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Diagnostics
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Advancements in Maternal–Fetal Medicine: 2nd Edition
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Advancements in Maternal–Fetal Medicine: 2nd Edition

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

Deadline for manuscript submissions: 31 October 2025 | Viewed by 960

Special Issue Editor

Dr. Elena Bernad

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Victor Babes”, 300001 Timisoara, Romania
Interests: gynecology; obstetrics; gynecological oncology; endocrinology and reproductive medicine; ethics; medical education; research design; epidemiology and statistics; computer applications
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The new Special Issue aims to improve the indicators of perinatal morbidity and mortality by publishing research conducted by specialists in maternal–fetal medicine. The published articles will address topics related to the diagnosis and management of high-risk pregnancies, complications, and modern therapies in obstetrics. We invite you to continue researching maternal–fetal and obstetrical difficulties, from early pregnancy and placentation to prenatal diagnostics, fetal therapy, and maternal–fetal and obstetrical complications, by submitting original research articles, case studies, case reports, and reviews.

Dr. Elena Bernad
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

  • pregnancy
  • fetus
  • ultrasound
  • maternal–fetal medicine
  • perinatal care high risk
  • obstetrics
  • complication
  • screening
  • diagnostics
  • fetal distress

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Published Papers (3 papers)

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Research

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27 pages, 10135 KB  
Article
Rotational Thromboelastometry (ROTEM) Hemostasis Profile in Pregnant Women with Preeclampsia and Their Offspring: An Observational Study
by Christos-Georgios Kontovazainitis, Dimitra Gialamprinou, Alexandra Fleva, Theodoros Theodoridis, Ilias Chatziioannidis, Christina Mitsiakou, Anastasia Banti, Elissavet Diamanti and Georgios Mitsiakos
Diagnostics 2025, 15(17), 2156; https://doi.org/10.3390/diagnostics15172156 - 26 Aug 2025
Abstract
Background/Objectives: Conventional Coagulation Tests (CCTs) fail to accurately reflect Preeclampsia’s (PE’s) coagulation status, disease progression, and hemostatic alterations. They do not differentiate between the normal hypercoagulability of healthy pregnancies and the pathological hypercoagulability associated with PE. Rotational Thromboelastometry (ROTEM) analyzes clot dynamics [...] Read more.
Background/Objectives: Conventional Coagulation Tests (CCTs) fail to accurately reflect Preeclampsia’s (PE’s) coagulation status, disease progression, and hemostatic alterations. They do not differentiate between the normal hypercoagulability of healthy pregnancies and the pathological hypercoagulability associated with PE. Rotational Thromboelastometry (ROTEM) analyzes clot dynamics from initiation through amplification and propagation to termination and fibrinolysis. However, their application in PE, particularly in neonates born to women with PE, is limited. We aimed to identify the hemostatic alterations in pregnant women with PE using ROTEMs that remain undetected by CCTs and to assess PE’s impact on neonatal hemostasis at birth. Methods: This was a single-center observational study (March 2022–March 2024) including 31 women with PE (34 newborns) and 45 pregnancies without PE (47 newborns). Maternal blood was collected intrapartum before placental delivery. Neonatal arterial samples were obtained within the first hour of life before vitamin K administration. ROTEM (Intrinsic (INTEM), Extrinsic (EXTEM), Fibrinogen (FIBTEM), Aprotinin (APTEM)), and CCTs were performed. Subgroup analyses considered PE severity and onset. ROC analyses examined discrimination for persistent maternal thrombocytopenia within 7 days of delivery and association with maternal platelet transfusion. Results: In preeclamptic women, the INTEM and FIBTEM assays were more affected, with higher Actual Clot Firmness (ACF) (p = 0.03, p = 0.04, respectively) and a higher Clot Formation Rate (CFR) (p = 0.03, p = 0.02, respectively). Hyperfibrinolysis was present (CT-APTEM < CT-EXTEM, MCF-APTEM > MCF-EXTEM). Clot Formation Time CFT-EXTEM was an indicator of maternal platelet transfusion (AUC = 0.81). Across EXTEM, INTEM, and APTEM, A10 (Amplitude at 10 min) and CFT showed good discrimination capability for maternal persistent thrombocytopenia within 7 days of delivery (AUCs 0.82–0.95). Neonates of women with PE presented lower ACF across all assays (INTEM p = 0.003; EXTEM p = 0.001; FIBTEM p = 0.01; APTEM p < 0.001), consistent across severity/onset subgroups. Conclusions: In this cohort, ROTEM identified maternal hypercoagulability with hyperfibrinolysis and neonatal hypocoagulability during the first hour of life. Several alterations were not reflected in CCTs. Further prospective studies should evaluate the role and clinical utility of combining ROTEM with CCTs for hemostatic monitoring in women with PE and their neonates. Full article
(This article belongs to the Special Issue Advancements in Maternal–Fetal Medicine: 2nd Edition)
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12 pages, 615 KB  
Article
Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor
by Hayan Kwon, Ji-Hee Sung, Hyun Soo Park, Ja-Young Kwon, Yun Ji Jung, Hyun-Joo Seol, Hyun Mi Kim, Won Joon Seong, Han Sung Hwang, Soo-Young Oh and on behalf of The Korean Consortium for the Study of Cervical Elastography in Prediction of Preterm Delivery
Diagnostics 2025, 15(15), 1934; https://doi.org/10.3390/diagnostics15151934 - 31 Jul 2025
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Abstract
Background/Objective: Accurately identifying women at high risk for preterm birth among those with threatened preterm labor (PTL) is crucial for effective interventions or tocolytic management to reduce preterm birth and its complications. This study aimed to determine the predictive value of cervical [...] Read more.
Background/Objective: Accurately identifying women at high risk for preterm birth among those with threatened preterm labor (PTL) is crucial for effective interventions or tocolytic management to reduce preterm birth and its complications. This study aimed to determine the predictive value of cervical elastography for preterm delivery before 37 weeks of gestation in patients with threatened PTL and a cervical length greater than 15 mm. Methods: This prospective cohort study included pregnant women presenting with threatened PTL at between 24 and 34 weeks gestation. All participants underwent cervical elastography at diagnosis. We compared cervical elastography parameters between women who delivered spontaneously preterm (<37 weeks) and those who delivered at full term and assessed the ability of these parameters to predict spontaneous preterm delivery. Results: Among the 107 enrolled individuals with threatened PTL and a cervical length of ≥15 mm, 55 (42%) experienced preterm birth (<37 weeks). Internal os stiffness (IOS), internal-to-external os stiffness ratio (IOS/EOS ratio), and elasticity contrast index (ECI) were significantly associated with a risk of preterm birth compared to full-term birth. The IOS/EOS ratio was associated with 10-fold higher odds of preterm birth at <37 weeks (95% confidence interval [CI], 1.82–59.98), and ECI was associated with 1.5-fold higher odds (95% CI, 1.01–2.37). The IOS/EOS ratio demonstrated good predictive value (area under the curve (AUC) = 0.678) and the combination of CL ≤ 25 mm and the IOS/EOS ratio had good diagnostic performance for predicting preterm birth (AUC = 0.708). Conclusions: Cervical elastography using the E-Cervix™ system appears to improve the ability to predict preterm birth in pregnant women with threatened PTL and a cervical length greater than 15 mm. Full article
(This article belongs to the Special Issue Advancements in Maternal–Fetal Medicine: 2nd Edition)
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Review

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15 pages, 899 KB  
Review
Liquid Biopsy and Single-Cell Technologies in Maternal–Fetal Medicine: A Scoping Review of Non-Invasive Molecular Approaches
by Irma Eloisa Monroy-Muñoz, Johnatan Torres-Torres, Lourdes Rojas-Zepeda, Jose Rafael Villafan-Bernal, Salvador Espino-y-Sosa, Deyanira Baca, Zaira Alexi Camacho-Martinez, Javier Perez-Duran, Juan Mario Solis-Paredes, Guadalupe Estrada-Gutierrez, Elsa Romelia Moreno-Verduzco and Raigam Martinez-Portilla
Diagnostics 2025, 15(16), 2056; https://doi.org/10.3390/diagnostics15162056 - 16 Aug 2025
Viewed by 315
Abstract
Background: Perinatal research faces significant challenges in understanding placental biology and maternal–fetal interactions due to limited access to human tissues and the lack of reliable models. Emerging technologies, such as liquid biopsy and single-cell analysis, offer novel, non-invasive approaches to investigate these processes. [...] Read more.
Background: Perinatal research faces significant challenges in understanding placental biology and maternal–fetal interactions due to limited access to human tissues and the lack of reliable models. Emerging technologies, such as liquid biopsy and single-cell analysis, offer novel, non-invasive approaches to investigate these processes. This scoping review explores the current applications of these technologies in placental development and the diagnosis of pregnancy complications, identifying research gaps and providing recommendations for future studies. Methods: This review adhered to PRISMA-ScR guidelines. Studies were selected based on their focus on liquid biopsy or single-cell analysis in perinatal research, particularly related to placental development and pregnancy complications such as preeclampsia, preterm birth, and fetal growth restriction. A systematic search was conducted in PubMed, Scopus, and Web of Science for studies published in the last ten years. Data extraction and thematic synthesis were performed to identify diagnostic applications, monitoring strategies, and biomarker identification. Results: Twelve studies were included, highlighting the transformative potential of liquid biopsy and single-cell analysis in perinatal research. Liquid biopsy technologies, such as cfDNA and cfRNA analysis, provided non-invasive methods for real-time monitoring of placental function and early identification of complications. Extracellular vesicles (EVs) emerged as biomarkers for conditions like preeclampsia. Single-cell RNA sequencing (scRNA-seq) revealed cellular diversity and pathways critical to placental health, offering insights into processes such as vascular remodeling and trophoblast invasion. While promising, challenges such as high costs, technical complexity, and the need for standardization limit their clinical integration. Conclusion: Liquid biopsy and single-cell analysis are revolutionizing perinatal research, offering non-invasive tools to understand and manage complications like preeclampsia. Overcoming challenges in accessibility and standardization will be key to unlocking their potential for personalized care, enabling better outcomes for mothers and children worldwide. Full article
(This article belongs to the Special Issue Advancements in Maternal–Fetal Medicine: 2nd Edition)
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