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New Insights in the Mechanism of Obstetrical Complications: Prevention, Diagnosis, Monitoring, Treatment

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: 20 April 2026 | Viewed by 4839

Special Issue Editors


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Guest Editor

Special Issue Information

Dear Colleagues,

Some women experience health problems during pregnancy. These complications can involve the mother's health, the fetus's health, or both. Even women who were healthy before becoming pregnant can experience complications. These complications may make the pregnancy a high-risk pregnancy.

Obtaining early and regular prenatal care can help decrease the risk for problems by enabling health care providers to diagnose, treat, or manage conditions before they become serious. Prenatal care can also help identify mental health concerns related to pregnancy, such as anxiety and depression.

Some common complications of pregnancy include, but are not limited to, the following: high blood pressure, gestational diabetes, infections, preeclampsia, preterm labor, depression, anxiety, pregnancy loss/miscarriage, stillbirth, premature membrane rupture, vaginal bleeding, placenta previa, and anemia.

In this Special Issue, we will include original articles, reviews, and case reports regarding biochemical, genetic, and epigenetic determinations with a role in the prevention, diagnosis, monitoring, and treatment of these obstetrical complications. Manuscripts may consider addressing maternal, fetal, or both risk factors in modulating the increased risk of morbidity and mortality.

Furthermore, this issue will take into account in silico, experimental in vitro and in vivo studies and clinical studies with a higher potential to improve the management (prevention, diagnosis, treatment) of obstetrical complications.

Prof. Dr. Lucia Maria Procopciuc
Prof. Dr. Roxana Liana Lucaciu
Guest Editors

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Keywords

  • high blood pressure
  • gestational diabetes
  • infections
  • preeclampsia
  • eclampsia
  • preterm labor
  • depresion
  • anxiety
  • pregnancy loss/miscarriage
  • stillbirth
  • premature membrane rupture
  • vaginal bleeding
  • placenta previa
  • anemia
  • intrauterine growth restriction
  • maternal risk factors
  • fetal risk factors
  • endothelial dysfunction
  • angiogenesis
  • oxidative stress
  • hormonal modifications
  • dyslipidemia
  • biochemical
  • genetic
  • epigenetic determinations
  • computational analysis

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Published Papers (3 papers)

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Research

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12 pages, 1039 KB  
Article
Investigation of Novel Predictive Biomarkers for Preeclampsia in Second-Trimester Amniotic Fluid
by Hyo Eun Lee, Yeonseong Jeong, Jue Young Kim, Ha-Yeon Shin, Young-Han Kim and Min-A Kim
Int. J. Mol. Sci. 2025, 26(21), 10530; https://doi.org/10.3390/ijms262110530 - 29 Oct 2025
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Abstract
Preeclampsia (PE) is a major cause of maternal and perinatal morbidity, and early prediction is critical for timely intervention. This study aimed to identify predictive biomarkers for PE through transcriptomic analysis of second-trimester amniotic fluid supernatant (AFS) collected prior to clinical symptom onset. [...] Read more.
Preeclampsia (PE) is a major cause of maternal and perinatal morbidity, and early prediction is critical for timely intervention. This study aimed to identify predictive biomarkers for PE through transcriptomic analysis of second-trimester amniotic fluid supernatant (AFS) collected prior to clinical symptom onset. AFS samples from women who later developed PE (n = 7) and matched controls (n = 7) underwent RNA sequencing to identify differentially expressed genes (DEGs). Candidate genes were validated by real-time PCR in HTR-8/SVneo cells exposed to fluid shear stress at 3, 10, and 20 dyn/cm2 for 24 h, mimicking the hemodynamic environment of PE, and siRNA-mediated knockdown was used to assess effects on trophoblast migration and invasion. RNA sequencing revealed 19 DEGs, with 3 upregulated and 16 downregulated genes in the PE group. HOOK2 emerged as the most significantly upregulated gene. Four candidate genes, including HOOK2, CCDC160, CKB, and PARP15, were selected for further validation. HOOK2 mRNA expression significantly increased with higher shear stress levels, consistent with sequencing data. Knockdown of HOOK2 led to a significant increase in trophoblast invasion, while migration showed no significant change. These findings suggest that HOOK2 may serve as a promising early biomarker for PE by modulating trophoblast invasiveness under altered hemodynamic conditions, with potential to improve risk stratification and personalized monitoring in pregnancy. Full article
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8 pages, 520 KB  
Communication
Relative Expression of Peptidylarginine Deiminase 2 and Sex Steroid Receptors in XX and XY Mouse Placenta
by Amanda Wewer, Autumn Bennitt, Emily Hinners, Morgan Helmich, Nathan Schnepp, Sean Pitcher, Agata M. Parsons and Gerrit J. Bouma
Int. J. Mol. Sci. 2025, 26(21), 10523; https://doi.org/10.3390/ijms262110523 - 29 Oct 2025
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Abstract
Although female (XX) and male (XY) placentas generally function the same, it is evident that there are sex-specific postnatal health outcomes following placental dysfunction and pregnancy complications. Although the underlying causes for these sex differences are unclear, it is postulated that differences in [...] Read more.
Although female (XX) and male (XY) placentas generally function the same, it is evident that there are sex-specific postnatal health outcomes following placental dysfunction and pregnancy complications. Although the underlying causes for these sex differences are unclear, it is postulated that differences in XX and XY placental function are involved due to sex chromosomes and/or sex steroids. Studies in breast and prostate cancer cells demonstrated a role for the citrullination enzyme peptidylarginine deiminase 2 (PAD2) in post-translational regulation of estrogen (ESR) and androgen receptor (AR) signaling. The goal of this study is to determine if PAD2 is present in mouse placentas and if XX versus XY differences exist in the relative level of PAD2. Fetuses and placentas were collected from three pregnant mice (C57BL6) at 14 days of gestation. Total RNA and protein were isolated from XX and XY placentas, and relative mRNA and protein were analyzed by real-time PCR and Western blot. AR and PAD2 levels were significantly higher in XY than in XX placentas. This study is the first to demonstrate XX and XY differences in PAD2 and AR in the placenta. It suggests a role for PAD2 regulation of androgen receptor signaling in the XY placenta. Full article
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Review

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22 pages, 1279 KB  
Review
From Molecular Insights to Clinical Management of Gestational Diabetes Mellitus—A Narrative Review
by Mohamed-Zakaria Assani, Lidia Boldeanu, Maria-Magdalena Manolea, Mihail Virgil Boldeanu, Isabela Siloși, Alexandru-Dan Assani, Constantin-Cristian Văduva and Anda Lorena Dijmărescu
Int. J. Mol. Sci. 2025, 26(17), 8719; https://doi.org/10.3390/ijms26178719 - 7 Sep 2025
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Abstract
Gestational diabetes mellitus (GDM) is one of the most common metabolic complications during pregnancy, affecting up to 14% of pregnancies globally. GDM is characterized by glucose intolerance that arises or is first identified during pregnancy and is linked to significant short- and long-term [...] Read more.
Gestational diabetes mellitus (GDM) is one of the most common metabolic complications during pregnancy, affecting up to 14% of pregnancies globally. GDM is characterized by glucose intolerance that arises or is first identified during pregnancy and is linked to significant short- and long-term adverse outcomes for both mothers and their offspring. The pathophysiology of GDM involves more than maternal insulin resistance and β-cell dysfunction. It is influenced by complex interactions among placental hormones, adipokines, inflammatory mediators, and oxidative stress pathways. Additionally, placental-derived exosomes and metabolomic signatures have emerged as promising biomarkers for early prediction and monitoring of the disease. Despite advancements in clinical diagnosis and management, including lifestyle interventions and pharmacological treatments, current strategies are still inadequate to prevent complications for both mothers and newborns entirely. Recent molecular insights into GDM development have been explored, along with emerging biomarkers and potential therapies. This synthesis also considers prospects for precision medicine strategies that could significantly improve GDM management. The urgent need for improved prevention and treatment of GDM is evident. A deeper understanding of the molecular foundations of GDM is essential and urgent, as it may enhance clinical outcomes and provide opportunities for early prevention of intergenerational metabolic disease risk. Full article
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