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Background. Cervical cancer is the fourth most common cancer in the world affecting females, with high incidence and mortality. In recent years, ultrasound has gained increased attention in the preoperative staging, and Doppler color exam increased its clinical applicability for cervical cancer. Aim. Our objective was to study the tumor size, color score and the possible invasion of parametrium tissue, to predict the operability of cases with cervical carcinoma. Materials and method. The study group comprised 78 patients with histologically confirmed carcinoma of the cervix. A prospective study was performed which included patients diagnosed with cervical cancer admitted to the First Gynecology Department, Iaşi, during the period 2017-2022. Maximum cervical tumor length, anterior-posterior diameter and width have been measured. The intratumoral blood flow was subjectively evaluated by color Doppler examination. We also evaluated the tumor extension to the level of the parametrium. Results. The average age of the patients was 54.3±3 years old (range: 29-81 years old). Nineteen patients (24.35%) were diagnosed with stage IB (FIGO) cervical cancer, 51 patients (63.38%) were diagnosed with stage IIB or higher, and eight women were diagnosed with in situ carcinoma. Histologically, 68 cases (87.17%) were squamous cell carcinoma and 10 cases (12.83%) were adenocarcinoma. The sonographic findings suggestive of parametrial invasion are represented by an extension of the cervical tumor beyond the cervical stroma and the presence of hypoechoic irregular tissue infiltrating the paracervical tissue. The surrounding cervical tissue with invasion usually had a very scarce vascularization. Transvaginal ultrasound combined with colposcopy increases the accuracy of diagnosis in early-stage cervical cancer. Conclusions. The results of this study demonstrate that transvaginal ultrasound – an inexpensive method, easily accepted by patients – could be carried out quickly and could be used to evaluate the local extension of cases with large cervical tumors, and to monitor the effectiveness of cervical cancer treatment widely as an alternative method to MRI. There was an increased concordance between the ultrasound evaluation and the histological results. [ABSTRACT FROM AUTHOR]

Introduction. A breast hamartoma (fibroadenolipoma) is a rare, benign mass of disorganized mature breast tissue elements, composed of well-encapsulated fatty, fibrous and adenomatous elements. This type of breast tumor can be present in patients with some syndromes such as Cowden disease or Peutz-Jeghers syndrome. Breast hamartoma often present as a prominent palpable mass or as gross breast asymmetry. In the event the lesion undergoes rapid progressive growth, surgical excision would be indicated. Hamartomas can recur if the excision is incomplete. Materials and method. We present 13 cases of breast hamartomata treated by surgery, from January 2018 to June 2023, in the “Cuza Vodă” Clinical Hospital of Obstetrics and Gynecology, Iași. Results. The tumor varied in size from 1 and 17 cm (average: 6.75 cm). The mean age for these patients was 33.35 years old (limits: 22 to 57 years old). The clinical presentation was a painless mass. The diagnosis was established by ultrasound exam. On ultrasound, hamartomas appeared as well-circumscribed oval heterogeneous in echotexture. The surgical treatment was represented by lumpectomy with a small portion of normal tissue around the tumor. Macroscopically, they are typically surrounded by fibrous tissue, demarcating them from adjacent breast tissue. The cut surface showed variable fatty areas within a fibrotic stroma. The variability in histological features can be problematic for pathologists and contributes to the suspected underdiagnosis of this entity. Also, we have a case of breast lipoma with a rapid growth which was diagnosed by ultrasound exam and MRI as hamartoma. Conclusions. Most hamartomas have typical features on ultrasound, which are related to the presence of fibrous, glandular and adipose tissues. The correct identification of hamartoma is important, because there are problems of recurrence. Women from our study had no recurrence during the follow-up period. [ABSTRACT FROM AUTHOR]

Introduction/aim. Stillbirth represents a devastating experience for both family and care providers. The proportion of unexplained fetal deaths can be reduced following a rigorous and systematic evaluation and identifying a cause of death helps emotional healing and closure for parents, reducing the recurrence risk for future pregnancies. The objective of this study is to establish the fetal death causes, comparing with other data from the literature, and to propose a protocol for earlier assessment. Methodology. The retrospective, descriptive study included 300 cases of stillbirths hospitalized between 2015 and 2022 in the Department of Obstetrics of the “Cuza Vodă” Clinical Hospital of Obstetrics and Gynecology, Iaşi, a Romanian tertiary care maternity. The main inclusion criteria were all stillbirths ≥24 gestational age or ≥500 g weight birth. According to these criteria, the selected cases were subgrouped into four categories: extremely preterm birth (less than 28 weeks), very preterm (28-32 weeks), moderate to late preterm birth (32-36 weeks), and post-term pregnancies. A clinical, laboratory, ultrasonography and histopathological assessment was performed in all cases. Results and discussion. Possible causes of fetal death in more than 60% of stillbirth cases were identified, thus obtaining similar results to the scientific international literature. The most common causes of stillbirth were: infectious, hypertensive disorders, preexisting diabetes and gestational diabetes, umbilical cord abnormalities (excluding nuchal loop), and placental insufficiency, fetal structural and genetic abnormalities. Moreover, a checklist was designed in order to evaluate parental and current pregnancy history together with blood test parameters, trying to investigate other possible factors that can contribute to stillbirth. Conclusions. A systematic assessment including infectious medical history, placental examination, perinatal autopsy, and chromosomal microarrays represent important tools for determining the cause of stillbirth, and further investigations should be recommended when clinical findings are suggestive for a specific death cause. [ABSTRACT FROM AUTHOR]

Introduction/aim. The relationship between uterine fibroids and pregnancy is nor fully understood, but the prediction of the fibroids effect on pregnancy outcome may be possible by identifying maternal, fetal and leiomyoma features. Materials and method. A retrospective, descriptive study was conducted in a maternal fetal center in Iaşi, Romania, between 2018 and 2023, which included 147 pregnant women with leiomyomas. Clinical characteristics and ultrasound examinations were conducted to evaluate the features of the leiomyoma, along with fetal and maternal prenatal outcomes to facilitate decision-making and prenatal counseling. In all patients, it was described the type, the number, the size and location of the leiomyoma, trying to establish their influence on obstetric outcomes. Relationships between leiomyoma features and placental localization, risk of placenta praevia or placental abruption, fetal malposition and IUGR were made. Maternal characteristics, which included parity, gestational, age, number of fetuses, localization of placenta and previous caesarean sections, were documented. Results and conclusions. In the selected cohort, 62 cases with fetal malpresentation were recorded, representing 42.1%. In fifteen cases (10.2%), it was found a lower placental insertion located anteriorly or posteriorly. The number, size and type of leiomyoma vary widely. In 29 of the patients (19.7%), the localization of the fibroids was in the uterine lower segment, but a relationship of their effects and fetal and maternal features was not established. To evaluate the growth pattern of uterine fibroids and their effect on obstetrics outcomes, it is necessary to evaluate patients diagnosed with fibroids prior to pregnancy and enroll them prospectively during the gestation and puerperium period. [ABSTRACT FROM AUTHOR]

Introduction. Ultrasonographic diagnosis of amniotic bands may be difficult due to the similar appearance between uterine malformations and amniotic band syndrome. Band-like structures within the gestational sac are frequently noted on obstetric sonograms during the first and second trimesters of pregnancy. Clinicians should have a high index of suspicion of uterine anomaly to make an early diagnosis of bicornuate uterus and for preventing complications, but when the pregnancy history is unknown, it is difficult to establish a diagnosis in the third trimester. Materials and method. A 22-yearold second gravida, with a previous history of caesarean section, with undispensed pregnancy, presented at the “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology, Iaşi, for routine examination. No uterine abnormality was reported by abdominal ultrasound in the first pregnancy. The ultrasound (US) showed breech presentation of the fetus, with no gross fetal anomalies. The bidimensional US revealed a band of tissue crossing the amniotic cavity, but not sectioning any part of the fetal body. Color Doppler revealed no blood flow through this structure. Due to insufficient data regarding the pregnancy, it was not known any uterine malformation. The patient gave birth, by caesarean section for fetal distress indication, to a female newborn, weighing 3470 g, with an Apgar score at 1 minute and 5 minutes of 4 and 8, respectively, with no structural anomaly observed at the postpartum examination. After the fetal delivery, the uterine cavity was examined and the patient was diagnosed with a bicornuate uterus with a single common cervix. Discussion and conclusions. The importance of evaluating the pregnancy in this pathology is essential due to the complications that can appear in the fetus intrapartum development. True amniotic bands are relatively rare. When are detected, the prognosis of amniotic bands is usually very poor. The visualization of a band-like structure should not be confused with amniotic band syndrome, especially when a thorough fetal anatomy survey reveals no structural anomalies. [ABSTRACT FROM AUTHOR]

Introduction. Preexistent maternal hypertension requires usually treatment from the beginning of pregnancy. If the causes remain unknown, they can lead to a poor outcome of the fetus and can have a strong psychological impact on the mother. Case presentation. A 27-year-old patient, known for 10 years with severe arterial hypertension, presented for an investigation with angio-MRI following a second-term intrauterine fetal death at 18 weeks of pregnancy. The angio-MRI objectivated a 90% occlusion on the right renal artery. A double-stent was placed, leading to a significative reducing of the occlusion to only 10%. Normal values of the blood pressure were achieved and no medication was further acquired for this pathology. Currently, a second pregnancy was achieved, now the patient being followedup, at 37 weeks of gestation, with no complications until now, and she will be giving birth the following weeks. Discussion. The management of severe arterial hypertension was difficult to achieve for this patient, in her first pregnancy. She was treated with alpha-methyldopa 250 mg per day and nifedipine, without success, unfortunately. The importance and success of this case were given by the resilience of doctors who discovered the stenosis after her fourth MRI. Conclusions. Although rare, we can say that there are cases with congenital renal artery stenosis that can be treated in young women, helping them conceive spontaneously healthy babies. The multidisciplinary follow-up was important in this case, as the patient was first refused for angio-MRI because of allergic reaction to intravenous substance. [ABSTRACT FROM AUTHOR]

Introduction. Peripartum cardiomyopathy (PPCM) is a relatively rare cardiac disease that manifests in the final stage of pregnancy and in the first months after delivery in women with no preexisting heart disease. Many etiological processes have been suggested: viral myocarditis, abnormal immune response to pregnancy, excessive prolactin excretion, prolonged tocolysis and a familiar predisposition to PPCM. Its diagnosis is often delayed because its symptoms, which include fatigue, dyspnea and palpitations, are nonspecific. For this reason, the diagnosis of PPCM is still made by exclusion of other etiologies. Methodology. We conducted a multidisciplinary assessment of the case of a 28-year-old patient who presented with suggestive cardiovascular symptoms shortly after caesarean section delivery. Under the guidance of our cardiology department, the patient was diagnosed and treated promptly. Given the complexity of the case, we reviewed multiple literature data and we hereby present a summary of our findings. Results. The overall prognosis of PCM is good in the majority of the cases, although some patients may progress to irreversible heart failure. Progression of the condition requiring heart transplantation is described in 4% of cases, and death appears in 9% of cases at a two-year follow-up. Complete recovery of systolic function occurs usually in the first six months after delivery, although the recovery phase need not be limited to the first 12 months. Continuing improvement was observed in the second and third year after diagnosis. Persistence of the disease after six months portends worse survival. Conclusions. PCM is a relatively rare disease which can have devasting consequences and should be promptly identified and correctly treated. Early diagnosis is important and, therefore, women who develop symptoms of heart failure during pregnancy or shortly after that should be investigated for this condition. The effective treatment reduces the mortality rates and increases the chance of complete recovery of the ventricular systolic function. [ABSTRACT FROM AUTHOR]

Introduction/aim. Postpartum hemorrhage (PPH) represents one the main causes of maternal death all over the world, among infections, preeclampsia, eclampsia, unsafe abortion and complications of delivery. In cases with severe hemorrhage (≥1500 ml), the blood product transfusion will significantly contribute to maternal morbidity. Thus, only by understanding the complex changes in the coagulation cascade we will be able to intervene optimally, without having harmful side effects. Materials and method. The increasing number of caesarean sections (C-section) determined a high incidence of the placenta accreta spectrum disorders, contributing significantly to PPH cases. A retrospective, descriptive study was carried out between 2018 and 2022, which included patients who underwent hysterectomy for severe postpartum hemorrhage after C-section (e.g., accreta, atony, uterine rupture, leiomyomas). Maternal characteristics that include parity, gestational age, number of fetuses, presence of placenta praevia and previous C-section were documented. The preoperative coagulation tests were performed in all cases, and a multimodal management regimen was used for the majority of severe PPH cases, before resorting to a hysterectomy, including the administration of tranexamic acid and recombinant activated factor VII. Also, the transfusions of blood products (e.g., packed red blood cells, fresh frozen plasma, thrombocyte concentrate), characteristics of the hysterectomy and intraoperative complications, has been recorded too. Results and conclusions. This retrospective, hospitalbased study made a considerable share to available knowledge about peripartum hysterectomies. One of the worst scenarios in postpartum hemorrhage represents the coagulopathy. The iatrogenic factors such as hypothermia, massive transfusion, quantity and type of replacement solutions can increase the intraoperative morbidity. The major indication for PPH was abnormal placentation (placenta accreta), reason why it should be utilized thromboelastography (TEG) and rotational thromboelastometry (ROTEM) as methods to individualize the treatment for coagulopathy, and to initiate it immediately. [ABSTRACT FROM AUTHOR]

Introduction. The increased social and economic burden caused by the novel COVID-19 outbreak is gradually becoming a worrisome issue for the health sector. The novel coronavirus invades the target cell by binding to ACE2, which is widely expressed in the ovaries, uterus, vagina and placenta. Significantly, the SARS-CoV-2 is said to interrupt female fertility through regulating ACE2. Thus, it is essential to investigate if SARS-CoV-2 infection hampers female fertility, given that there is no systematic and comprehensive evidence on the association of COVID-19 with fertility. Materials and method. We performed a web research regarding male and female fertility and COVID-19. The eligibility criteria included: population aged 13-49 years old; exposure (infection with SARS-CoV-2); comparison (population without SARS-CoV-2 infections or latent SARS-CoV-2 infections); and outcome (female fertility, such as ovarian reserve function, uterine receptivity, oviducts status and menstruation status, male fertility and parameters). Results. Some studies showed that COVID-19 vaccines don’t impair fertility in men or women, but SARS-CoV-2 infection could potentially affect a man’s fertility for up to 60 days; for example, being 18% less likely to conceive during the next cycle of their female partner, compared with men who had not tested positive. Conclusions. Further data need to be acquired to synthetize the new effects on the population. Any infection – particularly an infection that involves fever – can affect sperm production and can affect ovulation, factors that apply in COVID-19. [ABSTRACT FROM AUTHOR]

Introduction. Meeting the contraceptive needs of women living with HIV (WLHIV) has primary health benefits for them, in addition to being a key element to prevent mother-to-child HIV transmission. This analysis will estimate the current number of infant HIV infections prevented by contraception. Methodology. We performed a literature search of PubMed to identify reports of drug interactions between hormonal contraceptives (HCs) and antiretroviral drugs (ARVs). We also reviewed the guideline of contraceptive hormone preparations and antiretrovirals for additional data and recommendations. Results. Several studies of combined oral contraceptive pills (COCs) identified decreased serum estrogen and progestin levels when co-administered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA) and the levonorgestrel intrauterine system (LNG-IUS) were largely unaffected by ARVs, while data on the contraceptive patch, ring and implant were not significant information to mention. Conclusions. Contraception continues to play an integral role in global HIV prevention efforts in the era of increasing HIV treatment coverage, especially in poor-income countries. Broad contraceptive availability, increased contraceptive voluntarism and method mix are key components to preventing unintended births and ending new infant HIV infections worldwide. [ABSTRACT FROM AUTHOR]

Introduction/objective. Zika virus (ZIKV) is a dangerous infectious agent, due to its potential to cause severe teratogenic results, especially an abnormal brain development – microcephaly. It is also well known that the most common geographical areas for the transmission of this disease are South and Central America, South Asia, the Pacific region and, in particular, the United Kingdom, which is contracted by mosquito bites. Methodology. For this paper, we consulted studies in the literature and selected the essential information on the complications of this infection. Results. Pregnant women are advised to avoid traveling to these areas or contraception for three months after returning from one of these regions. Like other agents, ZIKV can be transmitted vertically through the placenta during pregnancy, with potentially harmful consequences for the fetus. The easy clinical presentation made it difficult to establish a case definition for ZIKV infection in pregnant women. Zika virus infections during pregnancy are mainly identified using nucleic acid amplification and serological tests. Discussion and conclusions. While highly sensitive and specific laboratory diagnostic tests will improve the identification of maternal ZIKV infection before severe fetal abnormalities occur, there are currently no antivirals available to prevent the vertical transmission of Zika virus to humans. [ABSTRACT FROM AUTHOR]

Introduction/objective. Group B Streptococcus (GBS) is normally found in the body. This is one of the important factors that should be investigated during pregnancy. In women, group B Streptococcus is most often found in the vagina and rectum, which is why there is a risk of transmission from a pregnant woman to the fetus during labor, the chances of which decrease when the mother receives treatment. Methodology. For this paper, we consulted studies in the literature and selected the essential information on the complications of this infection. Results. Pregnant women are tested for GBS as part of routine prenatal care between 36 and 38 weeks of pregnancy. If the results show that GBS is present, most women will receive intravenous antibiotics once the labor has begun. This is done to help protect the fetus from being infected. The best time for treatment is during labor. Penicillin is the most commonly used antibiotic to prevent early-onset disease in newborns. Discussion and conclusions. Pregnant women should be tested for GBS, and if the test is positive, the baby can be monitored for GBS after birth. [ABSTRACT FROM AUTHOR]

Introduction. An isthmocele, a caesarean scar defect or uterine niche, is any indentation representing myometrial discontinuity or a triangular anechoic defect in the anterior uterine wall, with the base communicating to the uterine cavity, at the site of a previous caesarean section scar. Methodology. We studied the literature and we analyzed international standards of treatment regarding this defect and the criteria which are important for the treatment algorithm. Results. The hysteroscopic resection of isthmocele is a minimally invasive, non-time-consuming and low-morbidity procedure, allowing visualization and repair of the defect. A laparoscopic approach has been advocated for large defects (RM<3mm), in the presence of symptoms and desire to maintain fertility. Conclusions. The increasing prevalence of isthmocele, through its gynecological and obstetric complications, caused by the increasing number of caesarean sections (CS) deliveries performed worldwide, is alarming, therefore isthmocele should figure as a differential diagnosis in women with previous CS deliveries, especially in those with risk factors of multiple previous caesarean sections and retroflexed uterus. [ABSTRACT FROM AUTHOR]

Introduction. Parvovirus B19 (B19V) is the causative agent of the relatively benign childhood disease erythema infectiosum (fifth disease). Maternal B19V infection can lead to serious fetal complications during pregnancy. Up to 50% of women are nonimmune and susceptible to B19V infection. Methodology. We studied the literature and we search for the most frequent complications that were reported in the European Union regarding the parvovirus B19 infection. Results. Infection may result in anemia, spontaneous abortion and/or hydrops fetalis. The early diagnosis of B19V infection will identify those at risk and may allow for early intervention therapy, thereby improving fetal survival. The virus is spread via aerosol droplets through the respiratory route. It can be spread transplacentally to the fetus during active maternal infection (33% transmission rate across the placenta). Conclusions. Most pregnant women are asymptomatic but, for an appropriate patient management, there is a need for an accurate B19V diagnosis. [ABSTRACT FROM AUTHOR]

Introduction. Obesity has wide ranging effects on the whole body. The pressure of too much weight can weaken the pelvic floor, resulting in pelvic organs prolapse. Materials and method. We made a study on 28 cases with genital prolapse and obesity, admitted in the First Clinic of Gynecology Iaşi for surgery during the COVID-19 pandemic period. The grade of prolapse and the compartment which descend was correlated with grade of obesity appreciated by Body Mass Index (BMI). We also measured waist circumference, waist-to-hip ratio and the skinfold thickness in three sites – over the triceps in the back of the arm, subscapular and suprailiac. Results. The average age was 62.89±8.65 years old (limits: 46-83 years old). Regarding patients with uterine prolapse, 13 presented grade III obesity, 84.6% had grade I obesity and 15.4% had grade II obesity (p=0.734). Ninety percent of the 20 women with cystocele had grade III obesity and 88.9% of them had grade I obesity (p=0.209). Only seven cases presented grade II rectocele and 85.7% had grade I obesity. Twenty-five percent of cases had simultaneously central and anterior compartment descent. Three cases were recurrent. As comorbidities caused by obesity, 19 cases had high blood pressure and only seven cases had diabetes mellitus. It should be noted that only 21.4% of patients had ≥4 births. The weight of the baby at delivery was ≥4000 g for 53.3% of the ones with uterine prolapse (p=0.259), 30% of those with cystocele (p=0.067), and 47.6% of those witch rectocele (p=0.129). The types of surgery were hysterectomy with bilateral adnexectomy associated with sacropexy in 11 cases or colpo-suspension in two cases, and colporaphy was performed in 15 cases. Conclusions. The demographic characteristics of age, the reproductive status, the number of births and obesity assessment parameters did not differ significantly depending on the type of prolapse. The limit of the present study is represented by the lack of inclusion of patients with incipient degrees of prolapse and obesity, who are treated conservatively. [ABSTRACT FROM AUTHOR]

Myomas are the most common benign uterine tumors in women of childbearing age, with an incidence of up to 77% and a major impact on women's health. The aim of our study was to provide information concerning the incidence and prevalence of myomas in the patients admitted to a tertiary referral center in Northeastern Romania. This retrospective study conducted at the Iasi 'Cuza Voda' University Hospital of Obstetrics and Gynecology (Romania) included 11,538 patients, representing all patients admitted to the gynecology department between January 2013 and December 2019. During the study interval, the number of hysterectomies (total and for myomas) had increased. The rate of laparoscopic surgery showed a small decrease (31.3% from 34%), classic therapy showed a decrease by more than 10% and the hysteroscopy rate was tripled. There are few studies in the literature that have established with accuracy the incidence of myomas. In the present study, the prevalence of hysterectomy for myomas was 54.42%. Our results are in agreement with the data in the literature, namely that 40-60% of all performed hysterectomies are for myomas. The vast majority of admissions for myomas involve a surgical procedure most commonly hysterectomy. [ABSTRACT FROM AUTHOR]

Group B Streptococcus (GBS) normally colonises the bowel of 20-30% of adults. Vaginal colonization is transitory in 18% of pregnant women. Objective. To establish the GBS presence in women who gave birth, between October 2019 and September 2020, in the First Clinic of Obstetrics Iaşi, and the implications on the mothers’ and newborns’ condition. Materials and method. The study analyzed the pregnancy screening for GBS, the interval from membrane rupture until birth, the condition of mothers and newborns, and the inflammatory parameters. Results. A total of 192 cases had GBS in cultures – 32 on screening, 16 on vaginal discharge at hospitalization, 54 on amnioculture, and 90 on lochia culture. Out of 120 patients with antenatal care, only half were screened for GBS (28 absent and 32 present – 53.33%). Twenty-four patients gave birth by caesarean section. During puerperium, half of the women had hemorrhoids. The mothers or the newborns had no clinical manifestations of infection. The evolution of newborns was monitored through leukocytes and CRP. The interval from the membrane rupture to birth was over 18 hours in 12 patients. Ampicillin was administered to patients with positive screening. Twelve children were treated with amikacin, while the others were on antibioprophylaxis with ampicillin for three days. Conclusions. Although the number of pregnant women in care is increasing, the screening for GBS was made for 50% of them. Streptococcus was also present in cultures of patients with negative screening, explained by the vaginal collection without concomitant sample from the anus. The literature mentions that obesity increases the incidence of portage – in this study, only 6.25% of the subjects were obese. [ABSTRACT FROM AUTHOR]

Background. Fifty percent of adnexal masses are usually instantly recognisable at transvaginal ultrasound examination using simple descriptors. If the ovarian mass does not fit one of these categories, we must use IOTA (International Ovarian Tumor Analysis) simple rules to discriminate between benign and malignant masses. The simple rules were conclusive in about 75% of adnexal masses. If we have inconclusive cases, we can use the subjective opinion by an expert or ADNEX (IOTA risk of malignancy model). For ADNEX, the optimum cut-off is 26.1%, but the subjective appearance by expert is superior to ADNEX. Objective. To establish a prospective validation of IOTA group criteria. Methodology. We analyzed 250 patients admitted to the First Clinic of Gynecology, Iaşi, for surgical treatment during three years. Results. 55.2% of adnexal masses were recognisable using simple descriptors. The simple rules were applicable in 70.53% of the rest of tumors. We had 33 inconclusive cases. The malignancy rate was 5% in cases classified as benign, 89% in cases classified as malignant, and 37% in inconclusive cases. Feature B1 (unilocular cyst) was most predictive of a benign tumor, while feature B3 (acoustic shadows) was least predictive. Feature M2 (ascites) was most predictive of malignancy and feature M4 (irregular multilocularsolid tumor with the largest diameter ≥100 mm) was least predictive. Conclusions. The simple rules must be used on the assessment and management of ovarian masses. The ability to provide accurate risk estimates is highly relevant for risk stratification and individualized patient management. The important limitations of the simple rules are the inconclusive results for some cases and the absence of an estimated risk of malignancy. The simple rules cannot replace training and experience in ultrasonography. [ABSTRACT FROM AUTHOR]

Introduction. Breast cancer is the second leading cause of cancer mortality among women worldwide. Early diagnosis and monitoring of patients are the main aspects in its management. Over time, imaging techniques, such as mammography, ultrasonography and magnetic resonance imaging, have made a powerful contribution to the detection and monitoring of treatment response. Methodology. We conducted a thoroughgoing research in the scientific literature of the imaging methods used to diagnose and evaluate the response to treatment in malignant breast pathology, with particular attention to magnetic resonance imaging (MRI) and breast ultrasonography techniques. The techniques include ultrasound elastography, contrast enhanced ultrasound, 3D ultrasound and MRI. Results. We summarize the study results identified in the literature and discuss their future directions. We analyzed the efficacy, utility and feasibility of ultrasound as a screening tool for the early detection of breast cancer. We also offer a review of ultrasoundguided breast biopsy and ultrasound associated with other imaging modalities, especially magnetic resonance imaging (MRI). Conclusions. New ultrasound imaging techniques, ultrasound-guided biopsy and ultrasound associated with other modalities offer important tools for the management of breast cancer patients. [ABSTRACT FROM AUTHOR]