Papers by Andreea Carp-Veliscu
BMC Infectious Diseases, 2013
Practica medicală, Dec 15, 2021
Malignant ovarian neoplasms represent a public health issue, being one of the most frequent cance... more Malignant ovarian neoplasms represent a public health issue, being one of the most frequent cancers among women, exhibiting the highest mortality rate. The general purpose of this study lays in the analysis of the metastasizing potential of malignant ovarian neoplasms, the correlation between the histological subtype and the genesis of the metastasis. We present an observational retrospective study spanning over 2 years, between 2018-2019, on 30 admitted patients who were treated for malignant ovarian neoplasms in the department of Obstetrics and Gynecology of Bucharest Emergency University Hospital. The most frequent histopathological subtype encountered in our study has been the high grade serous ovarian carcinoma 46,67%, with 30% presenting poorly differentiated neoplasms (G3), therefore having poor prognosis. A considerable number of patients 56,67% presented ascites (among which 43,33% of patients also exhibited peritoneal carcinomatosis, direct dissemination representing the main metastasizing pathway of malignant ovarian neoplasms in the patients included in our study.From our study we can conclude that patients with ovarian malignant neoplasms are diagnosed in an advanced stage of the disease, when metastasis are already present, with a poor prognosis. This is mainly due to the lack of regular gynecological checkups in menopausal womenand because it is considered that once past the fertile age the gynecological examination no longer represents a necessity.
Practica medicală, Dec 15, 2021
Breast cancer represents a large proportion of cancers that affect women and it is a major public... more Breast cancer represents a large proportion of cancers that affect women and it is a major public health concern. For many years radical mastectomy was considered to be the only surgical procedure with curative potential for breast cancer. Radical mastectomy has a major negative impact on the quality of life. In order to avoid the complete removal of the breast, breast-conserving surgical techniques have been developed. During breast-conserving surgical procedures only the tumor is removed along with the surrounding breast tissue within the oncologic safety margin. Based on specialty literature we will summarize the surgical technique and explain the indications and contraindications of breast-conserving surgery for breast cancer along with the risk factors for disease recurrence.
Romanian Journal of Medical Practice
Amniotic fluid sludge is an ultrasound demonstrable hyperechogenic mass close to the uterine cerv... more Amniotic fluid sludge is an ultrasound demonstrable hyperechogenic mass close to the uterine cervix and is an independent risk factor for preterm birth and preterm premature rupture of membranes. Cervical insufficiency represents cervical dilatation in the mid-trimester of pregnancy regardless of uterine contractions. It appears to be associated with intraamniotic infection/inflammation. Chorioamnionitis is the inflammation of the fetal membranes (chorion and amnios) and is the consequence of the inflammatory response of the maternal organism to aggression that can be infectious or non-infectious (sterile intraamniotic inflammation). The paper illustrates the association between the amniotic fluid sludge and microbial invasion of the amniotic cavity and chorioamnionitis. Conclusion. Amniotic fluid sludge is a marker of intra-amniotic infection and histological chorioamnionitis in pregnant women with cervical insufficiency.
Medicina
Pruritic urticarial papules and plaques of pregnancy (PUPPP) usually occurs in the third trimeste... more Pruritic urticarial papules and plaques of pregnancy (PUPPP) usually occurs in the third trimester of pregnancy in primiparous women. It is a self-limiting inflammatory disorder with a still unknown pathogenic mechanism. The abdominal wall overdistension, with a subsequent inflammatory response due to damage to the connective tissue, represents a pathogenesis explanation. Clinical features involve intensely pruritic urticarial rash with edematous, erythematous papules and plaques. The clinical picture and dermal biopsy establish the diagnosis. Topical corticosteroids and oral antihistamines are usually sufficient, but sometimes systemic corticosteroids are necessary. Maternal and fetal prognosis is excellent, and the lesions resolve after birth with no scarring or pigmentary change. We present a case of a 36-year-old patient with a 32-week pregnancy who was admitted with a generalized pruritic rash accompanied by fever. The final diagnosis was decided after multiple pathology exclus...
Romanian Journal of Medical Practice
Polycystic ovary syndrome (POCS) is the most common endocrine disorder and affects women in each ... more Polycystic ovary syndrome (POCS) is the most common endocrine disorder and affects women in each stage of their life, lowering the quality of life and lifespan. After they overcome infertility and succeed to conceive, they will not be exposed just at severe obstetrical outcomes such as miscarriage, preterm birth, gestational diabetes, gestational hypertension, but at poor neonatal outcome as well such as increased perinatal mortality, congenital anomalies, extended stays in neonatal intensive care unit (NICU), low Apgar score, macrosomia, and growth restriction. Also, the children born from mothers with polycystic ovary syndrome, during childhood and adolescence will have a decreased quality of life, being forced to experience multiple episodes of hospitalization, metabolic disorders, and asthma. The purpose of this article is to make a literature review, in order to obtain a clearer picture over the impact of the POCS on fertility, pregnancy, and neonate. The analysis was limited t...
Romanian Journal of Medical Practice
Smoking is one of the most harmful habits among adults. During pregnancy, the adverse effects go ... more Smoking is one of the most harmful habits among adults. During pregnancy, the adverse effects go beyond the organism of the mother and it is considered to be a risk factor for miscarriage, stillbirth, placental abruption, preterm birth, low birthweight, morbidity and mortality. Through its numerous and dangerous compounds, tobacco smoking influence proteins and is leading to despaired fetal nourishment. Cigarette smoke toxicity is mainly driven by carbon monoxide, tar and nicotine. Carcinogens have a high negative impact, causing both maternal and fetal anemia, as well as abnormal fetal growth and development, pathology that by itself is associated with an additional risk of preterm delivery and low birthweight. Having the capability to cross the placenta, nicotine along with the other compounds, can be fetotoxic, neurologic teratogen and impact brain development. Smoking cessation outside or during pregnancy should be encouraged. Various medication and procedures have been proposed...
Romanian Journal of Medical Practice
Uterine leiomyoma is described in the literature as one of the most common benign tumors that is ... more Uterine leiomyoma is described in the literature as one of the most common benign tumors that is encountered and which cause relevant public health problems; it affects the fertile capacity especially on women that are in their thirties or younger, which makes it even more difficult to obtain an optimal treatment idea that transform into a physiologic pregnancy, naturally achieved or by ART. In order to understand this, we have decided to conduct this review with the purpose to bring up to date an insufficiently discussed matter, namely reducing the incidence in women diagnosed with uterine leiomyoma that associates loss of fertility, through a modern management of diagnostic resources, especially ultrasound, and treatment as well. Our main goal was to analyze the published articles from the PubMed database between 2015-2021, using keywords such as leiomyoma, female infertility, pregnancy, miomectomy, for relevant information and studies that include the easiest methods of diagnosis...
Romanian Journal of Medical Practice
Premature birth is a public health problem worldwide. Due to the lack of cardiotocography (CTG) g... more Premature birth is a public health problem worldwide. Due to the lack of cardiotocography (CTG) guidelines in preterm infants according to different gestational ages, we analyzed literature and synthesized the physiological and pathological characteristics of the CTG route of different gestational age preterm infants. The purpose of this analysis is to summarize the most relevant information regarding CTG monitoring in pregnancies with preterm infants and to provide CTG follow-up criteria for the daily practice of these conditions. In conclusion, the baseline of the fetal heart rate it is slightly increased in premature fetuses and decreases with increasing gestational age. During the second trimester of pregnancy, low-amplitude transitory decelerations occur more frequently and with a much lower frequency by the end of the third trimester. Cycling of variability is reduced due to incomplete development of the parasympathetic component of the autonomic nervous system in premature fe...
Romanian Journal of Medical Practice
Many women spend a third of their lives in postmenopause, and it’s a given that sexual life must ... more Many women spend a third of their lives in postmenopause, and it’s a given that sexual life must go on after menopause since its benefits were vastly proven. A number of factors influence sexuality in postmenopause: the age at which menopause sets in, how menopause sets in, physical and mental state, quality of sexual life in perimenopause and the quality and duration of the relationship with the partner. The hypoestrogenism that characterizes menopause leads to a decrease in libido, to changes in the genital apparatus (vaginal atrophy, dyspareunia) or other changes (hot flushes, impaired urination, depression), which negatively affect sexual health. Assessing sexual dysfunction is not easy. The interplay between the types of factors that predispose, precipitate and maintain sexual dysfunction requires preparation on the part of the clinician in identifying the elements of interest and indicating appropriate therapy. Research on the quantification of sexual dysfunction in women has ...
Romanian Journal of Medical Practice
In the time of modern medicine, gynecologic cancers kill millions of people annually. Worldwide, ... more In the time of modern medicine, gynecologic cancers kill millions of people annually. Worldwide, breast cancer is the first among cancer types in terms of incidence rate. Cervical cancer continues to be a public health issue, despite all methods of prevention and early detection. Ovarian cancer is considered a "silent killer" and associates high incidence and mortality in women. The incidence of uterine cancer has increased by one percent per year in the last ten years. We analyzed the histopathological results of gynecologic neoplasms during 2016-2021, using the database of the pathological anatomy department within the Bucharest University Emergency Hospital. Breast cancer was the most common type, with an incidence of 34.86%, followed by cervix cancer - 29.44%, uterine cancer - 24.93%, and ovarian cancer - 10.76%. The proportion of each form of cancer respected the reports declared for the worldwide female population. In our opinion, all forces should orient themselves ...
Romanian Journal of Medical Practice
Obesity and overweight, the most common metabolic disorders, have an increased incidence among wo... more Obesity and overweight, the most common metabolic disorders, have an increased incidence among women of reproductive age and represent major risk factors in obstetrics. Maternal obesity predisposes to multiple maternal and fetal complications, like pregnancy-induced hypertension, gestational diabetes, thromboembolic complications, recurrent miscarriages, stillbirth, macrosomia, congenital abnormalities.
Romanian Journal of Medical Practice
Background. Renal chronic disease can be categorized as an uncommon pathology associated with pre... more Background. Renal chronic disease can be categorized as an uncommon pathology associated with pregnancy, with a real incidence difficult to estimate. The significant risk for adverse outcomes can be translated into a high degree of occurrence of preeclampsia, fetal growth restriction, preterm delivery, and, also, progression of underlying renal dysfunction. The purpose of the article is to review the data from specialty literature, regarding the correlation between renal function and the pregnancy’s prognosis, so the best management can be implemented to improve the outcomes. Material and methods. We performed a research project conducted in Emergency University Hospital in Bucharest, regarding the impact of chronic renal disease on maternal and fetal outcome. The retrospective and prospective study extends over a period of over 4 years, between 2017 and 2021 and it is currently ongoing with the involvement of the Nephrology Department, the Dialysis Department and the Medical Labora...
Romanian Journal of Medical Practice
Bacterial vaginosis is an important public health issue, affecting women worldwide. Despite its i... more Bacterial vaginosis is an important public health issue, affecting women worldwide. Despite its increased incidence, the etiology is yet unclear. In all symptomatic cases, treatment must be started immediately to cure this condition that favors the acquirement of sexually transmitted diseases. Symptomatic pregnant women should always be treated, and treatment regimens are the same for pregnant and non-pregnant women. Possible complications of this disease include infertility, sexually transmitted diseases, HIV, premature rupture of membranes, premature birth, intra-amniotic infections and postpartum endometritis.
Romanian Journal of Medical Practice
Menopause, defined as the permanent cessation of menstruation resulting from the loss of the ovar... more Menopause, defined as the permanent cessation of menstruation resulting from the loss of the ovarian function, has gradually become a fundamental health concern. Menopause hormonal replacement therapies (HRT) were initially developed with the purpose to alleviate the estrogen deficiency induced symptoms. Currently, HRT is approved by the FDA (Food and Drug Association) for four indications: bothersome vasomotor symptoms (VMS); prevention of bone loss; hypoestrogenism caused by hypogonadism, castration, or premature ovarian failure and genitourinary symptoms. For patients younger than 60 years or within the first 10 years from menopause onset and without contraindications, the benefit-risk ratio should be favorable for treatment of VMS and for preventing bone loss and related fractures. For women who initiate HRT more than 10 / 20 years from menopause onset (or aged 60 years or older), the benefit-risk balance seems to be less favorable than for younger patients because of greater ab...
Romanian Journal of Medical Practice
The incidence of placenta percreta is currently increasing. The treatment strategies are not clea... more The incidence of placenta percreta is currently increasing. The treatment strategies are not clearly defined as there are a lot of inconsistencies in the literature regarding severity criteria. This pathology has a high risk for massive hemorrhage, therefore it is very challenging to agree on a standardized management. The therapeutic approaches include expectant management with placenta left in situ, conservative management and radical treatment. Cesarean hysterectomy currently represents the approach of choice for this condition, ideally performed by a multidisciplinary team. Conservative alternatives have been proposed to reduce maternal morbidity and maintain future fertility. The expectant management has benefits on reducing uterine perfusion and blood loss, useful in case of bladder or parametrial invasion. Potential late complications of placenta percreta left in situ often require further emergency surgery. Delayed hysterectomy has the aim to overcome these difficulties, but...
Romanian Journal of Medical Practice
Intrahepatic cholestasis of pregnancy (ICP) is a reversible cholestatic condition specific to pre... more Intrahepatic cholestasis of pregnancy (ICP) is a reversible cholestatic condition specific to pregnancy, characterized by pruritus, hepatic cytolysis and elevated serum bile acids. It usually starts at the end of the second or third trimester and is reversible rapidly after delivery. Incidence is higher in South American and Scandinavian countries (9.2-15.6% and 1.5% respectively) than in Europe (0.1-0.2%). Its aetiology is multifactorial, including genetic, endocrine and environmental factors. The maternal prognosis is usually benign, while fetal complications such as preterm birth, meconium apraxia, fetal distress and sudden intrauterine fetal death not infrequently lead to considerable perinatal morbidity and mortality. Ursodeoxycholic acid has proven to be the most effective therapeutic agent with proven safety and efficacy. Management of cholestasis of pregnancy (CP) consists of close monitoring of maternal liver function and serum bile acid levels, in addition to assessment of...
Romanian Journal of Medical Practice
Pelvic inflammatory disease (PID) is a very common condition among women of reproductive age. It ... more Pelvic inflammatory disease (PID) is a very common condition among women of reproductive age. It is also a common reason for presenting to the emergency room. Although it often presents with mild symptoms, it is very important to consider it in any sexually active patient in order to start treatment as soon as possible and avoid complications.
Romanian Journal of Medical Practice
Objectives. To evaluate which type of embryo transfer (ET) has a superior pregnancy rate. Materia... more Objectives. To evaluate which type of embryo transfer (ET) has a superior pregnancy rate. Material and method. Prospective observational non-randomized study including 79 women that underwent 145 ET. Outcomes. The results show that the highest biochemical pregnancy rate (BPR) was in the fresh day 3 ET group (47.62%), but in this group there were also the highest abortion rate (80%) and the highest premature birth rate (100%), giving that, after 21 fresh day 3 ET did not result any term live birth. The frozen day 3 embryo has the lowest BPR (30%), but also the lowest abortion rate (33.33%) and the lowest premature birth rate (0%), in the present study after 13 frozen day 3 ET resulting 2 full-term births (15.38%). The results for the fresh day 5 blastocyst show a good BPR (43.48%), a low abortion rate (33.33%) and the lowest premature birth rate (0%), giving that in the study performed after 23 day 5 ET resulted 4 newborns at term (15.38%). The frozen day 5 blastocyst has a very good...
Romanian Journal of Medical Practice
Cancer during pregnancy is a rare occurring, explained maybe by the fact that most of pregnant wo... more Cancer during pregnancy is a rare occurring, explained maybe by the fact that most of pregnant women are young patients. Unfortunately, if cancer appears during pregnancy it is many times diagnosed in advanced stages because of its symptoms similar with the pregnancy’s and may have devastating effects on both the mother and the newborn. Because of the COVID-19 pandemic many patients with cancer withdraw from or delay cancer treatment. Pregnant women with cancer need special attention provided by a multidisciplinary medical team with a close follow-up even during COVID-19 pandemic, beyond all restrictions.
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Papers by Andreea Carp-Veliscu