Factors affecting the decision to undergo abortion in Romania: Experiences at our clinic.

RATIONALE, AIMS, AND OBJECTIVES: It is estimated that 25% of pregnancies worldwide end in induced abortion. In Romania, the abortion situation shows a specific pattern. Following the fall of the communist regime, first-trimester abortions were legalized, and between 1990 and 1992, the country's abortion rate was the highest in the world, with 182 abortions per 1000 women of reproductive age. However, there are currently no statistically reliable data, as some abortions are not reported. The purpose of this study was to identify the main circumstances that determine the choice to undergo abortion with all related potential risks, rather than using contraception. METHOD: We conducted a prospective type 1 cohort study based on a Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement that included women who presented at Bucur Maternity, Saint John Hospital, Bucharest, for abortion during the first trimester, between July and December 2018. The patients were asked to complete a 21-item questionnaire based on psychosocial data. RESULTS: The study included 119 patients, with a mean age of 29.57 years. Their educational level was average (ie, 51.3%, 4.2%, and 8.4% had completed high school, elementary school, and college or university, respectively). Most women were married (46.2%), and 47.9% were unemployed. The main reason for deciding to undergo an abortion was poverty (P = .014), and guilt was correlated with this decision (P = .004). CONCLUSION: The profiles of the women who chose to undergo an abortion as a family planning method were as follows: in the third decade of life, resident of urban areas, married, unemployed, and with a low family income. The main reasons for abortion were financial status, advanced maternal age, incompatibility of pregnancy with future plans, and the desire to postpone conception.

A rare case of synchronous ovarian tumors: clinical case report and literature review.

Epithelial ovarian carcinoma makes up 90-95% of all ovarian malignancies, taking into account also low-malignant-potential tumors. The Krukenberg tumor is a rare metastatic adenocarcinoma (ADK) in the ovary, representing 1-2% of ovarian tumors. Multiple primary malignant neoplasms may exist when more than one cancerous tumor is diagnosed in the same or a different organ. The incidence of multiple primary cancers among malignancies is between 2.4% to 8%. The aim of this paper is to report the case of a 47-year-old patient with two synchronous malignant tumors involving both ovaries, one diagnosed as primary papillary serous cystadenocarcinoma and the other one diagnosed as ovarian metastasis (Krukenberg tumor) of a synchronous colorectal ADK, and the complex diagnostic and therapeutic challenges that such a rare case poses. Histopathological (HP) examination and especially the immunohistochemical analysis had a determining role in differentiating between an ovarian primary tumor and a metastasis from a gastrointestinal tract cancer. The tumors examination for somatic mutations of Kirsten rat sarcoma viral oncogene homolog (KRAS) and neuroblastoma RAS viral oncogene homolog (NRAS) genes was performed in order to individualize the chemotherapic treatment in this difficult case. The conclusion of this case is that, although synchronous multiple primary cancers in a young patient are a rare condition, this situation should be taken into account in the differential diagnosis when we encounter clinical and HP diagnostic challenges.