The role of biological markers in predicting infertility associated with non-obstructive endometriosis

Objectives: Our study evaluates if the use of biological markers can predict the infertility in women with non-obstructiveendometriosis.Material and methods: Two prospective, non-randomised studies were conducted to identify if CA-125, IL-6 and IL-8 can beused as predictive markers for infertility in women with non-obstructive endometriosis. Peripheral levels of CA-125, IL-6 andIL-8 were measured before laparoscopy in all patients.Results: We found a total number of 152 patients with non-obstructive endometriosis, we divided them in two groups: fertileand infertile women. There was a statistically significant difference of the mean of CA-125 values between the two groups(p = 0.00). The patients with infertility had a significantly higher IL-6 serum values than the fertile patients (p = 0.00). Regardingthe IL-8 serum values, there was no statistically significant difference between the two groups fertile vs infertile, (p = 0.06).Conclusions: The elevated serum levels of CA-125 and IL-6 was associated with an increased probability of being diagnosedwith infertility. The IL-8 had no value in predicting infertility associated with non-obstructive endometriosis

The social and the psychological impact of endometriosis on the Romanian urban population

Objectives. Our study assesses the social and psychological impact of the symptoms of endometriosis. Materials and methods. This crosssectional study was conducted from January 2014 to January 2016. The research involved two groups. The study instrument, the EHP-5 questionnaire, was completed by the respondents on the admission date or on the routine gynecological visit day. Results. Endometriosis has a negative social and psychological impact on women’s life, the most affected areas being work, fertility and sexual activity. Moreover, pain and the negative perception of self-image are major sources of distress. Conclusion. The symptoms and effects of endometriosis, especially chronic pelvic pain, mood changes and infertility, are significant negative factors in women’s life. The authors further conclude that the EHP-5 questionnaire can be more widely used to help select women who may need special attention in terms of their quality of life, thus helping gynecologists refer affected women to a health care professional

Corpus luteum in ectopic ovarian tissue miming tubal pregnancy

We report an extraordinarily rare case of a pregnant patient with history of multiple ovarian cyst surgery. The corpus luteum developed on an ectopic ovarian tissue, miming an tubal pregnancy. One week later after the diagnostic laparoscopy an intrauterine pregnancy was visualised. Therefore, ectopic ovarian tissue with normal follicular activity may appear after multiple ovarian surgery

Menstrual cycle abnormalities in women vaccinated against COVID-19

As more reports of menstrual cycle abnormalities after COVID-19 vaccine inoculation are emerging in media and in clinical practice as well, it was deemed necessary to investigate these claims. This review aims to gather current scientific evidence on COVID vaccination’s effect on menstrual cycle. Further and extensive research is undeniably needed to fully understand these phenomena, but current studies have demonstrated an undeniable link between some menstrual cycle abnormalities (especially heavy menstrual flow and variations in cycle length) and breakthrough bleeding in nonmenstruating population and vaccination against SARS-CoV-2. Up to this point, these disturbances seem to be temporary, not lasting for more than a few cycles. The reported menstrual changes have appeared after inoculations of all brands of vaccines, and no particular technology (mRNA or adenovirus-vectored) was particularly associated with them. The greatest concerns raised were those regarding fertility. However, until now, there is no evidence of any of the COVID vaccines affecting fertility when comparing vaccinated and unvaccinated populations

Pregnancy after miscarriage: Psychological implications and emotional care

This article propose a review of the most important medical and psychological aspects regarding pregnancy after miscarriage. We highlighted the results of studies that reflect the importance of psychological implications and emotional care. This paper is a review based on information from the literature. The analysis was limited to articles and guides in English published between January 1, 2010 and June 1, 2021 on PubMed, ScienceDirect and Google Scholar using the following keywords: miscarriage, pregnancy after miscarriage, psychological counseling, psychological interventions. In this review we discuss the medical and psychological characteristics of this research area. We focus on the emotional aspects involved, the emotional and mental states that appear and the ways to deal with this difficulty in life. Psychotherapy, psychological counseling and care practices influences the wellbeing of women and represents a real support in mental recovery after miscarriange

Risk of vertical transmission of chronic viral infections after invasive prenatal procedures

Objectives: Invasive prenatal procedures including amniocentesis, chorionic villus sampling (CVS) can be prenatally indicated for diagnostic purposes. Chronic viral infections with Human Immunodeficiency Virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) are not uncommon in women of reproductive age. The aim of this narrative literature review is to provide guidance on the best clinical practice in antenatal invasive testing and fetal surveillance in pregnancies with HIV, HCV, HBV and treponema pallidum infected women. Material and methods: A review of the literature was conducted in the database of PubMed to select full-length articles published in peer-reviewed journals between 1990 and 2020. The keywords along with respective combinations included in the search strategy were invasive testing, prenatal diagnosis, amniocentesis, chorionic villus sampling, cordocentesis, fetoscopy, chronic viral infections, hepatitis B, hepatitis C, HIV, treponema pallidum, syphilis, vertical transmission, MTCT. Results: For patients with hepatitis B infection, it is important to assess the HBeAg status and HBV DNA levels and for those patients with high viral load, antiviral therapy (Tenofovir) for a few weeks may be needed to reduce the viral load prior to the invasive procedure. In women positive for HCV, the viral load and HIV status should be assessed to establish the risk of vertical transmission; while for patients with HIV, highly active antiretroviral therapy administration and low viral load are predictive for reduced vertical transmission even after performing an invasive procedure. In all cases invasive procedure should be replaced by non-invasive prenatal testing if this is a feasible alternative and when invasive testing is indeed required, transplacental passage should be avoided.

Uptake of the COVID-19 vaccine in pregnancy

Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic with a devastating morbidity and mortality. Pregnant women seem to be at increased susceptibility to have a severe disease and suffer adverse pregnancy outcomes. The only solution to mitigate this pandemic is prophylaxis by mass vaccination. We report a review based on current literature about the evidence available on efficacy and safety of anti-COVID-19 vaccines in pregnancy to aid women decide whether to vaccinate or not, while being pregnant or lactating. Studies so far did not find concerning maternal or fetal outcomes and show a similar efficiency of mRNA vaccines as in non-pregnant population. Moreover, anti-SARS-CoV-2 antibodies resulted from the vaccination seem to be transferred to the newborn through the placenta or the breastmilk building up the neonatal immunity. However, the exclusion from clinical trials created a great deficiency of evidence regarding the vaccination in this high-risk population resulting in their reluctance

Behcet’s disease with oral manifestations during pregnancy

Behçet’s disease is a multisystemic inflammatory chronic vasculitis of unknown etiology characterized by recurrent oral ulcers, genital ulcers, eye lesions, and dermatological manifestations that is usually diagnosed during the reproductive years. There is limited information about the effects of Behçet’s disease on pregnancy and vice versa, but in most women, it appears to improve during this period. However, cases of activation or exacerbation of the disease in pregnancy are not uncommon and they are mainly manifested by oral ulcers, genital ulcers, and skin lesions. Corticosteroids and topical sucralfate are safe to use in pregnancy and while breastfeeding to treat oral ulcerations. The purpose of this study is to synthesize available information about Behçet’s disease oral manifestations in pregnancy, diagnosis, and treatment

Parvovirus infection in fetal life. Case report and recent literature updates

Background. The parvovirus B19 (B19V) belongs to the Parvoviridae family, genus Erythrovirus, and is a virus that causes a common childhood disease called erythema infectiosum, also largely known as the fifth childhood disease. The clinical appearance is marked by the “slapped cheek” facies and an erythematous rash localized mainly on the extremities and on the trunk. Most people gain immunity during childhood, and when it occurs in pregnancy in non-immunized women, there are some serious complications for the fetus that can occur. B19V infection in pregnancy can conduct to fetal loss or severe hydrops fetalis, due to the risk of vertical transmission to the fetus and the virus tropism for the erythropoietic fetal stem cells with subsequent cell destruction and fetal anemia. Invasive treatment, as intrauterine fetal transfusion, is necessary for the cases of severe fetal anemia with good survival rates afterwards. The purpose of this review is to update the current knowledge regarding the best management of severe fetal anemia and other complications related to B19V infection in pregnancy, based on the latest data from literature and guidelines. Methods. Electronic research for relevant articles published in the last years was made, with the usage of PubMed, Medline, Cochrane Data Base, and the current international guidelines promoted by the Obstetrics and Gynecology Societies. Results and conclusions. The importance of prenatal detection of non-immunized women by serologic testing for parvovirus B19 should not be overlooked, and subsequent follow-up should be recommended in order to lower the incidence of fetal complications associated with developing the disease in pregnancy, especially during epidemics. In case of P19V infection in pregnancy, serial ultrasounds and lab tests should be performed in order to determine the impact on the fetus and the apparition of fetal hydrops. The future moms who are not immunized to B19V should be advised about the risk of vertical transmission and the associated fetal sequelae that can occur. Assessment for maternal disease and for fetal impairment has to become a priority when there are signs of primary infection in pregnancy

HIV medication to prevent fetal infection during pregnancy

When it has been declared a global epidemic, HIV infection became a challenge for medical world. Even if there is only one healed case cited in literature, treatment for HIV-infection have evolved during time leading to very good results in disease control and limitation of virus transmission. When it comes for viral transmission, an essential research topic became the prevention of mother to fetal transmission. In the long run, many discovered antiretroviral drugs proved to be efficient in controlling HIV infection during pregnancy and thereby in reducing the risk of viral transmission to the fetus. But along with use of the HIV-treatment in pregnancy, many questions have appeared. Are the drugs safe for the fetus, or are there any adverse pregnancy outcomes? Should the treatment be adjusted for the desired results in pregnancy, or should the initial treatment be changed when the pregnancy is diagnosed? Many retrospective or prospective observational studies and comparative studies have been conducted in order to answer those questions and to analyze the efficacy and the safety of mostly used antiretroviral drugs in pregnancy. This article reviews the existing studies, guidelines and recommendations regarding the combined antiretroviral HIV treatment during pregnancy for fetal infection prevention