High-risk pregnancy – diagnosis and treatment

Our journal last edition of this year focuses on a series of papers regarding high-risk pregnancies and their management. The first article brings forward a less discussed domain, the vitamin A deficiency in pregnancy, which is the main cause for child morbidity and mortality in the developing world. As a conclusion, vitamin A supplementation is necessary in all pregnancies from endemic countries, keeping in mind a maximum limit of 10,000 UI/day, because hypervitaminosis can also cause congenital malformations.

The next paper addresses ultrasound findings in hypothyroidism, which proves to be an efficient and cost-effective method of diagnosis, with the sole purpose of reducing the negative effects in pregnancies.

A remarkable progress has been made in the neonatal recovery of premature babies born between 24 and 32 weeks of pregnancy. Cardiotocography (CTG) is an useful external tool for assessing the well-being of babies, when interpreted by an experienced observer. The article presents a literature review on cardiovascular and neurological development in order to better understand and interpret CTGs, leading, where possible, to the prolongation of pregnancies.

Moving on, preeclampsia – one of the most frequent pathologies complicating pregnancy – is observed from the point of view of the new discoveries made in the diagnosis and possible targets of treatment: PIGF and sFlt-1 markers. The next review of literature focuses on gestational and preexisting diabetes treatment using metformin, concluding that it is an effective and well-tolerated treatment, but also that there is a need for more studies on the long-term fetal effects.

Furthermore, we present the rare case of a 34-year-old woman with an ova­r­ian ectopic pregnancy, with emphasis on the successful treatment using minimally invasive surgery, leading to a quick recovery.

The first articles of the gynecology section present a systematic review and meta-analysis of the advantages and disadvantages of abdominal and laparoscopic approaches for sacrocolpopexy, finally stating that both methods resulted in similar clinical outcomes, but with less possible complications, and shorter hospital stays and recovery for the laparoscopic approach.

The field of malignant tumors is addressed in a case report and literature review regarding sex cord-stromal tumors of the ovary. Given the rarity of this disease worldwide, it is important to raise awareness amongst medical staff and educate patients to seek medical attention early.

As this year comes to an end, the entire editorial team wishes all readers and collaborators Merry Christmas and a Happy New Year!