ABSTRACT
Pregnancy associate with thromboembolism is one of leading causes of maternal morbidity and mortality. Worldwide the incidence of pregnancy related venous thromboembolism is approximately 1 in 1500 deliveries. The arterial thromboembolism risk is increased from 3 to 4 fold and the risk of venous thromboembolism is five times higher in a pregnant that in a non-pregnant woman. With an appropriate prophylaxis and therapy, prevention of death from systemic thromboembolism in pregnancy necessitates a high index of clinical suspicion succeeded by a timely and accurate diagnostic approach. In pregnancy the clinical diagnosis of systemic thromboembolism is notoriously difficult due to the overlap of signs and symptoms between the pulmonary embolus with or without deep venous thrombosis. We performed a retrospective study of 86 pregnant women with Pulmonary thromboembolism (PTE) and Deep venous thrombosis (DVT) diagnosed between 2009-2015 in Obstetrics-Gynecology Clinic 1 at Emergency County Hospital of Craiova. Our study evaluated these cases considering frequency, maternal and fetus risk associated with thromboembolism. In 6 years we had 35 women diagnosed as PTE, 8 women diagnosed as DVT and PTE, and 43 patients diagnosed as DVT. The underlying disease in our study was hypertension and the most frequent symptoms reported were dyspnea and limb swelling.(100%).During the third trimester of pregnancy the incidence of PTE was 45% and DVT 57%. 12 cases of DVT were related to thrombophilia. Also we found 25 % of PTE that occurred after cesarean and 8 % of PTE after vaginal delivery. We notice that vaginal delivery is safer than cesarean surgery. Also the importance of third trimester of pregnancy and postpartum it is evident.
ABSTRACT
The authors analyze the main histopathological changes of placentas from pregnancies ended with fetal distress at birth and the tasks associated with diabetes. The parallel between the two types of placentas not trying to prove the existence of pathognomonic lesions. Are set out both the similarities between the two titles of placentas lesions (such as changes in microcirculation and so on) as well as particular aspects. The authors analyze a group of 19 pregnant women hospitalized in Obstetrics and Gynecology Clinics of Emergency County Hospital of Craiova, Romania, in September 2010-September 2011, who were born and who were diagnosed with diabetes. In the same period, were studied 21 pregnant women whose pregnancy ended with the birth of a child with fetal distress. Such were identified as placental lesions suggestive of fetal distress as diverse etiology of placental vascular changes and the placenta in pregnancy associated diabetes as immaturity and vascular edema and fibrinoid changes and glycogen stores. The authors have proposed to highlight some lesions suggestive of two groups of diseases but independent groups were analyzed and conclusions were drawn after discussing results. This study is justified by insufficient knowledge of the causes that lead to fetal distress regardless of its etiology. In conclusion, the authors mention both placenta's common changes as specifically changes of the placenta for each type of disorder.
