Clinical cases in gynecology

This edition of our journal begins by pointing out the impact that COVID-19 pandemic – this new challenge all over the world – had on the training of medical students and resident doctors worldwide, the first paper concluding that, although the decision of exclusive COVID hospital support was discriminatory, the theoretical training of the residents in the specialty of obstetrics-gynecology and the attention given by the trainee leader were maintained.

The next paper brings to the front the placenta accreta spectrum, a potentially fatal condition with an increasing incidence worldwide in the last few decades. It is one of the most difficult scenarios to manage for any obstetrician even in tertiary care setups, the article describing a series of three such patients managed in a time span of six months, with case history, comparative characteristics and a review of the current knowledge.

Organ donation from newborns for transplantation is a subject of great interest, being a relatively rare event, which requires proper knowledge of legal, ethical and medical issues. It implies the existence of a group of obstetricians, neonatologists, specialists in organ procurement, specialists in bioethics and lawyers.

Moving on to the gynecology sec­tion, the first paper presents the case of a 42-year-old woman diagnosed with aty­pical location of a leiomyosarcoma, de­scri­bing the evolution along with the sur­gi­cal and oncological treatment for this rare case. Uterine leiomyosarcoma re­pre­sents a rare malignancy, but it is ag­gres­sive and has a poor prognostic. The clinical manifestations are similar to those of leiomyoma, but leiomyosarcoma may present some specific features.

Furthermore, the aim of the next pa­per is to show unusual locations of a li­po­ma, the most common mesenchymal tu­mor. Vulva represents a rare location for the development of lipoma. The etiolo­gy of lipoma is still uncertain, but multiple fac­tors have been involved, such as obesity and trauma.

In the neonatology section, it is revealed the study carried out between June 2016 and August 2021 that included newborns from the “Bucur” Maternity, Bucharest, who were diagnosed with cardiac defects. Congenital heart defects (CHD) represent the most frequent birth defect, occurring in 1% to 5% of all live births. The study concluded that the variety of CHD in the clinic was from minor to severe, the environmental factors being correlated with the type of CHD. The congenital heart defects were more frequent in adolescent mothers and in pregnancies with no prenatal care. The neonatal characteristics are related to gestational age at birth and with the severity of congenital heart defects.