首页 > 最新文献

Romanian Medical Journal最新文献

英文 中文
Diagnostic and therapeutic particularities in a case of familial hypercholesterolemia secundary to a new mutation in the APOB gene 继发于APOB基因新突变的家族性高胆固醇血症的诊断和治疗特点
Pub Date : 2022-03-31 DOI: 10.37897/rmj.2022.1.5
Throughout the hereby article I will detail the case of a five-years old patient diagnosed with a new form of familial hypercholesterolemia. This way we wish to highlight the importance of swift diagnosis of all forms of familial dyslipidaemia. A particularity of this pathology is the long amount of time when no symptoms are present, thus creating the false impression that it is a benign, and very well tolerated condition. Currently the incidence of familial dyslipidaemia is continuously increasing, posing a real public health issue, both due to the complications it displays, and the degree of disability it produces to the patients. That is why it is extremely important that the lipidic profile be included in the package of regular laboratory tests of the paediatric practice.
在这篇文章中,我将详细介绍一个五岁的病人,他被诊断为一种新的家族性高胆固醇血症。通过这种方式,我们希望强调快速诊断所有形式的家族性血脂异常的重要性。这种病理的一个特点是长时间没有任何症状,从而产生了一种错误的印象,认为这是一种良性的,非常耐受的情况。目前,家族性血脂异常症的发病率不断增加,由于其并发症和对患者造成的残疾程度,构成了一个真正的公共卫生问题。这就是为什么将血脂分析纳入儿科常规实验室检查的原因。
{"title":"Diagnostic and therapeutic particularities in a case of familial hypercholesterolemia secundary to a new mutation in the APOB gene","authors":"Cristian Minulescu, N. Petcu","doi":"10.37897/rmj.2022.1.5","DOIUrl":"https://doi.org/10.37897/rmj.2022.1.5","url":null,"abstract":"Throughout the hereby article I will detail the case of a five-years old patient diagnosed with a new form of familial hypercholesterolemia. This way we wish to highlight the importance of swift diagnosis of all forms of familial dyslipidaemia. A particularity of this pathology is the long amount of time when no symptoms are present, thus creating the false impression that it is a benign, and very well tolerated condition. Currently the incidence of familial dyslipidaemia is continuously increasing, posing a real public health issue, both due to the complications it displays, and the degree of disability it produces to the patients. That is why it is extremely important that the lipidic profile be included in the package of regular laboratory tests of the paediatric practice.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78953979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dentists, members of the French Resistance movement during the World War II 牙医,二战期间法国抵抗运动的成员
Pub Date : 2022-03-31 DOI: 10.37897/rmj.2022.1.7
The Resistance was a reaffirmation of France's independence and individuality, as well as a struggle to regain freedom and, above all, national integrity. In fact, many historians appreciate that the French Resistance could have achieved more if it had been more effectively integrated into Allied plans and strategies. Thus, in this material we tried to present some short biographies of dentists who worked in the French Resistance against the German occupation troops, some of them even paying with their lives for the courage they showed.
抵抗运动是对法国独立和个性的重申,也是为重新获得自由,尤其是国家完整而进行的斗争。事实上,许多历史学家认为,如果法国抵抗运动能更有效地融入盟军的计划和战略,它本可以取得更大的成就。因此,在这份材料中,我们试图呈现一些在法国抵抗德国占领军中工作的牙医的简短传记,他们中的一些人甚至为他们表现出的勇气付出了生命。
{"title":"Dentists, members of the French Resistance movement during the World War II","authors":"S. Drafta, M. Burlibașa, V. Perieanu, Raluca Costea, O. Eftene, N. Măru, A. Ștețiu, M. Perieanu, M. V. Bucur, I. Beuran, M. Malița, M. Dina, ioana-Cristina neagoe, D. Bodnar, R. Costea, C. Ionescu","doi":"10.37897/rmj.2022.1.7","DOIUrl":"https://doi.org/10.37897/rmj.2022.1.7","url":null,"abstract":"The Resistance was a reaffirmation of France's independence and individuality, as well as a struggle to regain freedom and, above all, national integrity. In fact, many historians appreciate that the French Resistance could have achieved more if it had been more effectively integrated into Allied plans and strategies. Thus, in this material we tried to present some short biographies of dentists who worked in the French Resistance against the German occupation troops, some of them even paying with their lives for the courage they showed.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90726940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnosis and management of intestinal obstruction during pregnancy 妊娠期肠梗阻的诊断与处理
Pub Date : 2022-01-31 DOI: 10.37897/rmj.2022.s2.6
Acute intestinal obstruction in pregnancy is a rare, unusual, and very challenging non obstetric surgical pathology linked with great fetal-maternal morbidity and mortality. It is estimated that a surgeon may encounter and resolve 1 to 2 cases in his career. Bowel obstruction is difficult to diagnose because signs and symptoms such as pain, vomiting, abdominal distention, and constipation are frequently attributed to normal pregnancy. On the other hand, gravidity requires immediately, in case of suspicion of grave abdominal pathology, such as bowel obstruction, that surgery should not be delayed.
妊娠期急性肠梗阻是一种罕见的,不寻常的,非常具有挑战性的非产科手术病理,与胎儿和孕产妇的发病率和死亡率有关。据估计,外科医生在其职业生涯中可能会遇到并解决1至2例。肠梗阻很难诊断,因为疼痛、呕吐、腹胀和便秘等体征和症状通常被认为是正常妊娠引起的。另一方面,妊娠要求立即,在怀疑严重的腹部病理,如肠梗阻,手术不应延误。
{"title":"Diagnosis and management of intestinal obstruction during pregnancy","authors":"Bogdan-Gabriel Maxim, B. Cimpoca-Raptis, A. Ciobanu, C. Gică, Mihaela Demetrian, G. Peltecu, R. Botezatu, N. Gică, A. Panaitescu","doi":"10.37897/rmj.2022.s2.6","DOIUrl":"https://doi.org/10.37897/rmj.2022.s2.6","url":null,"abstract":"Acute intestinal obstruction in pregnancy is a rare, unusual, and very challenging non obstetric surgical pathology linked with great fetal-maternal morbidity and mortality. It is estimated that a surgeon may encounter and resolve 1 to 2 cases in his career. Bowel obstruction is difficult to diagnose because signs and symptoms such as pain, vomiting, abdominal distention, and constipation are frequently attributed to normal pregnancy. On the other hand, gravidity requires immediately, in case of suspicion of grave abdominal pathology, such as bowel obstruction, that surgery should not be delayed.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75741373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inflammatory bowel disease in pregnancy 妊娠期炎症性肠病
Pub Date : 2022-01-31 DOI: 10.37897/rmj.2022.s2.15
Inflammatory bowel disease (IBD), with its two main forms, Crohn’s disease, and ulcerative colitis, are characterized by chronic inflammation of the gastrointestinal tract. It is frequently diagnosed during childbearing years and its overlapping with pregnancy adds more complexity to the management of the disease. This review article aims to summarize what is acknowledged so far regarding IBD in pregnancy, providing up-to-date information. A systematic literature electronic search for journal articles and guidelines regarding IBD during pregnancy was undertaken. The most favorable pregnancy outcomes for pregnant women with IBD occur when the disease is in remission both at the time of conception and during the pregnancy. Most of IBD medication is considered safe during pregnancy and continuing therapy in pregnancy is fundamental for achieving optimal outcomes. Proper management of active IBD in pregnancy requires multidisciplinary care to lower adverse outcomes. There is insufficient knowledge among patients regarding how their pregnancy outcomes could be optimized.
炎症性肠病(IBD)有两种主要形式,克罗恩病和溃疡性结肠炎,其特征是胃肠道的慢性炎症。它经常在育龄期被诊断出来,它与妊娠期的重叠增加了疾病管理的复杂性。这篇综述文章旨在总结迄今为止公认的妊娠期IBD,提供最新的信息。对有关妊娠期IBD的期刊文章和指南进行了系统的文献电子检索。对于患有IBD的孕妇来说,最有利的妊娠结局发生在疾病在受孕和妊娠期间都得到缓解的时候。大多数IBD药物在怀孕期间被认为是安全的,在怀孕期间继续治疗是获得最佳结果的基础。妊娠期活动性IBD的适当管理需要多学科护理以降低不良后果。患者对如何优化妊娠结局的认识不足。
{"title":"Inflammatory bowel disease in pregnancy","authors":"D. Cudalbă, A. Ciobanu, C. Gică, Mihaela Demetrian, B. Cimpoca-Raptis, G. Peltecu, R. Botezatu, N. Gică, A. Panaitescu","doi":"10.37897/rmj.2022.s2.15","DOIUrl":"https://doi.org/10.37897/rmj.2022.s2.15","url":null,"abstract":"Inflammatory bowel disease (IBD), with its two main forms, Crohn’s disease, and ulcerative colitis, are characterized by chronic inflammation of the gastrointestinal tract. It is frequently diagnosed during childbearing years and its overlapping with pregnancy adds more complexity to the management of the disease. This review article aims to summarize what is acknowledged so far regarding IBD in pregnancy, providing up-to-date information. A systematic literature electronic search for journal articles and guidelines regarding IBD during pregnancy was undertaken. The most favorable pregnancy outcomes for pregnant women with IBD occur when the disease is in remission both at the time of conception and during the pregnancy. Most of IBD medication is considered safe during pregnancy and continuing therapy in pregnancy is fundamental for achieving optimal outcomes. Proper management of active IBD in pregnancy requires multidisciplinary care to lower adverse outcomes. There is insufficient knowledge among patients regarding how their pregnancy outcomes could be optimized.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79126176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Urolithiasis – a challenge during pregnancy 尿石症——怀孕期间的一大挑战
Pub Date : 2022-01-31 DOI: 10.37897/rmj.2022.s2.18
Urolithiasis during pregnancy is a rare condition despite the prolithogenic state determined by the physiological changes in the urinary system. The incidence is similar among pregnant women and the general female population, pregnancy not being a risk factor for the appearance of kidney stones. Urolithiasis is a challenge for the obstetrician because diagnosis and treatment require a particular approach in order not to harm the fetus. Ultrasonography is the first choice for diagnosing kidney stones even though it has a reduced sensibility. The first line of treatment in renal colic is expectant management. If this is ineffective, then urological interventions are being taken into consideration. Left untreated, urolithiasis exposes the pregnancy and the baby to higher risks of complications.
妊娠期尿石症是一种罕见的疾病,尽管尿石原状态是由泌尿系统的生理变化决定的。在孕妇和一般女性人群中发病率相似,怀孕不是肾结石出现的危险因素。尿石症对产科医生来说是一个挑战,因为诊断和治疗需要一种特殊的方法,以不伤害胎儿。超声检查是诊断肾结石的首选,尽管它的敏感性降低了。治疗肾绞痛的第一线是期待治疗。如果这是无效的,那么泌尿干预是考虑。如果不及时治疗,尿石症会使孕妇和婴儿面临更高的并发症风险。
{"title":"Urolithiasis – a challenge during pregnancy","authors":"Miliana Cretu, A. Ciobanu, C. Gică, Mihaela Demetrian, B. Cimpoca-Raptis, G. Peltecu, R. Botezatu, N. Gică, A. Panaitescu","doi":"10.37897/rmj.2022.s2.18","DOIUrl":"https://doi.org/10.37897/rmj.2022.s2.18","url":null,"abstract":"Urolithiasis during pregnancy is a rare condition despite the prolithogenic state determined by the physiological changes in the urinary system. The incidence is similar among pregnant women and the general female population, pregnancy not being a risk factor for the appearance of kidney stones. Urolithiasis is a challenge for the obstetrician because diagnosis and treatment require a particular approach in order not to harm the fetus. Ultrasonography is the first choice for diagnosing kidney stones even though it has a reduced sensibility. The first line of treatment in renal colic is expectant management. If this is ineffective, then urological interventions are being taken into consideration. Left untreated, urolithiasis exposes the pregnancy and the baby to higher risks of complications.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"89 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80366330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cervical cancer – a real medical challenge when diagnosed during pregnancy 子宫颈癌-一个真正的医疗挑战,当诊断在怀孕期间
Pub Date : 2022-01-31 DOI: 10.37897/rmj.2022.s2.9
One of the most common malignancies diagnosed during pregnancy is cervical cancer. If a local examination and a Papsmear have not been done for screening, when some symptoms appear during pregnancy, they might be easily mistaken for pregnancy early related complaints. The treatment of cervical cancer during pregnancy should take into consideration many factors including the size of the tumor, lymph node involvement, gestational age, the wish of pregnancy continuation and fertility preservation. All these factors make the optimal treatment decision difficult to be taken and suggest that a multidisciplinary team including an obstetrician, neonatologist, medical oncologist, psychologist, pathologist, and radiologist, is necessary for the best management. This article reviews the existing studies, guidelines and recommendations regarding the diagnosis and management of cervical cancer during pregnancy.
宫颈癌是孕期最常见的恶性肿瘤之一。如果没有进行局部检查和巴氏涂片检查,当怀孕期间出现一些症状时,很容易被误认为是与妊娠早期有关的疾病。妊娠期宫颈癌的治疗应综合考虑肿瘤大小、淋巴结受累情况、胎龄、继续妊娠意愿和生育能力保存等诸多因素。所有这些因素使最佳治疗决策难以做出,并建议一个包括产科医生、新生儿医生、肿瘤内科医生、心理学家、病理学家和放射科医生在内的多学科团队对最佳管理是必要的。本文综述了有关妊娠期宫颈癌诊断和治疗的现有研究、指南和建议。
{"title":"Cervical cancer – a real medical challenge when diagnosed during pregnancy","authors":"T. Cioroba, R. Botezatu, A. Ciobanu, C. Gică, Mihaela Demetrian, B. Cimpoca-Raptis, G. Peltecu, N. Gică, A. Panaitescu","doi":"10.37897/rmj.2022.s2.9","DOIUrl":"https://doi.org/10.37897/rmj.2022.s2.9","url":null,"abstract":"One of the most common malignancies diagnosed during pregnancy is cervical cancer. If a local examination and a Papsmear have not been done for screening, when some symptoms appear during pregnancy, they might be easily mistaken for pregnancy early related complaints. The treatment of cervical cancer during pregnancy should take into consideration many factors including the size of the tumor, lymph node involvement, gestational age, the wish of pregnancy continuation and fertility preservation. All these factors make the optimal treatment decision difficult to be taken and suggest that a multidisciplinary team including an obstetrician, neonatologist, medical oncologist, psychologist, pathologist, and radiologist, is necessary for the best management. This article reviews the existing studies, guidelines and recommendations regarding the diagnosis and management of cervical cancer during pregnancy.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80649120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reducing surgical complications after cesarean section: Vaginal birth after cesarean section. Identifying the ideal candidate 减少剖宫产术后手术并发症:剖宫产术后顺产。识别理想的候选人
Pub Date : 2022-01-31 DOI: 10.37897/rmj.2022.s2.21
Vaginal birth after cesarean section (VBAC) is worldwide accepted and encouraged. Currently, in Romania due to increased cesarean section rate especially for maternal request, a high number of patients with scarred uterus is seeking for VBAC at subsequent pregnancies. Because of specific complications of trial of labor after cesarean section (TOLAC), risks and benefits need to be individualized for each specific candidate. This study is about VBAC in Filantropia Clinical Hospital from Bucharest and how we are selecting the ideal candidate.
剖宫产后阴道分娩(VBAC)在世界范围内被接受和鼓励。目前,在罗马尼亚,由于剖宫产率的增加,特别是产妇的要求,大量子宫瘢痕患者在随后的怀孕中寻求VBAC。由于剖宫产后试产(TOLAC)的特殊并发症,风险和利益需要个性化的每个特定的候选人。本研究是关于布加勒斯特Filantropia临床医院的VBAC以及我们如何选择理想的候选人。
{"title":"Reducing surgical complications after cesarean section: Vaginal birth after cesarean section. Identifying the ideal candidate","authors":"R. Botezatu, G. Peltecu, N. Gică, A. Panaitescu","doi":"10.37897/rmj.2022.s2.21","DOIUrl":"https://doi.org/10.37897/rmj.2022.s2.21","url":null,"abstract":"Vaginal birth after cesarean section (VBAC) is worldwide accepted and encouraged. Currently, in Romania due to increased cesarean section rate especially for maternal request, a high number of patients with scarred uterus is seeking for VBAC at subsequent pregnancies. Because of specific complications of trial of labor after cesarean section (TOLAC), risks and benefits need to be individualized for each specific candidate. This study is about VBAC in Filantropia Clinical Hospital from Bucharest and how we are selecting the ideal candidate.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82024101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hernia and pregnancy: A symbiosis of two bumps 疝气和怀孕:两个肿块的共生关系
Pub Date : 2022-01-31 DOI: 10.37897/rmj.2022.s2.7
One of the most common surgical entities, globally, is hernia. Even though it affects female population less often than men and its occurrence is rather exceptional during pregnancy, it must not be neglected, especially due to the difficulties in diagnosing this entity correctly in the gestation period. We conducted a review article based on data from 13 papers published between 2015 and 2021 which assessed the challenge of hernia diagnosis during pregnancy, available and recommended investigations for a proper diagnosis, potential complications that hernia might cause in pregnant patients, the appropriate treatment during pregnancy and the ideal moment for surgery, if necessary. It appears to be widely acknowledged that it is best to uphold surgical repair of hernia until after delivery. Nevertheless, there is no clinical guideline available on this matter and the existing studies are either case-reports or have used rather small group of patients, therefore future studies are of utmost necessity.
疝是全球最常见的外科疾病之一。尽管它对女性人口的影响比男性少,而且在怀孕期间发生的情况相当罕见,但它不能被忽视,特别是由于在怀孕期间难以正确诊断这一实体。我们根据2015年至2021年期间发表的13篇论文的数据进行了一篇综述文章,评估了妊娠期间疝气诊断的挑战、可用的和推荐的诊断调查、妊娠患者疝气可能导致的潜在并发症、妊娠期间的适当治疗以及必要时手术的理想时机。它似乎被广泛承认,最好坚持手术修补疝,直到分娩后。然而,在这方面没有临床指南,现有的研究要么是病例报告,要么是使用了相当小的患者群体,因此未来的研究是非常必要的。
{"title":"Hernia and pregnancy: A symbiosis of two bumps","authors":"C. Mugescu, A. Ciobanu, C. Gică, Mihaela Demetrian, B. Cimpoca-Raptis, G. Peltecu, R. Botezatu, N. Gică, A. Panaitescu","doi":"10.37897/rmj.2022.s2.7","DOIUrl":"https://doi.org/10.37897/rmj.2022.s2.7","url":null,"abstract":"One of the most common surgical entities, globally, is hernia. Even though it affects female population less often than men and its occurrence is rather exceptional during pregnancy, it must not be neglected, especially due to the difficulties in diagnosing this entity correctly in the gestation period. We conducted a review article based on data from 13 papers published between 2015 and 2021 which assessed the challenge of hernia diagnosis during pregnancy, available and recommended investigations for a proper diagnosis, potential complications that hernia might cause in pregnant patients, the appropriate treatment during pregnancy and the ideal moment for surgery, if necessary. It appears to be widely acknowledged that it is best to uphold surgical repair of hernia until after delivery. Nevertheless, there is no clinical guideline available on this matter and the existing studies are either case-reports or have used rather small group of patients, therefore future studies are of utmost necessity.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89676532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spontaneous hemoperitoneum in pregnancy 妊娠期自发性腹膜出血
Pub Date : 2022-01-31 DOI: 10.37897/rmj.2022.s2.5
Spontaneous hemoperitoneum in pregnancy (SHP) is an uncommon, but very critical complication when present in pregnancy, leading to important morbidity and mortality for both mother and fetus. The etiology includes a large spectrum of causes, not taking into consideration trauma or other pathologies not pregnancy related. One of the most frequent triggers is the rupture of the varicose veins around the uterus that can occur either spontaneously or during labor, that can be associated with the unfortunate event of delivery of a stillborn baby. Endometriosis has been suspected to be also implicated in the apparition of spontaneous hemoperitoneum in pregnant women due to the fragility of the tissues associated with endometriosis chronic inflammation (ruptured endometrioma, intraabdominal adhesions, decidualization at the site of endometriotic implants). Even the operative vaginal delivery can conduct to this complication, but the cases described in the literature were also associated with lesion of endometriosis at the bleeding site. Moreover, assisted reproductive procedures (IVF-ET) is incriminated as one of the possible etiologies. The improvements in the resuscitation, operative and anesthetic management of these cases have lowered the maternal mortality, but perinatal mortality still has a high value (31%). Symptoms as acute or subacute abdominal pain, that can be associated or not with hypovolemic shock and signs of fetal affliction, identified as heart decelerations, should raise a question mark regarding the possibility of a hemoperitoneum. Electronic research for subject related reviews and articles has been made, using PubMed, Medline, Cochrane Data Base and also the current international guidelines regarding the management of hemoperitoneum in pregnancy, recommended by Obstetrics and Gynecology Societies in United States and United Kingdom. Adequate case management as hematologic analysis, abdominal ultrasound, CT scan or MRI should reveal free intrabdominal fluid and estimate the blood loss, which can then be confirmed by paracentesis or by direct urgent laparotomy or laparoscopy. The aim of the current review is to raise awareness of this rare, but potentially fatal, complication in pregnancy and its most appropriate management, according to the current information presented in the medical literature.
妊娠期自发性腹膜出血(SHP)是一种罕见但非常严重的并发症,可导致母亲和胎儿的重要发病率和死亡率。病因包括多种原因,不考虑创伤或其他与妊娠无关的病理。最常见的触发因素之一是子宫周围静脉曲张破裂,这种情况可能自发发生,也可能在分娩过程中发生,这可能与分娩死产婴儿的不幸事件有关。由于慢性炎症(子宫内膜异位症破裂、腹腔内粘连、子宫内膜异位症植入部位脱个体化)相关组织的易碎性,子宫内膜异位症也被怀疑与孕妇自发性腹膜出血的出现有关。即使阴道手术分娩也可能导致该并发症,但文献中描述的病例也与出血部位子宫内膜异位症病变有关。此外,辅助生殖手术(IVF-ET)被认为是可能的病因之一。这些病例的复苏、手术和麻醉管理的改善降低了孕产妇死亡率,但围产期死亡率仍然很高(31%)。急性或亚急性腹痛的症状,可能与或不与低血容量性休克有关,胎儿不适的迹象,确定为心脏减速,应该对腹膜出血的可能性提出质疑。使用PubMed、Medline、Cochrane数据库以及美国和英国妇产科学会推荐的关于妊娠期腹膜出血管理的现行国际指南,对相关主题的评论和文章进行了电子研究。充分的病例管理,如血液学分析、腹部超声、CT扫描或MRI应显示腹腔内游离液体并估计出血量,然后可通过穿刺或直接紧急剖腹手术或腹腔镜检查确认。本综述的目的是根据目前医学文献中的信息,提高人们对这种罕见但可能致命的妊娠并发症的认识,并对其进行最适当的处理。
{"title":"Spontaneous hemoperitoneum in pregnancy","authors":"Ruxandra-Patricia Nitica, A. Ciobanu, C. Gică, Mihaela Demetrian, B. Cimpoca-Raptis, G. Peltecu, R. Botezatu, N. Gică, A. Panaitescu","doi":"10.37897/rmj.2022.s2.5","DOIUrl":"https://doi.org/10.37897/rmj.2022.s2.5","url":null,"abstract":"Spontaneous hemoperitoneum in pregnancy (SHP) is an uncommon, but very critical complication when present in pregnancy, leading to important morbidity and mortality for both mother and fetus. The etiology includes a large spectrum of causes, not taking into consideration trauma or other pathologies not pregnancy related. One of the most frequent triggers is the rupture of the varicose veins around the uterus that can occur either spontaneously or during labor, that can be associated with the unfortunate event of delivery of a stillborn baby. Endometriosis has been suspected to be also implicated in the apparition of spontaneous hemoperitoneum in pregnant women due to the fragility of the tissues associated with endometriosis chronic inflammation (ruptured endometrioma, intraabdominal adhesions, decidualization at the site of endometriotic implants). Even the operative vaginal delivery can conduct to this complication, but the cases described in the literature were also associated with lesion of endometriosis at the bleeding site. Moreover, assisted reproductive procedures (IVF-ET) is incriminated as one of the possible etiologies. The improvements in the resuscitation, operative and anesthetic management of these cases have lowered the maternal mortality, but perinatal mortality still has a high value (31%). Symptoms as acute or subacute abdominal pain, that can be associated or not with hypovolemic shock and signs of fetal affliction, identified as heart decelerations, should raise a question mark regarding the possibility of a hemoperitoneum. Electronic research for subject related reviews and articles has been made, using PubMed, Medline, Cochrane Data Base and also the current international guidelines regarding the management of hemoperitoneum in pregnancy, recommended by Obstetrics and Gynecology Societies in United States and United Kingdom. Adequate case management as hematologic analysis, abdominal ultrasound, CT scan or MRI should reveal free intrabdominal fluid and estimate the blood loss, which can then be confirmed by paracentesis or by direct urgent laparotomy or laparoscopy. The aim of the current review is to raise awareness of this rare, but potentially fatal, complication in pregnancy and its most appropriate management, according to the current information presented in the medical literature.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78573857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leiomyomas in pregnancy 妊娠期平滑肌瘤
Pub Date : 2022-01-31 DOI: 10.37897/rmj.2022.s2.8
Uterine fibroids are the most common benign tumors affecting female genital tract, responsible for a high morbidity across fertile age women, with a prevalence of 0,1-11% among pregnant women. Although generally asymptomatic, they can lead to a series of symptoms and complications such as pain, infertility, miscarriages, antenatal bleeding, postpartum hemorrhage, preterm labor, fetal malpresentation, placental abruptio and high cesarean section rates. The purpose of review is to update information regarding fibroids specifications and their correlation with pregnancy outcomes as well as fibroids management during pregnancy. Because of uterine fibroids heterogeneity and lack of large, randomized trials there are encountered discrepancies among studies, but it was observed that uterine fibroids increase the risks of negative obstetrical outcomes, especially when it goes to large, multiple, submucous and retroplacental myomas. Conservative management during pregnancy is advised, but in special situations myomectomy could be recommended and possible. Trial of labor should be offered to pregnant women even if they have large uterine fibroids, or previous myomectomy excepting fibroids obstructing the birth canal or patients who underwent extensive surgery for fibroids removal.
子宫肌瘤是影响女性生殖道的最常见的良性肿瘤,在育龄妇女中发病率很高,在孕妇中患病率为0.1% -11%。虽然一般无症状,但可导致一系列症状和并发症,如疼痛、不孕、流产、产前出血、产后出血、早产、胎儿畸形、胎盘早剥和剖宫产率高。回顾的目的是更新有关子宫肌瘤规格及其与妊娠结局的相关性以及妊娠期间子宫肌瘤的处理的信息。由于子宫肌瘤的异质性和缺乏大型随机试验,研究之间存在差异,但观察到子宫肌瘤增加了不良产科结局的风险,特别是当它发展为大型、多发性、粘膜下和胎盘后肌瘤时。建议在怀孕期间保守处理,但在特殊情况下,子宫肌瘤切除术是可行的。孕妇即使有较大的子宫肌瘤,或有子宫肌瘤切除史,但子宫肌瘤阻塞产道者除外,或接受过子宫肌瘤切除手术的患者,也应进行试产。
{"title":"Leiomyomas in pregnancy","authors":"Ana Maria Huszti, A. Ciobanu, C. Gică, Mihaela Demetrian, B. Cimpoca-Raptis, G. Peltecu, R. Botezatu, N. Gică, A. Panaitescu","doi":"10.37897/rmj.2022.s2.8","DOIUrl":"https://doi.org/10.37897/rmj.2022.s2.8","url":null,"abstract":"Uterine fibroids are the most common benign tumors affecting female genital tract, responsible for a high morbidity across fertile age women, with a prevalence of 0,1-11% among pregnant women. Although generally asymptomatic, they can lead to a series of symptoms and complications such as pain, infertility, miscarriages, antenatal bleeding, postpartum hemorrhage, preterm labor, fetal malpresentation, placental abruptio and high cesarean section rates. The purpose of review is to update information regarding fibroids specifications and their correlation with pregnancy outcomes as well as fibroids management during pregnancy. Because of uterine fibroids heterogeneity and lack of large, randomized trials there are encountered discrepancies among studies, but it was observed that uterine fibroids increase the risks of negative obstetrical outcomes, especially when it goes to large, multiple, submucous and retroplacental myomas. Conservative management during pregnancy is advised, but in special situations myomectomy could be recommended and possible. Trial of labor should be offered to pregnant women even if they have large uterine fibroids, or previous myomectomy excepting fibroids obstructing the birth canal or patients who underwent extensive surgery for fibroids removal.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90954487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Romanian Medical Journal
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1