EDITORIAL

Obstetrics – clinical rare conditions

Radu Vlădăreanu

31 Mai 2022

This edition of our journal emphasizes the fact that minimally invasive gynecologic procedures, such as hysteroscopic myomectomy, laparoscopic myomectomy and hysteroscopic uterine septum resection, present numerous advantages, including the preservation of the reproductive potential, but they do not lack complications, therefore in the first paper it is underlined that the potential risks in future pregnancies must be explained to patients before surgery.

In the last decades, the medical system has encountered more frequently obese and overweight patients. It is estimated that 15-20% of the population is affected by this condition, and the percentage for the pregnant women has doubled in the last decade, making the ultrasound examination an important part of prenatal care, even more difficult.

The next paper brings to the fore pem­phi­gus vulgaris, a rare and serious (po­ten­tially life-threatening) condition that causes painful blisters on the skin and mucous membranes of the mouth, nose, throat and genitals, presenting the case of a woman with a 36-week pregnancy who presented to the emergency room for generalized rash accompanied by severe pruritus, a rash that had started about two months before, with worsening of the symptoms in the last 24 hours.

Moving on, SARS-CoV-2 infection has a great impact on first-trimester preg­­nancy. Thus, in the next paper, it is presented the case of a pregnant woman who became infected with SARS-CoV-2 in the first trimester of pregnancy, with a moderate form of the disease. Severe placental insufficiency associated with severe oligohydramnios set in around the 18th week of gestation, after the acute onset of the disease. Anticoagulant and supportive treatment for placental circulation was urgently instituted, the normal values of the amniotic index were restored within 14 days, and the normal development of the fetus was resumed, pointing out that SARS-CoV-2 infection causes an intense systemic inflammatory process (cytokine storm) that is associated with an increased risk of thrombosis, the placenta in particular being a vulnerable organ to these pathophysiological processes.

Pregnancy among teenagers represents a public health problem that has a huge impact for the mother, newborn, society and even for the new genera­tions. This paper brings to the fore both the obstetrical and the newborns’ complications, underlining that the nutritio­nal status has a negative impact on the mother and the fetus, with a higher risk of premature birth for the adolescent patients with anemia, compared to those who were not diagnosed with anemia.

In the midwives and nurse section, there are presented the pathologies asso­cia­­ted with pregnancy at extreme ages with po­ten­tial significant clinical im­pli­­ca­­tions for both maternal and fetal health.

In the end, it is our great pleasure to invite you all to the 4th National Congress of the East-European Society of Endometriosis and Infertility and to the 7th National Conference of the Romanian Society of HPV, which will take place between the 2nd and the 4th of June 2022, in Eforie Nord, Romania.

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