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Uterine rupture is a significant maternal and fetal morbidity and mortality factor. It is defined as the complete cleaving of the three uterine layers. The pregnancy distention leads to alteration of the uterine wall fibers, especially in the low resistance points like surgical scars. World Health Organization realized an extensive systematic review to determine the prevalence of uterine rupture. A lower prevalence was seen in developed countries and higher rates for least developed countries. The incidence of uterine rupture in women with caesarean section is estimated to be 1% and without caesarean section is as low as 0.006%. Although the uterine scar is the main feature of uterine rupture, other contributing influences on untoward outcomes must be promptly recognized. The aim of this paper was to assess the frequency of uterine ruptures in a tertiary referral center, to identify risk factors and symptoms for complete and partial uterine rupture before labor, common symptoms of uterine rupture, multidisciplinary approach, and emergency surgical management.

Ovarian cancer is the seventh most commonly diagnosed cancer in women, with the highest mortality rate among female genital cancers. Due to the nonspecific symptoms and the lack of effective screening strategies, ovarian cancer is often diagnosed in an advanced stage of the disease, with a 5-year survival rate of 25%. The efforts of specialists are aimed at identifying screening methods, with the lowest possible rates of false positive or false negative results in order to diagnose the disease at an early stage, when the 5-year survival rate is 92%. In this study we analyzed the incidence of ovarian cancer in the last five years in the Bucharest University Emergency Hospital, being registered 153 cases of ovarian cancer. The aim of this paper is to analyze the correlation between the early diagnosis of ovarian cancer and the long-term prognosis.

COVID-19 pandemic had an impact without precedent. Pregnant women are part of the vulnerable population and the extent of SARS-CoV-2 infection consequences on obstetrical and neonatal outcome are still studied. It’s been speculated, based on what is known about other pathogenic viruses, SARS-CoV-2 virus can interfere with placental defense mechanisms and increase the miscarriage and preterm birth rate. Often, pregnant women infected with SARS-CoV-2 virus develop mild pneumonia. Severe pneumonia occurs very rarely and is statistically significant related to neonatal death. Our study has been conducted in a multidisciplinary hospital unit and included 184 pregnant women with SARS-COV-2 infection who gave birth in our hospital, diagnosed through polymerase chain reaction. There have been analyzed data regarding the maternal symptomatology, the gestational age, the method of giving birth, complications that have occurred during birth, the newborns weight and neonatal outcome through Apgar score. There have been three cases of severe infection with maternal death and one case with neonatal death. Overall, 20% of patients had mild symptomatology, 2% had severe form and the rest of the patients were asymptomatic. We found a high rate of preterm birth and intrauterine growth restriction and an increase incidence of acute fetal distress followed by caesarean section. SARS-CoV-2 virus affects both the mother and the fetus as a whole and, subsequently, individually. Our results show the adverse obstetrical and neonatal outcome in peripartum period complicated with SARS-CoV-2 infection even in asymptomatic and mild-symptomatic cases.

(1) Background: A quarter of maternal deaths are caused by post-partum hemorrhage; hence obstetric bleeding is a significant cause of morbidity and mortality among women. Pelvic artery embolization (PAE) represents a minimally invasive interventional procedure which plays an important role in conservative management of significant bleeding in Obstetrics and Gynecology. The aim of this study was to evaluate the effect and the complications of PAE in patients with significant vaginal bleeding with different obstetrical and gynecological pathologies. (2) Methods: We conducted an observational, retrospective study on 1135 patients who presented to the University Emergency Hospital of Bucharest with vaginal bleeding of various etiology treated with endovascular therapy. All the patients included in the study presented vaginal hemorrhage that was caused by: uterine leiomyomas, genital tract malignancies, ectopic pregnancy, arterio-venous mal-formations and other obstetrical causes. We excluded patients with uncontrolled high blood pressure, severe hepatic impairment, congestive heart failure, renal failure or ventricular arrhythmias. (3) Results: Bleeding was caused in 88.19% of cases by uterine leiomyomas (n = 1001), 7.84% (n = 89) by cervical cancer, 2.29% by ectopic pregnancy (n = 26), 1.23% by arteriovenous malformation (n = 14) and 0.52% by major hemorrhage of obstetrical causes. Endovascular procedures were used in all the cases. In patients with uterine leiomyomas, supra-selective uterine arteries embolization was used. In 97% (n = 1101) of patients, bleeding was stopped after the first attempt of PAE. 3% (n = 34) needed a second embolization. In 12 of 14 cases of AVM, PAE was successful, two other cases needed reintervention; (4) Conclusions: Endovascular procedures represent a major therapy method for both acute and chronic hemorrhage in Obstetrics and Gynecology. It can be used in post-partum or post-traumatic causes of vaginal bleeding, but also in patients with chronic hemorrhage from uterine leiomyomas or inoperable genital malignancies or even as a preoperative adjuvant in cases of voluminous uterine fibroids or invasive malignant tumors, aiming to reduce intraoperative hemorrhage.

Rationale: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a form of autoimmune synaptic encephalitis, often mediated by neuronal surface antibodies. Clinically, it manifests through a diverse range of neurological and psychiatric symptoms, primarily affecting young women with ovarian teratoma, which is rare in pregnant women. Patient concerns: We report a case of a 35-year-old multiparous pregnant patient at 38 weeks of gestation presented to the emergency room with seizure, psychiatric symptoms like delirious speech with mystical visual and auditory hallucinations, bradylalia, and retrograde amnesia. Diagnosis: The diagnosis of autoimmune encephalitis with anti-NMDA antibodies was concluded by considering the lumbar puncture results, brain imaging, and the patient’s persistent symptoms. Outcomes: This case is noteworthy for its rarity and the symptoms’ breadth. At 38 weeks of gestation, the patient underwent a cesarean section, resulting in excellent maternal recovery observed during the 6-month follow-up and good neonatal adaptation. Lessons: Our goals include raising awareness about this condition and emphasizing the significance of early diagnosis. This encephalitis is treatable and potentially reversible, underscoring the importance of prompt identification.