For this year’s last issue, we review the diagnostic criteria, treatment and obstetrical implications in a condition which becomes more and more frequent today, yet still incompletely understood: adenomyosis. The authors present the clinical elements that must alert the clinician towards this diagnosis and also the most relevant ultrasound and MRI features.
Taking into account the fact that cervical cancer remains one of the major public health problems in our country and that it is now regarded worldwide as a preventable disease (by efficient screening, treatment of preinvasive disease and vaccination), we discuss the latest recommendations regarding cervical cancer screening. Although there are some differences between the guidelines from various speciality societies, the mainstay screening recommendation is primary HPV testing due to its well-proven superiority over cervical cytology.
For the obstetrics section, we review the early pregnancy signs of viability and failure, emphasizing the growing importance of establishing an early diagnosis of pregnancy and thus improving the quality of patient care and reducing the morbidity associated with obstetric complications. The authors list the sonographic criteria which are highly suspicious for a nonviable pregnancy, an algorithm for cases of positive pregnancy test with no visible sac in the uterus at ultrasound and also possible causes of first-trimester fetal growth delay.
Consistent with the times that we live in, it was much needed to address the problem of the impact that SARS-CoV-2 infection has on fertility, pregnancy and fetal outcome. We are expecting new data in order to better assess these effects; for the moment, evidence shows that positive pregnant women are less likely to be symptomatic and the maternal outcomes are favourable, but premature birth rates are higher and vertical transmission may be possible.
It is widely known that a diverse and balanced diet is very important during pregnancy; omega-3 are essential fatty acid that should be a part of the diet as they ensure brain development, formation of fetal retina and contribute to the normal fetal psychomotor development. The review presents the recommendations of consumption of omega-3 acids during pregnancy and the effects it has on childrens’ outcome.
Furthermore, advanced maternal age (over 35 years old) is a situation increasingly encountered by clinicians and is associated with certain risks for both the mother and fetus. Closely related to the advances of ART, especially in developed countries and in those with higher education, these patients need to be carefully addressed in order to reduce as much as possible the perinatal complications.
The incidence of neoplastic disease in pregnancy is increasing, posing major difficulties in decision-making regarding the best management; the safety of the fetus, the risk of metastasis, the viability of the fetus are all elements that need to be taken into account. The authors list the risks associated with oncologic diagnostic tools and treatment and highlight the importance of a multidisciplinary approach.
Finally, the editorial team would like to wish all the readers happy holidays and to share an optimistic belief that the upcoming year will bring us once again together to all the great and exciting scientific events that we are preparing. Merry Christmas and a Happy New Year!