High-risk pregnancy

In this issue, our focus is mainly set on obstetrics, reviewing some of the major complications that can occur in pregnancy and also outlining some of the interventions that can be made in order to improve both maternal and fetal outcomes. 

To begin, it is well known that the prevalence of hypovitaminosis D is increasing worldwide and that a sufficient level of vitamin D ensures an optimal growth for the fetus. We present a review of the trials analyzing vitamin D dosing and the obstetric  impact of supplementation in pregnancy.

Regarding the basic protocol for mid trimester central nervous system evaluation recommended by ISUOG, a set of new parameters (such as saggital image with the corpus callosum and vermis, color Doppler evaluation of the pericallosal artery and vein of Galen) has been proposed to improve the diagnosis of fetal abnormalities. In addition, we describe the main chromosomal disorders (numerical and structural as well) which are associated with oro-dental defects and emphasize the importance of genetic examination, prenatal diagnosis and counselling of the parents with an affected child.

Continuing our interesting case reports, we present two cases of chronic kidney disease (CKD) in pregnancy and we also assess the main adverse maternal and fetal events that can occur. CKD remains a challenge in pregnancy that requires a multidisciplinary approach, and therapy should be individualized for each patient.

To continue, we address one of the main public health issues worldwide, which is responsible for serious neonatal morbidity: premature birth. One review analyzes the role of Mycoplasma hominis in preterm premature rupture of membranes and preterm birth by means of intraamniotic infection which is associated with inflammation. Moreover, there has been an increased number of studies that support the role of periodontal disease in the occurrence of preterm birth; the Gram-negative anaerobic bacteria from the gingival pockets have proved a potential to enhance the inflammation of the maternal-fetal membranes.

Furthermore, we bring into attention one of the most common conditions oc­­cu­ring during pregnancy, which is ges­ta­tional diabetes. Knowing the risk factors for this complication helps the phy­si­cian to identify women who are affected and initiate specific therapeutic means to control blood sugar levels and reduce the negative impact on both the mother and the fetus.

Finally, it is our great pleasure to welcome participants from various medical fields to Sinaia, in June, at the 2nd National Congress of Endometriosis and at the Conference of the Romanian Society of HPV. This year, we focus on multidisciplinarity and the lectures will comprise minimal invasive surgery in endometriosis, infertility treatment and HPV infection and vaccination.