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Bridging Bench, Bedside, and Beyond: Clinical and Translational Strategies for Pregnancy Complications

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 20 September 2026 | Viewed by 1772

Special Issue Editors

Dr. Thenral Socrates

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Guest Editor
Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
Interests: hypertension; hypertensive disorders in pregnancy; postpartum hypertension; cardiovascular risk in women
Special Issues, Collections and Topics in MDPI journals
Dr. Federica Piani

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Guest Editor
Division of Physiology and Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
Interests: cardiovascular medicine; cardiovascular risk; cardiovascular physiology; pregnancy complications; preeclampsia; sex and gender differences
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue, entitled “Bridging Bench, Bedside, and Beyond: Clinical and Translational Strategies for Pregnancy Complications,” focuses on pregnancy-related cardiovascular and metabolic disorders, including hypertensive disorders (preeclampsia, eclampsia, chronic hypertension), gestational diabetes mellitus (GDM), and their vascular complications. These conditions significantly increase maternal and fetal morbidity and mortality, necessitating early prediction, accurate diagnosis, and timely intervention. This Issue highlights advances in risk stratification using biomarkers, cardiovascular imaging, and AI-based predictive models. It also explores therapeutic strategies, such as antihypertensive regimens, glycemic control, and various others. Special attention is given to endothelial dysfunction, placental ischemia, and long-term cardiovascular risks postpartum. By integrating clinical guidelines, cutting-edge research, and multidisciplinary approaches, this collection aims to optimize maternal/fetal outcomes and reduce the burden of pregnancy-related cardiovascular and metabolic diseases.

Dr. Thenral Socrates
Dr. Federica Piani
Guest Editors

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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

  • high-risk pregnancy
  • cardiovascular complications
  • cardiometabolic complications
  • gestational diabetes
  • pregnancy complications
  • preeclampsia
  • hypertension
  • vascular disorders
  • endothelial dysfunction
  • clinical prediction
  • antenatal diagnosis
  • personalized treatment

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Published Papers (3 papers)

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Research

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10 pages, 207 KB  
Article
Laparoscopy vs. Laparotomy for Management of Postpartum Complications—A Retrospective Cohort Study
by Liat Mor, Ohad Gluck, Amit Kreiner, Ram Kerner, Shimon Ginath, Ran Keidar and Ron Sagiv
J. Clin. Med. 2026, 15(5), 1982; https://doi.org/10.3390/jcm15051982 - 5 Mar 2026
Viewed by 331
Abstract
Background: Postpartum complications requiring surgical intervention are challenging due to physiologic and anatomic changes. While laparotomy remains standard, laparoscopy is increasingly used. We compared outcomes of laparoscopic management of postpartum complications versus open management of postpartum complications. Methods: This retrospective cohort study included [...] Read more.
Background: Postpartum complications requiring surgical intervention are challenging due to physiologic and anatomic changes. While laparotomy remains standard, laparoscopy is increasingly used. We compared outcomes of laparoscopic management of postpartum complications versus open management of postpartum complications. Methods: This retrospective cohort study included patients undergoing surgical intervention within three weeks postpartum at a single tertiary center between 2010 and 2023. Approach selection was primarily time-dependent, following an institutional practice change in 2020. Demographic, operative, and postoperative outcomes were compared. Results: Sixty-two participants with postpartum complications necessitating surgical intervention were included: 54 in the laparotomy group and 8 who underwent laparoscopy. Demographic characteristics were similar between groups. The main indication for laparoscopy was suspected uterine scar defects (p = 0.006), while laparotomy was obtained mainly in cases of suspected bleeding (p = 0.001). Both groups had comparable operative time, though the laparoscopy group had a shorter postoperative admission (p = 0.043). Conclusions: Laparoscopy is feasible for various postpartum complications. It offers comparable operative times to laparotomy with shorter postoperative admissions. Therefore, it is a promising alternative in selected cases when surgical expertise is available. Full article
(This article belongs to the Special Issue Bridging Bench, Bedside, and Beyond: Clinical and Translational Strategies for Pregnancy Complications)
13 pages, 2449 KB  
Article
AI Decision-Making Performance in Maternal–Fetal Medicine: Comparison of ChatGPT-4, Gemini, and Human Specialists in a Cross-Sectional Case-Based Study
by Matan Friedman, Amit Slouk, Noa Gonen, Laura Guzy, Yael Ganor Paz, Kira Nahum Sacks, Amihai Rottenstreich, Eran Weiner, Ohad Gluck and Ilia Kleiner
J. Clin. Med. 2026, 15(1), 117; https://doi.org/10.3390/jcm15010117 - 24 Dec 2025
Viewed by 756
Abstract
Background/Objectives: Large Language Models (LLMs), including ChatGPT-4 and Gemini, are increasingly incorporated into clinical care; however, their reliability within maternal–fetal medicine (MFM), a high-risk field in which diagnostic and management errors may affect both the pregnant patient and the fetus, remains uncertain. Evaluating [...] Read more.
Background/Objectives: Large Language Models (LLMs), including ChatGPT-4 and Gemini, are increasingly incorporated into clinical care; however, their reliability within maternal–fetal medicine (MFM), a high-risk field in which diagnostic and management errors may affect both the pregnant patient and the fetus, remains uncertain. Evaluating the alignment of AI-generated case management recommendations with those of MFM specialists, emphasizing accuracy, agreement, and clinical relevancy. Study Design and Setting: Cross-sectional study with blinded online evaluation (November–December 2024); evaluators were blinded to responder identity (AI vs. human), and case order and response labels were randomized for each evaluator using a computer-generated sequence to reduce order and identification bias. Methods: Twenty hypothetical MFM cases were constructed, allowing standardized presentation of complex scenarios without patient-identifiable data and enabling consistent comparison of AI-generated and human specialist recommendations. Responses were generated by ChatGPT-4, Gemini, and three MFM specialists, then assessed by 22 blinded board-certified MFM evaluators using a 10-point Likert scale. Agreement was measured with Spearman’s rho (ρ) and Cohen’s (κ); accuracy differences were measured with Wilcoxon signed-rank tests. Results: ChatGPT-4 exhibited moderate alignment (mean 6.6 ± 2.95; ρ = 0.408; κ = 0.232, p < 0.001), performing well in routine, guideline-driven scenarios (e.g., term oligohydramnios, well-controlled gestational hypertension, GDMA1). Gemini scored 7.0 ± 2.64, demonstrating effectively no consistent inter-rater agreement (κ = −0.024, p = 0.352), indicating that although mean scores were slightly higher, evaluators varied widely in how they judged individual Gemini responses. No significant difference was found between ChatGPT-4 and clinicians in median accuracy scores (Wilcoxon p = 0.18), while Gemini showed significantly lower accuracy (p < 0.01). Model performance varied primarily by case complexity: agreement was higher in straightforward, guideline-based scenarios and more variable in complex cases, whereas no consistent pattern was observed by gestational age or specific clinical domain across the 20 cases. Conclusions: AI shows promise in routine MFM decision-making but remains constrained in complex cases, where models sometimes under-prioritize maternal–fetal risk trade-offs or incompletely address alternative management pathways, warranting cautious integration into clinical practice. Generalizability is limited by the small number of simulated cases and the use of hypothetical vignettes rather than real-world clinical encounters. Full article
(This article belongs to the Special Issue Bridging Bench, Bedside, and Beyond: Clinical and Translational Strategies for Pregnancy Complications)
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Review

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15 pages, 896 KB  
Review
Alteration in Fetal Cardiac Function at Mid-Gestation Among Pregnancies Subsequently Complicated by Preeclampsia, Fetal Growth Restriction and Gestational Diabetes Mellitus: A Literature Review
by Iulia Huluță, Livia-Mihaela Apostol, Nicoleta Gana, Radu Botezatu and Anca-Maria Panaitescu
J. Clin. Med. 2026, 15(5), 1845; https://doi.org/10.3390/jcm15051845 - 28 Feb 2026
Viewed by 363
Abstract
Preeclampsia (PE), fetal growth restriction (FGR), and gestational diabetes mellitus (GDM) complicate approximately 15–20% of pregnancies and represent major contributors to perinatal morbidity, mortality, and long-term cardiovascular risk in offspring. Increasing evidence from longitudinal cohort studies indicates that adult cardiovascular disease, including hypertension, [...] Read more.
Preeclampsia (PE), fetal growth restriction (FGR), and gestational diabetes mellitus (GDM) complicate approximately 15–20% of pregnancies and represent major contributors to perinatal morbidity, mortality, and long-term cardiovascular risk in offspring. Increasing evidence from longitudinal cohort studies indicates that adult cardiovascular disease, including hypertension, coronary artery disease, and stroke, may be programmed in utero through early alterations in fetal cardiac structure and function. Two-dimensional speckle-tracking echocardiography (2D-STE) has emerged as the most sensitive non-invasive technique for detecting subclinical myocardial deformation, often preceding abnormalities detected by conventional Doppler or biometric parameters. While numerous third-trimester studies have demonstrated impaired global longitudinal strain (GLS), altered ventricular geometry, and diastolic dysfunction in established disease, data from mid-gestation (18–28 weeks), the critical preclinical window, remain extremely limited. Therefore, this review aims to systematically synthesize the available evidence on fetal cardiac deformation parameters assessed by 2D-STE at mid-gestation in pregnancies that subsequently developed PE, FGR, or GDM, in order to identify the earliest detectable signatures of fetal cardiovascular programming and highlight key knowledge gaps that must be addressed prior to clinical implementation. Full article
(This article belongs to the Special Issue Bridging Bench, Bedside, and Beyond: Clinical and Translational Strategies for Pregnancy Complications)
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