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Endometriosis is a gynecological estrogen-dependent disease, characterized by the presence of active endometrial tissue, represented by glandular epithelial and stromal cells, outside the uterine cavity. There have been described three types of endometriosis: peritoneal superficial endometriosis, ovarian endometriomas, and deep infiltrating endometriosis (DIE). DIE is deffined from a histologically perspective as a lesion that extends more than 5 mm into the peritoneal space or which affects the wall of the pelvic organs. Endometriosis of the bladder is considered to be a form of deeply infiltrating endometriosis. The relation with infertility involves multiple and complex mechanisms. It is estimated that over half of the patients affected by this condition are subfertile. Many women with either minimal, mild or severe endometriosis experience difficulties in conceiving or maintaining a pregnancy. We report the case of a women diagnosed with a severe form of infiltrating endometriosis, with endometrioma in the bladder, who obtained a pregnancy and delivered in the 39 week of gestation by caesarean section and had a good evolution.

The spectacular evolution of the ultrasound equipment and techniques has allowed the assessment of the fetal heart increasingly earlier during the gestation, as well as the diagnosis of the fetal abnormalities in the first trimester of pregnancy. Transvaginal ultrasound and transabdominal ultrasound are used in early fetal echocardigraphy. Studies have shown that the heart defects diagnosed early in gestation are more complex and have a high degree of association with chromosomal abnormalities, compared to those diagnosed in the second trimester of pregnancy. There are many studies on the correlation between the increase in the nuchal translucency (NT) and congenital heart defects, NT being one of the most frequently studied and efficient screening parameters in maternal-fetal medicine. The morphology of the umbilical cord can be assessed in the first trimester of pregnancy by colour Doppler examination. Numerous anomalies associated with single umbilical artery are described. The principles of fetal echocardiography in the first trimester are similar to those of the morphological examination in the second trimester of pregnancy, with certain peculiarities and differences. The complete examination of the fetal heart, with minimal false results, can be done under the conditions of a trained and experienced examiner within the range of 12-13 gestational weeks. The examination route must be adapted to the particularities of the case. Early fetal echocardigraphy should be recommended only in the presence of a precise medical indication.

Total placenta praevia is used to describe a placenta that completely covers the internal os. Placenta increta is one of the most important complications of placenta praevia and requiring usually a hysterectomy. We report a case of central placenta praevia diagnosed by ultrasound in which we accomplished conservative management of postpartum period.

A pregnancy becomes at high-risk when the life of the mother or the fetus is becoming fragile. Nowadays, many health problems come to different women before pregnancy and then extended during and after pregnancy. Health problems can occur before a woman becomes pregnant or during pregnancy. We report the management of a 48 -year- old female patient with pregnancy obtained via in vitro fertilization with the use of donor oocytes and prophylactic transabdominal cerclage for history of cervical amputation, diagnosed with gestational diabetes mellitus. During the 38 week of pregnancy she delivered by cesarean section, a healthy fetus.

Premature rupture of fetal membranes is associated with a substantial fetal morbidity and mortality. Immediate actions that can improve the future neonatal outcome are the administration of antenatal corticosteroid therapy, infection prophylaxis, tocolytic drugs and insurance of an appropriate neonatal nursery level. One of the essential points in the management of these cases is the attempt to extend as much as possible the gestational age, especially in mid trimester premature rupture of membranes and even more considering that the duration of the latency period inversely correlates with gestational age at membrane rupture. We present the case of a patient aged 41 years admitted as obstetric emergency for suspected leakage of clear fluid in context of dichorionic, diamniotic twin pregnancy, 22 weeks of gestation, obtained by in vitro fertilization due to primary infertility. Under continuous tocolytic and antibiotic treatment, the extension of the gestational age of the first fetus with 5 weeks was successfully obtained. The second fetus was born one week later as a result of the abandonment in utero of the placenta. Complications implied by preterm rupture of membranes in twin pregnancies are significantly influenced by the presence of chorioamnionitis and by placentation. We consider that the prognosis of the second fetus, perfectly normal developed during first 5 years, was positive and significantly influenced by the prolonged gestational age with almost one week.

The pelvic tumors with the highest prevalence are uterine leiomyoma. These benign tumors are associated with symptoms like: pain, menorrhagia and menometrorrhagia. A modern method of treatment in these cases is uterine arteries embolization. This technique consists in injecting particles of polyvinyl alcohol into vessels that supply the tumorsin order to block their vascularization. This procedure is performed by femoral or brachial artery approach with a 3F micro catheter. First, a dye is injected followed by X-ray guidance. Another used method consists in surgical excision of the leiomyoma - myomectomy. We performed a retrospective descriptive study analyzing a group of 90 patients hospitalized in the University Emergency Hospital Bucharest on the Obstetrics-Gynecology ward between 01.01.2011-01.01.2015 diagnosed with bulky uterine fibroids. Two groups were formed. Group A included 45 patients who underwent uterine artery embolization. Group B consisted of 45 patients who underwent myomectomy. All patients were re-evaluated clinically and by ultrasound at 1 month, 3 months and 6 months after the procedure to assess treatment response. An extensive comparison was conducted between the two groups.

We report the case of a 33 weeks pregnant woman who was admitted in our hospital for recent jaundice. The controversial results of medical investigations and the patient’s clinical outcome indicated the necessity for immediate caesarian-section along with exploratory laparotomy. The surgeons extracted gelatinous membranes from the main biliary duct. At the Department of Pathology from University Emergency Hospital from Bucharest, we received the placental components, were we noted the presence of one true umbilical cord knot and meconium impregnation, a non-slatted gallbladder of 18 cm long and the numerous, heterogeneous membranes. On histopathological examination we found uteroplacental hypoxia-related features in the placenta together with retroplacental hematoma, umbilical cord edema, and inflammatory content of the gallbladder and hydatid cyst fragments on the common bile duct samples. The premature new-born survived and both the mother and the infant were discharged in good health condition after 2 weeks.