Chirculescu B.,Filantropia Clinical Hospital |
Chirculescu R.,Polizu Hospital |
Ionescu M.,Polizu Hospital |
Peltecu G.,Carol Davila University of Medicine and Pharmacy |
Panaitescu A.,Carol Davila University of Medicine and Pharmacy
Chirurgia (Romania) | Year: 2017
Tubal abortion is characterized by the extrusion of an ectopic product of conception implanted in the fallopian tube through the abdominal ostium into the peritoneal cavity. It can be either complete or incomplete and may lead to severe bleeding. Recognition of a complete tubal abortion may be challenging but is essential because it allows conservative management which make possible preservation of tubal function and fertility without the need for further cytostatic therapy. A case of a 30 years-old woman admitted for lower abdominal pain is reported.The level of β-hCG was 659.2 mU/mL and transvaginal ultrasound reveled a fluid collection in the pouch of Douglas. Laparoscopy was subsequently performed for the suspicion of ectopic pregnancy with hemoperitoneum. Corroborating theβ-hCG dynamics with the laparoscopic findings, the diagnosis of complete tubal abortion was established. The histopathological examination confirmed the presence of intermediate trophoblastic cells in the tissue collected during laparoscopy. Ultrasound examination helps recognition of hemoperitoneum but adds little value to the diagnosis of tubal abortion. Laparoscopic findings alone are only suggestive for complete tubal abortion but in combination with ß-hCG dynamics, the diagnosis can be established. Conservative management might be sufficient in complete tubal abortion and ensures preservation of tubal function and fertility.
Herghelegiu D.,Sanador Hospital |
Ionescu C.A.,Carol Davila University of Medicine and Pharmacy |
Pacu I.,Carol Davila University of Medicine and Pharmacy |
Bohiltea R.,Carol Davila University of Medicine and Pharmacy |
And 2 more authors.
Medicine (United States) | Year: 2017
Rationale:Vein of Galen aneurysmal malformation (VGAM) is a rare complex malformation of the cerebral vascular system consisting of arteriovenous shunts between the vein of Galen and the cerebral arteries. Patient concerns:We present the case of a 31-year-old pregnant woman, para 1, gravida 1. Diagnoses:At 26 weeks' gestation who was examined for an anechoic mass on the cerebral median midline with color and pulsed Doppler. She presented with positive flow on the color and pulsed Doppler test, associated with hydrocephalus, cortical hypoplasia, cardiomegaly, jugular vein distension. Interventions:No intervention for VGAM was done. Outcomes:This case of a VGAM was associated with negative prognostic factors. Lessons:The ultrasound color Doppler together with the 3D power Doppler allowed reconstruction of the vascular connections and of the relationship of these with other anatomical structures, which contributed to establishing the prognosis. © 2017 the Author(s). Published by Wolters Kluwer Health, Inc.
Suciu N.,University of Bucharest |
Suciu N.,Polizu Hospital |
Manta L.,Polizu Hospital |
Ciomartan T.,Institute for Mother and Child Care Alfred Rusescu |
Suciu I.D.,Polizu Hospital
Obstetrica si Ginecologie | Year: 2015
Introduction. The continuous increase of caesarean section rate from about 6% in the 70's, to about 60% today, due to sometimes unjustified extension of cesarean section indications, forced obstetricians to deal with uterine scar specific pathology and pediatricians with neonatal and long term fetal morbidities, witch led to adverse consequences for bouth mother and child. Objectives/material and methods. This is a compilation study for creating a critical picture over the existing literature about the incidence and consequences of the cesarean delivery. Results. At this increased incidence of birth by Caesarean section contributed the consideration of this method more convenient for both physician and patient, continuous CTG monitoring during labor (many false positive for fetal distress occurence), excessive medicalization and labor induction in the absence of favorable conditions and last but not least, the gradual loss of obstetrical skills. A reconsideration of the birth process approach and limiting cesarean section indications only for cases with real benefits, could lead to morbidity and mortality decrease for both mother and child. The overall rate of late-preterm births is rising, and so are rates of morbidity and mortality, especially among infants delivered by ceasaerian section in the absence of labor. Imediate consequences of caesarean delivery(CD) includes complications subsequent pregnancies and iatrogenic early delivery, increased incidence rates of the respiratory distress syndrome, neonatal hypoglycemia, hyperbilirubinemia, sepsis and neonatal intensive care unit admission As a long-term implication, CDs results in a 20–50% higher incidence of autoimmune diseases and obesity in the offspring. Conclusion. The choice of the delivery path in prematurity, non-cephalic presentation and associated maternal pathology, should be done after proper information, evaluation and individualization of the case for improving obstetrical and fetal outcome. © 2017 Revista Obstetrica Si Ginecologia. Toate drepturile rezervate.
Anca F.A.,Carol Davila University of Medicine and Pharmacy |
Negru A.,University of Bucharest |
Mihart A.E.,University of Bucharest |
Grigoriu C.,Carol Davila University of Medicine and Pharmacy |
And 2 more authors.
Journal of medicine and life | Year: 2015
UNLABELLED: Twin pregnancy generally represents a high-risk pregnancy, but monozygous twin pregnancy is a real challenge for the obstetrician due to the serious complications that may occur during its evolution. A very rare, severe complication of monozygous twin pregnancy, which we recently dealt with in the Obstetrics and Gynecology Department of the University Emergency Hospital Bucharest, was a monochorionic monoamniotic twin pregnancy with acardiac twin (TRAP). One of the fetuses (acardiac twin) presented a rudimentary unfunctional heart or even no heart at all, underdeveloped inferior part of the body and head, being transfused by the other fetus with a normal heart (pumping twin) by one superficial arterio-arterial anastomosis through which blood pumped backwards. The understanding of these cases is mandatory in order to offer maximum survival and heath chances to the viable fetus.ABBREVIATIONS: RFA = radiofrequency ablation, TRAP = reversed arterial perfusion.
Bacalbasa N.,Carol Davila University of Medicine and Pharmacy |
Balescu I.,Ponderas Hospital |
Suciu N.,Polizu Hospital
Gineco.eu | Year: 2015
Vulvar carcinomas are rare gynecologic malignancies. In cases presenting local invasion oncologic treatment such as chemo-irradiation might be performed. However complete remission is achieved in rare cases, most of the patients necessitating an aggressive surgical therapy such as pelvic exenteration. We present the case of a 78 year old patient who was diagnosed with a poorly differentiated squamous cell vulvar cancer with urethral invasion in whom a total vulvectomy en bloc with anterior pelvic exenteration, pelvic, para-aortic and inguinal lymph node dissection was performed. © 2015 Romanian Society of Ultrasonography in Obstetrics and Gynecology.