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Biomedicines
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Pathogenesis, Diagnostics and Therapeutics in Obsterics and Gynaecology (2nd Edition)
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Pathogenesis, Diagnostics and Therapeutics in Obsterics and Gynaecology (2nd Edition)

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 August 2026 | Viewed by 8413

Special Issue Editor

Dr. Nikolaos Machairiotis

E-Mail Website
Guest Editor
Third Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Interests: endometriosis; pelvic pain; infertility; inflammation; minimal access surgery; laparoscopy; hysteroscopy; robotics; fibroids
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue aims to deepen and familiarise its readers with all topics of obstetrics and gynaecology. Understanding the pathophysiological mechanisms allows us to better study the disease and provide early diagnosis. It is fundamental to choose the correct test as a diagnostic tool and then, thanks to cooperation with other specialty departments, establish the best therapeutic plan. The individualization of each case helps us to choose the best treatment regimen for the patient.

We invite you to contribute to our Special Issue either with an original article or with a review paper.

Dr. Nikolaos Machairiotis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gynaecology
  • obstetrics
  • diagnosis
  • pathogenesis
  • treatment

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Published Papers (4 papers)

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Research

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16 pages, 957 KB  
Article
Risk-Based Triage Using Cytology and HPV Genotyping to Reduce Unnecessary Colposcopy: A Real-World Cross-Sectional Study
by Sait Erbey, Mehmet Alican Sapmaz, Murat Polat, Ömer Osman Eroğlu and Çağanay Soysal
Biomedicines 2026, 14(6), 1224; https://doi.org/10.3390/biomedicines14061224 - 28 May 2026
Viewed by 153
Abstract
Background and Objectives: Despite the widespread adoption of HPV-based cervical cancer screening, the optimal triage strategy for women with low-grade cytological abnormalities and non-16/18 high-risk HPV (hrHPV) types remains debated. This study evaluated the impact of ASCCP risk-based triage strategies on colposcopy referral [...] Read more.
Background and Objectives: Despite the widespread adoption of HPV-based cervical cancer screening, the optimal triage strategy for women with low-grade cytological abnormalities and non-16/18 high-risk HPV (hrHPV) types remains debated. This study evaluated the impact of ASCCP risk-based triage strategies on colposcopy referral and biopsy outcomes in a large tertiary care center. Methods: This retrospective cross-sectional study included 2748 sexually active women aged 30–65 years who underwent colposcopy at Ankara Etlik City Hospital (January 2023–June 2025). Of these, 1932 met ASCCP criteria for cervical biopsy. Cytology results, HPV genotypes (16, 18, and other hrHPV types), and histopathological findings were analyzed. CIN3+ (CIN3, adenocarcinoma in situ, or invasive carcinoma) was the primary outcome. Multivariable logistic regression identified independent predictors, with model fit assessed by Nagelkerke R2 and the Hosmer–Lemeshow test. Results: The mean age was 42.8 ± 8.1 years. The overall CIN3+ prevalence was 15.9% (308/1932). HSIL cytology was the strongest independent predictor of CIN3+ (adjusted OR 22.41, 95% CI: 11.28–44.52). HPV16/18 combined with HSIL or ASC-H cytology conferred the highest risk (adjusted OR 17.88–21.67). Women with ASC-US or LSIL cytology and non-16/18 hrHPV types had CIN3+ rates below 10%. Irregular screening history was also an independent predictor (adjusted OR 1.38). A risk-based triage approach suggested a potential reduction of approximately 29.7% in colposcopy utilization. However, this estimate applies exclusively to the biopsied subgroup and does not account for potentially undetected lesions in the 816 non-biopsied women enrolled in surveillance follow-up. Conclusions: HSIL cytology and HPV16/18 positivity represent the highest-risk profile for CIN3+ and should remain primary indications for colposcopy. Conversely, women with ASC-US or LSIL cytology and non-16/18 hrHPV types may be candidates for surveillance-based co-testing rather than immediate colposcopy, potentially enabling a resource-efficient reduction in unnecessary procedures within the biopsied cohort studied. Prospective validation in broader colposcopy-referred populations is needed before generalizing these findings to primary screening settings. Full article
(This article belongs to the Special Issue Pathogenesis, Diagnostics and Therapeutics in Obsterics and Gynaecology (2nd Edition))
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13 pages, 2175 KB  
Article
sMICA/sMICB and Immune Checkpoint in Endometriosis: Toward a Minimally Invasive Diagnostic Model Based on Machine Learning
by Anastasia Belevich, Maria Yarmolinskaya, Ilya Smirnov, Anastasia Stolbovaya, Olga Shashkova, Marina Samoylovich, Sergey Selkov, Polina Grebenkina, Elizaveta Tyshchuk and Dmitry Sokolov
Biomedicines 2026, 14(3), 647; https://doi.org/10.3390/biomedicines14030647 - 12 Mar 2026
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Abstract
Background: Endometriosis is a complex condition that impairs women’s quality of life and reproductive potential. Its diagnosis remains significant challenge for clinicians. The aim of the study was to investigate cancer-like immune evasion mechanisms in endometriosis and to develop a novel diagnostic model [...] Read more.
Background: Endometriosis is a complex condition that impairs women’s quality of life and reproductive potential. Its diagnosis remains significant challenge for clinicians. The aim of the study was to investigate cancer-like immune evasion mechanisms in endometriosis and to develop a novel diagnostic model using machine learning. Methods: In this study, we measured the levels of soluble forms of the following immune markers in blood serum and peritoneal fluid (PF): sMICA, sMICB, sEng, sCD25, s4-1BB, sB7.2, sCTLA-4, sPD-L1, sPD-1, sTIM-3, sLAG-3, and sGal-9. Results: sMICB levels in PF differed across endometriosis stages and were higher in patients with endometriosis-associated adhesions. sMICA levels in PF were elevated in women with endometriosis-associated infertility. The disease severity was inversely correlated with serum sB7.2 levels and positively correlated with serum sTIM-3 levels. A logistic regression model achieved an accuracy = 0.79, AUC = 0.94, and F1-score = 0.88, whereas XGBoost performed better with accuracy = 0.94, AUC = 0.95, and F1-score = 0.96. The key predictive features in both models were sMICB serum level and patients’ pain score. Conclusions: Our results demonstrate the potential role of sMICA and sMICB shedding in endometriosis and present a novel, minimally invasive diagnostic approach. Full article
(This article belongs to the Special Issue Pathogenesis, Diagnostics and Therapeutics in Obsterics and Gynaecology (2nd Edition))
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15 pages, 6292 KB  
Article
Differential Scanning Calorimetry, a Novel Method to Detect Uterine Ischemia-Reperfusion Injury During Autotransplantation in Experimental Sheep Model
by Gabor Fazekas, Balint Farkas and Denes Lorinczy
Biomedicines 2025, 13(10), 2388; https://doi.org/10.3390/biomedicines13102388 - 29 Sep 2025
Viewed by 928
Abstract
Background/Objectives: A novel treatment of absolute uterine factor infertility is uterus transplantation. In preparation for human surgery, autotransplantation was performed in a sheep model to assess ischemia-reperfusion injury of the uterine wall. Methods: Seven multiparous ewes underwent live-donor uterus autotransplantation; in [...] Read more.
Background/Objectives: A novel treatment of absolute uterine factor infertility is uterus transplantation. In preparation for human surgery, autotransplantation was performed in a sheep model to assess ischemia-reperfusion injury of the uterine wall. Methods: Seven multiparous ewes underwent live-donor uterus autotransplantation; in six, the procedure was completed successfully. Tissue blocks of complete uterine wall, endometrium, and myometrium were obtained at four predefined time points: native (baseline), after 1 h of cold ischemia, after 30 min of warm ischemia, and after 30 min of reperfusion. Samples were analyzed by differential scanning calorimetry and routine hematoxylin–eosin histology. Results: Histology demonstrated preserved epithelial, glandular, and stromal structures, with only minimal, reversible changes that increased with the ischemic duration. Differential scanning calorimetry confirmed alterations in thermal stability: in the uterine wall and myometrium, the calorimetric enthalpy decreased from baseline (3.40 ± 0.53 J/g) to reperfusion (2.62 ± 0.22 J/g), indicating structural loosening; in contrast, the endometrium calorimetric enthalpy slightly increased, suggesting greater flexibility and less susceptibility to ischemia-reperfusion injury. Conclusions: In this preliminary study, differential scanning calorimetry proved to be an effective and sensitive method for detecting early structural alterations in the uterine wall that could negatively impact post-transplant function. Cold and warm ischemia did not cause irreversible damage within a two-hour time frame, supporting the feasibility of short-term preservation in uterus transplantation. The myometrium demonstrated more significant vulnerability than the endometrium, which highlights the necessity of protective strategies to preserve smooth muscle integrity during transplantation. Full article
(This article belongs to the Special Issue Pathogenesis, Diagnostics and Therapeutics in Obsterics and Gynaecology (2nd Edition))
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Review

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21 pages, 912 KB  
Review
After the Shock: Impact of Ectopic Pregnancy on Subsequent Fertility and Parenthood
by Efthalia Moustakli, Ekaterini Domali, Anastasios Potiris, Angeliki Gerede, Ismini Anagnostaki, Athanasios Zikopoulos, Charalampos Theofanakis, Nikolaos Kathopoulis, Konstantinos Louis, Peter Drakakis and Sofoklis Stavros
Biomedicines 2025, 13(9), 2205; https://doi.org/10.3390/biomedicines13092205 - 9 Sep 2025
Cited by 1 | Viewed by 5456
Abstract
The potentially fatal condition known as ectopic pregnancy (EP) occurs when an embryo implants outside of the uterus, usually in the fallopian tube. It accounts for approximately 1–2% of all pregnancies and remains a leading cause of maternal morbidity in the first trimester. [...] Read more.
The potentially fatal condition known as ectopic pregnancy (EP) occurs when an embryo implants outside of the uterus, usually in the fallopian tube. It accounts for approximately 1–2% of all pregnancies and remains a leading cause of maternal morbidity in the first trimester. EP is an important area of focus in reproductive health that extends beyond its immediate clinical care. The purpose of this study is to investigate the effects of EP on the physical, reproductive, and psychological aspects of eventual fertility and parental outcomes. The findings from qualitative interviews, case–control studies, and cohort studies that have been published in peer-reviewed journals over the past 20 years were compiled into a narrative literature review. Included were studies looking at patient experiences after EP, psychosocial impacts, and reproductive results. According to research, women who have had EP in the past may have a slightly lower chance of becoming pregnant in the future, particularly following a salpingectomy. Assisted reproductive technology may potentially mitigate some of these risks. The parenting journey is often complicated by psychological consequences. Access to fertility services and counseling was found to have a significant impact on post-EP reproductive outcomes. The need for thorough follow-up care that addresses both physical and mental wellness is highlighted by the fact that EP can have long-lasting impacts on fertility and the parenting path. To optimize patient well-being and reproductive results, post-EP treatment must include early fertility counseling and psychological support. Full article
(This article belongs to the Special Issue Pathogenesis, Diagnostics and Therapeutics in Obsterics and Gynaecology (2nd Edition))
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