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Facial dysostoses are clinically and genetically heterogeneous conditions characterized by congenital craniofacial anomalies which result from abnormal development of the first two pharyngeal arches and their derivatives during embryogenesis. Mandibulofacial dysostosis Guion-Almeida type (MFDGA) is a rare and relatively new syndrome described in the literature, first identified by Guion-Almeida et al. in 2000 and 2006. Another 108 cases have been documented after that. Prenatal diagnosis of this syndrome has not been described yet. Here we present the prenatal ultrasound findings in a case where MFDGA was confirmed after delivery. We suggest that MFDGA should be included in the prenatal differential diagnosis of syndromes with micrognathia and craniofacial anomalies.

Background: RhD alloimmunization remains a severe problem worldwide, but its management has been revolutionized by two important discoveries: the possibility to establish fetal Rh genotype non-invasively by using a maternal blood sample, and using of Doppler velocimetry to monitor early signs of affected fetuses. Materials and methods: We performed a literature review by searching PubMed for relevant information about diagnosis, prognosis, and management of secondary affected Rh alloimmunized pregnancies. Results:The risk to develop fetal anemia and hydrops seems to increase with increasing concentrations of Rh antibodies, and studies show it is higher for subsequent pregnancies. Individuals presenting the DEL phenotype with the types 1, 2 or 3 can be considered RhD positive and anti-D immune globulin is not indicated. Discussions: Medical algorithm involves previous pregnancy history together with serum parameters. Follow-up in a department of maternal fetal medicine is desired and encouraged in these cases. Depending on the severity and woman’s previous pregnancy history, especially condition prior to 24 weeks of gestation, several therapies such as plasmaphereses, intravenous immune globulin or intrauterine transfusions can be conducted. Intrauterine transfusions have a better prognosis when performed earlier and on fetuses without hydrops. Conclusion:Although the incidence of hemolytic disease of the fetus and newborn has decreased and is no longer a major cause of perinatal mortality, vigilance is still required. There is a strong argument for reunite the management of these cases in dedicated maternal fetal medicine centers that perform invasive procedures in order to improve knowledge, gain skills and enhance clinical management.

Objective: The aim of the current study is to assess the prevalence of hepatitis B and the risk of hepatitis reactivation in carriers of hepatitis B virus (HBV) cancer patients who underwent chemotherapy for gynecologic and/or breast cancers in a single institution, during a period of five years, and to identify a relationship to some particular chemotherapy regimen, more prone to lead to reactivation. Material and methods: We conducted a retrospective chart review on all consecutive oncological patients treated for a gynecologic and/or breast cancers who presented for the first time to the Gynecologic Oncology Department of Filantropia Hospital, Bucharest, Romania, between January 2016 and December 2020. Results: A total of 1 895 patients diagnosed with ovarian, cervical, endometrial or breast cancers were admitted to hospital for systemic therapy during the mentioned period. Among these, only four patients (two patients with breast cancers, one cervical cancer and one endometrial carcinoma) were chronic carriers of HBV surface antigen (HBsAg positive). Patients received a variety of chemotherapeutic regimens including corticosteroids, gemcitabine, cisplatin, carboplatin, taxanes and anthracyclines. We report one reactivation that occurred in one occult carrier of hepatitis B virus diagnosed with breast cancer (HBsAg negative, hepatitis B core antibody positive – HBcAb), initially excluded from this study, as being screened negative for HBV, treated with taxanes-based chemotherapy and corticosteroids. Conclusion: HBV reactivation had a low incidence in our population of patients diagnosed with gynecologic or breast cancer who received systemic chemotherapy. The HBV reactivation risk was positively correlated with breast cancer and to taxanes-based regimens and glucocorticoids. Further studies to identify additional risk factors of HBV infection reactivation in gynecologic oncology patients and possible risk reducing measures are warranted.

The theory of multicyclic development of follicles during the menstrual cycle prompted new approaches to ovarian stimulation such as double stimulation within the same menstrual cycle, in both follicular and luteal phases. New stimulation approaches, together with cryopreservation techniques, provide higher chances for patients with poor ovarian response who undergo in vitro fertilization (IVF) to get pregnant. The double ovarian stimulation protocol has been proposed to optimize the number of oocytes retrieved within the shortest possible timeframe. Moreover, the short overall duration of this strategy is also useful in cases of a fertility preservation that requires rapid intervention before administering a gonadotoxic therapy, such as in oncologic therapy. In general, the aim of DUOSTIM is to obtain the highest number of oocytes in the shortest time, thus avoiding waste of time, which is crucial for these patients. Several protocols have been proposed with similar results, regardless of the protocol used.

Background:Asthma is the most common respiratory disorder affecting women during pregnancy. Although it is a reversible disease, it may adversely affect maternal quality of life and perinatal outcomes, especially in severe and inappropriately managed cases. Conversely, pregnancy influences the course of asthma through the physiological respiratory, hormonal, and immune system changes. Exacerbations are a key feature of asthma, representing a significant problem if severe, requiring aggressive medical intervention, hospital and even ICU admission. Purpose: The purpose of this article is to summarize the current knowledge and to provide a comprehensive overview of asthma in pregnancy. We also want rising awareness among patients and clinicians on the importance of proper asthma management during pregnancy. Data sources: A comprehensive literature search in PubMed, Medline, and Taylor& Francis was performed. We have searched for review articles as well as prospective and retrospective studies published in English, investigating the bilateral relationship between asthma and pregnancy, using the key words mentioned bellow. Manual search through both national and international guidelines as well as relevant journals and publications on the topic has been also conducted. Conclusion:Optimal asthma control, preventing, detecting, and treating the exacerbations are of the utmost importance to minimize the adverse effects for both the mother and fetus/neonate. Guidelines recommend active asthma management during pregnancy. Strong support prior and throughout the pregnancy and individualized treatment, guided by a multidisciplinary team, is suggested. Education on the importance of anti-asthmatic therapy, avoiding triggers, frequent and accurate monitoring are essential for good asthma management. Considering the pandemic, we are facing and the potential impact of COVID-19 on asthma, Global Initiative for Asthma (GINA) guideline recommendations for physicians are mentioned in the present article.

Coronaviruses are a group of viruses which, even if they are affecting mainly mammals and birds, could be transmitted to humans, generating common cold. The new virus strain is named SARS-CoV-2 and has 85% sequence similarity to SARS-CoV. Until now, it has caused more than 100 000 confirmed cases of infection and almost 5000 deaths, having a mortality rate of 4%. All information (symptoms, signs, management, complications) are taken from the other pandemic infections (SARS, MERS). Information about viral infection concerning pregnant women are limited and are common to other SARS infections. There are very few cases of pregnant patients infected with SARS-CoV-2 and studies are ongoing.