Knowledge about evolution of treated and untreated primary vaginal intraepithelial neoplasia (VaIN) remains limited, as current guidelines recommend treatment. This study investigates the natural history of VaIN based on existing literature.

This study is a systematic review and descriptive meta-analysis. We searched the PubMed, Scopus, Web of Science (WoS), and Scientific Electronic Library Online (SciELO) databases to identify clinical series reporting the no-regression rate(including persistence, recurrence, or progression events) of primary VaIN. We recorded data categorized by VaIN grade and treatment status. Clinical series that reported VaIN grade, follow-up time (median or mean of six months or more), treatment details, and whether treatment was performed were eligible for inclusion. Additionally, some internal hospital databases on VaIN were included. Data were pooled at each follow-up time point, using six-month intervals. From these pooled rates, trend curves were constructed to describe the natural history of treated (various therapies) and untreated low-grade and high-grade VaIN.

A total of 150 series were included in the data synthesis. Five subgroups were assessed for low-grade VaIN and twelve for high-grade VaIN. The estimated 5-year no-regression rate of untreated low-grade VaIN, predicted by trend curve, was 14.0% (95% confidence intervals (95% CI): 9.2%–44.0%), indicating that 86.0% of untreated low-grade VaIN would regress within 5-years. The 5-year no-regression rate for untreated high-grade VaIN, also predicted by trend curve, was 14.2% (95% CI: 10.2%–24.8%), indicating that 85.8% of untreated high-grade VaIN regress within 5-years. It cannot be determined to what extent treatment modifies the natural history of VaIN. Current assessments suggest that only low-level evidence is available on VaIN.

A large proportion of untreated VaIN lesions, regardless of grade, would resolve after 5 years of follow-up, with at least 14% of lesions unlikely to resolve.

The study has been registered on https://www.crd.york.ac.uk/PROSPERO/view/CRD42023445810 (registration number: CRD42023445810).

Ovarian cancer (OC) is among the most common types of cancer affecting the female reproductive system, second only to cervical cancer in incidence. Recent studies have identified Microtubule associated protein 7 (MAP7) as a key factor influencing the malignant characteristics of various tumor cell types. However, the expression levels and functional roles of MAP7 in OC remain insufficiently characterized. This study aims to explore the expression profile of MAP7 and its functional implications in OC, with the goal of clarifying its potential contribution to tumor development and the underlying molecular mechanism.

The MAP7 expression in OC was assessed using data from The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx), and The Human Protein Atlas (HPA) databases. A tissue microarray assay (TMA) was constructed to evaluate protein expression. Study gene function was investigated through MAP7 silencing and overexpression experiments in A2780 and SKOV3 OC cell lines. Cell proliferation and invasion/migration assays were conducted to assess cellular proliferation and mobility, respectively. Western blotting was performed to analyze related signaling pathways, while tumor formation in nude mice assessed in vivo tumorigenicity.

Data from TCGA and GTEx databases showed MAP7 overexpression in OC tissues, consistent with the findings from our local dataset. MAP7 mediated cell invasion, migration, and promoted cell proliferation in OC cells via the Protein Kinase B/mammalian Target of Rapamycin (Akt/mTOR) signaling pathway (p < 0.05). MAP7 knockdown significantly inhibited the tumorigenicity of OC cells in nude mice (p < 0.05).

Our results highlight the role of MAP7 in the progression of OC. Given its involvement in Akt/mTOR signaling and tumorigenicity in preclinical models, MAP7 represents a novel potential therapeutic target for OC that warrants further investigation.

This review aimed to implement a search strategy focused on vaginal candida infections in pregnant women and to analyze specific vulvovaginal symptom questionnaires (VSQs) for Candida infections.

A literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The MEDLINE, Web of Science, and Scopus databases were searched for studies published between 1997 and 2023. The search strategy included keywords related to vaginal candidiasis, pregnancy, risk factors, symptoms, and self-assessment VSQs. The studies were assessed for quality using Joanna Briggs Institute Critical Appraisal Tools, focusing on validity, reliability, and appropriate statistical methods.

A total of 36 papers with vaginal candidiasis reported during pregnancy were included (1997–2023), along with 14 papers reporting the use of VSQs. The literature was found to lack sufficient data, with a wide variation in population size and data across studies. Sample sizes ranged from as few as 80 patients to as many as 13,863 patients in other studies. Notably, a significant age range was observed among the participants, spanning from 10 to 64 years. Additionally, symptoms and signs were not investigated in 17 studies, while risk factors were not discussed in 20 studies. A total of 14 studies were identified; however, only one was presented with a fully developed VSQ, which had been validated and was available in multiple languages. Meanwhile, none of the studies focused on pregnant women and the role of VSQs.

Incorporating self-assessment VSQs into clinical practice would improve everyday practice and increase awareness among pregnant women regarding vulvovaginal Candida infections, improve the identification and management of these infections, leading to earlier detection, more timely treatment, and improved health outcomes for newborns.

Adnexal torsion is a gynecological emergency that can lead to loss of ovarian function if not diagnosed promptly. This study aimed to determine which computed tomography (CT) findings, or combinations of findings, can accurately diagnose adnexal torsion in women presenting with abdominal pain and adnexal masses.

In this retrospective single-center cohort study conducted between January 2018 and December 2023, a total of 66 patients were evaluated. Group 1 (n = 35; 53%) included women who underwent preoperative CT for abdominal pain and were subsequently diagnosed with adnexal torsion. Group 2 (n = 31; 47%) served as the control group and comprised patients who underwent preoperative CT for untwisted adnexal masses. Statistical analysis was performed using SPSS version 26.0. Normality was assessed with the Kolmogorov-Smirnov test. Non-normally distributed variables were analyzed using the Mann-Whitney U test. Categorical variables were analyzed using the chi-square test or Fisher’s exact test. Interobserver agreement for CT findings was evaluated, and logistic regression analyses were conducted. A p-value < 0.05 was considered statistically significant.

Interobserver agreement was almost perfect for the identification of unusual adnexal and uterus location, the presence of an interutero-ovarian mass, the whirlpool sign, peritoneal effusion, and tubal thickening. The unusual location of the adnexa and the presence of the whirlpool sign were significantly more frequent in the adnexal torsion group (Group 1) and remained statistically significant in the logistic regression analysis.

Accurate interpretation of CT scans performed in emergency settings, particularly in experienced centers, may help in reliably diagnosing or excluding adnexal torsion, potentially reducing unnecessary surgical interventions.

Primary immune thrombocytopenia (ITP) during pregnancy is an acquired autoimmune disorder characterized by a decreased platelet count (<100 × 10⁹/L) due to the presence of platelet-specific autoantibodies. Although ITP is rare, with an incidence of just 1–10 cases per 10,000 pregnancies, it poses significant risks of maternal hemorrhage and neonatal thrombocytopenia. Management options include first-line treatments such as corticosteroids and intravenous immunoglobulin (IVIG), while second-line therapies (high-dose steroids, or splenectomy) are reserved for refractory cases. Treatment is aimed at maintaining safe platelet thresholds (>30 × 10⁹/L during pregnancy and >50 × 10⁹/L for delivery) rather than achieving normal levels, thereby balancing maternal safety with fetal considerations. Multidisciplinary management involving hematologists, obstetricians, and neonatologists is essential for optimal outcomes.

6 primiparous women with severe ITP in late pregnancy (platelet count <20 × 10⁹/L) were treated with a comprehensive regimen including prednisone, recombinant human thrombopoietin, IVIG, and platelet transfusions, resulting in increased platelet counts (range of 48 to 294 × 10⁹/L). All 6 cases exhibited platelet counts <20 × 10⁹/L, gestational ages ranging from 32 to 34+ weeks, and were hospitalized for induction of labor.

Individualized comprehensive treatment can effectively manage severe ITP during late pregnancy, with protocols tailored to each patient’s condition, gestational age, and platelet count fluctuations.

Postoperative infections remain a significant complication following cesarean delivery, highlighting the need for reliable and accessible methods for early detection. This study aimed to evaluate the predictive value of preoperative and postoperative systemic inflammation markers for post-cesarean section infections.

This case-control study included women admitted to the maternity ward of Niğde Ömer Halisdemir University Hospital between 1 October 2021, and 1 October 2023. 50 patients who developed infections following cesarean sections (CS) were compared with 50 control patients. Demographic, clinical, and obstetric information was collected from hospital records. Complete blood count (CBC) results collected 3–10 days prior to surgery and 24 hours post-surgery were analyzed and compared between the two study groups.

Among patients in the study group, 84% developed surgical site infection (SSI), while the remaining 16% experienced other types of infections. No significant differences were observed between the groups in terms of maternal age, body mass index (BMI), birth weight, length of surgery, blood loss, gestational age at delivery, smoking history, gestational diabetes mellitus, hypertensive disorders of pregnancy, intensive care unit admission, history of emergency CS, gravidity, and parity (p > 0.05). No significant differences were observed between preoperative and postoperative values for platelet count (PLT), mean platelet volume (MPV), mean platelet volume-to-platelet ratio (MPV/PLT), or platelet-to-lymphocyte ratio (PLR) (p > 0.05). Postoperative monocyte-to-lymphocyte ratio (MLR) and neutrophil-to-lymphocyte ratio (NLR) were significantly in patients with post-CS infections; receiver operating characteristic (ROC) analysis was used to determine optimal cut-off values (p < 0.001).

NLR and MLR may serve as reliable, simple, and effective biomarkers to enhance clinical decision-making for the early detection and prediction of post-cesarean infections.

During follow-up, some patients with endometrial hyperplasia (EH) progress to endometrial cancer (EC) while others diagnosed with EH experience pathological escalation following hysterectomy. When treating premenopausal women, it is imperative to consider reproductive function, especially if they wish to preserve fertility.

This study adhered to the Network Meta-Analysis extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. We screened the PubMed, Web of Science, Cochrane Library, and Embase databases to identify relevant studies published from inception through July 31, 2023. The methodological quality of the studies was evaluated using the Cochrane Collaboration’s tool for evaluating risk of bias. RevMan version 5.3 software, provided by the Cochrane Collaboration, was used for statistical meta-analysis.

A total of 45 studies were selected for final analysis, including 9 randomized controlled trials. We identified a pooled complete response (CR) rate of 0.82 [95% confidence interval (CI): 0.78–0.86] among premenopausal patients with EH undergoing fertility preservation therapy. In addition, we identified a pooled assisted reproductive technology (ART) utilization rate of 0.30 (95% CI: 0.10–0.49) among premenopausal patients with EH receiving fertility preservation therapy. The pooled pregnancy rate and pooled live birth rate were 0.30 (95% CI: 0.24–0.37) and 0.24 (95% CI: 0.17–0.30), respectively. Finally, we performed a subgroup analysis in to investigate the outcomes associated with atypical forms of EH.

Our analysis confirmed that fertility preservation in premenopausal patients with EH is effective. Following treatment, some patients achieved satisfactory fertility outcomes, while others required ART support. Despite these findings, natural conception remained the primary mode of conception.

The study has been registered on https://www.crd.york.ac.uk/prospero/ (registration number: CRD42023433030; registration link: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023433030).

Fetal skeletal dysplasia is a group of disorders that cause abnormal bone growth and development in the fetus, resulting in severe complications and economic burdens on healthcare systems. This study aims to enhance the diagnosis and management of fetal skeletal dysplasia by examining its phenotypes, genetic causes, and the connection between genetic mutations and observed traits.

We performed a retrospective analysis of 28 prenatal cases diagnosed with fetal skeletal dysplasia using advanced genetic testing methods such as whole exome sequencing, chromosomal analysis, and single nucleotide polymorphism (SNP) array analysis.

Our findings revealed diverse phenotypic presentations, with 24 cases exhibiting limb shortening, and distinct genetic inheritance patterns: parental dominant (PAD), de novo mutations (DNMs), autosomal recessive (AR), and cases without pathogenic mutations (UN). Prenatal ultrasound was crucial for early detection and influenced management strategies. Additionally, SNP array analysis combined with short tandem repeats (STR) confirmed the biological relationship between the fetus and the mother, ensuring the integrity of the data. Exome sequencing identified candidate mutation sites, and whole genome sequencing provided insights into structural variations, facilitating personalized management approaches.

This study highlights the importance of early diagnosis and genetic counseling for at-risk families and emphasizes the need for further research to confirm genetic findings and investigate potential future therapies based on the identified mutations. Our research contributes valuable insights into the genetic and clinical characteristics of fetal skeletal dysplasia, paving the way for improved diagnostic accuracy and patient outcomes in affected families.

Amniotic fluid embolism (AFE) is a rare obstetric complication associated with high maternal morbidity and mortality. This article aims to provide a comprehensive overview of the key pathophysiological mechanisms, current therapeutic strategies, and emerging interventions for AFE, with the goal of reducing maternal mortality and improving clinical outcomes.

AFE results from the entry of amniotic fluid components into the maternal circulation, triggering a cascade of complex and poorly understood pathophysiological events. These include immune system activation, cardiopulmonary dysfunction, and coagulopathy.

The incidence of AFE ranges from approximately 1.9 to 6.1 cases per 100,000 births. Due to the lack of definitive diagnostic criteria and incomplete understanding of its underlying mechanisms, AFE remains challenging to diagnose and manage. Current treatment strategies primarily focus on supportive care.

AFE poses significant challenges in both diagnosis and management. This article underscores the limitations of current research and the obstacles encountered in clinical practice. Improving our understanding of AFE holds the potential to enhance treatment strategies and patient outcomes.

The impact of pregnancy on the pelvic floor is not yet fully understood. This study aimed to investigate pelvic organ displacement during pregnancy and identify its key influencing factors.

This retrospective case-control study analyzed 238 pregnant women (gestational age range: 12–41 weeks) and 238 age-matched (±1 year) non-pregnant controls. All participants underwent pelvic magnetic resonance imaging (MRI) at two hospitals during the same hospitalization period. Distances from the bladder neck (BN), cervix (C), and posterior fornix (PF) to the pubococcygeal line (PCL) were measured using MRI. These distances were compared between pregnant and non-pregnant groups. Pregnancy-related “inferior” or “superior” positions were classified using thresholds derived from the non-pregnant group (mean ± 1.96 standard deviations [SD]). Univariate and multivariate logistic regression analyses were performed to identify factors independently associated with positional deviations in the pregnant group.

The mean gestational age of the pregnant group was 32.3 ± 5.8 weeks. Compared with controls, pregnant women exhibited inferior BN (19.2 ± 6.1 vs. 23.3 ± 4.3 mm, p < 0.001) and C positions (19.1 ± 7.8 vs. 21.6 ± 5.3 mm, p < 0.001), but superior PF positions (42.3 ± 10.5 vs. 31.7 ± 8.1 mm, p < 0.001). In univariate analyses, the fetal engagement depth was significantly associated with positional changes in all pelvic organs (p < 0.001 for all). After adjusting for confounders, a fetal engagement depth of ≥40 mm was independently associated with increased odds of inferior BN (odds ratio [OR] = 5.04, 95% confidence interval [CI]: 1.59–16.01, p = 0.006) and C (OR = 11.46, 95% CI 2.53–51.92, p = 0.002) positions, whereas a depth of <20 mm predicted superior PF positioning (OR = 12.24, 95% CI 4.82–31.11, p < 0.001). Additionally, the presence of a low-lying placenta (OR = 2.96, 95% CI 1.18–7.39, p = 0.020) or placenta previa (OR = 2.70, 95% CI 1.29–5.64, p = 0.008) was significantly associated with superior PF position.

This study demonstrates that pregnant women exhibit significant positional alterations in pelvic organ anatomy. Notably, fetal engagement depth emerged as a robust biomechanical correlate of these anatomical changes.

Stress urinary incontinence (SUI) has been demonstrated to exert a detrimental effect on the quality of life of affected women, particularly with regard to their sexual function. The aim of this study was to evaluate the changes in sexual function among patients with SUI following sling surgery.

A total of 83 patients who sought treatment at our clinic for SUI and underwent mid-urethral sling (MUS) surgery were included in the study. Demographic data, preoperative laboratory results, residual urine volumes, and baseline sexual function status were systematically documented.

Female sexual dysfunction (FSD) was assessed using the Female Sexual Function Index (FSFI), with a defined cut-off score of 26.55. Surgical success was defined by the absence of SUI, which was achieved in 80 patients (96.3%). The mean FSFI score increased from 19.04 preoperatively to 24.47 postoperatively. Univariate and multivariate analyses showed that age, body mass index (BMI), education level, and menopausal status had no significant impact on FSFI scores. However, incontinence severity, coital incontinence, and diabetes mellitus (DM) were significantly affected with FSFI scores (p = 0.043, 0.028, and 0.019, respectively). Additionally, the difference in dyspareunia rates was statistically significant (p = 0.017). MUS surgery effectively treats SUI and improves FSFI scores.

This improvement was statistically significant among patients with severe incontinence, coital incontinence, and those without DM. However, the presence of dyspareunia may lead to a decline in sexual function postoperatively.

Anterior asynclitism, a rare but high-risk obstetric dystocia, disrupts normal fetal descent and is associated with increased maternal and neonatal complications. Despite its clinical significance, early diagnosis remains challenging due to nonspecific symptoms, and the associated risk factors require further clarification.

A retrospective analysis was conducted on clinical data of 96 pregnant women with anterior asynclitism (observation group) and 96 pregnant women with persistent occipital transverse position (control group) from January 2017 to January 2023. Differences between the two groups across various aspects were compared and analyzed, and logistic regression analysis was used to determine the independent risk factors for the occurrence of anterior asynclitism.

In terms of high-risk factors, the incidences of macrosomia, obesity, and pendulous abdomen were significantly higher in the observation group than those in the control group (p < 0.05). Through regression analysis, age, macrosomia, obesity, pendulous abdomen, and premature rupture of membranes (PROM) were identified as independent risk factors for anterior asynclitism (p < 0.05). Regarding clinical symptoms, as well as maternal and neonatal outcomes, the incidences of PROM, cervical edema, fetal head edema, abnormal fetal monitoring, risk of uterine rupture, difficulty in delivering the fetal head, neonatal asphyxia, and intracranial hemorrhage in the observation group were all higher than those in the control group (p < 0.05).

A three-tier prevention strategy is recommended: prenatal screening for key risk factors (pendulous abdomen, obesity), enhanced intrapartum monitoring combined with referral systems, and implementation of standardized surgical protocols. This study provides localized evidence for regional hospitals and underscores the need to prioritize obstetric technologies to narrow outcome gaps across healthcare tiers.

To examine the impacts of environmental chemicals on female reproductive health, identify key mechanisms of reproductive toxicity, and discuss potential strategies to mitigate these effects.

Environmental chemicals such as per- and polyfluoroalkyl substances, heavy metals, pesticides, microplastics, quaternary ammonium compounds, and other pollutants, disrupt the hypothalamic-pituitary-gonadal axis (HPG), impair ovarian function, and contribute to reproductive dysfunction through mechanisms such as oxidative stress, hormonal disruption, and epigenetic modifications.

These chemicals contribute to menstrual irregularities, infertility, and pregnancy complications. They also increase the risk of reproductive system disorders, including endometriosis, polycystic ovary syndrome (PCOS), and ovarian cancer. Additionally, transgenerational effects mediated by epigenetic modifications, germ cell damage, and placental transfer may adversely affect offspring health, increasing the risk of reproductive dysfunction, neurodevelopmental disorders, metabolic diseases, and cancer.

Despite growing evidence, significant knowledge gaps remain in understanding the mechanisms of reproductive toxicity, identifying biomarkers for early detection, and assessing the long-term effects of low-dose, chronic exposure. Addressing these challenges requires stricter regulations, the development of safer chemical alternatives, public awareness campaigns, and continued research to safeguard reproductive health for current and future generations.

The coiled-coil domain-containing protein 80 (CCDC80) has known roles in signal transduction and as a structural protein that stabilizes the extracellular matrix (ECM). CCDC80 is also linked to drug resistance in cancers; however, the specific role of CCDC80 in platinum resistance in ovarian cancer (OC) remains unclear. This study used a variety of gene analysis and complementary experimental approaches to examine the prognostic significance of CCDC80 and the potential of this protein as a therapeutic target in OC.

Differentially expressed genes (DEGs) were identified in the Gene Expression Omnibus (GEO) datasets (GSE15372, GSE51373, GSE114206) using the Limma package. The Kaplan-Meier analysis highlighted CCDC80 as a key gene. Weighted gene co-expression network analysis (WGCNA) identified a CCDC80-related module as being enriched in cell chemotaxis and ECM remodeling pathways. Quantitative reverse transcription polymerase chain reaction, Western blotting, and immunohistochemistry were used to confirm CCDC80 expression in platinum-resistant ovarian cancer (PROC) cell lines and clinical samples. Functional assays (cell count kit-8, colony formation, flow cytometry) were used to evaluate cisplatin sensitivity. Lastly, gene set enrichment analysis (GSEA), correlation analysis, and Western blotting were applied to investigate the mechanisms through which CCDC80 affected the platinum resistance of OC cells.

The Limma package and Kaplan-Meier analysis identified CCDC80 in the GEO datasets, and the WGCNA linked this protein to cell chemotaxis and ECM remodeling. The CCDC80 mRNA and protein expression levels were shown to be significantly higher in PROC cell lines and ovarian cancer tissue samples. Functional assays indicated that CCDC80 expression increases cisplatin resistance, while the GSEA and correlation analysis suggested that the epithelial–mesenchymal transition (EMT) pathway is a downstream target of CCDC80. Platinum resistance in OC cells was reduced by suppressing CCDC80 expression and increased by stimulating EMT, confirming the role of the CCDC80-EMT axis in platinum resistance.

This study shows that CCDC80 expression is significantly elevated in platinum-resistant OC cells and that platinum resistance arises from CCDC-mediated activation of the EMT pathway. The CCDC80-EMT link provides a new understanding of the mechanisms leading to platinum resistance in OC and highlights CCDC80 as a possible therapeutic target to prevent the development of chemotherapy resistance.

Vitamin D deficiency (VDD) and insulin resistance (IR) are well-known risk factors for recurrent pregnancy loss (RPL). Since VDD may contribute to the development of IR, this study aimed to investigate the role of fasting insulin (FINS) levels and the homeostasis model assessment of insulin resistance (HOMA-IR) in the association between vitamin D and RPL.

A total of 934 women were retrospectively analyzed between 2019 and 2022, including patients with RPL and age-matched controls. Clinical and biochemical data were collected, including serum 25(OH)D, FINS, fasting blood glucose (FBG), HOMA-IR, and sex hormone levels. Correlation, multivariate logistic regression, restricted cubic spline (RCS), and mediation analyses were conducted.

Compared to controls, the RPL group exhibited lower levels of 25(OH)D and higher levels of FINS and HOMA-IR. In the RPL group, 25(OH)D was negatively correlated with FINS and HOMA-IR. Higher levels of 25(OH)D were associated with reduced RPL, whereas elevated FINS and HOMA-IR levels were linked to an increased risk. A mediation analysis confirmed that FINS and HOMA-IR partially mediated the relationship between vitamin D and RPL, accounting for 10.9% and 10.7% of the total effects, respectively.

VDD is closely associated with increased RPL risk, potentially through impaired glucose metabolism. Therefore, improving vitamin D status and insulin sensitivity may help in reducing pregnancy loss and enhancing reproductive outcomes.

This study aimed to compare the cord blood phoenixin-14 (PNX-14) levels of newborns across various birth weight categories with those of infants born to mothers diagnosed with gestational diabetes mellitus, as well as those who were not classified by birth weight.

This prospective study was conducted between December 2022 and April 2024. Healthy term babies whose families agreed to participate in the study were divided into four groups: Three were according to their birth weight small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA), with the fourth being according to the gestational diabetes mellitus (GDM) status of the mother. This study included a total of 160 patients, with 40 in each group.

The PNX-14 values for the AGA and LGA groups were statistically similar, while those between the PNX-14 values of the SGA and GDM groups were also statistically similar. However, the PNX-14 values in the AGA and LGA groups were statistically higher than those in the SGA and GDM groups (p < 0.001).

This study provides evidence that lower cord blood PNX-14 levels in infants are associated with low birth weight and maternal diabetes. A correlation was found between the umbilical cord PNX-14 level and birth weight.

The study has been registered on https://clinicaltrials.gov/ (registration number: NCT06656481; registration link: https://clinicaltrials.gov/study/NCT06656481?cond=NCT06656481&rank=1#collaborators-and-investigators).