Obstetrics and Gynecology Commons^™

Caesarean Section Versus Vaginal Birth In The Perception Of Woman Who Gave Birth By Both Methods, Octavian Gabriel Olaru, Anca Daniela Stanescu, Cristina Raduta, Liana Ples, Adriana Vasilache, Nicolae Bacalbasa, Andrei Vasilache, Oana Denisa Balalau

Journal of Mind and Medical Sciences

The increase in the number of births by Caesarean section is a phenomenon whose global expansion is generated by numerous factors and especially by the contemporary perceptions of women regarding childbirth meeting the interests of the professionals in the field. However, the opinion of many women towards the benefits of Caesarean delivery is often not based on the experience or information from reliable sources. This study aimed at sharing the experience of women who gave birth both vaginally and by Caesarean section, focusing on their perception of these events. The study included 26 women and the conclusion of the vast …

The Social And The Psychological Impact Of Endometriosis On The Romanian Urban Population, Iulia Baciu, Alecsandra Irimie-Ana, Anca Maria Panaitescu, Gheorghe Peltecu, Corina Gica, Nicolae Gica

Journal of Mind and Medical Sciences

Objectives. Our study assesses the social and psychological impact of the symptoms of endometriosis. Materials and methods. This crosssectional study was conducted from January 2014 to January 2016. The research involved two groups. The study instrument, the EHP-5 questionnaire, was completed by the respondents on the admission date or on the routine gynecological visit day. Results. Endometriosis has a negative social and psychological impact on women’s life, the most affected areas being work, fertility and sexual activity. Moreover, pain and the negative perception of self-image are major sources of distress. Conclusion. The symptoms and effects of endometriosis, especially chronic pelvic …

A Comprehensive Analysis Of Postpartum Depression And Delivery Characteristics: A Cross-Sectional Study, Navdar Dogus Uzun, Mustafa Tekin, Fulya Uzun

Journal of Mind and Medical Sciences

Objective: We attempted to identify risk factors for postpartum depression (PPD) by evaluating individuals in terms of their birth patterns, as well as other characteristics, including income level, smoking habits, number of children, age, and history of antidepressants. Methods and results: Participants completed a questionnaire consisting of three sections: demographic characteristics, delivery characteristics, and Edinburgh Postpartum Depression Scale. Participants with a depression medical history had a higher depression level during the postpartum. There were significant correlations between postpartum depression, the husband’s working status, the desire fo r the pregnancy, and the patient’s depression medical history. PPD levels did not differ …

The Analysis Of Risk Factors Associated With Women's Urinary Incontinence; Literature Review, Denisa Oana Balalau, Octavian Gabriel Olaru, Nicolae Bacalbasa, Stana Paunica, Daniela Gabriela Balan, Anca Daniela Stanescu

Journal of Mind and Medical Sciences

Urinary incontinence (UI) is a common condition among women. Approximately 50% of them had an involuntary loss of urine at least once in their lifetime. It can be present during sexual activity, contributing to sexual dysfunction and often associated with anxiety or even depression, thus having a negative impact on the quality of life. The incidence of UI is related to the existence of predisposing factors. The best known are: age, weight, family history, race/ ethnicity, number of pregnancies and mode of birth, history of genitourinary interventions and factors related to ordinary habits: smoking, caffeine consumption, oral contraceptives. Studies on …

A Mini-Review Regarding The Carcinogenesis And Morphology Of Serous Tumors Of The Ovary, Fallopian Tube And Peritoneum, Tiberiu-Augustin Georgescu, Roxana Bohiltea, Octavian Munteanu, Corina Grigoriu, Ioana Paunica, Maria Sajin

Journal of Mind and Medical Sciences

Similar to the already well-recognized adenoma-carcinoma sequence in colorectal cancer pathogenesis, it has been believed for many decades that the progression of ovarian epithelial tumors occurs from benign serous cystadenomas to borderline tumors, to well-differentiated carcinomas, and ultimately, to poorly differentiated carcinomas. However, it is currently accepted that low-grade serous carcinoma (LGSC) and high-grade serous carcinoma (HGSC) are fundamentally different tumor types and, consequently, different diseases. In fact, whereas the benign-borderline-malignant sequence seems to apply quite well to low-grade serous carcinoma, the sequence of genetic alterations in high-grade serous carcinoma is substantially different. In this mini-review, we included the current …

Periodontitis As A Potential Risk Factor For Premature Delivery, Ana Turcu-Duminică, Anca Silvia Dumitriu, Stana Paunica, Corina Gică, Radu Botezatu, Nicolae Gică, Gheorghe Peltecu, Anca Maria Panaitescu

Journal of Mind and Medical Sciences

Pregnancy is a particular period of time for a woman, so that it is important to accurately determine the impact of adjacent pathologies on the natural evolution of the nine months of pregnancy. Although there is still much to debate on the association between periodontal disease and pregnancy, the conclusion seems to remain the same: untreated periodontal pathology in pregnancy could have adverse consequences such as premature birth or low birth weight fetuses. Periodontopathies are introduced as risk factors, the novelty of the subject being the association between untreated periodontal pathology and the evolution of pregnancy. The affected periodontal tissue …

Modes Of Birth And Their Impact On The Psychological And Physical Health Of Women, Myriam Natascha Wieser, Kleanthi Gourounti, Antigoni Sarantaki

Journal of Mind and Medical Sciences

Objective. The aim of this review was to evaluate the literature concerning modes of birth and their impact on the psychological and physical health of women. Methods. A search was conducted in PubMed Central and Scopus to identify relevant studies in the literature. The searching phrases were “mode of birth” AND “maternal health”. No date restriction was applied. The languages were restricted to English, German, and Greek. Results. Women giving birth through assisted vaginal births, especially by means of forceps, had a higher risk of dealing with different health problems in the postpartum period. Caesarean sections are not able to …

The Quality Of Sexual Life After Vaginal Surgical Interventions, Maria Pană, Romina-Marina Sima, Oana-Denisa Bălălău, Anca-Daniela Stănescu, Liana Pleş, Mircea-Octavian Poenaru

Journal of Mind and Medical Sciences

Introduction. The malfunction of the supporting pelvic system generates signs and symptoms that require various procedures. The aim of our study was to evaluate whether vaginal surgical interventions for genital prolapse or urinary incontinence have an impact on patients’ sexual quality of life. Materials and methods. We studied 40 eligible women who underwent vaginal surgical procedures in Saint John Hospital, Bucharest. Patients completed a questionnaire 6 months after the intervention. Results. Patients who underwent vaginal surgery for prolapse were 50-64 years of age. The most frequent vaginal surgical intervention was vaginal hysterectomy (32.5%), followed by anterior and …

Impact Of A Protocol Implementation On Identification And Referral Of Women At-Risk For Hereditary Breast Cancer, Chrysanthemum Davis Lawson

Evidence-Based Practice Project Reports

Breast cancer is the foremost new cancer diagnosis and the second highest cause of cancer death in American women (American Cancer Society, 2019). Hereditary breast cancer is most commonly caused by a mutation within the breast cancer susceptibility genes, BRCA 1 or 2, which increases women’s risk for breast cancer by five to ten-fold the average population (Mayo Clinic, 2019). The U.S. Preventive Services Task Force has assigned a Grade B recommendation advising health care providers to use a risk assessment tool, such as the Breast Cancer Genetics Referral Screening Tool (B-RST™), to recognize and provide medical management recommendations for …

Mass Matters: Increasing Mammography Rates To Underserved Women, Ingrid N. Cooper

Evidence-Based Practice Project Reports

Breast cancer is the most frequently diagnosed cancer among women in Indiana and the United States (Indiana Cancer Organization, 2019). An estimated 268,000 new cases of invasive breast cancer were diagnosed and 41,760 women died due to breast cancer in 2019 (ACS, 2019). Substantial breast cancer-related morbidity and mortality disparities persist among the underserved. Disparities in breast cancer outcomes are due to lower mammography screening rates, lack of timely follow-up of abnormal results, and lack of timely treatment initiation among women with breast cancer (Highfield et al., 2015). The purpose of this evidence-based practice project was to address low mammography …

Warty Carcinoma Of Uterine Cervix - Review Of The Literature And Case Report, Octavian Gabriel Olaru, Catalina Monica Pena, Oana Denisa Balalau, Anca Daniela Stanescu

Journal of Mind and Medical Sciences

Introduction. The Histological Classification of Epithelial Tumors of the Uterine Cervix of the World Health Organization includes inter alia warty carcinoma as a variant of squamous cell carcinoma. Until now several case reports and studies have shown that this particular cancer is associated with human papillomavirus/ HPV infection.

Case presentation. A 58-year-old woman presented with a vegetant cervical tumour. Biopsy samples were collected from the tumour, and the histological exam successively confirmed the warty cell carcinoma. Additional tests revealed the presence of single human papillomavirus/ type-45. An immunohistochemistry exam was performed in order to confirm the diagnosis, and …

Risk Factors, Predictive Markers And Prevention Strategies For Intrauterine Fetal Death. An Integrative Review, Roxana Bohiltea, Natalia Turcan, Christina M. Cavinder, Ionită Ducu, Ioana Paunica, Liliana Florina Andronache, Monica Mihaela Cirstoiu

Journal of Mind and Medical Sciences

According to World Health Organization (WHO), fetal death is defined as the death of the fetus prior to its complete expulsion, independent of the duration of pregnancy, thus only ascribing the term stillbirth to fetal deaths in the case of pregnancies after 28 weeks of gestation. The great progress of perinatology care is reflected in a significant reduction in the rate of stillbirths, especially in well-developed countries, with approximately 98% of stillbirth cases now occurring in poor and developing countries. Stillbirth powerfully impacts both the patient and the practitioner. Because nearly half of stillbirth cases result from apparently uncomplicated pregnancies, …

The Serine/Threonine Protein Kinase (Akt)/ Protein Kinase B (Pkb) Signaling Pathway In Breast Cancer, Daniela Miricescu, Camelia Cristina Diaconu, Constantin Stefani, Ana Maria Alexandra Stanescu, Alexandra Totan, Ioana Ruxandra Rusu, Ovidiu Gabriel Bratu, Dan Spinu, Maria Greabu

Journal of Mind and Medical Sciences

According to statistical data published in 2019, breast cancer is among the leading causes of death in women worldwide. The serine/threonine kinase (AKT) or protein kinase B (PkB) signaling pathway is activated by phosphorylation processes, which further is associated with cell growth, proliferation, and survival, but also with activation of glucose metabolism. Mutations of the AKT signaling pathway components (especially PI3KCA and PTEN) have been observed in breast cancer patients, which are associated with resistance to hormonal treatment. Many clinical trials are testing the effect of AKT inhibition in order to block the growth and proliferation of breast cancer cells. …

Anorexia Nervosa And Reproduction: Connecting Brain To Gonads, Mihaela Poterasu, David L. Rowland, Corina Ciobanu, Simona Fica

Journal of Mind and Medical Sciences

Anorexia nervosa (AN) is a psychiatric disorder that predominantly affects young women and is characterized by low caloric intake and a major dissatisfaction with one’s body image. It is often overlooked and, while patients and family seek medical help, emaciation and nutritional misbalances may become extreme and potentially life threatening. Among the many somatic complications, an accumulation of early endocrine adaptations occurs, leading to functional amenorrhea and impaired reproduction as a result of dysfunction of the hypothalamic-pituitary-ovarian axis. Even though these conditions are reversible, long-term consequences may affect the fertility of women with AN and can lead to maternal and …

Increasing Chlamydia Trachomatis And Neisseria Gonorrhea Screening Among Women 15 To 24 Years Old Using A Multifaceted Approach, Mackenzie Shireman

Evidence-Based Practice Project Reports

The Centers for Disease Control and Prevention (CDC) (2017a) estimates that one-quarter of sexually active people are between 15 and 24 years old, but account for half of 20 million sexually transmitted diseases (STD) reported annually in the United States. Chlamydia trachomatis (CT) and Neisseria gonorrhea (NG) are the most common reportable STDs (CDC, 2018). The purpose of this project was to increase CT/NG screening rates among sexually active, nonpregnant women 15 to 24 years old within the primary care setting through colleague education, routine sexual history taking, and indicated testing. A 30-minute colleague in-service was provided to educate clinical …

Chronic Vulvar Paget’S Disease: A Therapeutic Challenge With A Review Of The Literature, Bouhani Malek, Zemni Ines, Fertani Yasmine, Bouzaiene Hatem, Rahal Khaled

Journal of Mind and Medical Sciences

Vulvar Paget’s disease is an uncommon adenocarcinoma of the female genital tract, occuring more often in postmenopausal Caucasian women and accounting for 1-2% of all vulvar malignancies. A 39-year-old female patient was examined for the erythematous and pruritic vulvar lesion, with biopsy and histological examination revealing vulvar Paget’s disease. We did not diagnose any associated neoplasm. The patient underwent four surgical resections for relapsed disease, varying from local excision to extended excision, including radical vulvectomy, with esthetic coverage. The margins were involved. Due to the extended target volumes, radiotherapy was rejected and the patient underwent a local topical therapy with …

Conservative Surgical Treatment In Cervical Dysplastic Lesions Associated With Cystorectocele, Bogdan Marian Puca, Anca D. Braila, Cosmin V. Obleaga, Mihai Braila, Hany Saad, Cristian Lungulescu, Mihai Deca

Journal of Mind and Medical Sciences

The treatment of cervical intraepithelial neoplasia aims at removing the squamocolumnar junction area, including abnormal tissues, up to the healthy tissue. Old postpartum perineal tears associated with cystorectocele, hypertrophic cervical elongation, and first and second degree uterine prolapse are pelvic static disorders. Particular aspects of pelvic-genital static disorder are related to the vulnerability of the pelvic-perineal floor during birth. On the occasion of birth, especially when there are different forms of dystocia during labor, the degradation of soft pelvic, genital, and vaginal-perineal tissues can occur. The objective of this study was to re-evaluate the conservative treatment of cervical dysplasia, depending …

Patients’ Perception Of Childbirth According To The Delivery Method: The Experience In Our Clinic, Camelia Alexandroaia, Romina-Marina Sima, Oana-Denisa Bălălău, Gabriel-Octavian Olaru, Liana Pleş

Journal of Mind and Medical Sciences

Introduction: The aim of this study is to identify the way in which childbirth in general, and the delivery method in particular, influenced the maternal psychosocial status and the perception upon birth during postpartum. Material and method: We conducted a cohort type 2 prospective study. We included patients who had given birth at “Bucur” Maternity of Hospital “St. John” Bucharest from the 1st of January 2017 until the 1st of January 2018. Results: The majority of the patients (21.05%) who chose to give birth vaginally assigned the maximum degree (10) to the difficulty of birth. The patients who gave birth …

The Correlation Between Histopathological And Ultrasound Findings Regarding Cesarean Section Scars – A Three-Year Survey Study, Oana D. Bălălău, Nicolae Bacalbașa, Cristian Bălălău, Carolina Negrei, Bianca Gălățeanu, Octav Ghinghină, Cristina Răduță, Liana Pleș, Anca D. Stănescu, Vasile A. Dumitru

Journal of Mind and Medical Sciences

The cesarean operation represents a major surgery, with a higher risk of postoperative complications and longer postoperative recovery than vaginal delivery.

Due to the increasing frequency of cesarean sections, the ultrasound imaging of the uterine scar has become a particularly useful tool in identifying its potential long-term complications. This should be done pre-conceptively and quarterly or whenever necessary during pregnancy.

Currently, there are only few histopathological studies on the uterine scar, trying to assess the myometrial repair and certain factors that influence the quality of the scar.

The study was performed on a batch of 123 patients with previous C-sections, …

Postpartum Depression And Thyroid Dysfunction– Should Pregnant Women Be Screened For Thyroid Disorders?, Anca A. Simionescu, Erika Marin

Journal of Mind and Medical Sciences

The relationship between thyroid dysfunction and postpartum depression has been investigated for quite some time now, but no consensus has been reached regarding the need for screening for thyroid function during pregnancy. This paper aims to investigate whether thyroid hormone screening in pregnancy might contribute to the diagnosis of postpartum depression.

Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) - one of the most widely used measures in detecting postpartum depression and anxiety. Thyroid function was measured using the commonly recommended thyroid laboratory tests.

A structured questionnaire was given to 61 patients closely monitored during their pregnancy and …

Pain Management For Intrauterine Device Insertion And Endometrial Biopsy, Michelle Lipton-Carroll

Evidence-Based Practice Project Reports

Intrauterine device (IUD) insertions and endometrial biopsies (EMB) can be painful in office gynecological procedures. In the clinical setting used for this evidence-based project (EBP) it was noted there was no consistent pain management being used for these procedures. For this EBP project a protocol for pain management during IUD insertions and EMBs was developed and implemented into this clinical setting. The protocol was created from an exhaustive literature search, which yielded six pieces of high-level evidence of good quality. The evidence supported the use of a 1% lidocaine paracervical block prior to IUD insertion and a 2% lidocaine intrauterine …

Sentinel Lymph Node In Early Stage Ovarian Cancer; A Literature Review, Irina Balescu, Nicolae Bacalbasa, Mihaela Vilcu, Vladislav Brasoveanu, Iulian Brezean

Journal of Mind and Medical Sciences

Although sentinel lymph node mapping has been widely implemented in gynecological malignancies in order to minimize the number of unnecessary lymph node dissections and to diminish postoperative morbidity rate, little is known about ovarian cancer sentinel lymph node mapping. This article presents a literature review regarding the effectiveness, safety and benefits of this method.

Sentinel lymph node detection in early stage ovarian cancer seems to be a safe and effective method, able to minimize the rate of patients submitted to unnecessary lymph node dissection. The second goal of the procedure, to minimize the risk of missing involved lymph nodes, seems …

Postpartum Depression: Prevention And Multimodal Therapy, Anca Daniela Stanescu, Denisa Oana Balalau, Liana Ples, Stana Paunica, Cristian Balalau

Journal of Mind and Medical Sciences

A woman goes through many biological (hormonal, physical), psychological (emotional), and socio-cultural changes during pregnancy. Furthermore, changes also occur in the mother's familial and interpersonal world after childbirth. While some mothers have positive emotions at birth, such as joy and pleasure, others complain of negative experiences varying from sadness and depression to psychosis. Thus, the risk of depression is higher for women during the postpartum period, having a tendency to decrease in most cases over the first 2 weeks after delivery. Unfortunately, this favorable evolution does not happen in about 1 in 4-7 women, who develops postpartum depression. Postpartum depression …

Recurrent Vulvar Carcinoma: Complex Surgical Treatment Via Perineal Excision And Reconstruction With Musculocutaneous Flap, Dragoș Popa, Cosmin V. Obleagă, Ștefan Paitici, Stelian Ș. Mogoanta, Ionică D. Vîlcea, Pouya Pourgolafshan, Cristian Gheorghe, Manuela I. Vasile, Raluca Câmpeanu, Cecil S. Mirea

Journal of Mind and Medical Sciences

Vulvar cancer is a malignant disease having a low frequency and with well-established surgical and oncological treatments based on the stage of the disease. The most important therapeutic problem encountered is represented by cases of perineal local regional recurrence, which are common in patients with large primary tumors and can occur even if the margins of the resection had no tumoral invasion.

We present a case study of a 64-year-old patient diagnosed one year ago with squamous vulvar carcinoma (G3) for which a vulvectomy was performed after neoadjuvant radiotherapy. The patient later developed local recurrence with invasion of the anal …

The Psychosocial Impact Of Vaginal Delivery And Cesarean Section In Primiparous Women, Ples Liana, Romina M. Sima, Delia Carp, Camelia Alexandroaia, Denisa O. Balalau, Anca D. Stanescu, Octavian G. Olaru

Journal of Mind and Medical Sciences

The aim of this study was to identify how the method of delivery and birth experience interfere with maternal psychological status early after puerperium. We conducted a prospective study on 148 women after puerperium from November 2017 to January 2018 in Bucur Maternity Hospital. Women that delivered vaginally mobilized in the first 6 hours in 73.7% of the cases, but for cesarean section after 12- 24 hours in 43.6% of the cases. Women described good support from the obstetrician in 58.1% of the cases. 90.5% of the women reported that the method of delivery did not have an impact on …

Pelvic Floor Disorders In Gynecological Malignancies. An Overlooked Problem?, Oana M. Bodean, Radu D. Marcu, Dan A. Spinu, Bogdan Socea, Camelia C. Diaconu, Octavian Munteanu, Nicoleta Taus, Monica Cirstoiu

Journal of Mind and Medical Sciences

Cervical, endometrial, ovarian, vulvar, and vaginal cancers affect women of a broad age spectrum. Many of these women are still sexually active when their cancer is diagnosed. Treatment options for gynecological malignancies, such as gynecological surgery, radiation, and chemotherapy, are proven risk factors for pelvic floor dysfunction. The prevalence of urinary incontinence, fecal incontinence, and sexual dysfunction before cancer treatment is still unclear. Hypotheses have been raised in the literature that these manifestations could represent early symptoms of pelvic cancers, but most remain overlooked even in cancer surviving patients.

The primary focus of therapy is always cancer eradication, but as …

The Psychological Influence Of The Diagnosis Of Breast Cancer On Therapeutic Options Selection, Razvan V. Scaunasu, Stefan Voiculescu, Bogdan Popescu, Cristina Cozma, Radu Jecan, Cristian Balalau

Journal of Mind and Medical Sciences

The therapeutic management decision-making process for breast cancer is complex, and is influenced by multiple factors including patient age, comorbidities, ethnicity, education, and availability of immediate or delayed reconstruction options. Our study analysed 276 patients diagnosed with breast cancer in the “Colțea” Clinical Hospital between 2014 and 2015. Mean patients age was 61.24, median 62, with a range of 31 to 89 years. Younger age was associated with a less advanced local disease and younger patients were more likely to choose and benefit from conservative surgery. Most patients (61.76%) came from rural areas. Place of origin had a significant influence …

Cesarean Scar Defects And Placental Abnormalities – A 3 Year Survey Study, Denisa Oana Bălălău, Nicolae Bacalbașa, Anca D. Stănescu

Journal of Mind and Medical Sciences

The placenta is an essential organ for embryonic and fetal development, ensuring nutrient uptake, gas exchange (via the mother's blood supply), waste elimination, thermo-regulation, immunological and hormonal factors, etc. The most common placental abnormalities are represented by placenta previa, and a morbidly adherent placenta (in the form of accreta, increta, and percreta placenta). This study was performed on a sample of 99 patients diagnosed with abnormalities of placentation who underwent cesarian delivery during a period of 3 years in Bucur Maternity Hospital. Seven patients were diagnosed with morbidly adherent placenta (5 accreta and 2 percreta subtypes), the others having placenta …

High-Grade Cervical Dysplasia In Pregnancy – Psychological And Medical Challenges, Denisa O. Balalau, Romina M. Sima, Nicolae Bacalbasa, Petrisor Banu, Cristian Bălălău, Liana Ples, Anca D. Stanescu

Journal of Mind and Medical Sciences

Despite being rare, the incidence of pregnancy-related cancer is expected to rise as women continue to delay childbearing and give birth later in their reproductive years. In this broad category, tumors like breast cancer, dermatological neoplasia and cervical cancer are most common and tend to arise in women of childbearing age. All pregnant women with clinical and cytologic suspicion of cervical cancer, except for squamous atypia or low-grade squamous intraepithelial lesions, should undergo colposcopy, with or without biopsy, the latter being avoided if possible due to possible complications which, although rare, may involve preterm labor initiation.

Some studies have attempted …

Vulvodynia; An Under-Recognized Disease, Simona Roxana Georgescu, Cristina I. Mitran, Mădălina I. Mitran, Maria I. Sârbu, Mircea Tampa

Journal of Mind and Medical Sciences

Vulvodynia is a chronic condition which affects an increasing number of women; it presents currently an incidence that is higher than had previously been estimated. Regarding pathogenesis, several (hormonal, infectious, inflammatory and psychological) factors have been proposed, but vulvodynia etiology remains still unclear. This disorder is a multifactorial condition with a significant impact on the patient’s quality of life, yet is difficult to diagnose (an under-estimated/ under-recognized affection). Certain medical investigations are required in order to exclude other diseases (the diagnosis of vulvodynia being one of exclusion), but anamnesis and physical examination are essential steps in the diagnosis.

Although many …