Few studies have examined the impact of subsequent deliveries on levator hiatus morphology and no study has described its changes throughout gestation and postpartum in multiparous women. The aim of this study was to investigate the changes that occur in the levator hiatus (i) during pregnancy, and (ii) after labor in a cohort of multiparous women. Pregnant women with a history of vaginal birth were compared to those with a history of cesarean section (CS).

Prospective cohort longitudinal study, consisting of 82 multiparous women who were examined and recruited at an antenatal clinic. All participants underwent real-time three-dimensional transperineal ultrasound (3D-TPUS) evaluation of the levator ani at 12, 22, and 32 weeks of pregnancy, as well as 4–6 months after delivery. 3D volumes were acquired and stored for offline analysis.

Data from 66 women with at least two measurements were available for analysis. 31 had a history of vaginal delivery (VD) and no history of CS (Group 1), while 35 had a history of previous CS and no history of vaginal birth (Group 2). When comparing levator ani dimensions at rest, during Valsalva, and pelvic floor muscle contraction (PFMC) in the third-trimester to those in the first-trimester, almost all hiatal dimensions were statistically significantly enlarged. Postpartum hiatal dimensions were lower compared to third-trimester measurements in both groups. The incidence of new levator trauma in Group 1 was 3.7%.

In multiparous women: (a) ultrasound (US) measurements of the levator hiatus increased significantly between the first-, second-, and third-trimester, and (b) many of the levator hiatus dimensions decreased significantly postpartum, regardless of whether the delivery was a non-traumatic vaginal birth or a CS. The incidence of new levator trauma is reduced in multiparous women with a history of previous vaginal births who deliver vaginally.

Hemolytic disease of the fetus and newborn (HDFN) can cause severe prenatal and postnatal outcomes. The main objective of this study is to characterize the clinical impact of HDFN on pregnant women and their newborns.

A retrospective cohort study was performed on de-identified data extracted from Maccabi Healthcare Services (MHS), a large nationwide health organization. The cohort included women and newborns diagnosed with HDFN between January 1998 and December 2021. Cohort characteristics and outcomes are described.

Over the 24-year study period, the incidence rate of HDFN among pregnant women remained stable, while the incidence rate among newborns declined. Severe HDFN was diagnosed in 22 (30.1%) of 73 HDFN-affected pregnancies. Among 450 HDFN newborns, one-third were diagnosed with anemia or jaundice, and 5 cases of kernicterus were observed.

Severe prenatal and postnatal outcomes were observed in cases of HDFN. Further studies are needed to evaluate treatment regimens and to assess the association between treatment management and both short- and long-term outcomes.

Observational studies have demonstrated a potential association between hypertensive disorders of pregnancy (HDPs) and an elevated risk of subsequent kidney impairment. The present study aimed to evaluate the possible causal relationship between HDPs and future renal dysfunction using a genetic approach.

This two-sample Mendelian randomization (MR) analysis, conducted between October 2023 and January 2024, examined the effects of HDPs—both overall and by subtype (gestational hypertension and preeclampsia/eclampsia)—on chronic kidney disease (CKD), albuminuria, and estimated glomerular filtration rate (eGFR). Genetic data were sourced from publicly available genome-wide association studies (GWAS) provided by the FinnGen, CKDGen, UK Biobank, GIANT (Genetic Investigation of ANthropometric Traits), deCODE, and DIAMANTE (DIAbetes Meta-ANalysis of Trans-Ethnic association studies) consortia. The primary method employed was inverse-variance weighting, supplemented by sensitivity analyses and instrument-strength validation to ensure causal robustness.

This study included approximately 300,000 to 600,000 individuals per kidney function trait, with around 15,000 HDP cases. Genetically predicted HDPs showed a weak but statistically significant association with albuminuria [odds ratio (OR): 1.02; 95% confidence interval (CI): 1.00–1.03; p = 0.01]. This association remained consistent after adjustments for body mass index (BMI), smoking, and type 2 diabetes (T2D) in the multivariable MR analysis (OR: 1.03; 95% CI: 1.01–1.04; p < 0.001). No significant associations were observed between HDPs, including for the subtypes, and the presence of CKD or eGFR. These results demonstrated robustness across diverse sensitivity analyses.

The genetic proxy for HDPs was identified as causally associated with maternal long-term albuminuria, independent of BMI, smoking, and T2D. These results offer novel insights bolstering the causal relationship between HDPs and long-term maternal kidney dysfunction.

Family planning is a crucial aspect of reproductive health that allows individuals to determine the number and timing of their children. The main reasons include the very low use of contraceptives (approximately 7% among married women aged 15–49, with only 1–2% using modern methods) and limited access to family planning services. Unintended pregnancies are a major contributor to maternal mortality, resulting from delayed or inadequate antenatal care, unsafe abortions, high-parity births, and short birth intervals. In Somalia, the gap between high levels of awareness and low rates of utilization of family planning, as well as the uncertainties regarding attitudinal and sociocultural determinants, is particularly noteworthy. Somali society follows strict norms based on religious beliefs and cultural values, which influence family decision-making and often limit women’s ability to plan their fertility or use family planning methods. Additionally, due to health policies such as the illegality of elective pregnancy termination, the country’s high fertility rate poses a serious public health concern. Studies have shown that the use of family planning methods remains low across East African countries, including Somalia. Understanding women’s attitudes toward family planning is essential to addressing this issue. This study aimed to examine the attitudes of married women in Mogadishu toward family planning and to identify the sociodemographic and obstetric factors associated with contraceptive use.

This descriptive cross-sectional study was conducted among 286 married women aged 18–49 years who attended gynecological outpatient clinics in Mogadishu, Somalia. Data were collected through structured face-to-face interviews using a validated Family Planning Attitude Scale (FPAS). Data were analyzed using means, standard deviations, medians, frequencies, and percentages using the Statistical Package for the Social Sciences (SPSS) version 21.0.

The mean age of participants was 28.7 ± 5.57 years. Although 30.8% of women were aware of family planning methods, 82.2% did not use any form of contraception. Oral contraceptive pills were the most widely recognized method (14.3%), while implants were the most commonly used (4.5%). Women with no formal education had significantly more traditional views toward childbirth (p < 0.05).

The findings indicated low contraceptive utilization despite high awareness, with cultural and religious beliefs strongly influencing attitudes. Active participation in decision-making and increased knowledge of family planning were significantly associated with enhanced contraceptive use. These results highlight the need for targeted educational programs and policies that promote reproductive autonomy to improve family planning adoption in Mogadishu, Somalia. Achieving desirable women’s health outcomes requires improvements in national health service provision, strengthened efforts by non-governmental organizations (NGO), and the integration of these efforts into development goals.

This study aimed to investigate the differences in the current clinical practice of menopause in China’s hierarchical medical system, with the goal of informing policy development and optimizing health promotion strategies for menopausal women in China.

An epidemiological survey was conducted using an online questionnaire distributed through China’s largest obstetrics and gynecology academic training platform between April and May 2020.

A total of 4458 questionnaires were collected, with 3853 meeting the criteria for analysis. Physicians’ familiarity with menopausal syndrome varied significantly across hospital tiers (χ² = 69.24, p < 0.001), with limited awareness in grade 3 hospitals (48.25%) and highest in community hospitals (69.47%). More than half (60.42%) had less than five years of clinical experience in menopause management (χ² = 26.75, p < 0.001). The proportion of physicians who often or occasionally recommended hormone therapy (HT) was 84.12% in grade 3 hospitals, 79.20% in grade 2 hospitals, and 77.16% in community hospitals, while the proportion of physicians who never recommended HT was the lowest in grade 3 hospitals and the highest in community hospitals (7.58%). Use of traditional Chinese medicine (TCM) was also widespread, reported by 84.12% of grade 3, 79.38% of grade 2, and 67.58% of community hospitals. Chinese patent medicines were the most commonly recommended form of TCM.

The understanding of menopause among Chinese physicians remains limited, an issue that is particularly pronounced among doctors in primary care institutions compared to those in higher-level hospitals. Both HT and TCM are widely utilized in clinical practice. Doctors from community hospitals require further education and training in menopausal management.

To evaluate the feasibility and clinical utility of developing a risk prediction model for placental abruption among patients with severe preeclampsia, incorporating maternal age, baseline systolic blood pressure (SBP), baseline diastolic blood pressure (DBP), retroplacental hematoma width, placental growth factor (PlGF), and the soluble fms-like tyrosine kinase-1/PlGF factor (sFlt-1/PlGF) ratio.

This retrospective study enrolled 260 patients with severe preeclampsia who were admitted to the hospital from January 2022 to October 2024. The cases were randomly divided into a training set (n = 182) and a validation set (n = 78) in a 7:3 ratio. The primary outcome was placental abruption. Clinical data, imaging parameters, and biomarker levels were collected. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. A nomogram was subsequently developed, and its predictive performance was evaluated and validated.

The incidence of placental abruption was 35.16% (64/182) in the training set and 33.33% (26/78) in the validation set. Multivariate logistic regression analysis identified age, baseline SBP, baseline DBP, retroplacental hematoma width, PlGF, and the sFlt-1/PlGF ratio as independent risk factors (all p < 0.05). The nomogram demonstrated good discriminative ability, with C-index values of 0.890 and 0.848 in the training and validation sets, respectively. The area under the curve (AUC) was 0.890 (95% confidence interval [CI]: 0.827–0.953) and 0.848 (95% CI: 0.733–0.963), respectively. Sensitivity was 0.766 in the training set and 0.588 in the validation set, whereas specificity was 0.890 and 0.944, respectively. Calibration curves showed excellent agreement between predicted and observed outcomes. The Hosmer-Lemeshow test yielded p-values of 0.583 and 0.290, respectively, suggesting good model fit.

The nomogram model, incorporating age, baseline SBP, baseline DBP, retroplacental hematoma width, PlGF, and sFlt-1/PlGF ratio effectively predicted the risk of placental abruption in patients with severe preeclampsia. This model may support early clinical intervention. However, the use of single-center data and lack of external validation limit its generalizability, highlighting the need for further verification through multicenter studies.

Ovarian pregnancy (OP) is a rare type of ectopic pregnancy (EP) that can become life-threatening due to the risk of severe complications, such as pelvic hemorrhage and circulatory collapse. The diagnosis and treatment of OP are challenging. Thus, this study aimed to investigate the clinical characteristics of OP, explore current and potential diagnostic and therapeutic strategies, and summarize the experience with laparoscopic treatment for OP.

A retrospective analysis was performed on data from 16 consecutive patients with OP who underwent surgical treatment between March 2016 and May 2025. We collected clinical data from these patients, including sociodemographic information, suspected risk factors, clinical manifestations, preoperative examinations [e.g., serum beta human chorionic gonadotropin (β-hCG) test and ultrasonography], treatment methods, and outcomes.

The mean age of the patients was 32.44 ± 6.37 years, and the mean gestational age at diagnosis was 50.13 ± 9.91 days. Abdominal pain was the most common presenting symptom (reported in 15 patients, 93.75%), followed by vaginal bleeding (7 patients, 43.75%) and hemorrhagic shock (2 patients, 12.50%). Serum β-hCG (measured in 15 patients) ranged from 700.56 to 12,661.89 mIU/mL, with a median of 4756.03 mIU/mL [interquartile range (IQR), 1730.39–8174.70 mIU/mL]. The preoperative ultrasound diagnostic rate for OP was 6.25% (1/16). All patients underwent laparoscopic surgery for the excision of OP tissue. A ruptured OP was observed in 13 patients (81.25%). Hemoperitoneum ranged from 30 to 2000 mL, with a median of 900 mL (IQR, 350–1000 mL). The mean operative time was 1.23 ± 0.60 h, and the mean postoperative hospital stay was 2.50 ± 1.51 days. None of the patients required additional surgical or medical treatments after laparoscopy (LC).

Rupturing is a common complication of OP, highlighting the importance of early diagnosis and timely intervention. Laparoscopic techniques facilitate the early detection and accurate diagnosis of OP. Laparoscopic surgery is a safe, effective, and minimally invasive treatment option for OP.

Perioperative hypothermia and shivering are common in patients undergoing cesarean section; however, the effectiveness of active warming (AW) compared to passive warming (PW) in preventing perioperative outcomes for pregnant females and their offspring remains controversial.

A search was performed for randomized controlled trials (RCTs) on the impact of AW devices on perioperative hypothermia in mothers undergoing cesarean section in the Cochrane Library, PubMed, Embase, and Web of Science databases (inception–October 2024). Two researchers independently screened studies and performed a meta-analysis using Review Manager 5.4.

A total of 12 articles were included, encompassing 1184 patients. The meta-analysis results indicated that AW devices can mitigate the decrease in core body temperature in cesarean section mothers postoperatively (mean difference [MD] = 0.26, 95% confidence interval [CI]: (0.10, 0.43); p = 0.002), reduce the incidence of hypothermia (relative risk [RR] = 0.69, 95% CI: (0.60, 0.80); p < 0.00001), and decrease the occurrence of shivering (RR = 0.54, 95% CI: (0.40, 0.74); p = 0.0001.

This meta-analysis demonstrates that AW devices effectively mitigate perioperative hypothermia in patients undergoing cesarean section, reducing hypothermia and shivering incidence and improving temperature management.

The study has been registered on https://www.crd.york.ac.uk/prospero/ (registration number: CRD42024592013; registration link: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024592013).

The health benefits of exclusive breastfeeding (EBF) are well established; however, adherence to recommended durations remains suboptimal. This study investigates how maternal breastfeeding self-efficacy (SE), postpartum depressive symptoms, and perceived social support interact to influence EBF duration, providing evidence to guide comprehensive interventions.

This prospective cohort study included 312 postpartum women and divided them into tertiles based on their scores on the Breastfeeding Self-Efficacy Scale (BSES): low (n = 83), moderate (n = 122), and high (n = 107). EBF duration was analyzed using Kaplan–Meier survival curves and Cox proportional hazards regression models. Postpartum depression, measured by the Edinburgh Postnatal Depression Scale (EPDS), was evaluated as a mediator using bootstrap mediation analysis, while perceived social support, assessed by the Personal and Social Performance Scale (PSP), was examined as a moderator through interaction analysis.

Median EBF duration was 5.6 months in the low SE group, 5.8 months in the moderate SE group, and was not reached (>6 months) in the high SE group (log-rank p < 0.001). When BSES was modeled categorically, higher breastfeeding self-efficacy was associated with a reduced hazard of discontinuing EBF (high tertile vs. low tertile: hazard ratio [HR] = 0.55, 95% confidence interval [CI]: 0.39–0.78, p = 0.001). Mediation analysis indicated a significant indirect effect of SE on EBF duration through EPDS (indirect effect: –0.18, 95% CI: –0.24 to –0.12), accounting for approximately 40% of the total association between SE and breastfeeding duration. The interaction between BSES and Postpartum Social Support Scale (PSP) was statistically significant (HR for interaction = 0.97, 95% CI: 0.95–0.99, p = 0.030). Stratified analyses showed that the protective association between higher BSES and sustained EBF was strongest among women reporting higher perceived social support.

Maternal SE is associated with prolonged EBF, partly through its association with reduced postpartum depressive symptoms. Perceived social support independently promotes EBF persistence and strengthens the beneficial association between SE and breastfeeding duration. Integrated interventions that foster maternal confidence, identify and manage postpartum mood disturbances, and mobilize social support networks are recommended.

Perinatal depression is prevalent and affects the physical and psychological well-being of both mothers and their offspring. Conventional antidepressants represent the most commonly used pharmacological treatments. However, concerns about safety during pregnancy and breastfeeding persist, alongside limitations such as delayed onset of action and suboptimal response rates. This review comprehensively examines biological treatment strategies for perinatal depression, with a focus on evidence for conventional antidepressants, novel neurosteroid-based therapies, emerging experimental treatments including oxytocin and perioperative esketamine, and neuromodulation methods.

Conventional antidepressants modulate monoamine neurotransmission. Novel agents such as brexanolone, zuranolone, and esketamine act through neurosteroid modulation and N-methyl-D-aspartate (NMDA) receptor antagonism, producing rapid antidepressant effects. Oxytocin, a neuropeptide involved in social bonding and stress regulation, contributes to maternal mood regulation. Neuromodulation techniques, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), target relevant brain circuits.

Evidence indicates a slight increase in the risk of congenital malformations, particularly cardiovascular (CV) defects, and birth complications such as preterm birth or low birth weight associated with antidepressant use. However, absolute risks remain small and warrant cautious interpretation, as maternal depression itself is linked to adverse birth outcomes. Late pregnancy exposure to antidepressants may increase the risk of neonatal withdrawal symptoms or persistent pulmonary hypertension, but clinical guidelines do not recommend tapering treatment solely to prevent these outcomes. Brexanolone, zuranolone, and esketamine have emerged as rapid postpartum treatments, often used alongside standard antidepressants. Intranasal oxytocin and perioperative esketamine administered during cesarean section show promise, warranting further study. Neuromodulation techniques like rTMS and tDCS offer potential as adjuncts or alternatives.

Biological treatments for perinatal depression are evolving rapidly. While conventional antidepressants remain the foundation of therapy, neurosteroids, esketamine, and oxytocin offer promising complementary options. Neuromodulation methods provide emerging alternatives. Ongoing research is essential to establish their safety and efficacy in perinatal populations and tailor personalized treatments that balance maternal and fetal-neonatal health.

Bartter syndrome (BS) is a rare autosomal recessive genetic disorder, typically characterized by hypokalemic metabolic alkalosis, and sometimes accompanied by hyponatremia and hypochloremia. BS is caused by mutations at multiple gene loci with strong genetic heterogeneity, making accurate genetic analysis crucial for diagnosis.

We collected peripheral blood samples from three family members: an 8-week pregnant woman, her husband, and their daughter, with BS symptoms. Whole-exome sequencing (WES) and whole-genome sequencing (WGS) were performed, with variants verified by Sanger sequencing. Minigene assays were used to investigate splicing effects, and in silico predictions were conducted to assess the impact of mutations on protein structure. A prenatal diagnosis was performed at 18 weeks of gestation via amniocentesis and Sanger sequencing.

This case highlights three critical values. First, clinically, WGS provides a feasible solution for diagnosing BS cases with negative WES results, which helps reduce hypokalemia-related complications. Second, this is the first report of the SLC12A1 c.2961-647T>G and c.1153G>A variants, and integrated validation confirms their pathogenicity, expanding the spectrum of pathogenic SLC12A1 variants. Third, our findings guide clinicians to consider deep intronic variants and WGS application in unexplained hereditary renal diseases, which is highly relevant to current prenatal diagnosis and genetic counseling practices. WGS can identify deep intronic variants in SLC12A1, and functional experiments can strengthen pathogenicity evidence, providing an effective prenatal diagnostic approach for families with a history of BS.

The main aim of this study is to increase the recognizability of aortic arch anomalies during fetal echocardiographic examination. To evaluate intervessel distances in the three-vessel view in fetuses with isolated right or double aortic arch (DAA) anomalies during fetal echocardiography.

This retrospective study included six fetuses examined between 19⁺⁰ and 21⁺⁰ weeks of gestation, with isolated right or DAA anomalies confirmed postnatally. Five fetuses had an isolated right aortic arch (RAA) anomaly, while one had an isolated DAA anomaly. Diameters of the main pulmonary artery (PA) and ascending aorta (Ao) were measured from the three-vessel view. Additionally, intervessel distances between the main PA–Ao, the Ao and superior vena cava (Ao–SVC), and the main PA–SVC were assessed. The standard deviation (SD) values were assessed using nomograms appropriate for gestational age.

The diameters of the PA and Ao were not significantly different from those in the normal population in any of the fetuses. In five of the six fetuses, the PA–Ao distance exceeded +3 SD, indicating an increase compared with fetuses without congenital heart defects. Additionally, the PA–SVC distance exceeded +3 SD in four fetuses, indicating a marked increase compared to fetuses without congenital heart anomalies. In contrast, the Ao–SVC distance was below –3 SD in only two fetuses, indicating a decrease, while no significant deviation was observed in the remaining four cases.

In fetal echocardiography, isolated right or DAA anomalies can lead to altered intervessel distances on the three-vessel view. Notably, increases in the PA–Ao and PA–SVC distances were observed.

Although multiple factors contribute to recurrent spontaneous abortion (RSA), recent studies have highlighted a role for regulatory T cells (Tregs) in maintaining immune tolerance during pregnancy. Understanding the intricate relationship between RSA and Tregs offers promising avenues for diagnosis and therapeutic strategies in reproductive medicine.

We successfully established a mouse model of RSA, and all animals were euthanized on gestational day 13. Uterine horns were examined upon dissection to determine the number of viable fetuses and resorption sites, after which the post-implantation loss rate (abortion rate) was calculated. Placental morphology was evaluated via hematoxylin and eosin staining, whereas gene expression was analysed by immunohistochemistry. Treg abundance was determined by flow cytometry. Gene expression and cytokine levels in EL4 cells and patient samples were evaluated by quantitative real-time polymerase chain reaction (qPCR) and Western blotting.

The abortion rate of RSA mice was 31.64%. In addition, Treg numbers were reduced in both RSA mice and patients, while the expression of Toll-like receptor 4 (TLR4) and p65 was upregulated, further suppressing forkhead box protein P3 (FOXP3) expression. Blocking p65 expression with small interfering RNA (siRNA) targeting p65 prevented the lipopolysaccharide (LPS)-induced downregulation of FOXP3 in EL4 cells. The TLR4 inhibitor IAXO102 was ineffective at increasing FOXP3 expression in EL4 cells following p65 overexpression p65.

The results of this study suggest that activation of the TLR4/p65 signalling in RSA inhibits FOXP3 expression and contributes to abortion. Importantly, the findings indicate that Treg suppression in RSA is p65-dependent.

Ovarian Hyperstimulation Syndrome (OHSS) is a severe complication of assisted reproductive therapy. Patients with severe OHSS are complicated with pleuroperitoneal effusion, while isolated pleural effusion is clinically rare. Previous studies have shown that isolated unilateral pleural effusion caused by OHSS mostly involves the right side. Among the 14 patients with severe OHSS complicated with isolated pleural effusion admitted to our hospital from April 2020 to December 2024, the proportion of right-sided effusion was 85.71%, which was consistent with the literature reports. All patients recovered and were discharged after multidisciplinary diagnosis, treatment and nursing care. This study aimed to summarize the nursing experience and provide a reference for clinical practice.

A retrospective analysis was conducted on the nursing methods for 14 patients with severe OHSS complicated by isolated pleural effusion (IPE) who underwent puncture and drainage between April 2020 and December 2024.

All 14 patients completed thoracentesis and drainage, their symptoms were controlled, and each patient quickly navigated the critical period.

Dynamic patient monitoring of the condition, standardized preoperative preparation, full-cycle catheter management, individualized psychological care, and multi-dimensional thrombosis prevention represent the main nursing measures for patients with severe OHSS complicated by IPE undergoing thoracentesis and drainage.

Primary ovarian insufficiency (POI), characterized by infertility and an elevated risk of multiple comorbidities, affects approximately 1% of women <40 years of age. Although mitochondrial dysfunction has been associated with POI, the specific mitochondrial proteins involved in its pathogenesis remain largely unidentified. To address this gap, the present study investigated the causal relationship between mitochondrial proteins and POI using a bidirectional Mendelian randomization (MR) approach.

Bidirectional MR analysis was conducted using genetic data derived from the INTERVAL and FinnGen databases. Plasma data for 3622 proteins, including 66 mitochondrial proteins, were examined. Genetic instruments were selected based on a stringent genome-wide significance threshold, and causal associations were estimated using the inverse-variance weighted method.

The analysis revealed that higher levels of 39S ribosomal protein L14 (odds ratio [OR] = 0.40, p = 0.009), oligoribonuclease (OR = 0.64, p = 0.031), and mitochondrial fission regulator 1 (OR = 0.60, p = 0.044) were significantly associated with a reduced risk POI. In contrast, higher levels of coiled-coil domain-containing protein 90B were associated with an increased risk of POI (OR = 1.80, p = 0.042).

This study identified key mitochondrial proteins associated with a reduced risk of POI, highlighting the potential role of mitochondrial pathways in POI pathogenesis and offering possible targets for future diagnostic and therapeutic interventions.

This review aimed to elucidate the physiological roles of seminal plasma (SP) in modulating female reproductive function, with an emphasis on the mechanisms that optimize the conception microenvironment. Moreover, this review further evaluated the translational potential of SP as an adjunct to assisted reproductive technologies (ARTs).

1. Molecular signaling: SP acted as both a transport medium for spermatozoa and a carrier of male-derived bioactive molecules (e.g., transforming growth factor-β (TGF-β), prostaglandins) that activated Toll-like receptor (TLR)-mediated signaling pathways in female reproductive tissues; 2. Immune modulation: SP triggered a transient inflammatory response in the cervicovaginal mucosa, enhancing pathogen clearance capacity by upregulating neutrophil recruitment and antimicrobial peptide secretion; 3. Receptivity regulation: SP components (particularly extracellular vesicles) modified endometrial epithelial-stromal crosstalk via paracrine interactions, extending the implantation window by modulating Homeobox A10 (HOXA10) expression. 4. Maternal-fetal tolerance: SP-induced regulatory T cell expansion promoted immune acceptance of semi-allogeneic embryos by suppressing Th1/Th17 responses at the decidual interface.

Exposure to SP induced a self-limiting inflammatory cascade that optimized sperm survival and endometrial preparedness in murine and human studies. ART cycles incorporating SP perfusion demonstrated a 14.4% increase in clinical pregnancy rates (pooled odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.08–1.61) across eight randomized trials. Proteomic analyses identified SP exosomes as critical mediators of endometrial receptivity, though batch variability remained a translational challenge.

SP emerged as a master regulator of peri-conception events through multimodal mechanisms. While preclinical data supported its therapeutic utility in recurrent implantation failure (RIF), standardized protocols for clinical deployment required further validation. Future research should prioritize the mechanistic dissection of exosome-carried microRNAs and large-scale studies of ART outcomes.

To evaluate whether common maternal conditions—such as vaginitis, infection, gestational diabetes mellitus (GDM), hypertensive disorders, hepatitis B virus (HBV) infection, Rh-negative pregnancy, and the use of low-molecular-weight heparin (LMWH)—influence the safety or outcomes of amniocentesis, and to provide practical recommendations to optimize maternal and fetal safety.

Amniocentesis is the most widely used invasive prenatal diagnostic procedure worldwide. It involves inserting via a transabdominal approach to obtain fetal samples, including cells, metabolites, urine, or secretions, from the amniotic fluid. Complications include premature rupture of membranes (PROM), infection, spontaneous miscarriage, and pregnancy loss, although their overall incidence is <1%. Although most studies have focused on procedure-related risks for pregnancy outcomes, the impact of maternal conditions on these outcomes has been less systematically evaluated.

This review found no solid evidence that maternal vaginitis, infection, GDM, hypertensive disorders, or HBV infection increase the risk of adverse outcomes following amniocentesis. Similarly, available data suggest that the use of LMWH does not significantly increase the risk of bleeding when appropriately.

Amniocentesis can generally be performed safely when maternal disorders are in a relatively stable phase. For Rh-negative women, anti-D immunoglobulin should be administered prior to invasive testing to reduce the risk of alloimmunization. For pregnant women receiving prophylactic LMWH, discontinuation 24 hours before the procedure is recommended; while routine anti-Xa monitoring is not required except in cases of severe renal insufficiency. Although based on limited evidence, these recommendations aim to minimize procedure-related complications and optimize maternal and fetal safety.

Previous studies have reported that loss of muscle mass and quality (sarcopenia) is related to disability, poor quality of life, and decreased survival across various cancer types. This retrospective study aimed to evaluate the influence of preoperative skeletal muscle quantification on prognosis in epithelial ovarian cancer (EOC) patients undergoing primary debulking surgery (PDS).

The medical records of 222 EOC patients treated from June 2002 and December 2017 were reviewed. Preoperative computed tomography (CT) scans at the level of the third lumbar vertebra were used to identify and classify skeletal muscle based on radiodensity. The proportion of low-attenuation muscle within the total skeletal muscle area was calculated. Healthy muscle was defined as containing 23.5% or less low attenuation muscle, determined using a maximal chi-square test.

Based on these criteria, 84 patients were classified into the healthy muscle group, while the remaining 138 patients were categorized into the unhealthy muscle group. Patients with healthy muscle demonstrated improved overall survival (OS) and progression-free survival compared with those in the unhealthy muscle group. Multivariate analysis identified unhealthy muscle as a significant predictor of decreased survival, alongside with advanced stage, high-grade histology, and suboptimal surgery.

Preoperative skeletal muscle quantification was identified as an independent prognostic factor in EOC patients. EOC patients with healthy muscle demonstrated a better prognosis than patients with unhealthy muscle.

Platelet activation is central to preeclampsia (PE) pathobiology. We evaluated whether mean platelet volume (MPV) is independently associated with PE and quantified its individual discriminatory performance in a hospital-based case-control study in Peru.

We included 112 women with PE and 112 normotensive controls who delivered at the National Maternal Perinatal Institute (Lima) in 2024. MPV was obtained from the first complete blood count (CBC) performed at ≥20 gestational weeks. Logistic regression models estimated adjusted odds ratios (aORs) with 95% CIs. Receiver operating characteristic (ROC) analysis provided the area under the curve (AUC) with 95% CI and the optimal cutoff by Youden’s index.

Higher MPV was independently associated with PE (aOR: 2.16 per 1 fL; 95% CI: 1.55–3.01; p < 0.001). Gestational obesity (aOR: 2.43; 95% CI: 1.17–5.26; p = 0.039) and inadequate prenatal care (<6 visits; aOR: 3.71; 95% CI: 1.27–7.55; p = 0.006) were also associated with PE. MPV showed moderate discrimination (AUC: 0.686; 95% CI: 0.616–0.755). Using a cutoff of 8.80 fL, the sensitivity was 61.6%, the specificity was 71.4%, the positive likelihood ratio was 2.16, and the negative likelihood ratio was 0.54.

MPV is independently associated with PE and provides moderate individual discrimination. As MPV is routinely measured by hematology analyzers at no additional cost, incorporating it into trimester-specific, multivariable antenatal risk models may support cost-effective risk stratification in resource-limited settings.

Minimally invasive cosmetic procedures, including soft tissue filler injections, are increasingly performed worldwide. While complications such as inflammation, migration, and granuloma formation have been reported, pregnancy-related complications resulting from dermal filler migration have not yet been documented.

We describe the first known case of a 45-year-old primigravida with extensive breast filler migration, originally injected 17 years before conception, that extended to the lower abdomen and complicated both prenatal ultrasound evaluation and cesarean delivery. By 36 weeks of gestation, the migration had extended to the vulvar region. At 36 weeks and 2 days, an elective cesarean section was performed. Pelvic magnetic resonance imaging (MRI) and intraoperative findings demonstrated filler deposits between the subcutaneous tissue and the fascial layer, which restricted fascial mobility and hindered fetal extraction. Although additional fascial incisions were required to facilitate delivery, the neonate experienced no postnatal complications, and the maternal postoperative course was uneventful.

This case highlights the importance of thorough cosmetic history-taking in pregnant women and emphasizes the need for clinical awareness and guidelines that address the long-term obstetric implications of dermal filler migration.