent other situations that prove the increasingly frequent need to associate pelvic MRI with ultrasound. [ABSTRACT FROM AUTHOR]

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Formele maligne ale bolii trofoblastice gestaţionale sunt denumite neoplazii trofoblastice gestaţionale (NTG). Este cunoscut faptul că trofoblastul normal are intrinsec caractere de ţesut malign, astfel că trecerea de la ţesutul trofoblastic din sarcina normală la cel tumoral este foarte labilă, factorul primar al acestei degenerescenţe regăsindu-se la nivel vascular. NTGurile sunt patologii rare, agresive, care metastazează precoce şi au un prognostic rezervat. Se clasifică în: mola invazivă, coriocarcinomul, tumorile de sit placentar şi tumorile trofoblastice epitelioide, această diferenţiere fiind posibilă doar în urma examinării histopatologice. Deşi nu reprezintă gold standard în diagnosticul acestor afecţiuni, ultrasonografia 2D este invariabil prima examinare paraclinică ce atrage atenţia asupra gravităţii diagnosticului. Aspectul ecografic sugerează prezenţa unei mase ecogene/heterogene, cu arii de necroză şi/ sau hemoragie, iar ecografia Doppler evidenţiază o vascularizaţie extrem de abundentă. Lucrarea de faţă îşi propune să treacă în revistă aspectele ecografice particulare din neoplaziile trofoblastice gestaţionale diagnosticate şi tratate în clinica noastră. [ABSTRACT FROM AUTHOR]

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.)

Artera ombilicala unică (AOU) poate fi diagnosticată ecografic antenatal în până la 2% dintre sarcini, iar când este asociată cu alte defecte structurale fetale există un risc crescut de anomalii cromozomiale și eventuale complicații fetale perinatale. Diagnosticul AOU trebuie să alerteze medicul obstetrician pentru a căuta malformații asociate și markeri ai defectelor cromozomiale. Frecvența anomaliilor cromozomiale în artera ombilicală unică izolată (AOUI) este însă extrem de mică. Riscul pentru boală cardiacă congenitală după diagnosticul AOU la un făt aparent normal dintr-o populație neselectată pare să fie mic și nu justifică necesitatea consultării unui specialist în ecocardiografie fetală. AOUI poate fi însă un predictor independent pentru eventuale complicații fetale perinatale, cum ar fi: hipotrofie fetală, oligo- și polihidramnios, diabet zaharat gestațional și mortalitate perinatală crescută. Cu toate acestea, diagnosticarea AOUI nu scade rata nașterii vaginale pentru copiii la termen. În situația descoperirii incidentale a AOUI, cazurile diagnosticate necesită monitorizare atentă pe parcursul sarcinii, aspect crucial în depistarea și prevenirea unor eventuale complicații perinatale. Alături de examinarea ultrasonografică detaliată, se impun și teste de screening prenatale, cariotipare prin amniocenteză la cazurile cu alte anomalii asociate sau cu teste de screening pozitive. Cariotiparea nu este însă recomandată la cazurile cu AOUI. [ABSTRACT FROM AUTHOR]

Objective. Our objective was to evaluate the urinary tract complications during and after vaginal hysterectomy for benign gynecological pathology. Study design. We conducted a retrospective cohort study of 142 patients who underwent vaginal hysterectomy in our clinic, from January 2015 until July 2016. Strict definitions were formulated for perioperative and postoperative complications to the urinary tract, urinary bladder and vagina. Results. All complications were documented (n=13), including: urinary infections, bleeding, vaginal and urinary tract injuries. Urinary tract infections (n=4) represented 30.7% of all complications. Aside from urinary infections, 88.8% of all complications were diagnosed intraoperatively. Conclusion. Perioperative and postoperative complication rates in our study appear to be low. Disregarding urinary tract infections, the overall incidence of urinary tract injury during and after vaginal hysterectomy was 6.33%. [ABSTRACT FROM AUTHOR]

Background and aim. Preeclampsia remains a major problem of modern obstetrics with insufficiently elucidated etiology; early detection would diminish maternal and fetal mortality and morbidity. The aim of this study was to determine the serum values of β-hCG in the first and second trimesters of pregnancy and PAPP-A values in the first trimester of pregnancy in pregnant women with risk factors for preeclampsia, in order to evaluate their relevance in the prediction of this disorder. Material and methods. We performed a prospective longitudinal study on 120 pregnant women divided into two groups according to the evolution of pregnancy: group I - 26 pregnant women who developed preeclampsia and group II - 94 pregnant women who did not develop preeclampsia and had a physiological evolution of pregnancy. Results. Our results indicate the association between high β-hCG levels in the first and second trimesters of pregnancy and the development of PE, β-hCG having the highest predictive power in the second trimester. We also obtained a positive association between low serum levels in PAPP-A in the first trimester and onset of PE. The predictive power of conjugated β-hCG and PAPP-A values in the first trimester of pregnancy was better that any other marker analyzed separately. Conclusions. Increased β-hCG levels in the first and second trimesters of pregnancy and low PAPP-A levels in the second trimester of pregnancy are associated with a higher risk for PE, the study providing only a modest efficiency of the prediction capacity [ABSTRACT FROM AUTHOR]

Objective The study aims to evaluate the presence of a correlation between visceral fat assessed by ultrasonography and the plasmatic level of lipocalin in patients diagnosed with endometrial cancer. Material and Method The study is a case-control analysis including 2 groups of patients: group I - 44 patients diagnosed with endometrial cancer, group II - 44 patients without gynecological pathology or inflammatory disorders. After the clinical examination and anthropometric measurements, these patients underwent ultrasonography (US) examination, in view of determining the visceral fat. At the patients included in this study, we also determined the plasmatic levels for lipocalin. Results At the patients diagnosed with endometrial cancer, the intraabdominal fat area evaluated by US and the plasmatic level of lipocalin is significantly larger (p<0.0001) compared to the control group. A correlation was also found between the intraperitoneal fat area evaluated by US and the plasmatic level of lipocalin. Conclusions The measurement of the intraperitoneal fat by US in correlation with the plasmatic level of lipocalin can be a screening method for endometrial cancer in obese patients. [ABSTRACT FROM AUTHOR]