The role of infection in preterm premature rupture of membranes

Introduction: Preterm premature rupture of membranes (PPROM) is rupture of membranes prior to 37 weeks’ gestation before the onset of labor. 85 % of neonatal morbidity and mortality is a result of prematurity. PPROM is associated with 30-40% of preterm deliveries and is the leading identifiable cause of preterm delivery. When PPROM occurs remote from term, significant risks of morbidity and mortality are present for both the fetus and the mother. Objective: The aim of the study was to evaluate the role of infection in preterm premature rupture of membranes. Materials and methods: The clinical study was based on retrospective analysis of 417 medical records of patients who delivered preterm in the second Obstetric Department of the Research Institute of Mother and Child’s Health Care during one year (1.01-31.12.2010). Historical data, complications of pregnancy, birth and postpartum period and newborn status were analyzed in all patients included in the study. PPROM diagnosis was established based on clinical examination, laboratory and instrumental data. Results and discussions: Preterm premature rupture of membranes (PPROM) occurred in 42 % pregnancies with the gestational age < 36 weeks and 6 days. The incidence correlates with the literature data 30-56 %. In our study vaginal infection (mainly nonspecific) was detected in 19, 86% of cases (according to clinical examination, bacterioscopic and bacteriological examination). According to the studied medical records, choriodecidual infection was diagnosed in 8.58% of cases. Pathomorphological examination of placenta and annexes revealed leukocyte parietal chorioamnionitis, phlebitis, and umbilical funiculitis. 65% of pregnant women had a latency period > 24 hours. Some authors insist on the fact that prolongation of the latency period increases the risk of infectious diseases, others believe that antibiotics reduce the risk of infection to the minimum. According to the studied medical records the major part of patients with prolonged latency period received antibiotics as recommended by standardized clinical protocol. The literature data show that the main danger of prolonged latency period represents intrauterine infection of the fetus. 31, 2% of premature newborns had the risk to develop an intrauterine infection, 21.8% of them developed unilateral or bilateral congenital pneumonia, 35.5% were subject to antibacterial therapy. Congenital pneumonia, neonatal sepsis and respiratory distress of the newborn are the major causes of perinatal morbidity and mortality. Conclusions: 1. PPROM occurred in 42 % of pregnancies with the gestational age < 36 weeks and 6 days which correlates with the literature data. This means that every second the preterm birth is due to the preterm rupture of membranes. 2. Infection represents the leading cause of PPROM (vaginal infection was detected in 19, 86 % of cases, choriodecidual infection in 8.58% of cases)

Tonsilofaringitis chronic to the patients with rheumatic and respiratory disease

Catedra Otorinolaringologie "Nicolae Testemiţanu"Chronic tonsilitis and faringitis considered each one apart should be aborted as distinct problems in a diagnostic and tratment point of view. Both pathologies have a medical and social character the population morbidity of these diseases is very high, estimating 15-50%. Pathological processis located in the farynx though are named differently from a biological and practical point of view form an integral functional and clinical complex. Tonsilita şi faringita cronică luate fiecare aparte constituie probleme dificile, atât din punct de vedere al diagnosticului, cât şi a tratamentului. Ambele afecţiuni au un caracter medico-social, deoarece morbiditate în populaţie prin ele este foarte înaltă, constituind 15-50%. Pe de altă parte procesele patologice cu localizare în faringe deşi au denumiri diferite, prezintă din punct de vedere al biologiei şi al practicei medicale un complex anatomo-funcţional şi clinic

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

The morphpathohistiologic and pathogenetic aspects of tympanosclerosis

Catedra Otorinolaringologie USMF „Nicolae Testemiţanu”Tympanosclerosis is a condition caused by calcification of tissues in the middle ear, sometimes resulting in a detrimental effect to hearing. Myringosclerosis refers to a calcification only within the tympanic membrane and is usually less extensive than intratympanic tympanosclerosis. Tympanosclerosis can result with significant hearing loss, white patches on the middle ear or temporal membrane. The examination of the etiopathogenetic and morphohistopathologic elements is important in applying relevant treatment. Timpanoscleroza este o stare, cauzată de calcificarea ţesuturilor urechii medii, care uneori, este urmată de pierderea auzului. Miringoscleroza reprezintă o calcificare doar a membranei timpanice, care este mai puţin extensivă, decât timpanoscleroza intratimpanală. Timpanoscleroza poate evolua printr-o pierdere importantă a auzului , plăci alburii în urechea medie sau membrana timpanică. Examinarea elementelor etiopatogenetice şi morfohistopatologice este importantă pentru a aplica un tratament corespunzător

Clinico-anatomical and diagnosis features of the thyroid gland

Catedra ORL USMF “N.Testemiţanu”, Clinica O.R.L., IMSP SCRThyroid hormones have a metabolic effects in various tissues of the body by increasing oxygen consumption and heat production that as a principal role but also have specific effects on different organs such as the increasing frequency and cardiac onset, increasing the activity of digestive, skeletal effects contributing to the increase bone modeling and control center respiratory effects on muscles, nervous system. All these effects are exacerbated in hyperthyroidism and reduced in hypothyroidism, being directly responsible for specific clinical picture. Hormonii tiroidieni au efecte metabolice în diferite ţesuturi ale organismului prin creşterea consumului de oxigen şi a producţiei de căldură ca rol principal, dar au şi efecte specifice în diferite organe cum ar fi creşterea frecvenţei si debitului cardiac, cresterea activităţii digestive, modificări scheletice ce contribuie la creşterea si modelarea oaselor, controlul centrului respirator, efecte pe musculatură şi sistem nervos. Toate aceste efecte sunt exacerbate în hipertiroidism şi diminuate în hipotiroidism, fiind responsabilă în mod direct de tabloul clinic specific