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More studies are needed to understand the hemodynamic and mechanical effects as well as the impact on fetal growth and development of modified LTAC in women with a short cervix or cervical incompetence.During pregnancy, maternal diet is a modifiable factor that impacts the birth outcome. Since the nutritional needs of a pregnant women vary during preconception, gestational and breastfeeding period, it is necessary to adapt the diet and lifestyle, optimally under the personalized nutrition guidance of a specialist. High quality research regarding diet during pregnancy remains challenging as nutritional concerns also vary according to religion, financial income, age and education of the pregnant woman, as well as specific traditions of each country, limited number of dietitians with special training in maternal nutrition. The obstetrician usually plays a major role in dietary counselling and the use of nutritional monitoring tools can help identify pregnant women who may be at risk due to an inappropriate diet. The age of the pregnant women can be important when it comes to dietary and lifestyle changes. In this context, we addressed a questionnaire to 100 pregnant women in third trimester of pregnancy in order to evaluate a possible correlation between the age and the dietary behavior and lifestyle of a pregnant woman. Furthermore, the maternal compliance with dietary recommendations in pregnancy and the exposure to various risks due to unhealthy nutrition were also analysed in the study.Given its location and ubiquitous distribution, sialic acid can mediate or modulate a wide variety of physiological and pathological processes; however, there is scarce data regarding the associations between sialic acid serum levels and sex, age and menopause. The present study evaluated the age-related changes in serum sialic acid (SA) levels in 97 elderly subjects, including men and postmenopausal women. A significant increase in serum levels of sialic acid in postmenopausal women and a significant decrease in men were observed in an age-dependent manner. Furthermore, in postmenopausal women, positive correlations were observed between the total serum sialic acid level and age in all decades and subgroups. The total serum concentration of sialic acid in the postmenopausal women group exhibited a particular pattern; significantly lower levels were observed in subjects in the intermediate postmenopausal period compared with those in the first decade of post menopause and then higher levels again as the women get older (late climax), thus the concentration increased according to the age of the individual.Inflammatory mechanisms are involved in achieving a normal pregnancy and in the development of certain pregnancy complications. These changes are more intense in pregnant women that suffer of pregnancy complications, such as spontaneous preterm birth (SPB). This study compared the course of inflammatory markers (IM) [neopterin (Neo), neopterin/creatinine ratio (Neo/Cre), C-reactive protein (CRP), and chitotriosidase (Chito)] serum concentration in the early pregnancy of women with birth at term (BT) and preterm birth (PB). IM concentration was measured in 90 sera sampled from 45 pregnancies with BT and 30 sera from 15 pregnancies with PB. Two sera were sampled from each pregnant woman one in the first trimester and another one in the second trimester. Early pregnancy IM concentration showed a direct correlation with gestational age Neo (rho=0.262, P=0.004), Neo/Cre (rho=0.372, P less then 0.001), CRP (rho=0.187, P=0.041), and Chito (rho=0.039, P=0.66). The correlation was present in both categories of patients with BT and PB. Patients with PB before 34 week of pregnancy (wp) and 32 wp showed higher Neo and Neo/Cre concentration than BT patients. A significant association was found between the risk of PB before 34 wp, PB before 32 wp, and Neo concentration (PB less then 34 wp odds ratio (OR) =5.13, P=0.035) (PB less then 32 wp OR=8.2, P=0.020) and, respectively, Neo/Cre concentration (PB less then 34 wp OR=5.29, P=0.015) (PB less then 32 wp OR=9.25, P=0.006). No association between CRP or Chito and PB age was found. IM concentration correlates with the gestational age at the time of blood sampling. Increased Neo and Neo/Cre concentration are associated with PB. Further studies are needed to evaluate the usefulness of these markers in clinical practice.Adolescent pregnancies are associated with a high number of risks for the newborn and mother. Hence, an increased number of emergency caesarean extractions are performed in this group of patients. The aim of this study was to analyze the pregnancy-related conditions, the way of delivery and the neonatal outcome of all the patients who delivered in the Department of Obstetrics and Gynecology of University Emergency Hospital in Bucharest, a tertiary unit in Romania in a period of 5 years. An observational, retrospective study was performed on a group of 686 patients, aged 12 to 19 years, who delivered in the Department of Obstetrics and Gynecology of University Emergency Hospital in Bucharest, between January 1, 2014 and December 31, 2018. The pregnant women were divided into two age groups. In the first group were pregnant patients aged under 18 years, and in the second group pregnant adolescents between 18 and 19 years. Whether the patients underwent prenatal screening was analyzed. Furthermore, the age of the patients, the rate of caesarean extraction and vaginal birth and the obstetrical complications were evaluated and compared. The outcome of the newborns was assessed based on Apgar score at 1 min and birth weight. Regarding the results, 464 of the 686 patients did not undergo any medical visits during pregnancy. In total, 52.76% of the patients delivered by caesarean section. The most frequent indications for caesarean extraction, in both analyzed groups, were Cephalo-pelvic disproportion, fetal distress and uterine scar after caesarean section. The lack of specific protocols regarding the ante-, peri- and post-natal management of adolescents is probably the cause of the alarmingly increasing number of patients pertaining to the group who deliver by caesarean section.Cytomegalovirus (CMV) infection is the most common congenital infection worldwide, and remains a significant cause of the neurological deficiency and sensory deafness in developed countries. Maternal primary infection, reactivation or reinfection during pregnancy may lead to fetal infection and congenital CMV syndrome. The purpose of this study was to analyze the CMV seroprevalence according to demographic features of pregnant women in western Romania as well as the evolution of CMV immunity in two time intervals. IgG anti-CMV antibodies were tested in sera of 8,951 pregnant women during two successive intervals 2008-2010 (n=1466) and 2015-2018 (n=7485). The CMV seroprevalence in women of reproductive age decreased from 94.6 to 91.80% in the last decade. The seroprevalence was higher in women from rural areas compared with those from urban areas. These results show that the western region of Romania has a low-risk profile for primary CMV infection during pregnancy due to a large number of seropositive women. However, this risk has increased in the last ten years, from 5.4 to 8.2%, which may show the need to implement a national screening program.Fetal goitrous hypothyroidism is a rare condition associated with important obstetrical, neonatal complications, and neurodevelopmental impairments. Prenatal treatment remains controversial, and the risk to benefit ratio must be accurately assessed and considered for individualized management. The objective of this review was to evaluate the feasibility, safety, and effectiveness of the conservative in utero treatment of fetal goitrous hypothyroidism. In total, 25 reports that met our inclusion criteria were selected and the management of 38 cases was analyzed. Prenatal diagnosis consisted mainly of ultrasonographic findings. check details Fetal thyroid status was assessed by cordocentesis. Prenatal treatment varied widely in terms of levothyroxine (LT4) route of administration, dosage, number of injections, and frequency. Although different regimens and routes of administration were proposed, they seem to have similar results regarding fetal goiter reduction and thyroid status at birth. At birth, most babies had hypothyroidism, but the long-term follow-up indicated a normal psycho-neuromotor development. Our data confirm the feasibility of conservative treatment with LT4 for fetal goitrous hypothyroidism. Further studies are needed to determine the optimal management of this disorder.Autoimmune thyroid pathology has been connected with several systemic autoimmune disorders, namely hereditary thrombophilia and antiphospholipid syndrome. In an iodine-replete country, these diseases need to be evaluated simultaneously. This study was conducted to assess the connection between acute and chronic thyroiditis and inherited thrombophilia and their potential implications in pregnancy. In the analysis of the cases admitted to the Department of Obstetrics Gynecology of the University Emergency Hospital Bucharest from January 2015 up to September 2019, we identified pregnancies marked by autoimmune hypothyroidism and hyperthyroidism associated with hereditary thrombophilia, by standard statistical methods. In this investigation, we determined the prevalence of immunological markers specific for thrombophilia and against thyroid antigens in pregnant women, and explored whether they associate with distinct clinical phenotypes. Besides the well-accounted impact of hereditary thrombophilia during pregnancy - which is emphasized in our study by the incidence of moderate preeclampsia - we also account for a direct and statistically significant relationship between thrombophilia and moderate intensity autoimmune diseases (including autoimmune thyroiditis). Moreover, if these two pathologies are combined there is an increased risk of the presence of another autoimmune disease.The prevalence of pathologies due to placental dysfunction superimposed on pregnancy is constantly increasing. The prognosis of the cases complicated by gestational hypertension is usually good, significantly better compared with that of the cases associating preeclampsia. About half of the cases with gestational hypertension will progress to preeclampsia, the risk of decompensation being inversely proportional to the gestational age of the onset of gestational hypertension. The present study, analyzed the cases of pregnancy and postpartum complicated by pathologies related to placental dysfunction, during a period of 5 years. The risk factors analyzed were the presence of infections during pregnancy, diabetes, thrombophilia, pregnancy obtained by in vitro fertilization, abnormal adherence of the placenta, obesity, multiple pregnancy, the presence of an earlier hepatic, endocrine, renal, cardiac or autoimmune pathology, and the existence of an uterine malformation. Obesity appears with a significantly increased incidence in patients with gestational hypertension and middle preeclampsia. Intrauterine growth restriction appears with a significantly increased incidence in patients with mild preeclampsia. Complications such as prematurity, acute fetal distress and abruption of placentae had a significantly increased incidence in patients with severe preeclampsia. Thus, obese patients have a higher risk of moderate preeclampsia, following gestational hypertension and finally severe preeclampsia.
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