Fetal Abdominal Wall Defects

Abdominal wall defects (AWDs) represent a group of congenital anomalies that can be diagnosed early during pregnancy even at the time of the first trimester assessment, with direct impact on pre- and postnatal fetal prognosis and management decisions. The most frequent anomalies in this group are gastroschisis and omphalocele. The key method available, that allows the detection of any deviation from the physiologic midgut herniation, is the ultrasound (US) assessment. A precise algorithmic scan approach is imposed not only for an accurate detection of any abdominal wall defect, but also for a proper location of the defect and of the spatial relation to the umbilical cord insertion, fundamentally important in differentiating among various malformations. Other structural or chromosomal anomalies should be excluded. Suitable multidisciplinary counseling should be considered. Unfortunately, in utero surgery, in these cases, has not been yet successful. Postnatal early interventions are usually required in specialized pediatric centers

Abnormalities of the Placenta

The placenta is considered an important organ that evolves with the implantation of the blastocyst throughout the pregnancy. The placenta has an essential role in functions such as nutrition, excretion, and immunologic and endocrine function. The normal placenta is a round- or oval-shaped organ that attaches to the uterine wall and has roughly 22 cm in diameter and a thickness of about 2–2.5 cm and weighs about one sixth of the fetal birth weight. Thus, a normal development of the placenta is important for an uneventful embryonic and fetal development. Consequently, the placenta abnormalities can range from structural anomalies, to function disorders, to site of implantation abnormalities

Congenital Abnormalities of the Fetal Face

Even at the early stages of gestation, the fetal face can be examined. There have been observations of the normal anatomy, such as orbits and the forehead, starting with the 12th week of gestation. However, nowadays, ultrasound equipment still cannot distinguish the soft tissues of the face, which are too thin. Yet, after the age of 14 weeks, we can easily examine the forehead, orbits, nose, lips, and ears. Recently, three-dimensional ultrasound (3D) images of the fetus can also be obtained. However, two-dimensional (2D) ultrasonographic (US) images are more easily, rapidly, efficiently, and accurately obtained. At the first stage of embryogenesis, the main part in the development of the fetal face is taken by the genetic factors. Later, the influence of the environment becomes more important. It is known that the outcome of chromosomal aberrations and of teratogenic factors is the facial malformation. Therefore, examining the facial dimorphism may get us useful hints in revealing chromosomal or genetic abnormalities. This chapter focuses on the fetal face anomalies more frequently found while performing the prenatal diagnosis. It is divided into anomalies of the orbits, nose, lip, palate, and mandible

CLINICAL AND MORPHOLOGICAL ASPECTS OF GINGIVAL OVERGROWTH INDUCED BY FIXED ORTHODONTIC THERAPY

Aim of the study The purpose of our study is to present the clinical aspects of gingival overgrowth induced by orthodontic therapy and to highlight the tissue changes of this gingival lesion. Materials and methods Biopsies of the gingival mucosa were taken from subjects diagnosed with gingival overgrowth and who were undergoing orthodontic therapy. The gingival mucosa samples were processed in the histology laboratory of University of Medicine and Pharmacy Craiova and the usual histological staining (hematoxylin-eosin) was performed. Results Gingival overgrowth (GO) is a condition characterized by an increase in gingival size, often observed in patients undergoing orthodontic therapy. The gingival enlargement begins o two or three months after the insertion of orthodontic appliance. The main causes of gingival overgrowth during orthodontic treatment include increased plaque accumulation due to challenges in maintaining oral hygiene with fixed appliances. Another cause is represented by the excessive pressure exerted by the orthodontic forces on the periodontium.Various factors influence the development of gingival overgrowth, including gender, age, and duration of orthodontic treatment. Conclusions Gingival overgrowth of orthodontic etiology can take on various clinical and morphological aspects and depends on the status of oral hygiene, the duration and correctness of orthodontic therapy

ORAL CANCER: ETIOLOGY AND THERAPEUTIC ASPECTS. LITERATURE REVIEW

Introduction The heterogeneity of head and neck cancers poses challenges in treatment planning, necessitating a nuanced approach.Materials and methods We have carried out a literature review that highlights the risk factors in the onset of oral and head and neck cancers. We also addressed the therapeutic aspects and the influence of epigenetics.Results In identifying risk factors, our literature research highlights systemic causes such as age, gender, heredity, race, socio-economic status, and immunodeficiency. Local causes, including tobacco and alcohol use, chronic traumas, chronic infections, and the role of viruses, underscore the multifactorial nature of oral cancer etiology. Addressing prevention strategies, our review underscores the potential of probiotics in suppressing oral cancer cell proliferation, with specific strains demonstrating efficacy in reducing mucositis caused by radiotherapy and chemotherapy. Additionally, the role of vitamins, omega-3 fatty acids, and compounds like curcumin in chemoprevention is explored. The Mediterranean diet emerges as a potential preventive measure, given its association with reduced cancer risk due to its rich content of monounsaturated fatty acids, antioxidants, and dietary fiber. Conclusions In conclusion, the intricate interplay of various risk factors underscores the multifactorial nature of oral cancer, with systemic and local influences contributing to its onset and progression. Age, gender, heredity, race, socio-economic status, immunodeficiency, and lifestyle choices such as tobacco, alcohol, and poor oral hygiene collectively elevate the risk. Specific chronic infections, the role of viruses, and even certain medications further contribute to the complexity of this disease

First Trimester Ultrasound Detection of Fetal Central Nervous System Anomalies

Objective: To evaluate the potential of the first-trimester ultrasound (US) features for the detection of central nervous system (CNS) anomalies. Methods/Methodology: This is a prospective one-center three-year study. Unselected singleton pregnant women were examined using an extended first-trimester anomaly scan (FTAS) that included the CNS assessment: the calvaria shape, the septum (falx cerebri), the aspect of the lateral ventricles, the presence of the third ventricle and aqueduct of Sylvius (AS) and the posterior brain morphometry: the fourth ventricle, namely intracranial translucency (IT), brain stem/brain stem–occipital bone ratio (BS/BSOB) and cisterna magna (CM). The spine and underlying skin were also evaluated. The cases were also followed during the second and third trimesters of pregnancy and at delivery. FTAS efficiency to detect major CNS abnormalities was calculated. Results: We detected 17 cases with CNS major abnormalities in a population of 1943 first-trimester (FT) fetuses, including spina bifida with myelomeningocele, exencephaly-anencephaly, holoprosencephaly, hydrocephaly, cephalocele and Dandy-Walker malformation. The CNS features in the abnormal group are presented. In the second trimester (ST), we further diagnosed cases of corpus callosum agenesis, cerebellar hypoplasia, vein of Galen aneurysm and fetal infection features (ventriculomegaly, intraventricular bands, intraventricular cyst and hyperechoic foci), all declared normal at the FTAS. During the third trimester (TT) scan we identified a massive fetal cerebral haemorrhage absent at previous investigations. We report a detection rate of 72.7% of fetal brain anomalies in the FT using the proposed CNS parameters. The sensitivity of the examination protocol was 72.7%, and the specificity was 100%. Conclusion: A detailed FT CNS scan is feasible and efficient. The majority of cases of major CNS abnormalities can be detected early in pregnancy. The visualization rates of the CNS parameters in the FT are great with short, if any, additional investigation time. FT cerebral disorders such as haemorrhage or infections were missed in the FT even when an extended evaluation protocol was used