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Diagnostics
Special Issues
Diagnosis and Management of Contemporary Issues in Maternal-Fetal Medicine
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Diagnosis and Management of Contemporary Issues in Maternal-Fetal Medicine

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 2310

Special Issue Editors

Dr. Themistoklis Dagklis

E-Mail Website
Guest Editor
Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
Interests: fetal medicine; obstetric medicine
Special Issues, Collections and Topics in MDPI journals
Dr. Ioannis Tsakiridis

E-Mail Website
Guest Editor
Third Department of Obstetrics and Gynecology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Agiou Dimitriou, 54124 Thessaloniki, Greece
Interests: high-risk pregnancies; perinatal medicine; placental research; fetal medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Maternal–fetal medicine is a specialized field focusing on managing high-risk pregnancies to ensure the health of both the mother and the fetus. While advances in medical technology and prenatal care have improved outcomes, several contemporary challenges persist, requiring ongoing research and policy adjustments. Despite medical advancements, factors such as cardiovascular disease, hypertension, and hemorrhage contribute significantly to rising trends in maternal mortality rates. Moreover, prematurity remains a leading cause of neonatal morbidity and mortality. The exact causes are often multifactorial, involving genetic, environmental, and medical factors. Efforts to prevent preterm labor have shown mixed success rates, highlighting the need for more effective interventions. Furthermore, many rural and underserved areas lack access to maternal–fetal medicine specialists, leading to delayed or inadequate prenatal care. Rising obesity rates have led to an increase in gestational diabetes, preeclampsia, and other metabolic disorders, complicating pregnancies and increasing long-term health risks for both mothers and infants. Managing these conditions requires a multidisciplinary approach, including lifestyle interventions and medical management. Advancements in fetal medicine, such as in utero surgeries and genetic testing, raise ethical dilemmas regarding fetal rights, parental decision making, and resource allocation. Additionally, evolving abortion laws in various regions impact the management of high-risk pregnancies and fetal anomalies. To conclude, maternal–fetal medicine faces complex challenges that require a combination of medical innovation, policy reform, and equitable healthcare access.

Dr. Themistoklis Dagklis
Dr. Ioannis Tsakiridis
Guest Editors

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 100 words) can be sent to the Editorial Office for announcement on this website.

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. Diagnostics is an international peer-reviewed open access semimonthly 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

  • obstetrics
  • high-risk pregnancy
  • maternal medicine
  • fetal medicine
  • prenatal diagnosis

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Published Papers (3 papers)

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Review

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16 pages, 618 KB  
Review
Unmasking the Placenta–Heart Axis: A Comprehensive Review of Placental Abnormalities in Congenital Heart Disease
by Angeliki Gerede, Ilias Orgianelis, Sofoklis Stavros, Anastasios Potiris, Eirini Drakaki, Ioannis Tsimpoukis, Panagiota Papasozomenou, Ekaterini Domali, Nikolaos Nikolettos, Christos Chatzakis and Makarios Eleftheriades
Diagnostics 2025, 15(17), 2159; https://doi.org/10.3390/diagnostics15172159 - 26 Aug 2025
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Abstract
Congenital heart disease (CHD), the most prevalent congenital abnormality, is becoming increasingly acknowledged as a component of a broad fetoplacental pathology. This systematic review summarizes recent imaging-based data linking CHD to quantifiable placental abnormalities. In CHD pregnancies, placenta studies consistently show patterns of [...] Read more.
Congenital heart disease (CHD), the most prevalent congenital abnormality, is becoming increasingly acknowledged as a component of a broad fetoplacental pathology. This systematic review summarizes recent imaging-based data linking CHD to quantifiable placental abnormalities. In CHD pregnancies, placenta studies consistently show patterns of altered vascularization, decreased volumetric growth, microstructural heterogeneity, and impaired placental oxygenation. We conducted a thorough literature search from January 2020 to May 2025 to identify studies on placenta function and structure in CHD-affected pregnancies. The included studies primarily utilized MRI and Doppler methods, as well as some modern modalities. Seven studies were included in this review. Placental imaging reveals consistent structural and functional abnormalities in pregnancies affected by congenital heart disease, indicating some possible contribution of the placenta in CHD pathophysiology. Placental imaging may improve outcomes in this susceptible group of pregnancies, improve risk assessment, and direct surveillance when incorporated into prenatal care for congenital heart disease. Future research should concentrate on lesion-specific analysis, longitudinal imaging, and placenta–heart axis-targeting treatment therapies. Full article
(This article belongs to the Special Issue Diagnosis and Management of Contemporary Issues in Maternal-Fetal Medicine)
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16 pages, 5420 KB  
Case Report
Severe Aortic Stenosis and Pre-Excitation Syndrome in Pregnancy—A Multidisciplinary Approach
by Miruna Florina Ştefan, Lucia Ştefania Magda, Catalin Gabriel Herghelegiu, Doru Herghelegiu, Oana Aurelia Zimnicaru, Catalin Constantin Badiu, Maria Claudia Berenice Suran, Andreea Elena Velcea, Calin Siliste and Dragoș Vinereanu
Diagnostics 2025, 15(16), 2099; https://doi.org/10.3390/diagnostics15162099 - 20 Aug 2025
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Abstract
Background/Objectives: Heart disease affects 0.1% to 4% of pregnant women, with congenital heart defects being the leading cause in developed countries. While maternal mortality is generally low, pre-existing cardiac conditions substantially increase adverse outcome risks. This report describes the multidisciplinary management of [...] Read more.
Background/Objectives: Heart disease affects 0.1% to 4% of pregnant women, with congenital heart defects being the leading cause in developed countries. While maternal mortality is generally low, pre-existing cardiac conditions substantially increase adverse outcome risks. This report describes the multidisciplinary management of a pregnant patient with a bicuspid aortic valve, severe aortic stenosis, and ascending aortic ectasia. Case Presentation: A 34-year-old pregnant woman, asymptomatic but at high risk (World Health Organization Class III) for hemodynamic decompensation, was closely monitored throughout gestation. At 36 weeks, intrauterine growth restriction was detected, prompting an elective cesarean delivery at 38 weeks. Postpartum, the patient developed pre-eclampsia, which was managed successfully. Imaging revealed progressive aortic dilation, leading to surgical aortic valve replacement and ascending aorta reduction plasty. Post-operatively, atrioventricular reentrant tachycardia from an unrecognized accessory pathway developed; medical therapy effectively controlled the arrhythmia after failed catheter ablation. One year later, both mother and child remained in good health. Discussion: This case illustrates the complexity of managing pregnancy in women with congenital heart disease and significant aortic pathology. The physiological changes of pregnancy can exacerbate underlying lesions, necessitating individualized risk assessment, vigilant monitoring, and timely intervention. Conclusions: A multidisciplinary approach involving cardiology, obstetrics, anesthesiology, and genetics is essential to optimize outcomes for pregnant women with significant heart disease. As advances in care allow more women with congenital heart defects to reach childbearing age, structured care pathways remain vital for ensuring safe pregnancies and long-term cardiovascular health. Full article
(This article belongs to the Special Issue Diagnosis and Management of Contemporary Issues in Maternal-Fetal Medicine)
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19 pages, 9021 KB  
Systematic Review
The Association of Placental Grading with Perinatal Outcomes: A Systematic Review and Meta-Analysis
by Antonios Siargkas, Christina Pachi, Meletios P. Nigdelis, Sofoklis Stavros, Ekaterini Domali, Apostolos Mamopoulos, Ioannis Tsakiridis and Themistoklis Dagklis
Diagnostics 2025, 15(10), 1264; https://doi.org/10.3390/diagnostics15101264 - 15 May 2025
Cited by 1 | Viewed by 1197
Abstract
Objective: Premature placental calcification (PPC) has been implicated in adverse perinatal outcomes, yet its clinical significance remains controversial. This meta-analysis aimed to quantitatively synthesize current data on the association between PPC, defined as grade 3 placental calcification before 36+6 weeks of [...] Read more.
Objective: Premature placental calcification (PPC) has been implicated in adverse perinatal outcomes, yet its clinical significance remains controversial. This meta-analysis aimed to quantitatively synthesize current data on the association between PPC, defined as grade 3 placental calcification before 36+6 weeks of gestation and adverse perinatal outcomes. Data Sources: A systematic search was conducted in MEDLINE, Scopus and The Cochrane Library from inception until 11 March 2025, to identify eligible studies. Study Eligibility Criteria: Observational studies including singleton pregnancies with PPC diagnosed via ultrasonography between 28+0 and 36+6 weeks of gestation and comparing them with pregnancies with Grannum grade 0, 1, or 2 placentas were considered eligible. Methods: Study quality was assessed using the Newcastle−Ottawa Scale, and the risk of bias was evaluated with the Quality In Prognosis Studies tool. The primary outcomes were small-for-gestational-age (SGA) neonates and preeclampsia. Heterogeneity was assessed using Cochran’s Q test and the I2 statistic. Meta-analyses were conducted using a random-effects model, with outcomes reported as relative risk (RR) or mean difference (MD) with 95% confidence intervals (CIs). Results: In total, nine cohort studies were included. PPC was associated with an increased risk of SGA (RR, 1.99; 95% CI, 1.46−2.70), preeclampsia (RR, 5.27; 95% CI, 2.24−12.40), fetal growth restriction (RR, 2.31; 95% CI, 1.30−4.09), preterm delivery (RR, 2.11; 95% CI, 1.00−4.45), suspected fetal hypoxia (RR, 1.71; 95% CI, 1.13–2.56), low 5 min Apgar score (RR, 2.28; 95% CI, 1.50−3.44) and neonatal intensive care unit admission (RR, 1.80; 95% CI, 1.02−3.18). No significant associations were found with fetal or neonatal death (RR, 2.75; 95% CI, 0.87−8.71), cesarean delivery (RR, 1.26; 95% CI, 0.90−1.78), gestational diabetes mellitus (RR, 1.17; 95% CI, 0.81−1.70), neonatal resuscitation (RR, 1.04; 95% CI, 0.92−1.16), birthweight (MD, −187.46 g; 95% CI, −413.14 to +38.21), or gestational age at birth (MD, −0.62 weeks; 95% CI, −1.36 to +0.11). A sensitivity analysis excluding high-risk-of-bias studies yielded consistent results. Conclusions: PPC is associated with several adverse perinatal outcomes, including SGA and preeclampsia. While the clinical significance of placental grading has remained limited in recent years, this study has shown that PPC may serve as an early indicator of placental insufficiency, warranting enhanced fetal surveillance and risk assessment in affected pregnancies. Further research is needed to refine its prognostic utility and integration into obstetric practice. Full article
(This article belongs to the Special Issue Diagnosis and Management of Contemporary Issues in Maternal-Fetal Medicine)
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