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Papers by Anca Bivoleanu

Research paper thumbnail of The role of spinal ultrasound in the diagnosis of spinal dysraphism – correlation with MRI examination

Romanian Medical Journal

The paper presents the clinical, ultrasound and MRI appearances in the case of the closed spinal ... more The paper presents the clinical, ultrasound and MRI appearances in the case of the closed spinal dysraphisms with a cutaneous/ subcutaneous mass: lypomyelomeningocele, posterior meningocele and cervical meningocele. There is mentioned first the classification of these defects, then, for each type, a case example is presented, showing the clinical aspect of the lesion, the ultrasound features and the correlation of ultrasound with MRI images. The examples show a good correlation between ultrasound and MRI, entitling the ultrasound exam to be the first line of exploration in the case of this category of patients.

Research paper thumbnail of Diagnosis of lenticulostriate vasculopathy – past, present and the future

Romanian Journal of Pediatrics

Aim. The paper represents a review of the current state of knowledge regarding lenticulostriate v... more Aim. The paper represents a review of the current state of knowledge regarding lenticulostriate vasculopathy (LSV) in premature and term neonates. Material and method. There are reviewed the definition, the history of this diagnosis, the epidemiology, the anatomy of the vessels the etiology and the methods of diagnosis. Results. LSV is defined as the bright hyperechoic blood vessels in the region of the thalamus and basal ganglia. It was first described in 1960. The incidence is 0.3-2% of live births. The etiology is infectious (congenital rubella, cytomegalovirus, toxoplasma, or other chronic intrauterine infections), hypoxic-ischemic, and in many cases idiopathic (without a clear cause). The diagnosis is mainly done by ultrasonography – the are also proposed classification systems based on the number of vessels affected and/or the echogenicity of the vessels involved. Conclusion. LSV represents a pathology recognized for a long time, in the past, it was considered mainly associate...

Research paper thumbnail of Spinal ultrasound – Identification of the normal structures

Romanian Medical Journal

The incomplete ossification of the spinal processes allows the ultrasonographic evaluation of the... more The incomplete ossification of the spinal processes allows the ultrasonographic evaluation of the spinal cord and the adjacent structures in neonates and small infants. The paper describes the ultrasonographic examination of the spinal structures and the normal appearance of the spinal cord, the structures within the spinal canal, and the bony and muscular adjacent structures. Sagittal and axial sections at cervical, thoracic, lumbar, and sacral levels are described. There are also mentioned findings in the M mode and Doppler examinations.

Research paper thumbnail of Premature rupture of membranes versus colonization/infection in newborns

Universitatea de Medicină şi Farmacie „Gr. T. Popa” Iaşi, Departamentul Medicina Mamei şi Copilul... more Universitatea de Medicină şi Farmacie „Gr. T. Popa” Iaşi, Departamentul Medicina Mamei şi Copilului, Departamentul Medicină Preventivă şi Interdisciplinaritate Spitalul Clinic de Obstretică şi Ginecologie „Cuza-Vodă” Iaşi, CRTINNIntroduction: Premature rupture of amniotic membranes (PRM) is a condition of particular importance when it occurs 18 hours or more prior to delivery. Its’ management is tightly linked to the gestational age of the pregnancy, taking into account the possibility of infection of the fetus. Material and methods: In this retrospective study over 3 years, we included all 295b inborn neonates in our NICU from pregnancies with PRM over 18 hours. The following parameters were assessed: the duration of ruptured membranes, inflammatory syndrome and isolated germs in pregnant women, antepartum antibioprophylaxis, gestational age, birth weight, Apgar scores, inflammatory syndrome, cultures, clinical presentation, and outcome of the neonates. Results: The incidence of ne...

Research paper thumbnail of Nasal high-frequency oscillatory ventilation impairs heated humidification: A neonatal bench study

Pediatric Pulmonology, 2017

Research paper thumbnail of The Influence of Maternal KIR Haplotype on the Reproductive Outcomes after Single Embryo Transfer in IVF Cycles in Patients with Recurrent Pregnancy Loss and Implantation Failure—A Single Center Experience

Journal of Clinical Medicine

Research paper thumbnail of Fresh vs. frozen embryo transfers in patients with KIR Bx haplotype: impact on reproductive outcomes

PubMed, Nov 30, 2023

Objective: A controversy persists over whether or not the type of embryo transfer (ET) influences... more Objective: A controversy persists over whether or not the type of embryo transfer (ET) influences reproductive outcomes. This study aimed to evaluate the reproductive outcomes of pregnant patients undergoing their first in vitro fertilization procedure and explore the influence of various KIR genotypes on these reproductive outcomes. Patients and methods: Prospective enrollment of patients with infertility who sought treatment at Origyn Fertility Center in Iasi, Romania, was conducted between January 2019 and March 2023. Descriptive statistics and average treatment effects (ATE) using propensity-score matching were employed to analyze our data. Results: Our results indicated that both groups were homogenous regarding baseline characteristics. When we evaluated the ATE of fresh vs. frozen ET on the main outcomes, we discovered that only frozen ET significantly improved the pregnancy rates (ATE: 0.17, 95% CI: 0.04-0.30, p=0.011) and live birth rates (ATE: 0.36, 95% CI: 0.02-1.19, p=0.03). The miscarriage rates were similar between the two groups. None of the evaluated KIR genotypes had a significant influence on the ATE corresponding to fresh and frozen ET. Conclusions: KIR screening is not necessary before an IVF cycle, except for specific situations such as recurrent pregnancy loss or recurrent implantation failure.

Research paper thumbnail of Neurological follow-up in a lot of newborns with intrauterine growth restriction

Spitalul Clinic de Obstetrică şi Ginecologie „Cuza Vodă”, Iaşi, Divizia de Neonatologie, Departam... more Spitalul Clinic de Obstetrică şi Ginecologie „Cuza Vodă”, Iaşi, Divizia de Neonatologie, Departamentul Mama şi Copilul, Universitatea de Medicină şi Farmacie Grigore T.Popa, IaşiIntroducere. Restricţia de creştere intrauterină (IUGR) reprezintă un factor de risc cunoscut pentru morbiditatea perinatală precoce şi tardivă. Scop. Evaluarea patologiei din maternitate şi a riscului de a dezvolta sechele neurologice la un lot de nou-născuţi cu IUGR. Material şi metodă. Studiu prospectiv longitudinal efectuat pe o perioadă de trei ani, asupra unei cohorte de copii IUGR afl aţi în programul de urmărire al nou-născutului cu risc. Parametrii cuantifi caţi: mediul de provenienţă, vârsta de gestaţie (VG), greutatea la naştere (GN), indice ponderal, patologie prezentată în maternitate, rezultatele examenului Amiel-Tison la externarea din maternitate şi riscul fi nal în funcţie de scala BSID II (Bayley Scale of Infant Development). Datele au fost prelucrate SPSS versiunea 20.0. Rezultate. Au într...

Research paper thumbnail of Quality of Life in Premature Babies

Preterm babies represent a heterogeneous clinical group, whose health state is conditioned by the... more Preterm babies represent a heterogeneous clinical group, whose health state is conditioned by their maturity and the short and long term complications that they sometimes experience as a result of their premature birth. The health and wellbeing of this category of population is the focus of much international effort. Definition of quality of life creates a large debate in medical literature. Since earl’s ’70, hundreds of questioners and methods have been developed in order to measure and/or quantify quality of life. Measuring quality of life in a former premature child is a real challenge. Most of them, despite their poor neurologic outcome and severe disabilities, rate as normal their quality of life in contradiction with their families and physicians perspective. In our opinion, it is important for the medical community to accept, that even if the stated QoL is at odds with the objective assessment by a clinician, it is the perception of the affected individual that should take pr...

Research paper thumbnail of The Role of Follow-up in Monitoring the Outcomes of Prematurity in a Cohort of Romanian Infants

Balkan Medical Journal, 2017

Prematurity involves complex medical conditions (mainly respiratory, but also infectious, gastroi... more Prematurity involves complex medical conditions (mainly respiratory, but also infectious, gastrointestinal, feeding related and growth related), in addition to neurodevelopmental morbidities (neurologic, motor, sensory and behavioral), the severity of which increases with decreasing gestational age. These conditions affect the risk of morbidity and mortality, and they significantly influence later quality of life (1-4). 1 in 10 premature infants will develop a permanent minor neurological dysfunction, such as language disorders, learning disabilities, attention deficit-hyperactivity disorder, neuro-motor dysfunction or developmental coordination disorders, behavioral problems, and social-emotional difficulties, but also chronic health issues such as asthma, infections and increased risk of Sudden Infant Death Syndrome (5-9). Due to injury to the developing brain, 50% of premature infants born before the 26th week of gestation may present

Research paper thumbnail of P26.17: Echographic screening from first trimester of pregnancy and diagnostic of aberrant right subclavian artery

Ultrasound in Obstetrics & Gynecology, 2012

Poster abstracts Case story: Primigravida, 34 years, IVF patient (both egg and sperm donation). A... more Poster abstracts Case story: Primigravida, 34 years, IVF patient (both egg and sperm donation). At first trimester scan at local hospital a large nuchal translucency was found, and the patient was referred. We diagnosed a partial ectopia cordis (fistula from the right ventricle to the umbilicus, picture 1) and dextrocardia associated with a complex intra-cardiac defect (common atrioventricular valve with single right ventricle, double outlet right ventricle, DORV). Additional malformations were found: sternal cleft and 7 mm septate nuchal cystic hygroma. A striking hypercoiling of the umbilical cord was also seen. The patient opted for termination of pregnancy. The autopsy confirmed the prenatal findings. Fetal DNA was sent for array CGH, Agilent 180K. Prenatal, autopsy and array CGH findings will be presented. There seems to be a strong correlation between the PC and umbilical abnormalities, in particular in cases with ectopia cordis. Atypical coiling pattern of the umbilical cord has previously been descibed.

Research paper thumbnail of P04.01: Aberrant right subcalvian artery: prenatal diagnostic-routine exam or challenge?

Ultrasound in Obstetrics & Gynecology, 2011

Objectives: To investigate the clinical application of fetal echocardiography in the diagnosis of... more Objectives: To investigate the clinical application of fetal echocardiography in the diagnosis of complex fetal cardiac malformation using the sequence section planes and system scanning the fetal body. Methods: Using American Society of Echocardiography guidelines and standards for performance of the fetal echocardiogram, do antenatal examination for 352 cases to found if there are

Research paper thumbnail of 1104 Long-Term Outcome of Term Newborns with Perinatal Asphyxia - Predictive Factors

Archives of Disease in Childhood, 2012

Introduction Ambroxol hydrochloride (drug Lazolvan) inherent anti-inflammatory and antioxidant ef... more Introduction Ambroxol hydrochloride (drug Lazolvan) inherent anti-inflammatory and antioxidant effects that may have an impact onreducing the frequency and severity of intraventricular hemorrhage (IVH). Purpose Installing the clinical efficacy of intravenous slow (15 min)administration of the drug Lazolvan (single dose 7.5 mg twice a day from the first days of life for 7 days). Methods In retrospective case-control study included 50 infants with gestational age less than 35 weeks. The main group (n=18) received Lazolvan, control group not received. Before the beginning of the study formed the group did not differ among themselves on basic clinical and demographic indicators. Statistically significant group differ among themselves RDS third degree by the core group of children-27.8% vs 6.26%; p=0.03. Clinical efficacy of the drug Lazolvan determined in terms of relative risk (RR) of IVH an indicator of patient who need to treat (NNT). Results The relative risk of IVH in the main group 2.7 times less compared with the control group. At 2.17 times more often in terms of relative risk of IVH second degree occurred in the control group children. The treatment of 6.25 premature infants prevents a case of IVH. Newborn core group of perhaps less treated in the intensive care unit, respectively (days) 12.88±3.07 vs 9.07±3.73; p=0.0003. Conclusions The positive results from the use of Lazolvan in the complex treatmet of premature infants with risk of IVH prove its clinical effectiveness and extend its use.

Research paper thumbnail of Lung Malformations: Prenatal Ultrasound Diagnosis and Obstetrical Management

Donald School Journal of Ultrasound in Obstetrics and Gynecology, 2014

ABSTRACTPurposeWe present our experience in prenatal diagnosis and obstetrical management of cong... more ABSTRACTPurposeWe present our experience in prenatal diagnosis and obstetrical management of congenital lung malformations (CLM).Materials and methodsThe diagnosis of CLM was performed during routine second and third trimester fetal morphology assessment. The extent of the disease was established according to the type, localization and size of the pulmonary lesion and the presence of fetal complications (mediastinal shift, fetal hydrops, hydramnios). Termination of pregnancy (TOP) was indicated in cases associated with extrapulmonary anomalies, untreatable cases and fetal hydrops. After delivery a pulmonary X-ray and surgical examination was performed in all newborns.ResultsWe diagnosed 15 cases with congenital lung malformations. Of these, 9 had congenital cystic adenomatoid malformation (CCAM). TOP was performed in 6 cases with CCAM. Three cases had a favorable pre/postnatal evolution. Bronchopulmonary sequestration (BPS) was diagnosed in 3 cases, all with favorable perinatal evol...

Research paper thumbnail of Congenital heart disease with poor outcome in the absence of surgery

Early Human Development, 2008

The "growing" and the "pulsatile" pattern were documented respectively in 51 and 86 pts. Ductal c... more The "growing" and the "pulsatile" pattern were documented respectively in 51 and 86 pts. Ductal closure was observed in 103/137 subjects (75.1%) after one course of ibuprofen. A second course was performed in 22 of these (16.0%). Definitive ductal closure rate with pharmacological approach was 85.6%. Spontaneous ductal closure rate at the time of the first echocardiographic examination was 20.3% of 27 pts. with "pulmonary hypertension" or "closing" pattern, 25 (92.5%) showed spontaneous ductal closure in day 4th. Surgical ligation was performed in 5 pts. (2.4%), all of these with PMA <27 weeks (mean PMA 24.4 < 2.0). Mortality rate in the study group was 18/ 206 (8.7%), incidence of severe ICH and CLD was respectively of 6.3% and 3.8% Residual PDA at discharge was found in 15 subject, 2 of these receiving transcatheter closure at a mean age of 37.3 months. Conclusions Our data showed that ECI was associated with a high closure rate of the ductus and few side effects. Doppler assessment of PDA flow pattern is an important guide in order to predict the risk of developing significant PDA and to reduce the number of patients unnecessarily treated.

Research paper thumbnail of SFP-P154 – Néonatalogie – Infection et prématurité dans un service de réanimation néonatale niveau III en Roumanie

Archives de Pédiatrie, 2008

Research paper thumbnail of Physician Attitudes in Romania toward Withholding and Withdrawal of Intensive Care for Infants with Very Poor Prognosis

American Journal of Perinatology, 2013

The purpose of this study was to examine the attitudes of Romanian physicians toward withholding ... more The purpose of this study was to examine the attitudes of Romanian physicians toward withholding and withdrawing intensive care for infants whose prognosis is very poor. A survey tool was developed by the authors and completed by participants in the annual meeting of the Neonatology Association of Romania. The majority of respondents attempt resuscitation of all live-born infants, have never stopped resuscitation at birth while the infant was still alive, and have never stopped respiratory support because of poor prognosis. Nearly all respondents were uncomfortable talking with parents about withholding or withdrawing intensive care, and they were also uncomfortable talking to the parents about the death of their infant. Romanian physicians are uniformly reluctant to withhold or withdraw intensive care for infants, even those with very poor prognosis. In addition, physicians are very uncomfortable talking with parents about limiting or stopping support and talking about the death of an infant. Educational programs targeting the communication of difficult topics with parents have the potential to decrease the discomfort experienced by physicians in conversing with parents about their child&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s poor prognosis or death.

Research paper thumbnail of Complications of Prematurity as Risk Factors for Outcome

The increased rate of prematurity has been accompanied by high rates of neonatal complications an... more The increased rate of prematurity has been accompanied by high rates of neonatal complications and neurodevelopment sequels. Objective: The study was design to evaluate whether identifying certain complications of prematurity may be useful in predicting neurodevelopment outcome. Observational longitudinal study, over six years, of a cohort of premature infants. The risk factors quantified were: gestational age, birth weight, birth asphyxia, necessity of mechanical ventilation , specific pathology (respiratory distress syndrome, intraventricular hemorrhage, periventricular leukomalacia) ,results of Amiel –Tison, neurologic exam at discharge, total numbers of evaluations, final results of evaluations, acording to Bayley Scales of Infant Development, 2nd Edition at two years corrected age. The data were analyzed using SPSS Statistics version 18.0. From January 1, 2005 to December 31, 2011 the incidence of prematurity in our maternity was 13.65%. 33.03% (n=2182) were prematures and from...

Research paper thumbnail of Nasal High-Frequency Oscillatory Ventilation Use in Romanian Neonatal Intensive Care Units -Results of a Recent Survey

Children, 2024

Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial

Research paper thumbnail of The role of spinal ultrasound in the diagnosis of spinal dysraphism – correlation with MRI examination

Romanian Medical Journal

The paper presents the clinical, ultrasound and MRI appearances in the case of the closed spinal ... more The paper presents the clinical, ultrasound and MRI appearances in the case of the closed spinal dysraphisms with a cutaneous/ subcutaneous mass: lypomyelomeningocele, posterior meningocele and cervical meningocele. There is mentioned first the classification of these defects, then, for each type, a case example is presented, showing the clinical aspect of the lesion, the ultrasound features and the correlation of ultrasound with MRI images. The examples show a good correlation between ultrasound and MRI, entitling the ultrasound exam to be the first line of exploration in the case of this category of patients.

Research paper thumbnail of Diagnosis of lenticulostriate vasculopathy – past, present and the future

Romanian Journal of Pediatrics

Aim. The paper represents a review of the current state of knowledge regarding lenticulostriate v... more Aim. The paper represents a review of the current state of knowledge regarding lenticulostriate vasculopathy (LSV) in premature and term neonates. Material and method. There are reviewed the definition, the history of this diagnosis, the epidemiology, the anatomy of the vessels the etiology and the methods of diagnosis. Results. LSV is defined as the bright hyperechoic blood vessels in the region of the thalamus and basal ganglia. It was first described in 1960. The incidence is 0.3-2% of live births. The etiology is infectious (congenital rubella, cytomegalovirus, toxoplasma, or other chronic intrauterine infections), hypoxic-ischemic, and in many cases idiopathic (without a clear cause). The diagnosis is mainly done by ultrasonography – the are also proposed classification systems based on the number of vessels affected and/or the echogenicity of the vessels involved. Conclusion. LSV represents a pathology recognized for a long time, in the past, it was considered mainly associate...

Research paper thumbnail of Spinal ultrasound – Identification of the normal structures

Romanian Medical Journal

The incomplete ossification of the spinal processes allows the ultrasonographic evaluation of the... more The incomplete ossification of the spinal processes allows the ultrasonographic evaluation of the spinal cord and the adjacent structures in neonates and small infants. The paper describes the ultrasonographic examination of the spinal structures and the normal appearance of the spinal cord, the structures within the spinal canal, and the bony and muscular adjacent structures. Sagittal and axial sections at cervical, thoracic, lumbar, and sacral levels are described. There are also mentioned findings in the M mode and Doppler examinations.

Research paper thumbnail of Premature rupture of membranes versus colonization/infection in newborns

Universitatea de Medicină şi Farmacie „Gr. T. Popa” Iaşi, Departamentul Medicina Mamei şi Copilul... more Universitatea de Medicină şi Farmacie „Gr. T. Popa” Iaşi, Departamentul Medicina Mamei şi Copilului, Departamentul Medicină Preventivă şi Interdisciplinaritate Spitalul Clinic de Obstretică şi Ginecologie „Cuza-Vodă” Iaşi, CRTINNIntroduction: Premature rupture of amniotic membranes (PRM) is a condition of particular importance when it occurs 18 hours or more prior to delivery. Its’ management is tightly linked to the gestational age of the pregnancy, taking into account the possibility of infection of the fetus. Material and methods: In this retrospective study over 3 years, we included all 295b inborn neonates in our NICU from pregnancies with PRM over 18 hours. The following parameters were assessed: the duration of ruptured membranes, inflammatory syndrome and isolated germs in pregnant women, antepartum antibioprophylaxis, gestational age, birth weight, Apgar scores, inflammatory syndrome, cultures, clinical presentation, and outcome of the neonates. Results: The incidence of ne...

Research paper thumbnail of Nasal high-frequency oscillatory ventilation impairs heated humidification: A neonatal bench study

Pediatric Pulmonology, 2017

Research paper thumbnail of The Influence of Maternal KIR Haplotype on the Reproductive Outcomes after Single Embryo Transfer in IVF Cycles in Patients with Recurrent Pregnancy Loss and Implantation Failure—A Single Center Experience

Journal of Clinical Medicine

Research paper thumbnail of Fresh vs. frozen embryo transfers in patients with KIR Bx haplotype: impact on reproductive outcomes

PubMed, Nov 30, 2023

Objective: A controversy persists over whether or not the type of embryo transfer (ET) influences... more Objective: A controversy persists over whether or not the type of embryo transfer (ET) influences reproductive outcomes. This study aimed to evaluate the reproductive outcomes of pregnant patients undergoing their first in vitro fertilization procedure and explore the influence of various KIR genotypes on these reproductive outcomes. Patients and methods: Prospective enrollment of patients with infertility who sought treatment at Origyn Fertility Center in Iasi, Romania, was conducted between January 2019 and March 2023. Descriptive statistics and average treatment effects (ATE) using propensity-score matching were employed to analyze our data. Results: Our results indicated that both groups were homogenous regarding baseline characteristics. When we evaluated the ATE of fresh vs. frozen ET on the main outcomes, we discovered that only frozen ET significantly improved the pregnancy rates (ATE: 0.17, 95% CI: 0.04-0.30, p=0.011) and live birth rates (ATE: 0.36, 95% CI: 0.02-1.19, p=0.03). The miscarriage rates were similar between the two groups. None of the evaluated KIR genotypes had a significant influence on the ATE corresponding to fresh and frozen ET. Conclusions: KIR screening is not necessary before an IVF cycle, except for specific situations such as recurrent pregnancy loss or recurrent implantation failure.

Research paper thumbnail of Neurological follow-up in a lot of newborns with intrauterine growth restriction

Spitalul Clinic de Obstetrică şi Ginecologie „Cuza Vodă”, Iaşi, Divizia de Neonatologie, Departam... more Spitalul Clinic de Obstetrică şi Ginecologie „Cuza Vodă”, Iaşi, Divizia de Neonatologie, Departamentul Mama şi Copilul, Universitatea de Medicină şi Farmacie Grigore T.Popa, IaşiIntroducere. Restricţia de creştere intrauterină (IUGR) reprezintă un factor de risc cunoscut pentru morbiditatea perinatală precoce şi tardivă. Scop. Evaluarea patologiei din maternitate şi a riscului de a dezvolta sechele neurologice la un lot de nou-născuţi cu IUGR. Material şi metodă. Studiu prospectiv longitudinal efectuat pe o perioadă de trei ani, asupra unei cohorte de copii IUGR afl aţi în programul de urmărire al nou-născutului cu risc. Parametrii cuantifi caţi: mediul de provenienţă, vârsta de gestaţie (VG), greutatea la naştere (GN), indice ponderal, patologie prezentată în maternitate, rezultatele examenului Amiel-Tison la externarea din maternitate şi riscul fi nal în funcţie de scala BSID II (Bayley Scale of Infant Development). Datele au fost prelucrate SPSS versiunea 20.0. Rezultate. Au într...

Research paper thumbnail of Quality of Life in Premature Babies

Preterm babies represent a heterogeneous clinical group, whose health state is conditioned by the... more Preterm babies represent a heterogeneous clinical group, whose health state is conditioned by their maturity and the short and long term complications that they sometimes experience as a result of their premature birth. The health and wellbeing of this category of population is the focus of much international effort. Definition of quality of life creates a large debate in medical literature. Since earl’s ’70, hundreds of questioners and methods have been developed in order to measure and/or quantify quality of life. Measuring quality of life in a former premature child is a real challenge. Most of them, despite their poor neurologic outcome and severe disabilities, rate as normal their quality of life in contradiction with their families and physicians perspective. In our opinion, it is important for the medical community to accept, that even if the stated QoL is at odds with the objective assessment by a clinician, it is the perception of the affected individual that should take pr...

Research paper thumbnail of The Role of Follow-up in Monitoring the Outcomes of Prematurity in a Cohort of Romanian Infants

Balkan Medical Journal, 2017

Prematurity involves complex medical conditions (mainly respiratory, but also infectious, gastroi... more Prematurity involves complex medical conditions (mainly respiratory, but also infectious, gastrointestinal, feeding related and growth related), in addition to neurodevelopmental morbidities (neurologic, motor, sensory and behavioral), the severity of which increases with decreasing gestational age. These conditions affect the risk of morbidity and mortality, and they significantly influence later quality of life (1-4). 1 in 10 premature infants will develop a permanent minor neurological dysfunction, such as language disorders, learning disabilities, attention deficit-hyperactivity disorder, neuro-motor dysfunction or developmental coordination disorders, behavioral problems, and social-emotional difficulties, but also chronic health issues such as asthma, infections and increased risk of Sudden Infant Death Syndrome (5-9). Due to injury to the developing brain, 50% of premature infants born before the 26th week of gestation may present

Research paper thumbnail of P26.17: Echographic screening from first trimester of pregnancy and diagnostic of aberrant right subclavian artery

Ultrasound in Obstetrics & Gynecology, 2012

Poster abstracts Case story: Primigravida, 34 years, IVF patient (both egg and sperm donation). A... more Poster abstracts Case story: Primigravida, 34 years, IVF patient (both egg and sperm donation). At first trimester scan at local hospital a large nuchal translucency was found, and the patient was referred. We diagnosed a partial ectopia cordis (fistula from the right ventricle to the umbilicus, picture 1) and dextrocardia associated with a complex intra-cardiac defect (common atrioventricular valve with single right ventricle, double outlet right ventricle, DORV). Additional malformations were found: sternal cleft and 7 mm septate nuchal cystic hygroma. A striking hypercoiling of the umbilical cord was also seen. The patient opted for termination of pregnancy. The autopsy confirmed the prenatal findings. Fetal DNA was sent for array CGH, Agilent 180K. Prenatal, autopsy and array CGH findings will be presented. There seems to be a strong correlation between the PC and umbilical abnormalities, in particular in cases with ectopia cordis. Atypical coiling pattern of the umbilical cord has previously been descibed.

Research paper thumbnail of P04.01: Aberrant right subcalvian artery: prenatal diagnostic-routine exam or challenge?

Ultrasound in Obstetrics & Gynecology, 2011

Objectives: To investigate the clinical application of fetal echocardiography in the diagnosis of... more Objectives: To investigate the clinical application of fetal echocardiography in the diagnosis of complex fetal cardiac malformation using the sequence section planes and system scanning the fetal body. Methods: Using American Society of Echocardiography guidelines and standards for performance of the fetal echocardiogram, do antenatal examination for 352 cases to found if there are

Research paper thumbnail of 1104 Long-Term Outcome of Term Newborns with Perinatal Asphyxia - Predictive Factors

Archives of Disease in Childhood, 2012

Introduction Ambroxol hydrochloride (drug Lazolvan) inherent anti-inflammatory and antioxidant ef... more Introduction Ambroxol hydrochloride (drug Lazolvan) inherent anti-inflammatory and antioxidant effects that may have an impact onreducing the frequency and severity of intraventricular hemorrhage (IVH). Purpose Installing the clinical efficacy of intravenous slow (15 min)administration of the drug Lazolvan (single dose 7.5 mg twice a day from the first days of life for 7 days). Methods In retrospective case-control study included 50 infants with gestational age less than 35 weeks. The main group (n=18) received Lazolvan, control group not received. Before the beginning of the study formed the group did not differ among themselves on basic clinical and demographic indicators. Statistically significant group differ among themselves RDS third degree by the core group of children-27.8% vs 6.26%; p=0.03. Clinical efficacy of the drug Lazolvan determined in terms of relative risk (RR) of IVH an indicator of patient who need to treat (NNT). Results The relative risk of IVH in the main group 2.7 times less compared with the control group. At 2.17 times more often in terms of relative risk of IVH second degree occurred in the control group children. The treatment of 6.25 premature infants prevents a case of IVH. Newborn core group of perhaps less treated in the intensive care unit, respectively (days) 12.88±3.07 vs 9.07±3.73; p=0.0003. Conclusions The positive results from the use of Lazolvan in the complex treatmet of premature infants with risk of IVH prove its clinical effectiveness and extend its use.

Research paper thumbnail of Lung Malformations: Prenatal Ultrasound Diagnosis and Obstetrical Management

Donald School Journal of Ultrasound in Obstetrics and Gynecology, 2014

ABSTRACTPurposeWe present our experience in prenatal diagnosis and obstetrical management of cong... more ABSTRACTPurposeWe present our experience in prenatal diagnosis and obstetrical management of congenital lung malformations (CLM).Materials and methodsThe diagnosis of CLM was performed during routine second and third trimester fetal morphology assessment. The extent of the disease was established according to the type, localization and size of the pulmonary lesion and the presence of fetal complications (mediastinal shift, fetal hydrops, hydramnios). Termination of pregnancy (TOP) was indicated in cases associated with extrapulmonary anomalies, untreatable cases and fetal hydrops. After delivery a pulmonary X-ray and surgical examination was performed in all newborns.ResultsWe diagnosed 15 cases with congenital lung malformations. Of these, 9 had congenital cystic adenomatoid malformation (CCAM). TOP was performed in 6 cases with CCAM. Three cases had a favorable pre/postnatal evolution. Bronchopulmonary sequestration (BPS) was diagnosed in 3 cases, all with favorable perinatal evol...

Research paper thumbnail of Congenital heart disease with poor outcome in the absence of surgery

Early Human Development, 2008

The "growing" and the "pulsatile" pattern were documented respectively in 51 and 86 pts. Ductal c... more The "growing" and the "pulsatile" pattern were documented respectively in 51 and 86 pts. Ductal closure was observed in 103/137 subjects (75.1%) after one course of ibuprofen. A second course was performed in 22 of these (16.0%). Definitive ductal closure rate with pharmacological approach was 85.6%. Spontaneous ductal closure rate at the time of the first echocardiographic examination was 20.3% of 27 pts. with "pulmonary hypertension" or "closing" pattern, 25 (92.5%) showed spontaneous ductal closure in day 4th. Surgical ligation was performed in 5 pts. (2.4%), all of these with PMA <27 weeks (mean PMA 24.4 < 2.0). Mortality rate in the study group was 18/ 206 (8.7%), incidence of severe ICH and CLD was respectively of 6.3% and 3.8% Residual PDA at discharge was found in 15 subject, 2 of these receiving transcatheter closure at a mean age of 37.3 months. Conclusions Our data showed that ECI was associated with a high closure rate of the ductus and few side effects. Doppler assessment of PDA flow pattern is an important guide in order to predict the risk of developing significant PDA and to reduce the number of patients unnecessarily treated.

Research paper thumbnail of SFP-P154 – Néonatalogie – Infection et prématurité dans un service de réanimation néonatale niveau III en Roumanie

Archives de Pédiatrie, 2008

Research paper thumbnail of Physician Attitudes in Romania toward Withholding and Withdrawal of Intensive Care for Infants with Very Poor Prognosis

American Journal of Perinatology, 2013

The purpose of this study was to examine the attitudes of Romanian physicians toward withholding ... more The purpose of this study was to examine the attitudes of Romanian physicians toward withholding and withdrawing intensive care for infants whose prognosis is very poor. A survey tool was developed by the authors and completed by participants in the annual meeting of the Neonatology Association of Romania. The majority of respondents attempt resuscitation of all live-born infants, have never stopped resuscitation at birth while the infant was still alive, and have never stopped respiratory support because of poor prognosis. Nearly all respondents were uncomfortable talking with parents about withholding or withdrawing intensive care, and they were also uncomfortable talking to the parents about the death of their infant. Romanian physicians are uniformly reluctant to withhold or withdraw intensive care for infants, even those with very poor prognosis. In addition, physicians are very uncomfortable talking with parents about limiting or stopping support and talking about the death of an infant. Educational programs targeting the communication of difficult topics with parents have the potential to decrease the discomfort experienced by physicians in conversing with parents about their child&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s poor prognosis or death.

Research paper thumbnail of Complications of Prematurity as Risk Factors for Outcome

The increased rate of prematurity has been accompanied by high rates of neonatal complications an... more The increased rate of prematurity has been accompanied by high rates of neonatal complications and neurodevelopment sequels. Objective: The study was design to evaluate whether identifying certain complications of prematurity may be useful in predicting neurodevelopment outcome. Observational longitudinal study, over six years, of a cohort of premature infants. The risk factors quantified were: gestational age, birth weight, birth asphyxia, necessity of mechanical ventilation , specific pathology (respiratory distress syndrome, intraventricular hemorrhage, periventricular leukomalacia) ,results of Amiel –Tison, neurologic exam at discharge, total numbers of evaluations, final results of evaluations, acording to Bayley Scales of Infant Development, 2nd Edition at two years corrected age. The data were analyzed using SPSS Statistics version 18.0. From January 1, 2005 to December 31, 2011 the incidence of prematurity in our maternity was 13.65%. 33.03% (n=2182) were prematures and from...

Research paper thumbnail of Nasal High-Frequency Oscillatory Ventilation Use in Romanian Neonatal Intensive Care Units -Results of a Recent Survey

Children, 2024

Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial