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Diagnostics
Special Issues
New Insights into Maternal-Fetal Medicine: Diagnosis and Management
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New Insights into Maternal-Fetal Medicine: Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 May 2025) | Viewed by 2102

Special Issue Editor

Dr. Monika Szpotanska-Sikorska

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
Interests: obstetrics; pregnancy; pregnancy complications; liver transplantation; organ transplantation; kidney transplantation

Special Issue Information

Dear Colleagues,

As maternal-fetal medicine remains a top public health priority globally, there is an urgent need to integrate and disseminate new research findings to inform clinical practice and improve outcomes.

The purpose of this special issue is to highlight cutting-edge research and innovative approaches in the field of maternal-fetal medicine that can enhance the quality of care for pregnant individuals, improve pregnancy outcomes, and support the health and well-being of both mothers and newborns. We hope to bridge the gap between research and clinical application by focusing on interdisciplinary research, including advances in prenatal screening, management of high-risk pregnancies, and the impact of maternal health on fetal development.

Dr. Monika Szpotanska-Sikorska
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 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

  • maternal medicine
  • fetal medicine
  • placenta
  • prenatal screening
  • pregnancy

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Published Papers (4 papers)

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Research

16 pages, 842 KiB  
Article
Uterine Artery Doppler in Complicated Twin Pregnancies
by Dagmara Filipecka-Tyczka, Anna Scholz, Monika Szpotańska-Sikorska, Katarzyna Muzyka-Placzyńska, Artur Pokropek, Michał Rabijewski, Bożena Wroczyńska, Marcin Wieczorek, Małgorzata Zielińska, Magdalena Rudzińska, Krzysztof Berbeka, Paulina Pawłowska, Aleksandra Nowińska and Grzegorz Szewczyk
Diagnostics 2025, 15(13), 1696; https://doi.org/10.3390/diagnostics15131696 - 3 Jul 2025
Viewed by 254
Abstract
Background: We assessed the relationship between uterine artery (UtA) indices and the occurrence of obstetrical complications in twin pregnancies. Methods: It was a longitudinal, prospective observation of the UtA indices and obstetric outcomes in twin pregnancies between 11 weeks of gestation and delivery. [...] Read more.
Background: We assessed the relationship between uterine artery (UtA) indices and the occurrence of obstetrical complications in twin pregnancies. Methods: It was a longitudinal, prospective observation of the UtA indices and obstetric outcomes in twin pregnancies between 11 weeks of gestation and delivery. We used a logistic regression model with reliable estimators of standard errors considering the longitudinal structure. In 150 patients with twin pregnancies, 1086 ultrasound examinations were performed. The analysis incorporated nomograms for singletons and dichorionic (DC) twins. Results: In twin pregnancies, we observed a positive relationship between UtA indices and obstetrical complications (OR = 1.32, p = 0.043 for standardized PI and OR = 1.38, p = 0.018 for standardized RI). The risk increased with increasing UtA indices. There was a significant positive relationship between the UtA indices and analyzed pathologies in DC twins. We observed that both DC twins’ UtA indices below the 5th percentile were associated with favorable outcomes, while those above the 95th percentile were associated with adverse outcomes. According to the singleton nomograms, only the UtA PI above the 95th percentile showed significance. In MC twins, only significantly elevated UtA indices above the upper limit of nomogram were associated with adverse outcomes. Conclusions: The UtA nomogram for singleton and DC twins may be used in the prediction of twin pregnancy outcome, but DC nomograms are more accurate. The mechanism of obstetric complications in MC twins differs, and it requires further research. However, it seems that DC twin nomograms can be used in MC twins, but they will be less effective. Full article
(This article belongs to the Special Issue New Insights into Maternal-Fetal Medicine: Diagnosis and Management)
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15 pages, 256 KiB  
Article
Systemic and Local Immunological Markers in Preeclampsia
by Almagul Kurmanova, Altynay Nurmakova, Damilya Salimbayeva, Gulfiruz Urazbayeva, Gaukhar Kurmanova, Natalya Kravtsova, Zhanar Kypshakbayeva and Madina Khalmirzaeva
Diagnostics 2025, 15(13), 1644; https://doi.org/10.3390/diagnostics15131644 - 27 Jun 2025
Viewed by 319
Abstract
Preeclampsia (PE) is one of the main causes of obstetric complications and leads to both maternal and neonatal mortality. The maternal innate immune system plays an important role throughout pregnancy by providing protection against pathogens, while simultaneously inducing tolerance to a semi-allogenic developing [...] Read more.
Preeclampsia (PE) is one of the main causes of obstetric complications and leads to both maternal and neonatal mortality. The maternal innate immune system plays an important role throughout pregnancy by providing protection against pathogens, while simultaneously inducing tolerance to a semi-allogenic developing fetus and placental development. Background/Objectives: To conduct a comparative study of immunological markers in the blood and placenta in preeclampsia. Methods: A total of 35 pregnant women were enrolled in a comparative study with preeclampsia (7) and with physiological pregnancy (28). A study of the immune status in peripheral blood and placenta was conducted with an examination of the subpopulation of lymphocytes profile and intracellular cytokines production by flow cytometry. Results: In the blood of pregnant women with PE, there was a decrease in CD14+ monocytes, as well as a significant increase of natural killers CD16+, CD56+ and activation markers HLA-DR+ and CD95+, as well as a significant rise in production of IL-10, TNF, Perforin, GM-CSF, and IGF. At the same time, in placental tissue in patients with preeclampsia, on the contrary, a significant decrease in regulatory cells CD4+, CD8+, CD14+, CD56+, CD59+, activation markers CD95+, as well as anti-inflammatory cytokine IL-10, growth factors VEGFR and IGF was detected. Conclusions: The maternal–fetal immune profile is crucial for successful fetal development and dysregulation of T-, B-, and NK cells can contribute to inflammation, oxidative stress, and the development of preeclampsia. Full article
(This article belongs to the Special Issue New Insights into Maternal-Fetal Medicine: Diagnosis and Management)
11 pages, 942 KiB  
Article
Diagnostic Challenges and Perinatal Outcomes: A Case Series on a Retrospective Study
by Carmen Maria Moral-Moral, Lorena Porras-Caballero, Marta Blasco-Alonso, Celia Cuenca-Marín, Susana Monis-Rodriguez, Ernesto Gonzalez-Mesa, Isidoro Narbona-Arias and Jesus S. Jimenez-Lopez
Diagnostics 2025, 15(11), 1329; https://doi.org/10.3390/diagnostics15111329 - 26 May 2025
Viewed by 371
Abstract
Succenturiate placenta is a rare anatomical variant characterized by one or more accessory lobes connected to the main placental mass by fetal vessels. While frequently asymptomatic, this condition can lead to serious maternal–fetal complications if not diagnosed prenatally. Early detection through advanced ultrasonographic [...] Read more.
Succenturiate placenta is a rare anatomical variant characterized by one or more accessory lobes connected to the main placental mass by fetal vessels. While frequently asymptomatic, this condition can lead to serious maternal–fetal complications if not diagnosed prenatally. Early detection through advanced ultrasonographic techniques plays a critical role in guiding obstetric management and reducing adverse outcomes. Objective: To describe and analyze the prenatal diagnosis, sonographic characteristics, clinical management, and maternal–fetal outcomes of succenturiate placenta cases diagnosed over a ten-year period at a tertiary care center. Methods: We conducted a retrospective observational study of nine pregnancies diagnosed with succenturiate placenta between 2014 and 2024. Data collected included maternal demographics, ultrasound findings, type of cord insertion, presence of associated anomalies such as velamentous cord insertion or vasa previa, vaginal or cesarean delivery, complications, and neonatal outcomes. Ultrasound evaluation was scored based on a four-point checklist assessing key diagnostic steps. Results: Five of the nine cases (55.6%) presented isolated succenturiate placenta, while four (44.4%) were associated with velamentous cord insertion. No cases of vasa previa were identified. Obstetric outcomes included three vaginal deliveries (33.3%), two instrumental (22.2%), and four cesarean sections (44.4%), one of which was emergent due to fetal distress. Complications occurred in 44.4% of cases, with intrapartum bradycardia being the most common. One neonatal death was reported due to placental abruption. The quality of the ultrasound diagnosis was high in most cases, though transvaginal scanning was inconsistently applied. Conclusions: Prenatal identification of succenturiate placenta via detailed ultrasound, including color Doppler and targeted assessment of cord insertion, is essential to minimize risks associated with this condition. Standardized diagnostic protocols can improve detection rates and enable timely clinical decisions, ultimately improving maternal and neonatal outcomes. Full article
(This article belongs to the Special Issue New Insights into Maternal-Fetal Medicine: Diagnosis and Management)
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12 pages, 679 KiB  
Article
Exploring the Role of miRNA-101a in the Circulatory System’s Adaptive Mechanisms in Hypertensive Disorders of Pregnancy
by Ewa Szczerba, Eliza Kozyra-Pydyś, Agnieszka Zajkowska, Katarzyna Pankiewicz, Grzegorz Szewczyk, Tomasz Maciejewski, Maciej Małecki and Anna Fijałkowska
Diagnostics 2025, 15(5), 535; https://doi.org/10.3390/diagnostics15050535 - 22 Feb 2025
Viewed by 763
Abstract
Background/Objectives: Hypertensive disorders of pregnancy constitute one of the principal reasons for maternal and perinatal morbidity and mortality worldwide. Identification of molecular mechanisms causing placental dysfunction resulting in gestational hypertension is crucial in the development of new methods of prevention and treatment. The [...] Read more.
Background/Objectives: Hypertensive disorders of pregnancy constitute one of the principal reasons for maternal and perinatal morbidity and mortality worldwide. Identification of molecular mechanisms causing placental dysfunction resulting in gestational hypertension is crucial in the development of new methods of prevention and treatment. The aim of this case-control study was to assess changes in miRNA expression, and biomarkers such as NT-proBNP and galectin-3, in women with uncomplicated pregnancies and hypertensive disorders of pregnancy. Methods: This was a case-control study. We included 61 women with uncomplicated pregnancies and 31 women with hypertensive disorders of pregnancy (21 women with gestational hypertension and 10 women with chronic hypertension). Blood sample collection was performed at 33 weeks of gestation. Expression and expression levels of 26 microRNAs, NTproBNP, and galectin-3 were measured. Results: Lower expression of microRNA 101a was observed in patients with hypertensive disorders of pregnancy. The expression of microRNA 101a was significantly lower in the group of patients with gestational hypertension, but not with chronic hypertension. Not only was the expression of microRNA 101a lower in all women with gestational hypertension but also in XYZ% it reached undetectable levels. Other studied microRNAs were similar in expression and concentration levels among both groups. In all women with hypertensive disorders of pregnancy, statistically significant correlations were detected between NT-proBNP concentrations and microRNA 133a (r = −0.68; p = 0.030) and microRNA 195 (r = 0.67; p = 0.030), and between galectin-3 and microRNA 195 (r = 0.46; p = 0.010), microRNA 133a (r = 0.44; p = 0.020), microRNA 222-2276 (r = 0.39; p = 0.050). Conclusions: microRNA 101a, a molecule associated with placental dysfunction in preeclampsia and with inhibition of cardiac fibrosis, has lower expression and concentration levels in gestational hypertension but not in chronic hypertension. Full article
(This article belongs to the Special Issue New Insights into Maternal-Fetal Medicine: Diagnosis and Management)
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