Maternal ureterohydronephrosis (UHN) is a common anatomical change during the evolution of pregnancy, diagnosed especially after the 20th week of pregnancy. The aim of the present study was to evaluate the stages of UHN during pregnancy, depending on the gestational age, and to monitor the symptomatology and the adequate management. A total of 58 pregnant women with UHN, hospitalized in the Constanta County Emergency Hospital, were included in the present study, and had nephrological monitoring using ultrasound examination. Right UHN was observed in all cases and left UHN was observed in only 67.24% of the cases. Regarding the gestational age, right UHN grade III was most commonly seen between 27 and 31 weeks of pregnancy (48.6% of total right UHN grade III from the studied group). The data showed that gestational age and grade of UHN had a highly dependent association in the studied group. The majority of our patients (67.24%) were symptomatic, and the most common complaint on presentation was lumbar pain. According to the visual analog scale (VAS) of the lumbar pain, the group could be distributed as follows: 17.24% with severe pain, 36.21% with moderate pain and 13.79% with mild pain. Eight pregnant women (13.79%) from the present study developed UHN due to passage of a ureteral stone, although the majority of the patients experienced complications with urinary tract infection and acute kidney injury. In addition, 97% of the symptomatic UHN responded to conservatory treatment and only 2 patients (3.45%) with severe symptomatic UHN needed ureteral stent insertion. Data analysis was performed using IBM SPSS Statistics 23. The study highlighted the existence of an association between gestational age and UHN grading.

Introduction: The pathophysiology of preeclampsia is represented by placental ischemia and the release of angiogenic factors. Recent research suggests that using the value of the sFtl-1/PIGF ratio is more accurate for monitoring angiogenic activity. The aim of this study consists in assessing the clinical utility of the sFtl-1/PIGF ratio in determining the diagnosis and severity of preeclampsia. Material and Methods: In our study a descriptive and prospective plan was used for analyzing the specific value of the sFtl-1/PIGF ratio in women with preeclampsia and in women with gestational hypertension, depending on the gestational age and severity. Results: The study included 59 women with preeclampsia and 25 women with gestational hypertension. The mean value of the sFtl-1/PIGF ratio of pregnant women with preeclampsia was 209.2 pg/mL, while in the gestational hypertension group, the mean value of the sFtl-1/PIGF ratio was 46.08 pg/mL. The difference between the value of the sFtl-1/PIGF ratio of the group with preeclampsia and the gestational hypertension group was > 67 (pg/mL), with a sensitivity of 86.44% and a specificity of 92.00%. Significant differences were found between the median values of the sFtl-1/PIGF ratio in pregnant women with severe preeclampsia in the early-onset subgroup compared to those in the late-onset subgroup (307 pg/mL, and 98 pg/mL, respectively, p = 0.009 < α = 0.05). Conclusions: The sFtl-1/PIGF ratio may be an alternative method for diagnosing preeclampsia and it can provide data about this condition’s severity.

Background :The occurence of urinary tract infections (UTIs) in the course of a normal pregnancy should always be early diagnosed and treated, even asymptomatic as it could evolve to threatening pathological conditions, like sepsis with acute kidney injury, or preeclampsia. The aim of study was to establish a cartographic projection of the risk factors and etiopathogenesis of urinary tract infections diagnosed during pregnancy, with the purpose to control their severity and evaluate the therapeutic strategies used to reduce maternal and fetal risks. Material and methods: The study included 175 patients, pregnant women, diagnosed with UTIs hospitalized in the Nephrology Clinic and Obstetrics-Gynecology Clinic of the Emergency Clinical County Hospital of Constanta, in an interval of time of 4 years, between 2017-2021. Results: Out of the 247 patients recruited in our study, the distribution according to the trimester of pregnancy, there were : 72 pregnant women in the first trimester (41.14%), 35 in the second trimester (20.0%) and 68 in the third trimester (38.86%). The frequency of pregnant women who had other favorising conditions and detectable risk factors was 70.29%. The clinical manifestations of UTIs in our study group were distributed as follows : 36 (20.57%) asymptomatic bacteriuria, 56 (32.0%) acute cystitis, 44 (25.14%) recurrent lower urinary tract infections, and 39 (22.29%) acute pyelonephritis. There is an association (p ---lt--- 0.001) between the type of clinical form of UTIs and a certain trimester of pregnancy, for example the highest frequency of acute pyelonephritis (AP) was noticed in the third trimester of pregnancy (71.8%, 28/39). Out of 39 pregnant women with AP, 71.8% (28) had associated ureterohydronephrosis (UHN). E. Coli was present in 41.71% of pregnant women., followed by Klebsiella pneumoniae, Enterococcus faecalis and, less frequently, Staphylococcus aureus and Proteus mirabilis. The most frequently used antibiotics in pregnancy were: 2nd and 3rd generations of cephalosporins (42.29%), followed by ampicillin (34.29%); less used were amoxicillin with clavulanic acid (10.29%), quinolones (6.29%) and nitrofurantoin (6.86%). Most of the pregnant women (94.28%, 165/175) had remission of fever within 24-48 h of using appropriate antibiotic therapy. The recurrence rate was 22.28 %, (39/175). Conclusion All clinical forms of UTIs could be present during pregnancy, but the most common are lower urinary tract infections and the most involved germ is E. Coli. UHN is a factor that influences the occurence of UTIs, being the most common favorising condition.