Шеечная беременность: обзор литературы и клинический случай

USMF „Nicolae Testemiţanu”, Catedra Obstetrică şi Ginecologie FECMFCervical pregnancy is a rare form of ectopic pregnancy with an estimated incidence of 0.15-1% of all ectopic pregnancies. It is defined as the implantation of pregnancy in the cervix. Predisposing factors are previous abortion, previous caesarian, Asherman syndrome, exposure to DES, IVF, leiomyoma etc. Early detection by endovaginal ultrasound is desirable in order to plan management early and avoid serious and often life threatening complications. The management of a cervical pregnancy includes medical and surgical options. Medical options includes methotrexate therapy and intraamniotic administration of potassium chloride. Surgical options include uterine artery embolisation, dilatation, curettage and tamponade, hysterectomy. We report a case of cervical pregnancy of a 33-year-old woman with previous lower segment cesarean and two curettages, resulting in hysterectomyШеечная беременность является редкой разновидностью внематочной беременности с предполагаемой частотой 0,15-1% из всех внематочных беременностей и определяется как имплантация беременности в шейку матки. Предраспологающими факторами являются предшествующий аборт, кесарево сечение, синдром Ашермана, внутриматочные контрацептивние средства, ЭКО, лейомиома и т. д. Ранняя диагностика с помощью эндовагинальной УЗИ, желательно для раннего планирования лечения и для предотвращения серьезных и опасных для жизни осложнений. Лечение шеечной беременности включает медицинские и хирургические методы. Медицинские варианты включают терапию с метотрексатом и внутриматочное введение калия хлорид. Хирургические варианты включают эмболизацию маточной артерии, выскабливание и тампонаду, гистерэктомию. Мы представляем случай 33-летней пациентки с шеечной беременности, с кесаревым сечением и двумя выскабливаниями в анамнезе, которые закончился гистерэктомией

Ожирение и его влияние на развитие родовой деятельности

USMF „Nicolae Testemiţanu”, Catedra Obstetrică şi Ginecologie FECMFBackground: Obesity is a current problem in medicine which is recognized by WHO as a global epidemic, occurs more frequently in women, and brings many risk factors that affect fertility, pregnancy, and birth. In this study we evaluated the unfavorable aspects of obesity and its negative consequences during labor in obese pregnant women, compared with normal-weight pregnant women, and appreciated the difference between newborns from obese mothers compared with newborns from normal-weight mothers. Material and Methods: This is a retrospective study, including 72 pregnant women selected according to certain criteria, divided into 2 groups: 36 obese pregnant women and 36 normal-weight pregnant women, which birth occurred from January 2014 to September 2015, in PMI Mother and Child Institute from Chisinau, Moldova. Results: In obese pregnant women we determined a prolonged pregnancy in 44%, induction of labor in 39%, amniotomy for induction and stimulation in 56%, administration of Oxytocin in 86%, failed induction labor in 14%. In 28% of obese pregnant women, childbirths occurred by vaginal delivery, 31% - by instrumental extraction, 41% - by cesarean section. The labor in this group was longer than ≈ 1h and expulsion - than ≈ 30min (both primiparous and multiparous). We determined fetal macrosomia in 33% of the obese mothers' group. The average weight of newborns was 3844g, the average Apgar score was 7,27 in the first minute of life, and 7,92 points after 5 minutes. Conclusion: Obesity is actually public health problem, it is a risk factor that negatively influences labor progression and may lead to a lot of obstetrical complications, independent of the other maternal diseases.Мотивация исследования: Ожирение является актуальной проблемой в медицине, считаясь признанной ВОЗ глобальной эпидемией. Оно чаще возникает у женщин и является источником множества факторов риска, которые влияют на фертильность, беременность и роды. В данном исследовании мы оценили неблагоприятное влияние которому подвергаются пациентки с ожирением по сравнению с пациентками с нормальным весом с точки зрения развития родов, родовой деятельности и оценки новорожденных. Материалы и методы: Исследование основано на ретроспективном анализе данных 72 пациентов, отобранных в соответствии с определенными критериями и разделенных на 2 группы: 36 беременных с ожирением и 36 беременных с нормальным весом, родивших в период с января 2014 по сентябрь 2015 года в Институте матери и ребенка в Кишиневе, Молдова. Результаты: У пациенток с ожирением определилась тенденция к перенашиванию в 44%, родовозбуждению в 39%, амниотомии для индукции и стимуляции родов в 56%, стимуляции с Окситоцином в 86%, неудачных попыток родовозбуждения в 14%. В 28% роды разрешились натуральным путем, в 31% - прошли с инструментальной экстракцией, в 41% - путем кесарева сечения. Продолжительность первого родов. периода, в среднем, больше на ≈ 1 ч и второго на ≈ 30 минут (как первородящих так и у повторнородящих). В 17% был определен дефект в плаценте и мембранах, а также травма родовых путей в 86%. Среди новорожденных, у которых матери страдают ожирением, макросомия присутствовала в 33%, средний вес новорожденных был 3844g, оценка по шкале Апгар в среднем была в первые минуты жизни 7,27 и 7,92 на пятой минуте. Вывод: Ожирение является актуальной проблемой общественного здравоохранения, представляя собой фактор риска для нормального развития родов и способствует появлению акушерских осложнений, независимо от других материнских заболеваний

Патологическая локализация и инсерция плаценты

Universitatea de Stat de Medicină și Farmacie “Nicolae Testemițanu”, Institutul Mamei și CopiluluiPlacenta praevia and placenta accreta spectrum are the most morbid conditions obstetricians will encounter. Invasive placenta praevia represents one of the main causes of maternal morbidity and mortality from massive bleeding. The incidence of placenta praevia and placenta accreta has dramatically increased in the last decades. The major contributing factor to this is believed to be the increase of the rate of cesarean sections. The management of placenta accreta spectrum disorders remains undefined and it is determined by the capacity to diagnose invasive placentation before the operation and determine the depth of villous invasion. The presence of clinical symptoms is also important. The diagnosis of invasive placenta before delivery allows multidisciplinary planning, making it possible to minimize potential maternal or neonatal morbidity and mortality.Патология локализации и инсерции плаценты являются одним из самых сложных и опасных акушерских осложнений, а плацента превия перкрета крайне опасная ситуация которая иногда заканчивается материнской смертностью. Частота плаценты превия и акрета драматически выросла за последнее десятилетие, главной причиной этого является повышение количества кесаревых сечений. Подход к пациенткам с инвазивной плацентой превия зависит от возможностей предоперационной диагностики и определения глубины ее проникновения, а также присутствия какой-либо симптоматики. Ранняя диагностика позволяет провести своевременную запланированную операцию, уменьшая возможные осложнения

O nouă metodă de tratament al recidivelor de prolaps uterin total

Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu”, Catedra Obstetrică şi Ginecologie nr. 2, Institutul Mamei şi CopiluluiProlapsul organelor genitale reprezintă căderea din poziţia anatomică a uterului, vezicii urinare, rectului. Această patologie poate provoca disconfort, presiune vaginală, incontinenţă urinară, defecaţie dificilă, disfuncţie sexuală etc. şi afectează negativ calitatea vieţii femeilor. Deşi se poate întâlni şi la femeile tinere, incidenţa maximă este la femeile cu vârsta peste 60 ani. Luând în considerare îmbătrânirea populaţiei, se estimează că în următoarele decenii numărul femeilor cu prolaps genital va creşte cu 50% [4]. Se estimează că o femeie din opt va suferi o procedură de corecţie a prolapsului până la vârsta de 80 de ani, 11,9% din acestea vor necesita o nouă intervenţie chirurgicală pentru tratamentul unei recidive, iar 30% din ele vor necesita o intervenţie chirurgicală pentru corecţia prolapsului unui alt compartiment [5]

Ultrastructure and Development of Anthracoidea Elynae Ustilospores

The aim of the study was to examine the ultrastructure of Anthracoidea elynae ustilospores isolated from Kobresia myosuroides (Vill.) Fiori plant ovaries, harvested in the Bucegi Mountains, Romania. Samples examination was performed using scanning (SEM) and transmission (TEM) electron microscopy. The results showed that A. elynae ustilospores had a dynamic ultrastructure, because their three-layered cell wall, nucleus shape, lipid and glycogen accumulations in the cytoplasm changed at each developmental stage. In conclusion, according to the ultrastructural changes, A. elynae ustilospores development may be divided into three stages

Ведение клинических случаев при патологической локализации и инсерции плаценты

Universitatea de Stat de Medicină și Farmacie “Nicolae Testemițanu”, Institutul Mamei și Copilului, Spitalul Internațional privat MedparkPlacenta praevia and placenta accreta spectrum represents one of the most morbid conditions obstetricians will encounter. The management of placenta accreta spectrum disorders remains undefined and it is determined by the capacity to diagnose invasive placentation before the operation and determine the depth of villous invasion. The diagnosis of invasive placenta before delivery allows multidisciplinary planning, making it possible to minimize potential maternal or neonatal morbidity and mortality. Here we have 6 clinical cases of pregnancies with placenta praevia and pathological inserted placentas. The women have been operated in the last 2 years in the RM. The medical approach for each case is described.Патология локализации и инсерции плаценты представляют собой одну из самых сложных акушерских патологий и одну из главных причин заболеваемости и смертности беременных. Подход к пациенткам с предлежанием и глубоким вращением плаценты зависит от возможностей предоперационной диагностики и определения глубины ее проникновения, а также присутствия какой-либо симптоматики. Ранняя диагностика позволяет провести своевременную запланированную операцию, уменьшая возможные осложнения. Представляем вашему вниманию 6 клинических случаев беременностей с предлежанием и патологическим прикреплением плацент. Женщины были оперированы в течение последних двух лет в РМ. Описан акушерский подход к каждому из случаев

Big uterine myoma at an early age - clinical case

Department of Oncology, Hematology and Radiotherapy, State Medical and Pharmaceutical University “Nicolae Testemitanu”, Chisinau, Republic of MoldovaIntroduction: Uterine myoma is a benign mesenchymal tum or from smooth muscle tissue. Uterine myoma is one of the most common female tumors. Statistics show that uterine myoma is found in 20% of the female population. Purpose and objectives: We report an additionally case of uterine myoma. Materials and Methods: A 20 years old female patient was admitted with an giant abdominal tum or which raised in two months with an uterine provenience. This tumor was confirmed by clinical examination, USG and CT-scan. Result: During the surgery, was suspected a malignant uterine tumor. This patient support a total hysterectomy surgery, but histological examination and immunohistochemical analysis proved the benign uterine tumor. Three months after initial diagnosis and surgery the patient is asymptomatic and was scheduled for very close follow up. Conclusion: This case presents an interes with: an early age o f the patient, the rapid evolution of tumor process, difficulties in clinical and histological diagnosis, and in the origin and nature of the tumor (benign or malignant)

SARS-CoV-2 Seroprevalence in Western Romania, March to June 2021

Background and Objectives: The extent of SARS-CoV-2 infection among a population may be assessed by the presence of serum SARS-CoV-2 antibodies, which indicates previous exposure. The aim of this study was to determine the seroprevalence of SARS-CoV-2 infection in the adult population from Western Romania. Materials and Methods: Samples of 2443 consecutive individuals, referred for routine laboratory investigations, were tested for SARS-CoV-2 antibodies using the Elecsys immunoassay that targets the nucleocapsid protein, for identifying the presence of the total antibodies against SARS-CoV-2. Results: The overall SARS-CoV-2 seroprevalence was 45.60%. SARS-CoV-2 seroprevalence was significantly higher in age group 30–49 years (53.94%) compared to age groups 50–69 years (43.53%) and 70–91 years (30.79%) (p < 0.001, p < 0.001, respectively). No significant difference in seroprevalence was observed between females (44.83%) and males (47.05%). Conclusions: Our data revealed a high seroprevalence of SARS-CoV-2 infection in the adult population from Western Romania and indicate the rapid and significant spread of the virus. The estimated prevalence of 45.60% was 6 times higher than the rate of confirmed COVID-19 cases reported in the study area. This indicates the magnitude of virus transmission in the community

The First Evaluation of Serum Levels of MGP, Gas6 and EGFR after First Dose of Chemotherapy in Lung Cancer

Background: Vitamin K-dependent proteins (VKDPs) and the epidermal growth factor receptor (EGFR) are involved in lung cancer progression. Therefore, we aimed to study the serum concentration of Matrix Gla protein (MGP), Growth Arrest-specific 6 (Gas6), and EGFR before and after the first cycle of chemotherapy and to investigate how MGP, Gas6, and EGFR are modified after one cycle of chemotherapy. Methods: We performed an observational study on twenty patients diagnosed with lung cancer, by assessing the serum concentration of vitaminK1 (VitK1), MGP, Gas6, and EGFR using the ELISA technique before and after three weeks of the first cycle of chemotherapy. Patients were evaluated using RECIST 1.1 criteria. Results: Serum levels of MGP, Gas6, EGFR, and VK1 before and after treatment were not changed significantly. Regarding the pre-treatment correlation of the MGP values, we found a strong positive relationship between MGP and VK1 pre-treatment values (r = 0.821, 95%CI 0.523; 0.954, p 1 and EGFR pre-treatment values, with the relationship between them being marginally significant (r = −0.430, 95%CI −0.772; 0.001, p = 0.058). Post-treatment, we found a strong positive relationship between MGP and VK1 post-treatment values (r = 0.758, 95%CI 0.436; 0.900, p p = 0.051)