11 research outputs found
The Accuracy of Cytology, Colposcopy and Pathology in Evaluating Precancerous Cervical Lesions
Cervical cancer (CC) is the third most common cancer in the world, and
Romania has the highest incidence of cervical cancer in Europe. The aim of this study was to
evaluate the correlation between cytology, colposcopy, and pathology for the early detection of
premalignant cervical lesions in a group of Romanian patients. Methods: This observational type 2
cohort study included 128 women from our unit, âBucurâ Maternity, who were referred for cervical
cancer screening. Age, clinical diagnosis, cytology results, colposcopy impression, and biopsy results
were considered. Colposcopy was performed by two experienced examiners. The pathological
examination was performed by an experienced pathologist. Results: The cytology found high-grade
squamous intraepithelial lesions in 60.9% of patients, low-grade squamous intraepithelial lesions
in 28.1%, atypical squamous cells for which a high-grade lesion could not be excluded in 9.4%,
and atypical squamous cells of undetermined significance, known as repeated LSIL, in 1.6%. The
first evaluator identified low-grade lesions in 56.3%, high-grade lesions in 40.6%, and invasion in
3.1% of patients. The second evaluator identified low-grade lesions in 59.4%, high-grade lesions in
32.0%, and invasion in 8.6% of patients. The pathological exam identified low-grade lesions in 64.1%,
high-grade lesions in 25%, and carcinoma in 14% of patients. The colposcopic accuracy was greater
than the cytologic accuracy. Conclusions: Colposcopy remains an essential tool for the identification
of cervical premalignant cancer cells. Standardization of the protocol provided an insignificant
interobserver variability and can serve as support for further postgraduate teaching
The Impact of SARS-CoV-2 Infection on Premature BirthâOur Experience as COVID Center
Information about the impact of SARS-CoV-2 infection on pregnant women is still limited
and raises challenges, even as publications are increasing rapidly. The aim of the present study was
to determine the impact of SARS-CoV-2 infection on preterm birth pregnancies. We performed a
prospective, observational study in a COVID-only hospital, which included 34 pregnant women with
SARS-CoV-2 infection and preterm birth compared with a control group of 48 healthy women with
preterm birth. The rate of cesarean delivery was 82% in the study group versus 6% for the control
group. We observed a strong correlation between premature birth and the presence of COVID-19
symptoms (cough p = 0.029, fever p = 0.001, and chills p = 0.001). The risk for premature birth is
correlated to a lower value of oxygen saturation (p = 0.001) and extensive radiologic pulmonary lesions
(p = 0.025). The COVID-19 pregnant women with preterm delivery were older, and experienced an
exacerbation of severe respiratory symptoms, decreased saturation of oxygen, increased inflammatory
markers, severe pulmonary lesions and decreased lymphocytes
The quality of sexual life after vaginal surgical interventions
Introduction. The malfunction of the supporting pelvic system generates signs and symptoms that require various procedures. The aim of our study was to evaluate whether vaginal surgical interventions for genital prolapse or urinary incontinence have an impact on patientsâ sexual quality of life. Materials and methods. We studied 40 eligible women who underwent vaginal surgical procedures in Saint John Hospital, Bucharest. Patients completed a questionnaire 6 months after the intervention. Results. Patients who underwent vaginal surgery for prolapse were 50-64 years of age. The most frequent vaginal surgical intervention was vaginal hysterectomy (32.5%), followed by anterior and posterior colporaphy (17.5%), and direct cystopexy (15.0%). Regarding their sexual life, 42.5% patients described improvement in sexual life, 22.5% described decreased libido after surgery, and 35% indicated no significant improvement. 57.5% of women indicated that they had no sexual discomfort (57.5%), whereas 27.5% had dyspareunia and 15% had dysuria. There was no negative impact on patientsâ male partner quality of sexual intercourse after intervention. Conclusions. Vaginal surgical interventions for genital prolapse or urinary incontinence do not appear to lead to significant alteration of quality of sexual life in women
Persistent Left Superior Vena Cava Significance in Prenatal Diagnosis : Case Series
The persistent left superior vena cava (PLSVC) is a congenital heart anomaly reported in
0.3â0.5% of the general population and can be associated with congenital heart diseases in up to 8% of
cases. Prenatal identification of PLSVC is important to prompt an extended cardiac and extracardiac
fetal examination. We retrospectively reevaluated anomaly scans performed in our unit in a 2-year
interval according to the national guidelines to evaluate the incidence of PLSVC and its association
with prenatal morbidity. In our population, the incidence of PLSVC was 0.31%, and we found a low
association with cardiac and extracardiac anomalies. The standard sections (three-vessel and trachea
view, four-chamber view and outflow tractâs view) are insufficient to exclude cardiac anomalies
whenever PLSVC is found. In our case series, only one newborn required postnatal surgery for total
pulmonary vein anomaly, and at 2 years of life all babies had a normal evolution. Prenatal diagnosis
of PLSVC can raise counseling issues; therefore, awareness of its good outcome when isolated and
need for an extended examination to rule out other anomalies is very important
Can SARS-CoV-2 Induce Uterine Vascular Anomalies and Poor Contractile Response?âA Case Report
We are reporting a case of a 36 year-old Severe Acute Respiratory Syndrome Coronavirus-2
(SARS-CoV-2) positive hypertensive primigravida with postpartum uterine atony that required
emergency subtotal hysterectomy at Saint John Hospital Bucur Maternity Bucharest. The maternity
was designated as the Coronavirus Disease 2019 (COVID-19) Maternity for Bucharest and Ilfov
County since March 2020. The patient was mildly symptomatic for SARS-CoV-2, infection confirmed
with reverse transcription polymerase chain reaction (RT-PCR). The caesarean section was performed
and a live male fetus was born, 2630 g and Apgar Score of 9 (the male fetus was negative for SARSCoV-2). Postpartum hysterectomy with adnexal preservation was performed because of uterine
atony. The postoperative evolution was favorable. The patient was discharged with her baby 10 days
after birth. Given the limited resources, the placenta, the umbilical cord and the uterus were not
tested for SARS-CoV-2. The pathology exam revealed that on the maternal side there were specific
uterine atony lesions as well as endometrial and miometrial ischaemia. The placenta had nonspecific
findings: chronic ischemic lesions with small villi, fibrin deposits in the materno-fetal interface. The
peculiarity of the case is that we report the morphological findings of the placenta and uterus resulted
from intrapartum uterine atonia in a patient with gestational arterial hypertension, premature birth
and COVID-19. Further studies are required to characterize the pattern of such intricate conditions
Psycho-Emotional Impact of Anomaly Ultrasound Scan in Romanian Pregnant Women
Objective: Second-trimester anomaly scan was introduced as a regulated practice in
Romania in 2019, causing misperceptions and unrealistic expectations about this examination among
pregnant women. This study aimed to assess whether second trimester anomaly scan is a reason
âper seâ for maternal anxiety. Design: A prospective type 1 cohort study was conducted in a tertiary
prenatal diagnosis center with three locations in Bucharest, Romania, among pregnant women who
underwent a second trimester anomaly scan between 1 December 2019 and 29 February 2020. Main
outcome measure: Anxiety at the time of prenatal anomaly scan. Results: Out of the 138 participants,
32.6% believed that the anomaly scan could detect all fetus defects, 13.8% considered that the baby is
bothered by the probe âlightâ, 8.7% believed that the scan could harm the fetus, 96.4% reported that it
was a pleasant experience, and 95% felt that it strengthened their bond with the fetus. The State-Trait
Anxiety Inventory (STAI) score revealed that women with high state anxiety were more anxious
at pre-scan (p = 0.001). Conclusion: Ultrasound scan in the second trimester is correlated with a
significant anxiety for women who are prone to this psychological trait. It is also a good opportunity
to screen for highly anxious women who could benefit from prenatal psychological counseling to
facilitate timely recognition and prevention of postpartum psychiatric disorders such as depression
Persistent Left Superior Vena Cava Significance in Prenatal Diagnosis—Case Series
The persistent left superior vena cava (PLSVC) is a congenital heart anomaly reported in 0.3–0.5% of the general population and can be associated with congenital heart diseases in up to 8% of cases. Prenatal identification of PLSVC is important to prompt an extended cardiac and extracardiac fetal examination. We retrospectively reevaluated anomaly scans performed in our unit in a 2-year interval according to the national guidelines to evaluate the incidence of PLSVC and its association with prenatal morbidity. In our population, the incidence of PLSVC was 0.31%, and we found a low association with cardiac and extracardiac anomalies. The standard sections (three-vessel and trachea view, four-chamber view and outflow tract’s view) are insufficient to exclude cardiac anomalies whenever PLSVC is found. In our case series, only one newborn required postnatal surgery for total pulmonary vein anomaly, and at 2 years of life all babies had a normal evolution. Prenatal diagnosis of PLSVC can raise counseling issues; therefore, awareness of its good outcome when isolated and need for an extended examination to rule out other anomalies is very important
The Accuracy of Cytology, Colposcopy and Pathology in Evaluating Precancerous Cervical Lesions
Introduction: Cervical cancer (CC) is the third most common cancer in the world, and Romania has the highest incidence of cervical cancer in Europe. The aim of this study was to evaluate the correlation between cytology, colposcopy, and pathology for the early detection of premalignant cervical lesions in a group of Romanian patients. Methods: This observational type 2 cohort study included 128 women from our unit, “Bucur” Maternity, who were referred for cervical cancer screening. Age, clinical diagnosis, cytology results, colposcopy impression, and biopsy results were considered. Colposcopy was performed by two experienced examiners. The pathological examination was performed by an experienced pathologist. Results: The cytology found high-grade squamous intraepithelial lesions in 60.9% of patients, low-grade squamous intraepithelial lesions in 28.1%, atypical squamous cells for which a high-grade lesion could not be excluded in 9.4%, and atypical squamous cells of undetermined significance, known as repeated LSIL, in 1.6%. The first evaluator identified low-grade lesions in 56.3%, high-grade lesions in 40.6%, and invasion in 3.1% of patients. The second evaluator identified low-grade lesions in 59.4%, high-grade lesions in 32.0%, and invasion in 8.6% of patients. The pathological exam identified low-grade lesions in 64.1%, high-grade lesions in 25%, and carcinoma in 14% of patients. The colposcopic accuracy was greater than the cytologic accuracy. Conclusions: Colposcopy remains an essential tool for the identification of cervical premalignant cancer cells. Standardization of the protocol provided an insignificant interobserver variability and can serve as support for further postgraduate teaching
Can SARS-CoV-2 Induce Uterine Vascular Anomalies and Poor Contractile Response?âA Case Report
We are reporting a case of a 36 year-old Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) positive hypertensive primigravida with postpartum uterine atony that required emergency subtotal hysterectomy at Saint John Hospital Bucur Maternity Bucharest. The maternity was designated as the Coronavirus Disease 2019 (COVID-19) Maternity for Bucharest and Ilfov County since March 2020. The patient was mildly symptomatic for SARS-CoV-2, infection confirmed with reverse transcription polymerase chain reaction (RT-PCR). The caesarean section was performed and a live male fetus was born, 2630 g and Apgar Score of 9 (the male fetus was negative for SARS-CoV-2). Postpartum hysterectomy with adnexal preservation was performed because of uterine atony. The postoperative evolution was favorable. The patient was discharged with her baby 10 days after birth. Given the limited resources, the placenta, the umbilical cord and the uterus were not tested for SARS-CoV-2. The pathology exam revealed that on the maternal side there were specific uterine atony lesions as well as endometrial and miometrial ischaemia. The placenta had nonspecific findings: chronic ischemic lesions with small villi, fibrin deposits in the materno-fetal interface. The peculiarity of the case is that we report the morphological findings of the placenta and uterus resulted from intrapartum uterine atonia in a patient with gestational arterial hypertension, premature birth and COVID-19. Further studies are required to characterize the pattern of such intricate conditions
Placenta, the Key Witness of COVID-19 Infection in Premature Births
Adverse perinatal outcomes, such as increased risks of pre-eclampsia, miscarriage, premature birth, and stillbirth have been reported in SARS-CoV-2 infection. For a better understanding of COVID-19 complications in pregnancy, histopathological changes in the placenta, which is the interface between mother and foetus, could be the place to look at. The aim of this study was to determine placental histopathological changes and their role in preterm birth in pregnant women with SARS-CoV-2 infection. We performed a prospective, observational study in a COVID-only hospital, which included 39 pregnant women with SARS-CoV-2 infection and preterm birth compared with a control group of 39 women COVID-19 negative with preterm birth and a placental pathology exam available. The microscopic examination of all placentas revealed placental infarction (64.1% vs. 30.8%), decidual arteriopathy (66.7% vs. 23.1%), intervillous thrombi (53.8% vs. 38.5%), perivillous fibrin deposits (59% vs. 46.2%), inflammatory infiltrate (69.2% vs. 46.2%), chorangiosis (17.9% vs. 10.3%), and accelerated maturation of the villi (23.1% vs. 28.2%)