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Background/Objectives: Perineal injuries, including episiotomies and spontaneous tears, are common complications during childbirth, often leading to significant discomfort and prolonged recovery for women. This retrospective observational cohort study aimed to explore the relationship between antenatal anovaginal distance (AVD) and the incidence of perineal injuries in a cohort of pregnant women evaluated for pelvic floor health at 28 to 32 weeks of gestation. Methods: Conducted at the University Hospital of Padua over 18 months, the study included 416 women who underwent vaginal delivery at term. Based on AVD, the study participants were divided into two groups: AVD-N group, which included 252 patients with AVD ≥ 2 cm, and the AVD-R group, which included 164 with AVD < 2 cm. The results of the pelvic floor assessment and those related to childbirth were then examined in relation to AVD (reduced vs. normal). Results: The study found that women with reduced AVD were more likely to experience perineal injuries. Specifically, the incidence of episiotomy and severe perineal tears (3rd and 4th degree) was significantly higher in the reduced AVD group (p < 0.05). Furthermore, a lower AVD was associated with increased perineal muscle hypertonicity and a higher likelihood of operative delivery with episiotomy. Logistic regression analysis confirmed that reduced AVD was an independent risk factor for perineal injuries, regardless of other maternal or neonatal characteristics. Conclusions: These results suggest that AVD measurement during pregnancy may help identify women at higher risk of perineal trauma, enabling more personalized obstetric care to mitigate these outcomes. [ABSTRACT FROM AUTHOR]

Pelvic floor dysfunctions (PFD) are prevalent conditions that affect millions of women worldwide, encompassing a range of issues severely affecting women's quality of life. Pelvic floor muscle strength and function are fundamental to the management and prevention of PFD, and pelvic rehabilitation is a non-invasive approach that effectively improves symptoms, restores function, and prevents complications. This study aimed to evaluate the impact of pelvic floor muscle training program using weighted vaginal cones, on pelvic floor muscle function and quality of life in women with pelvic floor dysfunction (PFD). Fifty-four women aged 26-62 years, with different type of urinary incontinence, cystocele, and prolapse participated in this pre-post intervention comparative analysis. Pelvic floor muscle function was assessed using the PC test, which measures strength, endurance and fatigability, while the impact on patients' quality of life was assessed with the Pelvic Floor Impact Questionnaire - Short Form 7 (PFIQ-7). A three-month vaginal cone training regimen was implemented, with as-sessments conducted before the intervention (T0), one month later (T1), and three months later (T2). Data analysis showed a change with significant differences between the PC test score values at the level of each parameter and at each assessment (p<0.05, ES=0.254-511). The scores for bladder and urinary problems Urinary Impact Questionnaire (UIQ-7) significantly de-creased from 38.901 ± 1.268 at T0 to 29.366 ± 2.493 at T2 (W = 1082.000, p < 0.001, ES=0.570). In contrast, the scores for vaginal or pelvic problems (POPIQ-7) showed a slight, insignificant decrease from 12.699 ± 1.128 at T0 to 10.499 ± 2.362 at T2 (W = 278.000, p = 0.800, ES=0.053). fVaginal cone training significantly improves pelvic floor mus-cle function and reduces urynary symptoms in women with PFD [ABSTRACT FROM AUTHOR]

Oxidative stress (OS) and apoptosis are critical factors in placental development and function. Their interplay influences trophoblast proliferation, differentiation, and invasion, as well as vascular development. An imbalance between these processes can lead to pregnancy-related disorders such as preeclampsia, intrauterine growth restriction, and even spontaneous abortion. Our study seeks to elucidate the associations between preventive antioxidant/protective OS response factors—glutathione (GSH), MutT Homolog 1 (MTH1), and apoptotic regulation modulators—tumor protein p53 and B-cell lymphoma (Bcl-2) transcripts, in the context of spontaneous abortion (30 samples) versus elective termination of pregnancy (20 samples), using immunohistochemistry (IHC) to determine their proteomic expression in chorionic villi within abortive fetal placenta tissue samples. Herein, comparative statistical analyses revealed that both OS response factors, GSH and MTH1, were significantly under-expressed in spontaneous abortion cases as compared to elective. Conversely, for apoptotic regulators, p53 expression was significantly higher in spontaneous abortion cases, whereas Bcl-2 expression was significantly lower in spontaneous abortion cases. These findings suggest that a strong pro-apoptotic signal is prevalent within spontaneous abortion samples, alongside reduced anti-apoptotic protection, depleted antioxidant defenses and compromised oxidative DNA damage prevention/repair, as compared to elective abortion controls. Herein, our hypothesis that OS and apoptosis are closely linked processes contributing to placental dysfunction and spontaneous abortion was thus seemingly corroborated. Our results further highlight the importance of maintaining redox homeostasis and apoptotic regulation for a successful pregnancy. Understanding the mechanisms underlying this interplay is essential for developing potential therapies to manage OS, promote placentation, and avoid unwanted apoptosis, ultimately improving pregnancy outcomes. Antioxidant supplementation, modulation of p53 activity, and the enhancement of DNA repair mechanisms may represent potential approaches to mitigate OS and apoptosis in the placenta. Further research is needed to explore these strategies and their efficacy in preventing spontaneous abortion. [ABSTRACT FROM AUTHOR]

Background and Objectives: This retrospective analysis investigated the impact of preparation of the pelvic floor for childbirth with stretching balloons and perineal massage on the risk of pelvic floor injuries. Materials and Methods: We analyzed 150 primiparous women who accessed private clinics in Padua (Italy) in the period 2019–2023 regarding the rate of perineal trauma and postpartum dysfunction across three groups: the balloon stretching group (BSG, N = 50, 33.3%), the perineal massage group (PMG, N = 39, 26.0%), and the control group (CG, 61, 40.7%). Results: Prenatal perineal training had a significant impact on reducing the rate of perineal injury and episiotomy (27.5% in BSG vs. 48.7% in PMG and 68.3% in CG, p = 0.008, respectively, 9.8% vs. 26% and 40%, p = 0.046) and the duration of the second stage of labor (BSG and PMG had a shorter duration compared to CG with a mean difference of −0.97892 h, p < 0.001, respectively, −0.63372 h, p = 0.002). Patients who carry out the preparation with the stretching balloon are less likely to develop urinary and anal incontinence and pain during intercourse. Specifically, the rate of urinary incontinence in BSG stands at around 23.5% compared to 43.6% in PMG (p = 0.345) and 55% in CG (p = 0.034). Dyspareunia in BSG was detected in 11.8% of cases compared to 35.5% in PMG (p = 0.035) and 61.7% in CG (p < 0.01). Symptomatology inherent to the posterior compartment was reported in 9.8% of cases in BSG vs. 23.11% in PMG (p = 0.085) and 33.3% in CG (p = 0.03%). Conclusions: Stretching balloons and perineal massage can be chosen as tools to prevent and reduce the rates of obstetric trauma during childbirth and to reduce the use of episiotomies as well as protect against the development of dysfunctions of the pelvic floor. [ABSTRACT FROM AUTHOR]

Apoptosis is programmed cell death and is under the control of pro-apoptotic factors (p53) as well as anti-apoptotic factors (Bcl-2). In pregnancy, apoptosis ensures a relative state of balance in the normal evolution of the placenta. Spontaneous abortions are associated with cellular dysfunction phenomena that can be induced by excessive apoptosis. Thirty placentas from pregnant women aged between 35 and 40 years who had spontaneous miscarriages were collected and compared to 20 placentas obtained from on-demand abortions as a control group. The sections were incubated with anti-BCL2, mouse monoclonal antibody, and anti-p53-mouse monoclonal antibody and analyzed according to the H score. The information was shown as mean ± standard deviation (SD). T-tests for independent and paired students were used to compare continuous variables. The analysis of pro-apoptotic factors shows an increased expression of p53 in the patients in the study group (230,33 ±63,80) compared to the value in the control group (131,22±36,04). The H score in the case of antiapoptotic factors (Bcl-2) reveals an increased value in the control group (167±92,73), compared to the value obtained in the case of patients who had spontaneous abortion (120,20±100). The overexpression of pro-apoptotic factors in association with the decrease in the level of anti-apoptotic factors is associated with the involution of pregnancy and the occurrence of spontaneous abortion. This is an open-access article distributed under the terms of the Creative Commons Attribution. [ABSTRACT FROM AUTHOR]

Socioeconomic changes, as well as the development of new contraceptive modalities may influence women’s preferences in the selection of a method of contraception. The aim of this study was to evaluate the knowledge, opinions and attitudes of female university students regarding the menstrual cycle, sexual health and contraception. A questionnaire-based survey was conducted among 2572 female university students in Hungary, Romania and Serbia, between November 2009 and January 2011. A higher proportion of students of health sciences than students of other faculties had appropriate knowledge of the fertile period within a menstrual cycle: 86.0%, 71.5% (p = .02) and 61.1% vs. 71.9% (p < .001), 59.8% and 43.2% (p < .001) in Hungary, Romania and Serbia, respectively. Overall, more than 69% of the female university students believed in the need for monthly menstruation in order to be healthy; however, merely 30 to 40% of them wished to have monthly bleeding. In general, the respondents were aware of the importance of menstruation in relation to sexual health; however, they wished to suppress the menstruation-related symptoms. Differences in the knowledge and attitudes of female university students of the three assessed countries may be explained in part by cultural differences, and in part by the nature of their studies. [ABSTRACT FROM PUBLISHER]

Objectives. Uterine artery Doppler flow studies during the 11th and 14th weeks of pregnancy are important in the prediction of preeclampsia and IUGR in pregnant women and also in the prevention thereof. Methods. Our study of the Doppler flow indices of the uterine arteries involves 201 patients examined in our clinic, with pregnancies ranging from 11 weeks + 0 days to 13 weeks + 6 days. Results. There were 78 patients from 11 weeks + 0 days to 11 weeks + 6 days (38.80%), 57 from 12 weeks + 0 days to 12 weeks + 6 days (28.36%), and 66 from 13 weeks + 0 days to 13 weeks + 6 days (32.84%). The values of the Doppler indices were: PI 1.75±0.79, 1.90± 0.82, 1.72±0.81, and 1.58±0.71 and RI 0.72±0.14, 0.75±0.14, 0.72±0.13, and 0.70±0.13 for the entire group and for the three intervals respectively. There were 93 (46.27%), 36 (17.91%, with 20 cases or 55.55% on the right side), and 72 (35.82%) patients with bilateral, unilateral and absent uterine artery notching, respectively. The Doppler indices for the three aforementioned groups were: 2.15±0.79, 1.59±0.70, and 1.31±0.55 for the PI and 0.79±0.10, 0.70±0.13, and 0.65±0.14 for the RI, respectively. Conclusions. The mean uterine artery PI and RI decrease from 11 weeks+0days to 13 weeks + 6 days. Our results are similar to those in literature. [ABSTRACT FROM AUTHOR]

Objectives. Uterine artery Doppler flow studies during the 21st and 24th weeks of pregnancy are important in the prediction of preeclampsia and IUGR in pregnant women. Methods. Our study of the Doppler flow indices of the uterine arteries involves 138 patients examined in our clinic, with pregnancies ranging from 21 weeks+0 days to 23 weeks+6 days. Results. There were 37 patients from 21 weeks to 21 weeks+6 days (26.81%), 50 from 22 weeks to 22 weeks+6 days (36.23%), and 51 from 23 weeks to 23 weeks+6 days (36.96%). The values of the Doppler indices were: PI 1.06±0.45, 1.08±0.43, 1.06±0.57, and 1.06±0.33 and RI 0.58±0.11, 0.59±0.11, 0.57±0.13, and 0.59±0.09 for the entire group and for the three intervals respectively. There were 17 (12.32%), 21 (15.22%), and 100 (72.46%) patients with bilateral, unilateral and absent uterine artery notching. The Doppler indices for these groups were: 1.57±0.74, 1.13±0.42, and 0.96±0.32 for the PI and 0.69±0.11, 0.61±0.11, and 0.56±0.10 for the RI. The indices for the arteries with and without notching, as well as for the uterine arteries with and without notching in case of unilateral notching, were 1.46±0.67, 0.97±0.32, 1.27±0.49, and 0.99±0.28 for the PI and 0.67±0.12, 0.56±0.10, 0.64±0.12, and 0.58±0.09 for the RI. Conclusions. The mean uterine artery PI and RI decrease from 21 weeks + 0 days to 23 weeks + 6 days. Our results are similar to those in literature. [ABSTRACT FROM AUTHOR]

Endometriosis, marked by endometrial tissue outside the uterus, is a an important factor in infertility due to tubal and ovarian dysfunction. The lack of consensus on detection methods leads to delayed diagnoses, impacting therapeutic strategies. Around half a million patients in Romania suffer from this condition. This study aimed to correlate endometriosis with infertility. The study included 45 diagnosed patients endometriosi were aged 30 to 40 years. The study explored correlations between endometriosis and infertility in 45 diagnosed patients, noting a peak occurrence at age 40. Early menarche (11-14 years) and high nulliparity percentages aligned with previous findings linking younger menarche and infertility in endometriosis. Various correlations between pregnancies, lesion size, and serum Ca-125 were found, indicating a potential link between larger lesions and higher Ca-125 values, suggesting contributions of these factors to infertility. The study's emphasis on the multifactorial nature of the disease and its small sample size underscore the need for further investigation. The thesis choice stems from the lack of consensus on endometriosis etiopathogenesis, diagnosis, and management, compounded by the normalization of symptoms due to societal stigmatization of menstrual discussions. Clinical and paraclinical links between endometriosis and infertility were identified, highlights the multifactorial nature of infertility and calling for a comprehensive approach to diagnosis and management. Further research is crucial to unravel the complex interplay between genetic and environmental factors in endometriosis. In summary, endometriosis poses challenges to fertility through debated mechanisms, delayed diagnoses, and societal stigmatization. The study highlights correlations and emphasizes the multifactorial nature of infertility, stressing the need for tailored management and further research. [ABSTRACT FROM AUTHOR]

Objectives: Uterine artery Doppler flow studies during the 11th and 14th week of pregnancy are important in the prediction of preeclampsia and intrauterine growth restriction in pregnant women as well as in the prevention thereof. Methods: Our study on Doppler flow indices of the uterine arteries involved 168 patients examined in our clinic, with pregnancies ranging from 11 weeks + 0 days to 13 weeks + 6 days. Results: There were 72 patients from 11 weeks + 0 days to 11 weeks + 6 days (42.86%), 43 from 12 weeks + 0 days to 12 weeks + 6 days (25.60%), and 53 from 13 weeks + 0 days to 13 weeks + 6 days (31.55%). The mean values of the Doppler indices were PI 1.75±0.79, 1.88± 0.81, 1.71±0.81, and 1.58±0.72 and RI 0.72±0.14, 0.75±0.14, 0.71±0.14, and 0.70±0.14 for the entire group and for the three intervals, respectively. There were 71 (42.26%), 33 (19.64%, with 18 cases or 54.55% on the right side), and 64 (38.10%) patients with bilateral, unilateral and absent uterine artery notching, respectively. The mean Doppler indices for the three aforementioned groups were 2.18±0.79, 1.63±0.72, and 1.33±0.57 for the PI, and 0.79±0.11, 0.71±0.14, and 0.66±0.14 for the RI, respectively. The indices for the 175 arteries with and 161 without notching, taken separately, in all patients, as well as for the uterine arteries with and without notching in patients with unilateral notching only were 2.16±0.76, 1.30±0.54, 2.08±0.66, and 1.17±0.43 for the PI, and 0.79±0.11, 0.65±0.14, 0.79±0.11, and 0.63±0.12 for the RI, respectively. Conclusions: The mean uterine artery PI and RI decrease from 11 weeks + 0 days-11 weeks + 6 days to 13 weeks + 0 days-13 weeks + 6 days. They also decrease from patients with bilateral uterine artery notching to those without notching. The frequency of uterine artery notching decreases with increasing gestational age. Our results are similar to those in literature. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to statistically compare the mean ages of the patients with gynecologic cancer in our hospital during the 2000-2009 interval. Material and Methods: The data was collected from the Histopathology Exams (HPE) registers. Results: Gynecologic cancer was discovered in 1244 cases: 731 cervical cancers, 392 uterine cancers, 82 ovarian cancers, 31 vulvar cancers and eight vaginal cancers. The mean ages were 52.94±12.96 years for cervical cancer (age range 22-87 years), 61.71±9.06 years for uterine cancer (age range 38-85 years), 51.46±14.28 years for ovarian cancer (age range 18-77 years), and 65.90±9.65 years for vulvar cancer (age range 39-81 years). After performing Student's test, the statistically significant differences were: cervical vs uterine (p<0.000001), cervical vs vulvar (<0.000001), uterine vs ovarian (<0.000001), uterine vs vulvar (<0.05), and ovarian vs vulvar (p=0.000001). Cervical and ovarian cancer mean ages were not significantly different (p=0.33). Conclusions: The mean ages of the patients from the groups with five gynecological cancer types from our study are similar to those in literature. Existing screening measures must be applied and new ones must be implemented in order to reduce the burden of gynaecological cancers. [ABSTRACT FROM AUTHOR]

Objectives: Cesarean section has become recently the first choice for delivery in many clinics in Romania and worldwide. The purpose of our study is to assess the benefits of introducing the adapted Vejnovic uterine suture technique into daily practice., Material and Methods: A total of 1703 out of the 1776 cesarean section performed in the period January, 2012 - March, 2013 in the Obstetric Department of the Emergency Clinical County Hospital of Arad were retrospectively analyzed based on the cesarean section registries, birth registries and patient's personal medical records. We compared results between the group of patients undergoing adapted Vejnovic cesarean section technique and the group of patients operated in a classic manner., Outcomes: The cesarean section rate in the studied period was 56.48%. Adapted Vejnovic cesarean section technique was performed in 548 cases (30.86% of the cases), furthermore in the last 3 months studied it reached 57.27%. Mean APGAR score was better in the adapted Vejnovic cesarean section group (8.43) compared with the reference group (8.34). No significant differences were seen between the two groups regarding maternal age, gestation, weeks of gestation, newborn weight, anesthesia and indications for cesarean section. Exteriorizing the uterus helped the incidental diagnosis of 35 uterine myoma, 22 adnexal masses and 13 uterine malformations., Conclusion: In a society with a constant growth of cesarean rate, the adapted Vejnovic cesarean section technique is becoming popular amongst clinicians for its advantages, but further studies need to be developed for its standardization.

Objectives: This study intends to analyze some statistical data concerning Cervical Intraepithelial Neoplasia diagnosed in our hospital., Material and Methods: Our study concerning the incidence of Cervical Intraepithelial Neoplasia (CIN) covers the 2000-2009 time-span, the data being collected from the Histopathology Exams (HPE) registers., Results: During this period, CIN lesions were discovered in 1256 cases and Cervical Intraglandular Dysplasia (CIGD) in 53 cases. CIN I, CIN II and CIN III lesions represented 65.92%(828 cases), 19.67% (247 cases), and 14.41% (181 cases) of the total CIN cases, respectively. There were 26 cases combined with cervical carcinoma (2.07% of all CIN cases, 3.56% of the 731 cervical cancer cases). The mean patients' age was 44.65± 9.83 years for all cervical dysplasia cases, 44.58± 9.75 years for all CIN cases, 43.81±9.22, 46.50±10.17, and 45.46±11.05 years for CIN I, CIN II, and CIN III, respectively, and 46.45 ± 11.63 years for CIGD. The t-test revealed the following significant differences: all cases versus CIN I (p<0.05) and CIN II (p<0.01), CIGD versus CIN I (p<0.05), all cases versus CIN II (p<0.01), CIN I versus CIN II (p<0.0001) and versus CIN III (p<0.05). The mean age of the 731 cervical cancer cases diagnosed in our hospital during that same period was 52.94±12.96 years,and it was statistically significantly different from the mean ages of patients with CIN I, II and III (p <0.00000001) and with CIGD (p<0.0005)., Conclusions: Early detection of CIN is of utmost importance for preventing cervical cancer, a serious and frequent health problem in Romania.

Objectives: The purpose of this study is to statistically compare the mean ages of the patients with gynecologic cancer in our hospital during the 2000-2009 interval., Material and Methods: The data was collected from the Histopathology Exams (HPE) registers., Results: Gynecologic cancer was discovered in 1244 cases: 731 cervical cancers, 392 uterine cancers, 82 ovarian cancers, 31 vulvar cancers and eight vaginal cancers.The mean ages were 52.94±12.96 years for cervical cancer (age range 22-87 years), 61.71±9.06 years for uterine cancer (age range 38-85 years), 51.46±14.28 years for ovarian cancer (age range 18-77 years), and 65.90±9.65 years for vulvar cancer (age range 39-81 years).After performing Student's test, the statistically significant differences were: cervical vs uterine (p<0.000001), cervical vs vulvar (<0.000001), uterine vs ovarian (<0.000001), uterine vs vulvar (<0.05), and ovarian vs vulvar (p=0.000001). Cervical and ovarian cancer mean ages were not significantly different (p=0.33)., Conclusions: The mean ages of the patients from the groups with five gynecological cancer types from our study are similar to those in literature. Existing screening measures must be applied and new ones must be implemented in order to reduce the burden of gynaecological cancers.