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Background: Labial fusion is a rare condition typically observed in prepubescent girls, but it can also occur in postmenopausal women due to estrogen deficiency. Methods: Our case report presents a unique instance of recurrent complete labial fusion causing bladder outlet obstruction in a postmenopausal woman. Results: The 84-year-old patient presented with dysuria and intermittent urine leakage. A physical examination revealed complete labial fusion with a small central opening. The diagnosis was confirmed through clinical evaluation, and surgical intervention was necessary to relieve the obstruction. Recurrent episodes followed despite a hormonal treatment with topical estrogen. Conclusions: This case highlights the importance of early diagnosis and the challenge of managing labial fusion in postmenopausal women, where recurrent episodes may complicate treatment. Surgical management, along with hormone therapy, remain essential for optimal outcomes. Further studies are needed to understand the recurrence mechanisms and to establish standardized treatment protocols. [ABSTRACT FROM AUTHOR]

Introduction. Preexistent maternal hypertension requires usually treatment from the beginning of pregnancy. If the causes remain unknown, they can lead to a poor outcome of the fetus and can have a strong psychological impact on the mother. Case presentation. A 27-year-old patient, known for 10 years with severe arterial hypertension, presented for an investigation with angio-MRI following a second-term intrauterine fetal death at 18 weeks of pregnancy. The angio-MRI objectivated a 90% occlusion on the right renal artery. A double-stent was placed, leading to a significative reducing of the occlusion to only 10%. Normal values of the blood pressure were achieved and no medication was further acquired for this pathology. Currently, a second pregnancy was achieved, now the patient being followedup, at 37 weeks of gestation, with no complications until now, and she will be giving birth the following weeks. Discussion. The management of severe arterial hypertension was difficult to achieve for this patient, in her first pregnancy. She was treated with alpha-methyldopa 250 mg per day and nifedipine, without success, unfortunately. The importance and success of this case were given by the resilience of doctors who discovered the stenosis after her fourth MRI. Conclusions. Although rare, we can say that there are cases with congenital renal artery stenosis that can be treated in young women, helping them conceive spontaneously healthy babies. The multidisciplinary follow-up was important in this case, as the patient was first refused for angio-MRI because of allergic reaction to intravenous substance. [ABSTRACT FROM AUTHOR]

Introduction. Meeting the contraceptive needs of women living with HIV (WLHIV) has primary health benefits for them, in addition to being a key element to prevent mother-to-child HIV transmission. This analysis will estimate the current number of infant HIV infections prevented by contraception. Methodology. We performed a literature search of PubMed to identify reports of drug interactions between hormonal contraceptives (HCs) and antiretroviral drugs (ARVs). We also reviewed the guideline of contraceptive hormone preparations and antiretrovirals for additional data and recommendations. Results. Several studies of combined oral contraceptive pills (COCs) identified decreased serum estrogen and progestin levels when co-administered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA) and the levonorgestrel intrauterine system (LNG-IUS) were largely unaffected by ARVs, while data on the contraceptive patch, ring and implant were not significant information to mention. Conclusions. Contraception continues to play an integral role in global HIV prevention efforts in the era of increasing HIV treatment coverage, especially in poor-income countries. Broad contraceptive availability, increased contraceptive voluntarism and method mix are key components to preventing unintended births and ending new infant HIV infections worldwide. [ABSTRACT FROM AUTHOR]

Introduction. The increased social and economic burden caused by the novel COVID-19 outbreak is gradually becoming a worrisome issue for the health sector. The novel coronavirus invades the target cell by binding to ACE2, which is widely expressed in the ovaries, uterus, vagina and placenta. Significantly, the SARS-CoV-2 is said to interrupt female fertility through regulating ACE2. Thus, it is essential to investigate if SARS-CoV-2 infection hampers female fertility, given that there is no systematic and comprehensive evidence on the association of COVID-19 with fertility. Materials and method. We performed a web research regarding male and female fertility and COVID-19. The eligibility criteria included: population aged 13-49 years old; exposure (infection with SARS-CoV-2); comparison (population without SARS-CoV-2 infections or latent SARS-CoV-2 infections); and outcome (female fertility, such as ovarian reserve function, uterine receptivity, oviducts status and menstruation status, male fertility and parameters). Results. Some studies showed that COVID-19 vaccines don’t impair fertility in men or women, but SARS-CoV-2 infection could potentially affect a man’s fertility for up to 60 days; for example, being 18% less likely to conceive during the next cycle of their female partner, compared with men who had not tested positive. Conclusions. Further data need to be acquired to synthetize the new effects on the population. Any infection – particularly an infection that involves fever – can affect sperm production and can affect ovulation, factors that apply in COVID-19. [ABSTRACT FROM AUTHOR]

The rapid development achieved over the last decades in volume rendering of ultrasound data, known as three-dimensional (3D) ultrasound technique, leads to new opportunities for refining the diagnosis in many gynaecologic conditions. The aim of the present study was to evaluate the advantages of 3D ultrasound over two-dimensional (2D) ultrasound in uterine pathology and to establish the optimal time point during the menstrual cycle to perform 3D ultrasound examination in order to achieve the maximum of useful information. A cross-sectional study on 200 patients who underwent gynaecologic 2D and 3D ultrasound examinations was performed. The addition of 3D examination to 2D ultrasound in uterine pathology provided the most useful information concerning: Congenital uterine anomalies, intrauterine devices (IUDs), adenomyosis, and submucous myomas. The findings showed that the 3D ultrasound scan is a useful tool in gynaecology, especially in cases with congenital uterine anomalies, myoma, and IUD. Although initially it was used for research purposes only, recent findings suggest its usefulness in routine ultrasound scan and the possibility of witnessing its introduction as a recommended examination procedure in the foreseeable future. Further research should be conducted in order to establish the sensitivity of 3D ultrasound in the detection of minor endometrial conditions, by correlating the imaging findings with the hysteroscopic results. [ABSTRACT FROM AUTHOR]

Introduction. The management of pregnant women with cardiac mechanical valves represents a real medical challenge, since the anticoagulant used must not cross the fetal-placental barrier, in order to avoid its teratogenic effect or the appearance of hemorrhages at the fetal level. Anticoagulants available for management include: vitamin K antagonists, unfractionated heparin (UFH) and low molecular weight heparin (LMWH). Case presentation. A IIIG IIIP, at 37 weeks of gestation, with twin bichorial pregnancy, the first fetus - pelvic presentation, the second fetus - transverse presentation, with intact membranes, pregnancy cholestasis, double scar uterus, heart valve prosthesis, DSA, chronic venous insufficiency, under chronic anticoagulant treatment with Clexane® 80 mg x 2/day, was admitted for non-systemic uterine contractions. With 36 hours before the intervention, the Clexane® is replaced by HNF with aPTT taken at five hours, and stopped with five hours before the intervention, resuming it five hours postoperatively. Favorable evolution after caesarean intervention, but on the fifth day after birth, the presence of a subperitoneal subaponevrotic hematoma is established. After the reintervention, Clexane® 0.6 ml x 2/day is decided, with a favorable evolution, without the need for a surgical reintervention. Conclusions. Until the 38th week, LMWH is administered. This can be replaced with warfarin from S13-S36. At birth, warfarin should be replaced with LMWH or UFH due to the severe risk of bleeding. LMWH (atiXa) and UFH (aPTT) should be stopped 24 hours before birth is scheduled. The normalization of fetal INR takes longer than the maternal one. Postpartum rapid reintroduction of maternal anticoagulant therapy may lead to a major risk of bleeding. [ABSTRACT FROM AUTHOR]