Pregnancy in Teenage Romanian Mothers.

Background and purpose Teenage pregnancy is associated with an increased risk of adverse pregnancy outcomes. The objective of this research is to determine the profile of the pregnant teenager and the medical complications associated with pregnancy at this young age. Materials and methods A cross-sectional study based on a 29-item questionnaire was conducted in 2019 and 2020 in Ploiești, Romania. The participants were divided into two groups, namely, Group A, consisting of 100 minor, teenage childbearing women under the age of 18, and Group B, consisting of 100 childbearing women over 18 years of age. Results Group A had a mean age of 16.56 ± 1.65. The percentage of births in very young girls (13-15 years) from group A is 28%. In 65 adolescents, sexual intercourse began at the age of 14. Pregnancy monitoring, expressed by the number of medical examinations, shows significant differences between the studied groups. The Short Assessment of Health Literacy (SAHL) test applied to both groups revealed a low level of health literacy in group A. Also in this group A, teenagers gave birth to low-birth-weight children, the percentage is statistically significant (14% vs. 4%). The gestational age in this group had an average of 36.88 ± 2.13 weeks, compared to the gestational age in the control group of 38.41 ± 1.57 weeks. In Romania, there are teenagers who became mothers at an early age. There should be educational programs in rural and urban schools and communities. Poverty leads to inadequate medical supervision with significant consequences for the health of the mother and child, lack of education (school dropout, illiteracy), and inability to find a job. The midwife can play a key role in rural communities through health education conducted on specific communication channels and with different forms of presentation of messages, adapted to their needs. A good target would be the parents of adolescent mothers and better communication with them.

Human Papillomavirus Infection at the Time of Delivery.

Human papillomavirus (HPV) is one of the most encountered viral etiologies of genital infections that are transmitted through the sexual route in sexually active females. In the genital area, condylomata acuminate warts and the Buschke-Loewenstein tumor (giant condyloma acuminatum) are described. These lesions are associated with benign HPV6 and HPV 11 types. Condylomata acuminate may appear as exophytic growth similar to a cauliflower and is usually asymptomatic. The Buschke-Loewenstein tumor appears as ulcerated cauliflower-like lesions, often associated with fistulas and abscesses. They present exophytic and endophytic growth, local invasion, and high recurrence rates. This type of lesion may be associated with malignant HPV types. Here we present the case of a 34-year-old year pregnant woman who presented herself at the emergency room in labor with no previous medical evaluation during the pregnancy. The local examination revealed normal pubic hair, vulvar hyperpigmentation, and tonic and continent anal sphincter. At the vulvar level, a bulky cauliflower-like formation appeared. All routine investigations were normal. Immunological tests revealed the presence of antibodies anti-HPV immunoglobulin M (IgM) and immunoglobulin G (IgG). Treponema pallidum hemagglutination (TPHA) and HIV tests were negative. Samples collected from the genital lesions tested positive for both 6 and 11 DNA/HPV. The patient was diagnosed with condylomata acuminate and C-section was indicated as the methodology of birth so HPV infection of the newborn was avoided. We believe that HPV infection during pregnancy must be documented and treated when detected in order to avoid transmitting it to the newborn baby in a manner similar to TORCH testing. In pregnant women and women that want to conceive, in order to avoid transmission of infectious diseases from the mother to the newborn baby, TORCH testing is recommended. TORCH represents an acronym that includes: toxoplasmosis, other infectious diseases, rubella, cytomegalovirus infection, and herpes simplex infection.

Teenage Pregnancies and Childbirth Experience in Romania From the Midwives Point of View.

In Romania, in 2017, the infant mortality rate was eight per thousand; with 41,000 women who had no medical visits during pregnancy; 18,500 were teenagers. Our objective was to analyze how many teen pregnancies were in an Obstetrics and Gynaecology Hospital from Romania over a two-year period and underline the role that midwives have in preventing teenage pregnancies. A descriptive study of a group of 343 childbearing teenagers out of 7020 childbearing women who gave birth in 2017-2018 is presented. The teenagers were evaluated by age, the number of pregnancies, birth complications, way of delivery, and place of origin. The involvement of the midwife was highlighted. From the total of 7020 analyzed cases, 4.8% (n=343) were teen pregnancies. Within this group, 4.37%(n=15)were already at the third birth and 89.79 (n=308)were un-investigated during the entire pregnancy. Sixty-eight point fifty-one percent (68.51%; n=235)of the teenagers gave birth with the aid of a midwife while 4.66 (n=16) gave birth with no medical attendance and experienced homebirth. All the teenagers that gave birth at home were from rural areas and not married. High teenage pregnancy rates are determined in Romania by the low level of information about sexuality and family planning at young ages. The midwives have the ability to help to resolve these problems if they were more allowed to be involved in these programs, especially in rural areas.

SARS-CoV-2 Infection in Seven Childbearing Women at the Moment of Delivery, a Romanian Experience.

COVID-19 pandemic outbreak had officially started on 11 March 2020 according to the World Health Organization. In Romania the first case of COVID-19 was documented on 26th of February. Ploiesti Obstetrics and Gynecology Hospital is one of the biggest mono-specialty units from Romania that was designated to deal with COVID-19 infected pregnant women. We retrospectively analyzed seven pregnant women infected with SARS-CoV-2 who gave birth during the 1st July and 30thNovember 2020. The median age of pregnancy was 39 weeks. Three of the childbearing women presented rupture membranes at hospital admission and four gave birth by cesarean section (C-section). The women infected with SARS-CoV-2 had a good evolution, vertical transmission of the virus did not occur, measures to prevent mother-to-child transmission were applied. Apgar score was 9 for all new-born babies and they all tested negative for SARS-CoV-2. There were no maternal deaths. One new born baby was preterm but didn't present low birth weight or low Apgar score. Applying cesarean section as a method of birth did not influence vertical transmission. There is no evidence if it is necessary to anticipate the time of birth. We believe it is recommended to individualize each case according to the experience of the obstetrician and the severity of the maternal infection.

A Romanian experience of syphilis in pregnancy and childbirth.

OBJECTIVE: to establish the incidence of syphilis in a group of childbearing women and their newborn babies in Romania and to identify the major risk factors of materno-fetal transmission in order for midwives to develop strategies to help prevent congenital syphilis. MATERIAL AND METHODS: a descriptive study of a group of 982 childbearing women who gave birth during a three-month period at an Obstetrics and Gynaecology Hospital in Romania. The women completed a questionnaire, which consisted of three sections: general data, general knowledge of syphilis and birth and pregnancy data. After admission to hospital, the women were investigated for syphilis using serological tests. RESULTS: there was a syphilis frequency of 0.91649% (n = 9) among the surveyed women. Among the nine infected women, two were not aware that they had a syphilis infection when initially admitted to hospital. The maternal profile with the highest risk of being diagnosed with syphilis was a young woman who had not had adequate prenatal care, who had elementary sex education and who lacked knowledge of personal health and hygiene. A significant percentage of the respondents, namely 11.9% (n = 117), were aged 15 to 20. CONCLUSIONS: in certain population groups, syphilis is still an important health care problem, especially in vulnerable individuals, such as childbearing women and newborns babies. More attention needs to be paid to primary prevention; the number of cases of congenital syphilis could be reduced by more involvement of midwifes and family doctors in antenatal care.