Obstetrics and Gynecology Medicine: Go From Bench to Bedside

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 8 November 2024 | Viewed by 10232

Special Issue Editors


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Guest Editor
Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
Interests: fetal–maternal medicine; human pregnancy; placenta physiopathology and placental-derived mesenchymal stromal cells (PDMSCs)

Special Issue Information

Dear Colleagues,

Translational research aims to bridge the gap between laboratory studies and clinical demands by converting the achievements of basic science into everyday clinical practice. An efficient translational process is sustained by the mutual synergy of academic laboratory research and public/private hospitals. However, the process of transforming research innovations into new health products, as well as diagnostic and therapeutic strategies, remains a major issue of contemporary biomedical medicine. Among different fields of applications, over the last decades, obstetrics and gynecology have experienced a dramatic increase in several clinical and technical upgrades based on translational research discoveries. Improvements in the quality of life of cancer patients, pathological pregnancies treatments, drug discoveries, identification of new diagnostic and/or prognostic biomarkers, stem cells applications, discovery of new molecular pathways involved in obstetrics and gynecology pathophysiology as well as automation in assisted reproductive technologies represent only several examples of the clinical application of basic research. This Special Issue aims to collect original papers and innovative review articles detailing the use of basic research in translational research into obstetrics and gynecology in order to assist and support clinical practice in the near future.

Dr. Stefano Canosa
Dr. Anna Maria Nuzzo
Guest Editors

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Keywords

  • obstetrics
  • gynecology
  • translational research
  • translational medicine

Published Papers (8 papers)

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Research

Jump to: Review

10 pages, 387 KiB  
Communication
Second Trimester Amniotic Fluid Angiotensinogen Levels Linked to Increased Fetal Birth Weight and Shorter Gestational Age in Term Pregnancies
by Dionysios Vrachnis, Alexandros Fotiou, Aimilia Mantzou, Vasilios Pergialiotis, Panagiotis Antsaklis, George Valsamakis, Sofoklis Stavros, Nikolaos Machairiotis, Christos Iavazzo, Christina Kanaka-Gantenbein, George Mastorakos, Petros Drakakis, Nikolaos Vrachnis and Nikolaos Antonakopoulos
Life 2024, 14(2), 206; https://doi.org/10.3390/life14020206 - 31 Jan 2024
Viewed by 979
Abstract
Background: Despite the considerable progress made in recent years in fetal assessment, the etiology of fetal growth disturbances is not as yet well understood. In an effort to enhance our knowledge in this area, we investigated the associations of the amniotic fluid angiotensinogen [...] Read more.
Background: Despite the considerable progress made in recent years in fetal assessment, the etiology of fetal growth disturbances is not as yet well understood. In an effort to enhance our knowledge in this area, we investigated the associations of the amniotic fluid angiotensinogen of the renin–angiotensin system with fetal growth abnormalities. Methods: We collected amniotic fluid samples from 70 pregnant women who underwent amniocentesis during their early second trimester. Birth weight was documented upon delivery, after which the embryos corresponding to the respective amniotic fluid samples were categorized into three groups as follows: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Amniotic fluid angiotensinogen levels were determined by using ELISA kits. Results: Mean angiotensinogen values were 3885 ng/mL (range: 1625–5375 ng/mL), 4885 ng/mL (range: 1580–8460 ng/mL), and 4670 ng/mL (range: 1995–7250 ng/mL) in the SGA, LGA, and AGA fetuses, respectively. The concentrations in the three groups were not statistically significantly different. Although there were wide discrepancies between the mean values of the subgroups, the large confidence intervals in the three groups negatively affected the statistical analysis. However, multiple regression analysis revealed a statistically significant negative correlation between the angiotensinogen levels and gestational age and a statistically significant positive correlation between the birth weight and angiotensinogen levels. Discussion: Our findings suggest that fetal growth abnormalities did not correlate with differences in the amniotic fluid levels of angiotensinogen in early second trimester pregnancies. However, increased angiotensinogen levels were found to be consistent with a smaller gestational age at birth and increased BMI of neonates. Full article
(This article belongs to the Special Issue Obstetrics and Gynecology Medicine: Go From Bench to Bedside)
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12 pages, 789 KiB  
Article
Risk Prediction Model of Early-Onset Preeclampsia Based on Risk Factors and Routine Laboratory Indicators
by Yuting Xue, Nan Yang, Xunke Gu, Yongqing Wang, Hua Zhang and Keke Jia
Life 2023, 13(8), 1648; https://doi.org/10.3390/life13081648 - 28 Jul 2023
Cited by 2 | Viewed by 1596
Abstract
Background: Globally, 10–15% of maternal deaths are statistically attributable to preeclampsia. Compared with late-onset PE, the severity of early-onset PE remains more harmful with higher morbidity and mortality. Objective: To establish an early-onset preeclampsia prediction model by clinical characteristics, risk factors and routine [...] Read more.
Background: Globally, 10–15% of maternal deaths are statistically attributable to preeclampsia. Compared with late-onset PE, the severity of early-onset PE remains more harmful with higher morbidity and mortality. Objective: To establish an early-onset preeclampsia prediction model by clinical characteristics, risk factors and routine laboratory indicators were investigated from pregnant women at 6 to 10 gestational weeks. Methods: The clinical characteristics, risk factors, and 38 routine laboratory indicators (6–10 weeks of gestation) including blood lipids, liver and kidney function, coagulation, blood count, and other indicators of 91 early-onset preeclampsia patients and 709 normal controls without early-onset preeclampsia from January 2010 to May 2021 in Peking University Third Hospital (PUTH) were retrospectively analyzed. A logistic regression, decision tree model, and support vector machine (SVM) model were applied for establishing prediction models, respectively. ROC curves were drawn; area under curve (AUCROC), sensitivity, and specificity were calculated and compared. Results: There were statistically significant differences in the rates of diabetes, antiphospholipid syndrome (APS), kidney disease, obstructive sleep apnea (OSAHS), primipara, history of preeclampsia, and assisted reproductive technology (ART) (p < 0.05). Among the 38 routine laboratory indicators, there were no significant differences in the levels of PLT/LYM, NEU/LYM, TT, D-Dimer, FDP, TBA, ALP, TP, ALB, GLB, UREA, Cr, P, Cystatin C, HDL-C, Apo-A1, and Lp(a) between the two groups (p > 0.05). The levels of the rest indicators were all statistically different between the two groups (p < 0.05). If only 12 risk factors of PE were analyzed with the logistic regression, decision tree model, and support vector machine (SVM), and the AUCROC were 0.78, 0.74, and 0.66, respectively, while 12 risk factors of PE and 38 routine laboratory indicators were analyzed with the logistic regression, decision tree model, and support vector machine (SVM), and the AUCROC were 0.86, 0.77, and 0.93, respectively. Conclusions: The efficacy of clinical risk factors alone in predicting early-onset preeclampsia is not high while the efficacy increased significantly when PE risk factors combined with routine laboratory indicators. The SVM model was better than logistic regression model and decision tree model in early prediction of early-onset preeclampsia incidence. Full article
(This article belongs to the Special Issue Obstetrics and Gynecology Medicine: Go From Bench to Bedside)
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12 pages, 259 KiB  
Article
Outcomes of Pregnancy in COVID-19-Positive Mothers in a Tertiary Centre
by Vigneshwaran Subramaniam, Beng Kwang Ng, Su Ee Phon, Hamizan Muhammad Rafi’uddin, Abd Razak Wira Sorfan, Abd Azman Siti Hajar and Mohamed Ismail Nor Azlin
Life 2023, 13(7), 1491; https://doi.org/10.3390/life13071491 - 30 Jun 2023
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Abstract
Background: COVID-19 is an emerging global pandemic with potential adverse effects during pregnancy. This study aimed to determine the adverse maternal and foetal outcomes due to COVID-19 infection. We also compared maternal and neonatal outcomes with regard to the timing of diagnosis (first [...] Read more.
Background: COVID-19 is an emerging global pandemic with potential adverse effects during pregnancy. This study aimed to determine the adverse maternal and foetal outcomes due to COVID-19 infection. We also compared maternal and neonatal outcomes with regard to the timing of diagnosis (first and second trimester vs. third and fourth trimester); early COVID-19 (stage I and II) vs. severe-stage COVID-19 (III, IV, and V); and lastly, women who were partially vaccinated vs. unvaccinated. Methods: This was a retrospective study conducted in HCTM from January 2021 to January 2022. All pregnant women admitted for COVID-19 infections were recruited. The patients’ records were traced. Adverse maternal and neonatal outcomes were documented and analysed. Results: There were 172 pregnant women recruited into this study. We excluded twenty-four patients with incomplete data and nine women who delivered elsewhere. The final 139 patients were available for data analysis. The majority of women were in their third trimester of pregnancy (87.8%); however, only 5.0% and 7.2% were in the first and second trimesters, respectively. The study population had a median BMI of 29.1 kg/m2 and almost half of them had never received a COVID-19 vaccination. A sub-analysis of data concerning adverse maternal and foetal outcomes comparing early vs. severe stages of COVID-19 infection showed that severe-stage disease increased the risk of preterm birth (54.5% vs. 15.4%, p < 0.001) and preterm birth before 34 weeks (31.9% vs. 2.6%, p < 0.001) significantly. The severe-stage disease also increased NICU admission (40.9% vs. 15.4%, p = 0.017) with lower birth weight (2995 g vs. 2770 g, p = 0.017). The unvaccinated mothers had an increased risk of preterm birth before 34 weeks and this was statistically significant (11.6% vs. 2.9%, p = 0.048). Conclusions: Adverse pregnancy outcomes such as ICU admission or patient death could occur; however, the clinical course of COVID-19 in most women was not severe and the infection did not significantly influence the pregnancy. The risk of preterm birth before 34 weeks was higher in a more severe-stage disease and unvaccinated mother. The findings from this study can guide and enhance antenatal counselling of women with COVID-19 infection, although they should be interpreted with caution in view of the very small number of included cases of patients in the first and second trimesters. Full article
(This article belongs to the Special Issue Obstetrics and Gynecology Medicine: Go From Bench to Bedside)

Review

Jump to: Research

13 pages, 6261 KiB  
Review
Abdominal Parietal Metastasis from Cervical Cancer: A Review of One of the Most Uncommon Sites of Recurrence Including a Report of a New Case
by Irinel-Gabriel Dicu-Andreescu, Marian-Augustin Marincaș, Anca-Angela Simionescu, Ioana Dicu-Andreescu, Virgiliu-Mihail Prunoiu, Sânziana-Octavia Ionescu, Ștefania-Ariana Neicu, Gabriela-Mădălina Radu, Eugen Brătucu and Laurențiu Simion
Life 2024, 14(6), 667; https://doi.org/10.3390/life14060667 - 23 May 2024
Viewed by 428
Abstract
Introduction: Cervical cancer is the fourth most common cancer in women, the highest mortality being found in low- and middle-income countries. Abdominal parietal metastases in cervical cancer are a very rare entity, with an incidence of 0.1–1.3%, and represent an unfavorable prognostic factor [...] Read more.
Introduction: Cervical cancer is the fourth most common cancer in women, the highest mortality being found in low- and middle-income countries. Abdominal parietal metastases in cervical cancer are a very rare entity, with an incidence of 0.1–1.3%, and represent an unfavorable prognostic factor with the survival rate falling to 17%. Here, we present a review of cases of abdominal parietal metastasis in recent decades, including a new case of a 4.5 cm abdominal parietal metastasis at the site of the scar of the former drain tube 28 months after diagnosis of stage IIB cervical cancer (adenosquamous carcinoma), treated by external radiotherapy with concurrent chemotherapy and intracavitary brachytherapy and subsequent surgery (type B radical hysterectomy). The tumor was resected within oncological limits with the histopathological result of adenosquamous carcinoma. The case study highlights the importance of early detection and appropriate treatment of metastases in patients with cervical cancer. The discussion explores the potential pathways for parietal metastasis and the impact of incomplete surgical procedures on the development of metastases. The conclusion emphasizes the poor prognosis associated with this type of metastasis in cervical cancer patients and the potential benefits of surgical resection associated with systemic therapy in improving survival rates. Full article
(This article belongs to the Special Issue Obstetrics and Gynecology Medicine: Go From Bench to Bedside)
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15 pages, 1464 KiB  
Review
From Satirical Poems and Invisible Poisons to Radical Surgery and Organized Cervical Cancer Screening—A Historical Outline of Cervical Carcinoma and Its Relation to HPV Infection
by Leonard Jung, Gilbert Georg Klamminger, Bert Bier and Elke Eltze
Life 2024, 14(3), 307; https://doi.org/10.3390/life14030307 - 27 Feb 2024
Viewed by 1101
Abstract
Over the last century, the narrative of cervical cancer history has become intricately tied to virus research, particularly the human papillomavirus (HPV) since the 1970s. The unequivocal proof of HPV’s causal role in cervical cancer has placed its detection at the heart of [...] Read more.
Over the last century, the narrative of cervical cancer history has become intricately tied to virus research, particularly the human papillomavirus (HPV) since the 1970s. The unequivocal proof of HPV’s causal role in cervical cancer has placed its detection at the heart of early screening programs across numerous countries. From a historical perspective, sexually transmitted genital warts have been already documented in ancient Latin literature; the remarkable symptoms and clinical descriptions of progressed cervical cancer can be traced back to Hippocrates and classical Greece. However, in the new era of medicine, it was not until the diagnostic–pathological accomplishments of Aurel Babeş and George Nicolas Papanicolaou, as well as the surgical accomplishments of Ernst Wertheim and Joe Vincent Meigs, that the prognosis and prevention of cervical carcinoma were significantly improved. Future developments will likely include extended primary prevention efforts consisting of better global access to vaccination programs as well as adapted methods for screening for precursor lesions, like the use of self-sampling HPV-tests. Furthermore, they may also advantageously involve additional novel diagnostic methods that could allow for both an unbiased approach to tissue diagnostics and the use of artificial-intelligence-based tools to support decision making. Full article
(This article belongs to the Special Issue Obstetrics and Gynecology Medicine: Go From Bench to Bedside)
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17 pages, 1613 KiB  
Review
Artificial Intelligence in Obstetric Anomaly Scan: Heart and Brain
by Iuliana-Alina Enache, Cătălina Iovoaica-Rămescu, Ștefan Gabriel Ciobanu, Elena Iuliana Anamaria Berbecaru, Andreea Vochin, Ionuț Daniel Băluță, Anca Maria Istrate-Ofițeru, Cristina Maria Comănescu, Rodica Daniela Nagy and Dominic Gabriel Iliescu
Life 2024, 14(2), 166; https://doi.org/10.3390/life14020166 - 23 Jan 2024
Viewed by 1186
Abstract
Background: The ultrasound scan represents the first tool that obstetricians use in fetal evaluation, but sometimes, it can be limited by mobility or fetal position, excessive thickness of the maternal abdominal wall, or the presence of post-surgical scars on the maternal abdominal wall. [...] Read more.
Background: The ultrasound scan represents the first tool that obstetricians use in fetal evaluation, but sometimes, it can be limited by mobility or fetal position, excessive thickness of the maternal abdominal wall, or the presence of post-surgical scars on the maternal abdominal wall. Artificial intelligence (AI) has already been effectively used to measure biometric parameters, automatically recognize standard planes of fetal ultrasound evaluation, and for disease diagnosis, which helps conventional imaging methods. The usage of information, ultrasound scan images, and a machine learning program create an algorithm capable of assisting healthcare providers by reducing the workload, reducing the duration of the examination, and increasing the correct diagnosis capability. The recent remarkable expansion in the use of electronic medical records and diagnostic imaging coincides with the enormous success of machine learning algorithms in image identification tasks. Objectives: We aim to review the most relevant studies based on deep learning in ultrasound anomaly scan evaluation of the most complex fetal systems (heart and brain), which enclose the most frequent anomalies. Full article
(This article belongs to the Special Issue Obstetrics and Gynecology Medicine: Go From Bench to Bedside)
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12 pages, 1681 KiB  
Review
Hydatidiform Mole—Between Chromosomal Abnormality, Uniparental Disomy and Monogenic Variants: A Narrative Review
by Andreea Florea, Lavinia Caba, Ana-Maria Grigore, Lucian-Mihai Antoci, Mihaela Grigore, Mihaela I. Gramescu and Eusebiu Vlad Gorduza
Life 2023, 13(12), 2314; https://doi.org/10.3390/life13122314 - 10 Dec 2023
Viewed by 1759
Abstract
A hydatidiform mole (HM) or molar pregnancy is the most common benign form of gestational trophoblastic disease characterized by a proliferation of the trophoblastic epithelium and villous edema. Hydatidiform moles are classified into two forms: complete and partial hydatidiform moles. These two types [...] Read more.
A hydatidiform mole (HM) or molar pregnancy is the most common benign form of gestational trophoblastic disease characterized by a proliferation of the trophoblastic epithelium and villous edema. Hydatidiform moles are classified into two forms: complete and partial hydatidiform moles. These two types of HM present morphologic, histopathologic and cytogenetic differences. Usually, hydatidiform moles are a unique event, but some women present a recurrent form of complete hydatidiform moles that can be sporadic or familial. The appearance of hydatidiform moles is correlated with some genetic events (like uniparental disomy, triploidy or diandry) specific to meiosis and is the first step of embryo development. The familial forms are determined by variants in some genes, with NLRP7 and KHDC3L being the most important ones. The identification of different types of hydatidiform moles and their subsequent mechanisms is important to calculate the recurrence risk and estimate the method of progression to a malign form. This review synthesizes the heterogeneous mechanisms and their implications in genetic counseling. Full article
(This article belongs to the Special Issue Obstetrics and Gynecology Medicine: Go From Bench to Bedside)
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14 pages, 1068 KiB  
Review
The Task Matters: A Comprehensive Review and Proposed Literature Score of the Effects of Chemical and Physical Parameters on Embryo Developmental Competence
by Alessandro Bartolacci, Francesca Tondo, Alessandra Alteri, Lisett Solano Narduche, Sofia de Girolamo, Giulia D’Alessandro, Elisa Rabellotti, Enrico Papaleo and Luca Pagliardini
Life 2023, 13(11), 2161; https://doi.org/10.3390/life13112161 - 3 Nov 2023
Cited by 2 | Viewed by 1031
Abstract
To explore the effects of chemical and physical parameters on embryo developmental competence, we conducted a systematic search on PubMed for peer-reviewed original papers using specific keywords and medical subject heading terms. Studies of interest were selected from an initial cohort of 4141 [...] Read more.
To explore the effects of chemical and physical parameters on embryo developmental competence, we conducted a systematic search on PubMed for peer-reviewed original papers using specific keywords and medical subject heading terms. Studies of interest were selected from an initial cohort of 4141 potentially relevant records retrieved. The most relevant publications were critically evaluated to identify the effect of these parameters on embryo development. Moreover, we generated a literature score (LS) using the following procedure: (i) the number of studies favoring a reference group was expressed as a fraction of all analyzed papers; (ii) the obtained fraction was multiplied by 10 and converted into a decimal number. We identified and discussed six parameters (oxygen, temperature, humidity, oil overlay, light, pH). Moreover, we generated a LS according to five different comparisons (37 °C vs. <37 °C; 5% vs. 20% oxygen; 5–2% vs. 5% oxygen; humidity conditions vs. dry conditions; light exposure vs. reduced/protected light exposure). Only two comparisons (37 °C vs. <37 °C and 5% vs. 20% oxygen) yielded a medium-high LS (8.3 and 7, respectively), suggesting a prevalence of studies in favor of the reference group (37 °C and 5% oxygen). In summary, this review and LS methodology offer semi-quantitative information on studies investigating the effects of chemical and physical parameters on embryo developmental competence. Full article
(This article belongs to the Special Issue Obstetrics and Gynecology Medicine: Go From Bench to Bedside)
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