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Clinical Management of Pregnancy-Related Complications: 2nd Edition
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Clinical Management of Pregnancy-Related Complications: 2nd Edition

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

Deadline for manuscript submissions: 31 August 2025 | Viewed by 11005

Special Issue Editors

Dr. Panagiotis Peitsidis

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Helena Venizelou Hospital, 115 27 Athens, Greece
Interests: fetal medicine; hyperoscopy; laparoscopy; colposcopy
Special Issues, Collections and Topics in MDPI journals
Dr. Stephanos Zervoudis

E-Mail Website
Guest Editor
1. Breast Department, Rea Maternity Hospital, Pentelis, 175 64 Athens, Greece
2. Medical School, University of Montpellier-Nimes, 34090 Montpellier, France
Interests: high risk pregnancy; gynecology oncology
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Panagiotis Tsikouras

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis, Greece
Interests: obstetrics and gynecology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pregnancy is a unique and special period in a woman’s life. It is characterized by the presence of many alterations in the physiological and immune statuses. Several severe pregnancy-related conditions are not frequently seen in women of reproductive age. Often, various clinical specialties act in a multidisciplinary way to confront these complications. This clinical task is a difficult as well as demanding reality and endangers the lives of pregnant women and fetuses. New guidelines based on evidence-based medicine have been produced in order to minimize the frequency of these conditions. In the current Special Issue, we aim to review the pathogenesis and management of these pregnancy-related complications.

Dr. Panagiotis Peitsidis
Dr. Stephanos Zervoudis
Prof. Dr. Panagiotis Tsikouras
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. Journal of Clinical Medicine 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

  • diabetes
  • hypertension
  • post-partum hemorrhage
  • preterm labor
  • infection
  • cancer

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Related Special Issue

Published Papers (4 papers)

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Research

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14 pages, 1008 KiB  
Article
A Genetic Risk Score for Recurrent Miscarriages Based on Polymorphisms in Platelet Glycoproteins and Adhesion Molecules Genes
by Nikolaos Vlachadis, Chryssi Christodoulaki, Vassilios Tsamadias, Panagiotis Peitsidis, Nikolaos Machairiotis, Dimos Sioutis, Nikolaos F. Vlahos, Emmanuel Economou and Periklis Panagopoulos
J. Clin. Med. 2025, 14(7), 2355; https://doi.org/10.3390/jcm14072355 - 29 Mar 2025
Viewed by 327
Abstract
Background/Objectives: The objective of the study was to explore the combined effect of polymorphisms in the platelet glycoproteins Ia (GpIa) and IIIa (GpIIIa), along with the platelet-endothelial cell adhesion molecule-1 (PECAM-1) and P-Selectin genes, on the risk of recurrent pregnancy loss. Methods: This [...] Read more.
Background/Objectives: The objective of the study was to explore the combined effect of polymorphisms in the platelet glycoproteins Ia (GpIa) and IIIa (GpIIIa), along with the platelet-endothelial cell adhesion molecule-1 (PECAM-1) and P-Selectin genes, on the risk of recurrent pregnancy loss. Methods: This study involved 162 women with primary unexplained recurrent miscarriages and 60 fertile controls who had at least one uncomplicated full-term pregnancy without experiencing fetal loss. All participants were of Greek origin and were genotyped for four single nucleotide polymorphisms (SNPs), GpIa-C807T, GpIIIa-PlA1/PlA2, PECAM-1-C373G, and P-Selectin-A37674C, using pyrosequencing. A genetic risk score (GRS) was calculated in two forms: one based on the number of SNPs (dominant model) and the other based on the number of polymorphic alleles (additive model), utilizing logistic regression and receiver operator characteristic (ROC) analyses. Results: A statistically significant increase in the risk of miscarriage was observed with the number of polymorphic genes, with an odds ratio (OR) of 2.2 (95% confidence interval [CI]: 1.5 to 3.2, p < 0.001) for each additional SNP. The ROC analysis revealed an area under the curve (AUC) of 0.689 (95% CI: 0.614 to 0.763, p < 0.001). The presence of two or more polymorphic genes demonstrated a sensitivity of 69.8% and specificity of 65%, with an OR = 4.3 (95% CI: 2.3 to 8.0, p < 0.001). The performance of the GRS improved in younger patients and those experiencing late miscarriages. An AUC = 0.839 (95% CI: 0.749 to 0.930, p < 0.001) and an OR = 7.0 (95% CI: 2.8 to 17.8, p < 0.001) per SNP were achieved for the age group < 30 years. For subjects with second trimester fetal loss, the GRS yielded an AUC = 0.742 (95% CI: 0.610 to 0.874, p = 0.002) and an OR = 3.6 (95%OR = 7.0, 95% CI: 2.8 to 17.8) per SNP. The allelic GRS produced similar or slightly diminished results. Conclusions: This study highlights the promising potential of a genetic risk score based on four SNPs in predicting unexplained recurrent miscarriages, particularly in younger individuals and in cases of late miscarriage. These findings contribute to a deeper understanding of the epidemiology of unexplained recurrent miscarriage, emphasizing the role of platelet thrombophilia. Full article
(This article belongs to the Special Issue Clinical Management of Pregnancy-Related Complications: 2nd Edition)
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Review

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21 pages, 1334 KiB  
Review
Management of Postpartum Hemorrhage in Low- and Middle-Income Countries: Emergency Need for Updated Approach Due to Specific Circumstances, Resources, and Availabilities
by Gulzhanat Aimagambetova, Gauri Bapayeva, Gulnara Sakhipova and Milan Terzic
J. Clin. Med. 2024, 13(23), 7387; https://doi.org/10.3390/jcm13237387 - 4 Dec 2024
Cited by 1 | Viewed by 3536
Abstract
Postpartum hemorrhage (PPH) represents a critical emergency condition and the principal cause of maternal morbidity and mortality worldwide. It encompasses excessive bleeding following childbirth, which can arise from various causes. Prompt recognition and management are essential to mitigate severe outcomes and ensure maternal [...] Read more.
Postpartum hemorrhage (PPH) represents a critical emergency condition and the principal cause of maternal morbidity and mortality worldwide. It encompasses excessive bleeding following childbirth, which can arise from various causes. Prompt recognition and management are essential to mitigate severe outcomes and ensure maternal safety. The incidence of PPH in low- and middle-income countries (LMICs) is higher than in developed countries. Healthcare systems in developing countries face multiple challenges that may impact PPH management at policy, facility, and community levels. The mentioned barriers could be addressed by providing an empowering environment via the implementation of supportive policies, access to PPH care, planning supplies, allying strategies, providing training, and utilization of guidelines and algorithms for PPH management. Evidence-based international guidelines should serve as an integral part of appropriate management. On the other hand, LMICs have limited opportunities to implement the proposed international algorithms and guidelines. Therefore, some amendments based on the resource/expertise availability should be considered at the specific clinical site. This review summarizes and updates the accumulated knowledge on postpartum hemorrhage, focusing on challenging management options in developing countries. In many LMICs, maternal morbidity and mortality linked to PPH were improved after the implementation of standardized protocols and timely and purposeful interventions. International support in healthcare professionals’ training, enhancing resources, and the provision of an adapted evidence-based approach could assist in improving the management of PPH in LMICs. Refining our understanding of specific local circumstances, international support in specialists’ training, and the provision of evidence-based approaches may assist in improving the management of PPH in LMICs and contribute to safer childbirth. Full article
(This article belongs to the Special Issue Clinical Management of Pregnancy-Related Complications: 2nd Edition)
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13 pages, 1019 KiB  
Review
A Review of the Literature: Amniotic Fluid “Sludge”—Clinical Significance and Perinatal Outcomes
by Sonia-Teodora Luca, Vlăduț Săsăran, Mihai Muntean and Claudiu Mărginean
J. Clin. Med. 2024, 13(17), 5306; https://doi.org/10.3390/jcm13175306 - 7 Sep 2024
Viewed by 3165
Abstract
Introduction: This paper seeks to report and emphasize the most important aspects from the scientific literature about the diagnostic accuracy of the amniotic fluid “sludge” (AFS), its characterization, its treatment, and its association with premature birth. AFS is defined as a floating freely [...] Read more.
Introduction: This paper seeks to report and emphasize the most important aspects from the scientific literature about the diagnostic accuracy of the amniotic fluid “sludge” (AFS), its characterization, its treatment, and its association with premature birth. AFS is defined as a floating freely hyperechogenic material within the amniotic cavity in the proximity of the internal os. Materials and Methods: We conducted a search on Pubmed and Google Scholar for relevant articles on the subject of amniotic fluid “sludge” published until January 2024. Searches were focused on articles about diagnosis, treatment, maternal and neonatal outcomes, risk of preterm birth, and case reports. The full-text reading stage resulted in the inclusion of 51 studies. Results: AFS is independently associated with chorioamnionitis, preterm delivery, short cervix, increased risk of neonatal morbidity, and cervical insufficiency. This hyperechogenic free-floating material is linked with preterm birth before 32 weeks of gestation, especially when it is associated with short cervical length. Discussion: Present studies identify some controversial benefits of antibiotics in reducing the incidence of preterm birth in women with AFS. Nevertheless, in this review, we can conclude that the presence of AFS in pregnancy is a marker for the microbial invasion of the amniotic cavity, as it is associated with preterm birth. Further studies on a larger group of patients are necessary to clarify and exactly define the terms of managing these cases. Full article
(This article belongs to the Special Issue Clinical Management of Pregnancy-Related Complications: 2nd Edition)
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16 pages, 1058 KiB  
Review
The Role of Helicobacter pylori and Metabolic Syndrome-Related Mast Cell Activation Pathologies and Their Potential Impact on Pregnancy and Neonatal Outcomes
by Maria Tzitiridou-Chatzopoulou, Evangelos Kazakos, Eirini Orovou, Paraskevi Eva Andronikidi, Foteini Kyrailidi, Maria C. Mouratidou, Georgios Iatrakis and Jannis Kountouras
J. Clin. Med. 2024, 13(8), 2360; https://doi.org/10.3390/jcm13082360 - 18 Apr 2024
Cited by 1 | Viewed by 2283
Abstract
Helicobacter pylori infection, a significant global burden beyond the gastrointestinal tract, has long been implicated in various systemic pathologies. Rising evidence suggests that the bacterium’s intricate relationship with the immune system and its potential to induce chronic inflammation impact diverse pathophysiological processes in [...] Read more.
Helicobacter pylori infection, a significant global burden beyond the gastrointestinal tract, has long been implicated in various systemic pathologies. Rising evidence suggests that the bacterium’s intricate relationship with the immune system and its potential to induce chronic inflammation impact diverse pathophysiological processes in pregnant women that may in turn affect the incidence of several adverse pregnancy and neonate outcomes. Helicobacter pylori infection, which has been linked to metabolic syndrome and other disorders by provoking pericyte dysfunction, hyperhomocysteinemia, galectin-3, atrial fibrillation, gut dysbiosis, and mast cell activation pathologies, may also contribute to adverse pregnancy and neonatal outcomes. Together with increasing our biological understanding of the individual and collective involvement of Helicobacter pylori infection-related metabolic syndrome and concurrent activation of mast cells in maternal, fetus, and neonatal health outcomes, the present narrative review may foster related research endeavors to offer novel therapeutic approaches and informed clinical practice interventions to mitigate relevant risks of this critical topic among pregnant women and their offspring. Full article
(This article belongs to the Special Issue Clinical Management of Pregnancy-Related Complications: 2nd Edition)
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