Dietary Patterns of Pregnant Women and Their Association with Diet Quality Measures: A Comparative Analysis.

Healthy dietary patterns during pregnancy are crucial for ensuring maternal and foetal health outcomes. Numerous methodologies exist for assessing the diet of pregnant women, including dietary patterns and various appraisal tools of diet quality. This study aimed to assess the dietary patterns and diet quality of pregnant women and to investigate the relationship between dietary patterns, diet quality estimators, and the adequacy of nutrient intake. EPIC FFQ was applied to a sample of 251 pregnant women, and questionnaires were interpreted with the FETA program. Dietary patterns were then determined by means of principal component analysis. Our results showed a substantial association between dietary patterns and total diet quality, as measured by the Diet Quality Index for Pregnancy (DQI-Pc), PURE Healthy Diet Score, and FIGO Diet Quality Score. We also found correlations between certain dietary patterns and particular nutrient intakes recommended by the European Food Safety Authority during pregnancy. The most deficient intake was registered for iron (86.1%), zinc (87.3%) and magnesium (79.3%), posing a threat to normal bone development, anaemia prophylaxis, and immune status. These results highlight the importance of assessing and understanding eating habits during pregnancy in order to achieve optimal outcomes for both the mother and the foetus.

The Applicability of Artificial Intelligence in Predicting the Depth of Myometrial Invasion on MRI Studies-A Systematic Review.

(1) Objective: Artificial intelligence (AI) has become an important tool in medicine in diagnosis, prognosis, and treatment evaluation, and its role will increase over time, along with the improvement and validation of AI models. We evaluated the applicability of AI in predicting the depth of myometrial invasion in MRI studies in women with endometrial cancer. (2) Methods: A systematic search was conducted in PubMed, SCOPUS, Embase, and clinicaltrials.gov databases for research papers from inception to May 2023. As keywords, we used: "endometrial cancer artificial intelligence", "endometrial cancer AI", "endometrial cancer MRI artificial intelligence", "endometrial cancer machine learning", and "endometrial cancer machine learning MRI". We excluded studies that did not evaluate myometrial invasion. (3) Results: Of 1651 screened records, eight were eligible. The size of the dataset was between 50 and 530 participants among the studies. We evaluated the models by accuracy scores, area under the curve, and sensitivity/specificity. A quantitative analysis was not appropriate for this study due to the high heterogeneity among studies. (4) Conclusions: High accuracy, sensitivity, and specificity rates were obtained among studies using different AI systems. Overall, the existing studies suggest that they have the potential to improve the accuracy and efficiency of the myometrial invasion evaluation of MRI images in endometrial cancer patients.

Retained Placenta Percreta with Acquired Uterine Arteriovenous Malformation-Case Report and Short Review of the Literature.

Placenta accreta spectrum disorder (PAS) has an increased frequency due to the high number of cesarean sections. The abnormal placentation associated with a retained placenta can cause persistent uterine bleeding, with ultrasound Doppler examination being the main choice to assess the uterine hemorrhage. An acquired uterine arteriovenous malformation (AVM) may occur because of uterine trauma, spontaneous abortion, dilation and curettage, endometrial carcinoma or gestational trophoblastic disease. The treatment for abnormal placentation associated with AVM can be conservative, represented by methotrexate therapy, arterial embolization, uterine curettage, hysteroscopic loop resection or radical, which takes into consideration total hysterectomy. Therapeutic management always considers the degree of placental invasion, the patient hemodynamic state and fertility preservation. Considering the aspects described, we present a case of retained placenta percreta associated with acquired uterine AVM, with imagistic and clinical features suggestive of a gestational trophoblastic disease, successfully treated by hysterectomy, along with a small review of the literature, as only a few publications have reported a similar association of diagnostics and therapy.

Logistic models and artificial intelligence in the sonographic assessment of adnexal masses - a systematic review of the literature.

Adnexal masses are common, yet challenging, in gynecological practice. Making the differential diagnosis between their benign and malignant condition is essential for optimal surgical management, but reliable pre-surgical differentiation is sometimes difficult using clinical features, ultrasound examination, or tumor markers alone. A possible way to improve the diagnosis is using artificial intelligence (AI) or logistic models developed based on compiling and processing clinical, ultrasound, and tumor marker data together. Ample research has already been conducted in this regard that medical practitioners could benefit from. In this systematic review, we present logistic models and methods using AI, chosen based on their demonstrated high performance in clinical practice. Although some external validation of these models has been performed, further prospective studies are needed in order to select the best model or to create a new, more efficient, one for the pre-surgical evaluation of ovarian masses.

[How can we improve cervical cancer screening: What can we learn from mistakes?] / Comment pouvons-nous améliorer le dépistage du cancer du col de l'utérus : que pouvons-nous apprendre des erreurs ?

Cervical cancer screening is considered one of the most significant public health interventions that can reduce not only the incidence, but also the mortality of the disease. One of the most important factors for screening effectiveness is coverage defined as the number of women tested within a recommended interval. In the first years of the cervical screening, the participation rate in National Screening Program in Romania was 14.2% with slight difference in different region of the country. In the northeastern part of the country, in the first four years of the program, the rate was 16.9% with an alarmingly continuous decrease. Thus, increasing the rate of uptake of cervical screening is essential. The policy-makers should take new measures to increase women's participation in this screening program. The objective of this paper was to review situation of the screening program and to identify gaps and needs in the system and to bring or suggest solution.

Ultrasound features of osseous metaplasia of the endometrium-Case series and review of the literature.

Osseous metaplasia of the endometrium is a rare condition characterized by abnormal bone formation in the uterine endometrium. The osseous fragments act like a foreign body in the uterine cavity; thus, infertility, menstrual abnormalities, pelvic pain dysmenorrhea, and dyspareunia are commonly associated. We present a case series of four women with osseous metaplasia of the endometrium with different symptomatology. Two-dimensional endovaginal examination played a primary role in the diagnosis, the characteristic ultrasound pattern being hyperechoic linear or irregular areas within the endometrium casting posterior acoustic shadowing. Three-dimensional ultrasound better demonstrated the irregular appearance and clearly differentiated the oseous metaplasia from an intrauterine device.

Pentalogy of Cantrell associated with unilateral anophthalmia: Case report and literature review.

RATIONALE: Pentalogy of Cantrell, a very rare congenital condition, has an estimated incidence of 5.5 per 1 million live births. It includes five defects: a midline supraumbilical wall defect, a diaphragmatic defect, a cleft distal sternum, a defect in the diaphragmatic pericardium, and an intracardiac defect. Very few cases of this condition have been reported in the literature, most of them diagnosed in the second or third trimester of pregnancy. PATIENT CONCERNS: We present a case of pentalogy of Cantrell associated with cranioschisis and unilateral anophthalmia diagnosed at 14 weeks of amenorrhea. DIAGNOSES: The combination of abdominal and vaginal sonography established the diagnosis of 14 weeks of amenorrhea with a plurimalformative syndrome including: ectopia cordis, large suprambilical anterior abdominal wall defect, omphalocele, anomaly of the shape of the skull, and anomalies of the brain. INTERVENTIONS: After counseling the parents, the pregnancy was interrupted, as requested by the family. OUTCOMES: Pathological examination of the fetus after the therapeutic abortion confirmed the diagnosis. LESSONS: Because of the poor prognosis of Cantrell's pentalogy, early antenatal sonographic detection is important and allows for elective abortion before viability.

Preliminary results of the first cervical cancer screening programme in the North Eastern region of Romania.

OBJECTIVE: Cervical cancer represents a major health problem in Romania. A national population-based cervical cancer screening programme was launched in 2012. The aims of the study were to assess the participation rate and to estimate the prevalence of epithelial cell abnormalities in the first four years of the programme in North Eastern Romania. METHODS: The participation rate, representing the proportion of eligible women screened in the programme, was evaluated for 2012-2016. The prevalence of cytological abnormalities was estimated by age group and calendar year. RESULTS: Of 107,968 Pap smears taken, 312 were unsatisfactory (0.3%). The number of smears decreased by year. The participation rate over the four years was 16.9%. Of the 107,656 satisfactory smears, 6.5% were positive for squamous and/or glandular lesion, among which 0.5% contained high-grade squamous intraepithelial or worse lesions. CONCLUSION: The participation rate in the first four years of the programme was low. The effectiveness of the screening programme should be improved by attendance monitoring of the target population, and follow-up of screen-positive women. Measures should be taken to raise coverage and assure quality at all steps of the screening chain. The data collected should include all screening tests from both opportunistic and organized settings.

The role of 4D US in evaluation of fetal movements and facial expressions and their relationship with fetal neurobehaviour.

The introduction of four-dimensional (4D) ultrasonography (US) allows the study of fetal movements and facial expressions in real time. The possibility of evaluating fetal movements has led to the study of fetal neurobehaviour, which has been for a long period of time a mystery for physicians. The study of fetal activity in utero could differentiate between normal and abnormal behavioural patterns, thus making possible the early recognition of fetal brain impairment. Facial expressions observed with 4D US represent a marker for neurobehaviour and at the same time could enhance fetal-maternal bonding. The present review represents an update of the literature on fetal movements, facial expressions, and their relationship with fetal neurobehaviour.

Pictorial essay of ultrasound-reconstructed coronal plane images of the uterus in different uterine pathologies.

Imaging in the major planes (horizontal, coronal, and sagittal) of the uterus is important for determining anatomy and allowing the findings to be standardized, and for evaluating and diagnosing different pathological conditions in clinical practice. Examination of the coronal plane is an important step in identifying uterine pathologies and their relationships to the endometrial canal. Three-dimensional (3D) ultrasound reveals the normal anatomy better and improves the depiction of abnormal anatomy, as the coronal plane of the uterus can easily be obtained using 3D reconstruction techniques. Our pictorial essay demonstrates that adding 3D ultrasound to a routine gynecological workup can be beneficial for clinicians, enabling a precise diagnosis to be made. In addition, the volumes obtained and stored by 3D ultrasound can allow students or residents to become more familiar with normal and abnormal pelvic structures. Clin. Anat. 31:373-379, 2018. © 2017 Wiley Periodicals, Inc.

Three-dimensional ultrasound and HDlive in tubal serous cystadenofibroma: a case report and literature review.

Cystadenofibromas of the fallopian tubes are very rare benign tumors and very few cases have been reported in the literature worldwide. Usually, the tumor is asymptomatic, and for almost all cases reported, the tumors were incidentally discovered during surgery for other genital pathology. We report the case of a 30-year-old woman with a serous cystadenofibroma of the fallopian tube, presenting with chronic abdominal pain and secondary infertility. The diagnosis of tubal tumor was formulated before surgery and confirmed during laparoscopic surgery. Both 3D ultrasound and HDlive were useful tools for the diagnosis. The ultrasound diagnosis was helpful in planning appropriate surgical management.

Perception and use of Pap smear screening among rural and urban women in Romania.

Background: In 2012 the National Screening Program for all women between 25 and 64 years of age was launched in Romania. Public awareness is an important factor in the success of a screening program. For this reason, we intended to assess the perception and the level of awareness of Romanian women regarding the Pap test in the prevention of cervical cancer. Methods: A cross-sectional study was conducted among 454 women from rural and urban areas. For our study, we used a questionnaire covering general characteristics, awareness, knowledge and practices regarding cervical cancer and Pap smear. Results: 431 participants (95%) had heard of cervical cancer and Pap smear but only 71.8% knew the exact role of it. Bivariate analysis showed that knowledge about the importance of the Pap smear, early detection and treatment of early-stage cervical cancer was reduced among women with low socio-economic status, mainly living in rural area. The most frequent reasons for avoiding Pap smear screening were: lack of money, embarrassment or fear of gynaecological consultation and pain, the feeling that they don't need it, misconceptions about cervical cancer, fatalistic attitude, perceived low susceptibility to cervical cancer. Conclusions: Because the uptake and the success of cervical cancer screening are determined by women's knowledge and awareness of Pap smear, it is critical to improve these perceptions in the near future especially in rural area characterized by a low socio-economic status.

Small-Bowel Intussusception in a Pregnant Woman: A Case Report.

INTRODUCTION: Intussusception usually is associated with children, rarely with adults. CASE PRESENTATION: A 42-year-old pregnant woman (29 weeks' gestation) reported mild pain in the upper aspect of the abdomen after an intense physical effort. Ultrasound examination found a normally evolving pregnancy and a bowel obstacle, without bowel distention. Because it was not a surgical emergency at the time of evaluation, she was sent to the hospital's Obstetrics Department. The patient's symptoms worsened the next day. Ultrasound examination revealed dilated bowel loops and free fluid. Strangulated epigastric hernia was suspected. Computed tomography was not performed. Exploratory laparotomy revealed a small-bowel intussusception, which was successfully manually reduced, and no leading point was found. Four days later, she delivered a premature baby boy. Two days later the necrotized reduced ileal loop had to be surgically removed because of the patient's altered status. After this procedure, the patient's recovery was uneventful. DISCUSSION: To our knowledge, this is the first case of small-bowel intussusception in a pregnant woman reported in the literature.

Diagnostic hysteroscopy in endometrial hyperplasia.

OBJECTIVES: To assess the reproducibility of hysteroscopic diagnosis in the various types of endometrial hyperplasias and to compare different classifications of endometrial hyperplasia from this point of view. STUDY DESIGN: 109 endometrial hyperplasias, diagnosed in the last 5 years with hysteroscopy, were all biopsied and had a pathological examination. We tried to estimate the accuracy of hysteroscopy comparing the various classifications of endometrial hyperplasia to the final pathologic diagnosis. RESULTS: Using older endometrial hyperplasia classification, the overall diagnostic accuracy of hysteroscopy was 76% as for the correct type of hyperplasia. Classifying them at hysteroscopy into two categories only, i.e. hyperplasias and neoplasias, gave a more accurate result (90.26%). CONCLUSIONS: The newer classification is better from the hysteroscopist's point of view.