부산대학교 도서관

Introduction. Human papillomavirus (HPV) is known as one of the most common causes of genital infections in sexually active women. The virus is transmitted mainly sexually, but epidemiological and clinical studies suggest sufficient evidence for other routes of transmission. Newborns can contract the infection intrauterinely, perinatally or through horizontal transmission. Clinical case presentation. Patient S.I., 34 years old, employee, unmarried. Personal physiological history: menarche at 12 years old; menstrual cycle – regular, 28 days; average duration of 3-5 days, moderate menstrual flow about 3-4 absorbents/day; she denies phenomena associated with menstruation; no births; abortions – one spontaneous at 8 gestational weeks, an abortion on request. Personal pathological history: appendicectomy in 1999. Heredocollateral antecedents: she denies family diseases, she denies chronic diseases. Living and working conditions: house with two rooms, low average monthly income, she denies alcohol consumption, she has been smoking about 10 cigarettes per day for 11 years, she drinks coffee (1 cup per day), she has no stable partner. Local physical examination: normal pubic hair, vulvar hyperpigmentation, normal anal sphincter, tonic and continent, vulvar cauliflower-shaped voluminous formation, leucorrhea secretion inside vagina in a moderate amount, cervix dilated with 2-3 cm, intact membranes, skull applied, painful uterine contractions at 5 minutes lasting for 20 seconds, fetal heartbeats – 146 beats per minute. The ultrasound examination revealed intrauterine pregnancy with a single live fetus in left occipitoiliac presentation (biparietal diameter): 89 mm, HC (cranial circumference): 317 mm, AC (abdominal circumference): 315 mm, FL (femur length): 67 mm, amniotic fluid in normal amount, AFI: 15 cm, estimated fetal weight: 2500 g, gestational age: 37 weeks with symmetrical development, cardiac activity present, fetal heartbeat within normal limits, placenta inserted anteriorly. The anamnestic data and the clinical and paraclinical examinations support the diagnosis: IIIG IP, pregnancy of 37 weeks, live fetus. Occipitoiliac left cranial presentation, intact membranes, labor, bulky vulvar condylomatosis. Once the diagnosis is established, the birth by caesarean section is indicated. Discussion. During pregnancy, due to the changes that occur, the maternal body is in a stage of physiological immunosuppression, being more prone to contract infections. Thus, the main route of HPV transmission is the vertical transmission, from mother to fetus or newborn, during pregnancy, prenatally, and at birth, perinatally, a hypothesis supported by the fact that the viral types identified in the mother were the same as those identified in the newborn. The transmission can also occur at the time of fertilization or contraception, through the infected sperm, the virus being identified in semen and sperm in a variable proportion of 8-64%. The transmission is most common during spontaneous birth, being described as the classic mechanism of contracting the infection. Conclusions. The high heterogeneity of the effects that HPV has on pregnancy and the newborn makes it necessary to conduct studies with the same or almost the same HPV detection methods and on a larger population. [ABSTRACT FROM AUTHOR]