OBJECTIVES:The aim of this research was to assess the efficacy of the new generation micro-fractional CO2 laser low dose energy (Aphrodite, BH LASER, France) in the treatment of genitourinary syndrome. MATERIALS AND METHODS:This prospective interventional clinical study, included a total of 25 menopausal symptomatic patients and 25 non-menopausal symptomatic patients having symptoms of vulvovaginal atrophy. There were only two laser sessions spaced at 6 weeks. It was evaluated the Female Sexual Function Index (FSFI) and the QoL at baseline, 3 and 6 months. RESULTS:The study showed a significant improvement in both groups when assessing FSFI scores at 3- and 6-months follow-up compared to baseline (p<0.05) and secondary it was observed a significant initial improvement of QoL score at 3 and 6 months (p<0.05), compared to baseline. There were no important adverse events registered during the study period. CONCLUSIONS:The new micro-fractionated laser device with low dose energy - 18W, demonstrated significant improvement of genitourinary syndrome in both non-menopausal and post-menopausal women with no important adverse event.

ABSTRACT Objectives The objective of this prospective study was to analyze the effect of vaginal micronized progesterone (VMP) daily administrated in women with recurrent pregnancy loss, recurrent miscarriage, and/or preterm birth on neonatal outcomes. Methods In the treat group patients received 200 mg/day VMP (14 days/month, during the luteal phase) from preconception until completed 36 weeks of gestation. Women from the control group did not receive VPM treatment. Ultrasonographic examination was performed for gestational age confirmation, assessment of cervical length and congenital malformation screening in fetus. Results Compared with the control group, the women from the VMP group had a decreased time to conception, lower frequency of miscarriages and higher gestational age at delivery. Newborns from mothers treated with VPM had significantly higher birth weight than newborns from the control group of mothers (p = 0.022). The frequency of stillbirths and the need for oxygen supplementation and mechanical ventilation was lower in the newborns from treated group of mother compared with control group. Conclusion Vaginal micronized progesterone 200 mg/day from preconception to 36 weeks of gestation in women with recurrent pregnancy loss reduced the frequency of miscarriages, stillbirths, preterm births and neonatal morbidity. How to cite this article Russu M, Stănculescu R, Păun M, Marin JA. Neonatal Outcomes after Preconceptional Vaginal Micronized Progesterone Administration in Recurrent Pregnancy Loss: Five Years Prospective Study. Donald School J Ultrasound Obstet Gynecol 2014;8(2):128-133.

Objective. Assessment of patients’ profile with post par tum hys te rec tomy. Material and methods. A 8 years retrospective study (2001-2008), conducted in a ter ti a ry referral obstetrical unit, “Dr. Ion Cantacuzino” Cli nical Hospital, Bucharest, with the analysis of the re la tion ship between patient’s history and pregnancy outcome and hysterectomy indication. Results. There were 19388 births (15745 vaginal deliveries (79.81%), 3913 ce sarean sections (CS) (20.18%)), no maternal death. Hys te rec to my was performed in 19 cases (0.98/1000 obstetric ca ses), 7 nulliparas (36.84%) and 12 mul tipara (63.15%). Uni la te ral adnexectomy (UA) was performed in 5 cases. Week end obstetric hysterectomies (WOH, i.e. performed in week end) were 12 (63.15%). Indication for hysterectomy was ute rine atony (7 cases, 36.84 %), placenta accreta (7 cases, 36.84%), ute rine rupture (2 cases, 10,52 %), va gi nal haematoma, vascular fis tu la after cesarean sect ion and uterine myoma (1 case each, 5.26%). Six ca ses (31.57%) were considered preventable obstetric hys te rec to mies (POH): 2 cases of uterine rupture, 2 cases of uterine atony after vaginal delivery, 1 case of vaginal hae ma to ma and 1 case of vascular fistula after cesarean sec tion. POH followed vaginal de livery, respectively CS, in 80%, respectively 14.29%, p = 0.0072. POHs represent 100% of WHs, compared with 46.15% during week; p = 0.0237. WH was associated with severe intraoperative com pli ca tions in 41.66% cases, compared with 0% during week, p = 0.0466. Fetus was dead (anteor intrapartum) in 4 patients with severe intraoperative complications (57,14%), compared with one fetal death in patients with out severe intraoperative com plications (8.33%); p = 0.0198. UA was performed only non-monitored pa tients (5 cases out of 11; 45.45%), compared with 0% in mo ni tored patients (p = 0.0263). UA was necessary in 5 ca ses (71.43%) with dead fetus, com pared with 0% when fe tus was alive; p = 0.0006. Mean haemoglobin loss was 5.52 g/dL in POH, greater than 3.1 g/dL in non-POH; p = 0.0448. Conclusions: Post partum hysterectomy is a week end drama, performed on a mul ti para, with neglected labour, non-monitored; fetal death and ad nexectomy could serve as a retrospective marker of severity.

Umbilical cord blood (UCB) is an alternative for stem cell transplantation in the treatment of various diseases. Objective. In order to find out whether the maternal, placental or fetal pathology before storage might have an impact on the quality of umbilical cord stem cells (UCBSC) and on the success of sampling and cryopreservation, viability and quantity of UCB were assessed. Methods. All 145 CB samplings with Biogenis Cord Blood Bank between 2007-2009 of 93 healthy pregnant women and 52 women with pregnancy pathology were investigated in a 3 years retrospective multicenter clinical study. Were analyzed: gestational age at delivery, birth weight, child sex, mode of delivery, pregnancy pathology, umbilical cord and placental pathology. Primary outcomes included umbilical cord blood (UCB) amount, white blood cells (WBC) quantity and viability. Results. Neither gestational age, mode of delivery, child sex, maternal, placental or umbilical pathology affected the WBC quantity. By contrast, cumulative associated maternal pathology negatively affected WBC vitality (p=0.038). The placental pathology significantly influenced both UCB amount and CD34+ concentration. The placental pathology and birthweight are independentely correlated to UCB mass. The unsuccessful collection of UCB was signifficantly correlated with placental pathology (p<0.0001). Conclusions. Data of this study show that perinatal factors are influencing the quality or quantity of UCB. Standard multiple regression models may prove useful for predicting successful UCB mass sampling. In addition, sampling conditions procedures are requisite for pursuing the banking and release of quality UCB for successful transplantation.

Objective: The aim of this study was to assess the impact of tibolone compared to dydrogesterone on endometrial thickness, breast density, quality of life and lipid profile status. Method: The double blind prospective-randomized study included forty-six perimenopausal women which were randomly assigned for treatment with either tibolone 2.5 mg/day (22 patients) or dydrogesterone 20 mg/day (24 patients) from day 14 to day 25 of the cycle, for 6 months. All women complained for climacteric symptoms and irregular menstrual cycle at least for the last six months. Results: During the 6 cycles of treatment, there was no significant difference between groups regarding the regularity of the cycles. Similarly, no significant difference was observed between groups regarding endometrial thickness, breast density, levels of estradiol, FSH, progesterone and lipid profiles. Regarding vertigo, mood disorder, depression, loss of libido, dryness of skin and vagina, tibolone therapy was found to be much more effective than progestin.

Objective: The study's objective is to analyze the correlation between colposcopic score, the histopathological weighted score, the p16(ink4a) immunomarker investigated by immunocytochemistry method and the cytology as determined from liquid based cytology. Material and method: A prospective study was performed over 60 women with different types of cervical lesions, between September 2008 to September 2009, by using a colposcopic score, a p16(ink4a) intensity detection by immunocytochemical method and a histopathological weighted score. Data were processed in SPSS 15.0 using the correspondence analysis. Results: The results of correspondence analysis showed a correlation between the results of abnormal cytological categories and colposcopic score, hystopathologic score and also with the intensity score of p16(ink4a) immunomarker. The study identified the presence of a correlation between the p16(ink4a) immunomarker score and histopathologic weighted score too. Conclusions: Classical investigations used to assess lesion severity are not mutually exclusive; based on our made out correlations, the current study revealed the presence p16(ink4a) immunomarker within dysplastic cervical cells and that its overexpression is related to an increased histopathological score.

Objectives: Pregnancy outcome following preconception to 36(th) week of pregnancy treatment with vaginal micronized progesterone (VMP) for recurrent pregnancy loss. Methods: We prospectively analysed 96 cases divided in three groups (differentiated by the moment of two previous pregnancy losses) 32 cases - group A - during the first trimester 6 cases - group B - during the third trimester [treated with Folic Acid (FA) 200 mg/day VMP (14 days/month, luteal phase), continued after positive pregnancy test until 36(th) week], and 58 cases in the control group (C) on placebo. Primary outcomes included: time to conceive, gestational age at miscarriage/preterm birth birthweight, Apgar scores, congenital malformation, composite neonatal morbidity, oxygen supplementation, mechanic ventilation. Secondary outcomes included stillbirth new born death before discharge maternal weight gain, maternal morbidity, hospitalization for threatened abortion/preterm birth. Statistics analysis: Student t test/ANOVA. Results Primary outcomes: fetal weight: controls: 2506.1 +/- 699.21g. group A: 3100 +/- 489.41g (P=0.001 vs. control); group B: 3216 +/- 537.27 g (P=0.022 vs. control); Apgar Scors: 1/5 minutes: controls; 8.05 +/- 1.98/8.2 +/- 1.99, group A: 8.45 +/- 1.53 (P=0.40 vs. control)/8.77 +/- 1.11 (P=0.21 vs. control), group B: 4.83 +/- 4.57 (P=0.14 vs. control)/4.83 +/- 4.62 (P=0.13 vs. control); umbilical cord blood pH when Apgar < 7/5 minutes: controls: 7.20 +/- 0.19, group A :7.14 +/- 0.34 (P=0.81 vs. control), group B: 655 +/- 0 (P=0.0001 vs. control). GA at delivery: 24-28 weeks (0/0/2 in group A/B/C), 29-34 weeks (1/1/16 in group A/B/C); >= 35 weeks (21/5/23 in groups A/B/C). Malformations: 2 hypospadias (group A control), 1 cryptorchidism, 1 hydrocele, 1 umbilical hernia (control), Neonatal morbidity: Respiratory Distress Syndrome, 2/1/5 (group A/B/C), no BPD, IVH, AEC. Secondary outcomes: 25 miscarriages, 4 fetal deaths before discharge (0/2/2-group A/B/C); maternal weight gain: controls 11.95 +/- 4.75, group A:16.77 +/- 5.71 (P=0.001 vs. control), group B: 14.33 +/- 3.32 (P=0.24 vs. control) gestational hypertension [group B: 2(7.1%), controls. 3 (19%)], no gestational diabetes; hospitalization for threaten abortion (8 vs. 20 controls)/preterm birth (10 treated vs. 18 controls). Conclusion: The study suggest that VMP preconception to 36 weeks gestation in recurrent pregnancy loss is followed by reduction of: preterm birth before 34 weeks (13.6% treated vs. 36.6% controls), miscarriages (23.7% treated vs. 27.7% controls), increased birthweight (P=0.001, group A; P=.022 group B), less reduction of umbilical cord blood pH (P=0.0001 - group B) when Apgar score < 7/5 minutes; less neonatal morbidity (only RDS 10.3% treated vs. 12.2% controls), insignificant difference in perinatal mortality less fetal abnormalities, lower incidence of gestational hypertension (5.2% treated vs. 19961 controls), no gestational diabetes, and hospitalization for miscarriage (28.6% treated vs. 48.8% controls), or preterm birth threaten (35.1% studied vs 43.8% controls).

Objective: Perinatal outcomes in obese, excessive weight gain and diabetic mothers. Material and methods: 82 deliveries of mothers with obesity/ excessive weight gain (EWG), 7 - diabetes alone, and 16 cases of obesity/EWG and diabetes compared with a control group of 43 mothers. Results: Significant differences were observed between groups with Ob and /or EWG vs control for birth weight (3420±593g, p=0,006), mean arterial pressure (88,51±9,54mmHg, p=0,006), uterine hypokinezia (χ 2 =66.78, p<.0001), birth trauma (χ 2 =49.53, p<.0001), and abnormal placental histology (χ 2 =24.54, p<.0001). Significant differences were observed in diabetes/obesity/EWG for birthweight (3587,5±642, p=.026), mean arterial pressure (130,3±11mmHg, p<.001), fetal distress (χ 2 =5.61, p<.018), and birth trauma (χ 2 =33.19, p<.0001). Significant higher caesarean rate was observed in group with diabetes alone (χ 2 =10.82, p<.001), and diabetes+obesity/EWG (χ 2 =7.33, p<.007). Conclusion: diabetes, obesity and EWG are associated