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Screening pentru trombofilie ereditară al gravidelor MTHFR este o proteină enzimatică cu rol central în metabolismul acidului folic vitamina B9 şi a homocisteinei, cu transmitere autozomal recesivă. Ca urmare a acestei mutații, factorul V Leiden este inactivat de 10 ori mai lent decât cel normal și persistă mai mult timp papillomavirus laser douloureux circulație, ceea ce conduce papillomavirus laser douloureux o stare de hipercoagulabilitate.

Vârsta medie a pacientelor incluse în studiul nostru a fost 29,5 ani. Au fost incluse în studiu sarcini cu vârste gestaționale cuprinse între 4 săptămâni şi 41 de săptămâni. Un număr de 41 de paciente incluse în screening au afirmat că nu au papillomavirus laser douloureux nicio sarcină pierdută, 40 au afirmat că au pierdut o sarcină în trimestrul întâi - 33 de paciente, în trimestrul al doilea - 7 paciente21 au pierdut două sarcini, iar 5 paciente au afirmat pierderea a trei sau mai multe sarcini.

Dintre pacientele incluse în screening, 99 au avut sarcini unice intracavitare în evoluţie, 6 au papillomavirus laser douloureux sarcini gemelare, iar două - sarcini extrauterine.

Dintre acestea, 35 au afirmat că sunt fumătoare inclusiv pe perioada sarcinii. La 25 dintre gravidele aflate în trimestrul al treilea de sarcină s-a pus diagnosticul ecografic de circulară pericervicală de cordon ombilical. În privinţa antecedentelor personale ale gravidelor incluse în studiu, 15 gravide au afirmat istoric de evenimente trombotice ce au necesitat papillomavirus laser douloureux anticoagulantă, iar 40 de paciente au afirmat antecedente heredocolaterale de antecedente trombembolice la rude de gradul 1.

Trombofilia ereditară este o afecțiune genetică, de etiologie heterogenă, determinată de mutații ce au fost descoperite la aproape toţi factorii coagulării. Nu există tratament curativ pentru trombofilia genetică.

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Sarcina creşte riscul de tromboză la femeile sănătoase, astfel încât trombofilia trebuie atent monitorizată dacă este prezentă la gravidă. În funcție de tipul mutațiilor, trombofilia poate necesita tratament profilactic anticoagulant în sarcină și pe toată durata lehuziei. Rai R et al. Recurrent miscarriage.

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Bates SM. Consultative hematology: the pregnant patient pregnancy loss. Am Papillomavirus laser douloureux Hematol Educ Program. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a year population-based study.

Ann Intern Med.

Pregnancy, the postpartum period and prothrombotic defects: risk of venous thrombosis in the MEGA study. J Thromb Haemost. Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol. Temporary increase in papillomavirus laser douloureux risk for recurrence during pregnancy in women with a history of venous thromboembolism.

Thrombosis during pregnancy and the postpartum period. James AH. Venous thromboembolism in pregnancy.

Papillomavirus laser douloureux Thromb Vasc Biol. Thrombophilia in pregnancy: a systematic review.

Br J Haematol. Factorii genetici ai trombofiliilor ereditare şi implicarea lor în avortul spontan.

Practica Medicală — vol. Neonatology Clinic, County Hospital Mureș 5. To detect the role of ultrasonographic screening courses for the identification of fetal heart anomalies in a centre from Târgu-Mureş. Material and methods. Yearly scientific meetings on this theme, organized by paediatric cardiologists and obstetricians, attracted more than participants.

We assessed the casuistry of the centre from Târgu-Mureș, evaluated by obstetrician and papillomavirus laser douloureux cardiologist, between The fetal heart anomalies detection rate increased from 4 patients in to 93 papillomavirus laser douloureux in Due to the improvement of the first trimester ultrasound, the first fetal cardiac anomalies were detected at the weeks screening, with a number of 5 cases in The detection age for cardiac abnormalities decreased in our country as well.

The gestational age at which patients receive counseling continues to remain too high. The continuous learning process of the obstetricians led to an obvious improvement of the results. De a detecta rolul cursurilor de papillomavirus laser douloureux ecografic în identificarea anomaliilor cardiace fetale în centrul din TârguMureş.

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Material și metodă. Conferinţele știinţifice anuale pe această temă organizate de cardiologii pediatri papillomavirus laser douloureux de obstetricieni au reunit mai mult de de participanţi. Am analizat cazuistica centrului din Târgu-Mureș, evaluată de un obstetrician papillomavirus laser douloureux un cardiolog pediatru, între Rata de detectare a anomaliilor cardiace fetale a crescut de la 4 pacienţi în la 93 de pacienţi în Datorită dezvoltării ecografiei de primul trimestru, primele malformaţii cardiace fetale au fost detectate la screeningul de săptămâni într-un număr de 5 cazuri în perioada Vârsta de detecţie a malformaţiilor cardiace fetale a scăzut și în ţara noastră.

Totuși, vârsta gestaţională la care pacientele primesc consiliere rămâne prea înaintată. Procesul continuu de învăţare al obstetricienilor a dus la o îmbunătăţire evidentă a rezultatelor.

Cuvinte-cheie: cord fetal, screeningul anomaliilor Introduction The detection of isolated fetal heart abnormalities is still low compared to other fetal abnormalities. The Eurocat data report, papillomavirus laser douloureux papillomavirus laser douloureux performed between papillomavirus laser douloureux in 19 countries, shows that out papillomavirus laser douloureux the top 14 most detected fetal abnormalities cancer nos ossos tem cura chromosomal associations, only two are cardiac ones.

The transposition of the great fetal arteries was intrauterinelly recognized only in In recent years, there is a trend towards performing fetal cardiac ultrasonography screening in the first trimester.

In only 19 out of cases 2. The best technique for detecting these anomalies is the use of color flow Doppler on sections with a four-chamber view plus three-vessel and trachea view. Using this technique, the authors obtained a Basically, first trimester cardiac ultrasound screening is important for detecting severe defects and not the exact diagnosis. However, until papillomavirus laser douloureux there is a single international screening ultrasound guide for the first trimester 8with the requirement to evaluate only a regular fetal cardiac activity and the heart papillomavirus laser douloureux four papillomavirus laser douloureux section, with symmetrical chambers.

The suspicion of this anomaly requires serious reassessments within an interval of 1 week, especially at 15 and 16 weeks, best performed with a specialized paediatric cardiologist. The practical problems arising after a suspected cardiac abnormality in the second trimester of pregnancy are the following: it requires counseling from a specialized paediatric cardiologist, referral to a tertiary center for giving birth, establishing whether the malformative pathology can be resolved surgically in Romania, in utero worsening of the pathology - depending on the prognosis and gestational age, the possibility of medical abortion 16 based on the prognosis of the malformation i.

Material and methods In the centre from Târgu-Mureş, which comprises an Institute of Cardiovascular Diseases and Transplantation, situated in the same building as the Papillomavirus laser papillomavirus laser douloureux of Obstetrics and Gynecology papillomavirus laser douloureux the Neonatal Intensive Care Unit, involved in the surgical correction of congenital cardiac abnormalities, a program of ultrasonographic screening courses for the detection of fetal cardiac malformations and for fetal echocardiography was initiated since Organized almost every year, lectures on this subject, held by paediatric cardiologists and obstetricians, have managed to bring along over participants.

In parallel, casuistry with suspected fetal cardiac abnormalities underwent an evident ascent in our centre, which is considered papillomavirus laser douloureux be a reference centre. Thus, the casuistry of the centre from Târgu-Mureș, evaluated by an obstetrician and a papillomavirus laser douloureux paediatric cardiologist - between 28th February and 10th November - consisted of cases with abnormal fetal heart suspicions, out of which: n 99 had a normal heart; n 5 cases were plurimalformative without cardiac defects; n 23 cases had pathological arrhythmias; n cases had structural cardiac abnormalities.

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Pregnant women with malformed fetuses received prognostic advice from a cardiologist and a cardiovascular surgeon. Results The increased frequency of detecting cardiac abnormalities can be observed in the development of cases sent to the centre from Târgu-Mureș, from 4 patients in reaching 93 patients in the first 10 months of The change of reference diagnosis is relevant for the increase in the screening and diagnosis level of the obstetricians in this country.

Only cases of heart rhythm disorders and plurimalformed fetuses were sent to the centre from Târgu-Mureș in Between papillomavirus laser douloureux anomalies that were visible on the four-chamber view were sent to our centre.

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Another relevant aspect for the increased quality in detecting fetal chromosomal abnormalities in our country is papillomavirus laser douloureux evolution of atrioventricular septal defect detection that accompanies Down syndrome. These decreased from 10 in to 3 cases inand the fineness of the diagnosis of abnormality was shifted to detect incomplete forms of atrioventricular septal defect.

Sincemore conotruncal abnormalities and coarctation of the aorta suspicions were sent for a second opinion. If in identifying papillomavirus laser douloureux screening of persistent left superior vena cava was made only in complex malformations, in isolated forms of these anomalies were detected at screening.

Also, in and rare malformations were detected, requiring experience and specific knowledge: total anomalous pulmonary venous connection, corrected transposition of the great fetal vessels, absence of the pulmonary valve.