We present a case of a pregnant woman in the third trimester who came to the Department of Emergency, Sf. Apostol Andrei Emergency County Hospital, Constanţa, Romania, in September 2016, for abdominal pain and ascites. After admission, the patient was periodically tested (biochemically and by ultrasound). We also payed attention to the fetal well-being. During the hospitalization, the patient was also found positive for syphilis. Biochemical values have progressively altered, the fetus started to present acute fetal distress and the patient gave birth by Caesarean section after two days of hospitalization. The intraoperatory surprise was hemoperitoneum caused by posttraumatic splenic rupture. The relevance of this case consists in its rarity (we were not able to find in the literature a case with the association of pregnancy, syphilis, trauma, and splenic rupture), in the difficult histopathological clear assertion and in the clinical awareness of such a condition.
Preeclampsia is a multisystemic disease with yet unknown etiology, specific only for human gestation and with symptoms like arterial hypertension, proteinuria and edema. The study group was composed by 65 pregnant women with gestational age between 38-40 weeks, which gave birth in Obstetrics and Gynecology Clinic of Constanta Emergency Clinical County Hospital, during January 2001 - July 2011 and was divided in two groups, A and B, depending on the blood pressure values measured during hospitalization. Group A was composed of 33 hypertensive pregnant women and group B was composed of 32 pregnant women with physiological pregnancy evolution. The retroplacental arterioles diameter was measured by specific methods of morphometry, the probes being obtained from myometrial tissue after caesarian section for both groups. Morphometric differences between spiral retroplacental arterioles of preeclampsia pregnant women and of those with physiological evolution during gestation certify the presence of incomplete structural parietal vessel wall changes in preeclampsia.
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