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result(s) for
"Preda, Agnesa"
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Heart Morphometry in Standard Second Trimester Scan
by
Comănescu, Maria-Cristina
,
Bennasar, Mar
,
Preda, Agnesa
in
anomaly scan
,
cardiac morphometry
,
Cardiovascular disease
2025
Routine second trimester anomaly scans include standard cardiac planes, yet detailed cardiac morphometry is not part of current practice. We hypothesized that a comprehensive set of cardiac measurements could be obtained from these standard views without prolonging examination time and with clinically meaningful reproducibility.
We conducted a prospective study involving ninety-two uncomplicated singleton pregnancies undergoing routine second trimester anomaly scans. Cardiac measurements were obtained using standard ISUOG/SRUOG planes, both during the examination and offline. Feasibility, reproducibility, and the impact on scanning time were evaluated, and results were compared with established reference ranges.
All morphometric measurements were successfully obtained in 100% of included cases. Mean \"screen time\" increased only minimally from 35.45 min (95% CI 32.9-38.0) to 38.75 min (95% CI 36.1-41.4), with a non-significant mean difference of 3.30 min (
= 0.063). Most z-scores fell within ±2 SD. Intra-observer reproducibility ranged from fair to excellent, with strong correlations for major cardiac dimensions (r > 0.80 for multiple parameters).
Comprehensive fetal cardiac morphometry can be integrated into the routine second trimester anomaly scan using standard imaging planes, without prolonging the examination. This approach may support earlier recognition of atypical growth patterns or cardiac remodeling.
Journal Article
Dyslipidemia in Pregnancy: A Systematic Review of Molecular Alterations and Clinical Implications
by
Vladu, Ionela Mihaela
,
Zorila, Lucian George
,
Mitrea, Adina
in
Case reports
,
Cholesterol
,
Clinical trials
2024
Background: Dyslipidemia in pregnancy presents unique clinical challenges due to its effects on maternal and fetal health. This systematic review hypothesizes that molecular alterations in lipid metabolism during pregnancy contribute to adverse pregnancy outcomes and seeks to identify the clinical implications of these changes. The rationale behind this review stems from the increased risk of complications such as preeclampsia, intrauterine growth restriction, and acute pancreatitis associated with dyslipidemia in pregnancy. The primary objective is to examine the interplay between lipid metabolism and pregnancy outcomes. Methods: To achieve this, a systematic review following PRISMA guidelines was conducted, with a comprehensive search of the PubMed database covering articles from January 2014 to June 2024. Inclusion criteria focused on studies assessing molecular alterations and clinical outcomes of dyslipidemia in pregnancy, while case reports and relevant clinical trials were analyzed to evaluate both maternal and fetal outcomes. A total of 12 studies were included in the final analysis. Results: This study provided evidence of the need for early detection and management strategies to reduce risks. The outcomes revealed significant associations between dyslipidemia and adverse maternal outcomes such as preeclampsia, gestational diabetes, and pancreatitis, as well as fetal outcomes like preterm birth and fetal distress. Conclusions: Early lipid monitoring and intervention are crucial in mitigating these risks and suggests that a multidisciplinary approach is necessary to improve maternal and fetal health in pregnancies complicated by dyslipidemia.
Journal Article
An Update of Medical Nutrition Therapy in Gestational Diabetes Mellitus
by
Ștefan, Adela Gabriela
,
Vladu, Mihaela Ionela
,
Clenciu, Diana
in
Associations
,
Coronaviruses
,
COVID-19
2021
Gestational diabetes mellitus (GDM) is a serious and frequent pregnancy complication that can lead to short and long-term risks for both mother and fetus. Different health organizations proposed different algorithms for the screening, diagnosis, and management of GDM. Medical Nutrition Therapy (MNT), together with physical exercise and frequent self-monitoring, represents the milestone for GDM treatment in order to reduce maternal and fetal complications. The pregnant woman should benefit from her family support and make changes in their lifestyles, changes that, in the end, will be beneficial for the whole family. The aim of this manuscript is to review the literature about the Medical Nutrition Therapy in GDM and its crucial role in GDM management.
Journal Article
Analysis of Maternal and Neonatal Complications in a Group of Patients with Gestational Diabetes Mellitus
by
Vladu, Ionela Mihaela
,
Pădureanu, Vlad
,
Ștefan, Adela-Gabriela
in
Apgar score
,
Birth weight
,
Body mass index
2021
Background and Objectives: Gestational diabetes mellitus (GDM) represents one of the most common complications during pregnancy, being associated with numerous maternal and neonatal complications. The study aimed to analyze maternal and neonatal complications associated with GDM. The risk factors of GDM and of the maternal and neonatal complications were studied in order to prevent their occurrence. Materials and Methods: The study included 97 women in the study, who underwent an oral glucose tolerance test (OGTT) between weeks 24–28 of pregnancy, consequently being divided into two groups: pregnant women with and without GDM. Statistical analysis was performed using the SPSS 26.0 software and MATLAB fitglm, the results being considered statistically significant if p < 0.05. Results: We observed statistically significant differences between the group of women with and without GDM, regarding gestational hypertension (17.6% vs. 0%), preeclampsia (13.72% vs. 0%), and cesarean delivery (96.1% vs. 78,3%). Data on the newborn and neonatal complications: statistically significant differences were recorded between the two groups (GDM vs. no GDM) regarding the average weight at birth (3339.41 ± 658.12 g vs. 3122.83 ± 173.67 g), presence of large for gestational age (21.6% vs. 0%), macrosomia (13.7% vs. 0%), excessive fetal growth (35.3% vs. 0%), respiratory distress (31.4% vs. 0%), hospitalization for at least 24 h in the Neonatal Intensive Care Unit (9.80% vs. 0%), and APGAR score <7 both 1 and 5 min following birth (7.8% vs. 0%). Additionally, the frequency of neonatal hypoglycemia and hyperbilirubinemia was higher among newborns from mothers with GDM. Conclusions: The screening and diagnosis of GDM is vital, and appropriate management is required for the prevention of maternal and neonatal complications associated with GDM. It is also important to know the risk factors for GDM and attempt to prevent their appearance.
Journal Article
Analysis of Risk Factors for the Development of Gestational Diabetes Mellitus in a Group of Romanian Patients
by
Vladu, Ionela Mihaela
,
Fortofoiu, Maria
,
Clenciu, Diana
in
Adult
,
Blood Glucose
,
Blood pressure
2022
Introduction. Gestational diabetes mellitus (GDM) is caused by numerous risk factors, the most common being old age, obesity, family history of diabetes mellitus, GDM, history of fetal macrosomia, history of polycystic ovary syndrome or treatment with particular drugs, multiple births, and certain races. The study proposed to analyze the risk factors causing GDM. Method. In the study, we included 97 pregnant women to whom there was an OGTT performed between weeks 24th and 28th of pregnancy, divided into two groups, with GDM and without GDM. The statistical analysis was performed with SPSS 26.0, the tests being statistically significant if p value < 0.05. Results. The favoring risk factors for the onset of GDM were analyzed, with statistically significant differences between the GDM group and the group without GDM related to the delivery age (32.39±4.66 years old vs. 28.61±4.71 years old), history of fetal macrosomia (13.7% vs. 0%), presence of GDM during previous pregnancies (7.8% vs. 0%), HBP before pregnancy (9.8% vs. 0%), gestational HBP (17.6% vs. 0%), glycemia value at first medical visit (79.37±9.34 mg/dl vs. 71.39±9.16 mg/dl), and weight gain during pregnancy (14.61±4.47 kg vs. 12.48±5.87 kg). Conclusions. Identifying the risk factors for the GDM onset has a special importance, implying an early implementation of interventional measures in order to avoid the onset of GDM and associated maternal and fetal complications.
Journal Article
Transient Polyhydramnios during Pregnancy Complicated with Gestational Diabetes Mellitus: Case Report and Systematic Review
by
Ștefan, Adela Gabriela
,
Vladu, Mihaela Ionela
,
Preda, Agnesa
in
Amniotic fluid
,
Carbohydrates
,
Cardiac arrhythmia
2022
Polyhydramnios is an obstetrical condition defined as a pathological increase in the amniotic fluid and is associated with a high risk of maternal-fetal complications. Common causes of polyhydramnios include fetal anatomical and genetic abnormalities, gestational diabetes mellitus, and fetal viral infections. We present the case of a 30-year-old Caucasian woman with transient polyhydramnios associated with gestational diabetes mellitus and obstetric complications. The diagnosis was based on the ultrasound assessment of amniotic fluid volume during a common examination at 26 weeks. Two weeks prior, the patient had been diagnosed with gestational diabetes mellitus. After 4 days, the patient was examined, and the amniotic fluid index returned to normal values. At 38 weeks, the patient presented to the emergency room due to lack of fetal active movement. Ultrasound revealed polyhydramnios, the patient was admitted for severe fetal bradycardia, and fetal extraction through emergency cesarian section was performed. Six weeks after birth, the patient underwent an oral glucose tolerance test with normal values, confirming gestational diabetes mellitus. We performed a systematic review of the literature on polyhydramnios, from January 2016 to April 2022, to analyze all recent published cases and identify the most common etiological causes and important aspects related to maternal-fetal outcomes.
Journal Article
Gestational Diabetes and Preterm Birth: What Do We Know? Our Experience and Mini-Review of the Literature
by
Vladu, Ionela Mihaela
,
Țenea-Cojan, Tiberiu Stefaniță
,
Preda, Agnesa
in
Childbirth & labor
,
Clinical medicine
,
Complications and side effects
2023
Background: Gestational diabetes mellitus (GDM) is a form of diabetes that develops during pregnancy. The incidence of GDM has been on the rise in tandem with the increasing prevalence of obesity worldwide. We focused on the study of what causes premature births and if there are methods to prevent these events that can result in long-term complications. Methods: This study was a prospective, non-interventional study that lasted for 4 years from December 2018 to December 2022. From the group of women enrolled in the study, we selected and analyzed the characteristics of women who gave birth prematurely. Additionally, we performed a systematic review examining the association between GDM and the frequency of adverse pregnancy outcomes. Results: In total, 78% underwent an emergency caesarean and had polyhydramnios. The results indicate that women who had a preterm delivery had a significantly higher maternal age compared to those who had a term delivery (p < 0.001). Conversely, there was no significant difference in preconception BMI between the two groups (p = 0.12). Conclusions: In terms of the understanding of GDM and preterm birth, several gaps in our knowledge remain. The association between GDM and preterm birth is likely multifactorial, involving various maternal factors.
Journal Article
Management of Littre Hernia—Case Report and Systematic Review of Case Reports
by
Răcăreanu, Marian
,
Radu, Petru Adrian
,
Preda, Agnesa
in
Abdomen
,
Abnormalities
,
Care and treatment
2023
Littre hernia is a rare type of hernia in which a Meckel diverticulum is found in the hernia sac. Given the rare nature of this disease, little data on demographics and surgical management exists. In this article, we provide a case report of a strangulated inguinal Littre hernia and perform a systematic review of the literature. The PubMed database was searched on 5 March 2022, and all cases of Littre hernia in adults that had English abstracts or full-text were analyzed. Our primary objective was to evaluate the surgical management and outcomes of this particular type of hernia, and our secondary objectives were to assess demographic characteristics, presentation particularities, and recurrence rates. We identified 89 articles with 98 cases, including our own. Results show a high prevalence of complications described intraoperatively, with strangulation being present in up to 38.46% of patients. The laparoscopic approach was utilized in patients with femoral, inguinal, and umbilical hernias. The most commonly performed type of resection was MD resection, followed by bowel resection, while a minority of cases (5.48%) remained unresected. Mesh repair was more frequently performed in patients with MD resection. A mortality rate of 8.7% in patients who underwent bowel resection was found. A relatively high number of reports of ectopic tissue (21.21%), ulceration (12.12%), and tumors (9.09%) were found. The average follow-up was 19.5 ± 10.29 months, with no hernia recurrence. In conclusion, most cases are admitted in an emergency setting, and intestinal obstruction is frequently associated. A minimally invasive approach can be an option even for complicated hernias. MD resection or bowel resection is usually employed, depending on the extent of ischemic lesions. Patients undergoing bowel resection may be prone to worse outcomes.
Journal Article