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Medicina
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Diagnosis, Evaluation, and Management of Diseases During Pregnancy: Third Edition
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Diagnosis, Evaluation, and Management of Diseases During Pregnancy: Third Edition

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: closed (20 November 2025) | Viewed by 4690

Special Issue Editors

Prof. Dr. Marius L. Craina

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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
Special Issues, Collections and Topics in MDPI journals
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,

How an individual’s associated comorbidities can affect their pregnancy has always been an essential concern for medical specialists. The presence of these health conditions, no matter how minor, requires additional evaluation and appropriate treatment to avoid complications. They can worsen throughout the gestation period, influencing maternal health status, the evolution of pregnancy, and the outcome of birth. Thus, a perinatologist evaluates the pathology in collaboration with a specialist to reach the most favorable outcome for the patient and the fetus.

Despite success in understanding the pathophysiology and treatment development of multiple pathological conditions over the last few decades, many questions remain unsolved. Therefore, the purpose of this Special Issue is to share current management strategies regarding maternal-associated pathology from personal acquired experience and guidelines worldwide. This Special Issue will allow specialists worldwide to access public results of state-of-the-art research in prenatal care in cases with comorbidities. Moreover, this Special Issue aims to collect papers that reflect further progress in this field in the form of original research manuscripts, reviews, and case reports.

This Special Issue is the continuation of the Special Issue "Diagnosis, Evaluation, and Management of Diseases during Pregnancy: Part II".

Prof. Dr. Marius L. Craina
Dr. Elena Bernad
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 250 words) can be sent to the Editorial Office for assessment.

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. Medicina is an international peer-reviewed open access monthly 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 2200 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 prenatal care
  • high risk
  • pathology
  • genetics
  • endocrine system diseases
  • nutrition disorders
  • cardiovascular diseases
  • female urogenital diseases
  • immune system diseases
  • infections
  • neoplasms

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Related Special Issue

Published Papers (5 papers)

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Research

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13 pages, 1360 KB  
Article
Prenatal Diagnosis and Postnatal Outcomes of Fetal ADPKD: A Single-Center Retrospective Cohort Study
by Suhra Kim, Ju-hee Yoon, Yun Ji Jung, Hayan Kwon, JoonHo Lee, Ja-Young Kwon and Young-Han Kim
Medicina 2025, 61(12), 2145; https://doi.org/10.3390/medicina61122145 - 30 Nov 2025
Viewed by 239
Abstract
Background/Objectives: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder; it is typically diagnosed in adulthood, but occasionally presents antenatally as very-early onset ADPKD. Despite advances in prenatal ultrasonography, knowledge regarding the postnatal course of fetal ADPKD remains limited, [...] Read more.
Background/Objectives: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder; it is typically diagnosed in adulthood, but occasionally presents antenatally as very-early onset ADPKD. Despite advances in prenatal ultrasonography, knowledge regarding the postnatal course of fetal ADPKD remains limited, restricting reliable prognostic assessment and prenatal counselling. This study aimed to evaluate the prenatal sonographic features of fetal ADPKD and their correlation with postnatal outcomes. Materials and Methods: We retrospectively reviewed 20 cases of prenatally suspected ADPKD diagnosed at a single tertiary referral center between 2006 and 2024. Prenatal ultrasonographic findings including renal size, cortical echogenicity, corticomedullary differentiation (CMD), and cortical cysts were analyzed and correlated with postnatal clinical and genetic outcomes. Postnatal follow-up data, including renal function and progression to chronic kidney disease (CKD), were collected with a median follow-up of 93.6 months. Results: The most consistent prenatal ultrasonographic findings were increased cortical echogenicity (85%), increased CMD (75%), and renal enlargement (35%), with cortical cysts detected in 45% of cases. Amniotic fluid volume was preserved in most cases (80%). Postnatally, most infants maintained normal or near-normal renal function, although two progressed to CKD. Both CKD cases demonstrated absent CMD on prenatal imaging. Sonographic features resembling autosomal recessive polycystic kidney disease (ARPKD) were associated with adverse outcomes. Although CMD severity showed no correlation with short-term neonatal outcomes, loss of CMD may still serve as a potential early indicator of long-term renal dysfunction. Conclusions: Fetal ADPKD was associated with heterogeneous postnatal outcomes. Loss of CMD and ARPKD-like sonographic appearances may be associated with adverse prognosis, whereas most infants maintained preserved renal function. Early recognition of ADPKD is crucial for accurate counselling, appropriate perinatal management, and long-term surveillance. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases During Pregnancy: Third Edition)
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16 pages, 3219 KB  
Article
Oral, Vaginal, and Placental Microbiota Profiles in Japanese Pregnancies with Preterm Birth and Chronic Abruption-Oligohydramnios Sequence (CAOS): A Cross-Sectional Study
by Yuka Fukuma, Yoshifumi Kasuga, Keisuke Akita, Junko Tamai, Yuya Tanaka, Keita Hasegawa, Toshimitsu Otani, Marie Fukutake, Satoru Ikenoue, Satoru Morikawa, Taneaki Nakagawa, Kazuyuki Ishihara and Mamoru Tanaka
Medicina 2025, 61(12), 2096; https://doi.org/10.3390/medicina61122096 - 25 Nov 2025
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Abstract
Background and Objectives: Preterm birth (PTB) imposes a substantial medical and economic burden on perinatal care. Recent advances in 16S rRNA gene sequencing help detailed microbiota analysis. Understanding microbiota’s contribution may help in understanding PTB pathogenesis. We aim to investigate the microbiota [...] Read more.
Background and Objectives: Preterm birth (PTB) imposes a substantial medical and economic burden on perinatal care. Recent advances in 16S rRNA gene sequencing help detailed microbiota analysis. Understanding microbiota’s contribution may help in understanding PTB pathogenesis. We aim to investigate the microbiota profiles of the oral, vaginal, and placental microbiota in pregnant Japanese women hospitalized for care of preterm labor and examine the association between them and perinatal outcomes. Materials and Methods: This cross-sectional study included 20 pregnant Japanese women admitted to a single perinatal center for preterm labor between 2022 and 2023. Oral, vaginal, and placental samples were collected aseptically during hospitalization. The patients were retrospectively categorized into: term birth (TB, n = 10), chronic abruption-oligohydramnios sequence (CAOS, n = 3), and PTB without CAOS (PTB, n = 7) perinatal outcomes. Microbiota profiles were analyzed using 16S rRNA gene sequencing, and group comparisons were performed using univariate statistical methods. Results: Alpha or beta diversity of the oral and vaginal microbiota among the three groups did not differ significantly. CAOS and PTB groups showed a trend toward altered vaginal microbial composition, but not the TB group. In the placental microbiota, beta diversity differed significantly among the TB, PTB, and CAOS groups. Ureaplasma urealyticum was more abundant in the PTB group, whereas Ureaplasma parvum was more abundant in the CAOS group. Conclusions: A potential shift in the vaginal microbiota and alterations in the placental microbiota, observed in PTB, including CAOS, suggested a possible microbial contribution. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases During Pregnancy: Third Edition)
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15 pages, 1159 KB  
Article
Maternal and Fetal–Neonatal Complications of Romanian Women with Gestational Diabetes: A Retrospective Comparative Study
by Adriana Gherbon, Mirela Frandes, Corina Dalia Toderescu, Darius Dirpes, Romulus Timar, Marioara Neagu Nicula, Calin Dascau, Razvan Daniluc and Bogdan Timar
Medicina 2025, 61(7), 1190; https://doi.org/10.3390/medicina61071190 - 30 Jun 2025
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Abstract
Background and Objectives: Gestational diabetes mellitus (GDM) is a complex condition characterized by metabolic disorders of blood glucose that significantly impact the health of both mother and fetus. The objectives of this study were to assess the prevalence and risk factors for maternal [...] Read more.
Background and Objectives: Gestational diabetes mellitus (GDM) is a complex condition characterized by metabolic disorders of blood glucose that significantly impact the health of both mother and fetus. The objectives of this study were to assess the prevalence and risk factors for maternal and fetal–neonatal complications in women with GDM, comparing them to a control group (pregnant women without GDM) and pregnant women with type 1 diabetes mellitus (T1DM) or type 2 diabetes (T2DM). Materials and Methods: A retrospective observational study was conducted with 1418 pregnant women (279 with GDM, 74 with T1DM, 107 with T2DM, and 958 in the control group). The retrospective data included information on demographics, diagnostic test results, the medical history of pregnant women, treatments administered, identified complications, and other relevant variables for the study’s purpose. Results: Significant differences were found regarding maternal and neo-fetal complications between GDM and the control group in terms of abortion, pregnancy-induced hypertension, and increased fetal weight (macrosomia). Women with T1DM and T2DM showed a higher rate of abortion, premature birth, and an APGAR score of <7 at 5 min compared to those with GDM, and for T1DM, there was a higher rate of fetal mortality than in GDM cases. The primary risk factors for maternal complications included age OR = 1.03 (95% CI: 1.01–1.05, p = 0.002), obesity OR = 2.37 (95% CI: 1.42–3.94, p < 0.001), and chronic hypertension OR = 2.51 (95% CI: 1.26–5.01, p = 0.009). Age and obesity were also significant cofactors for maternal complications. Furthermore, the main significant risk factors for fetal–neonatal complications were obesity OR = 2.481 (95% CI:1.49–4.12, p < 0.001) and chronic hypertension OR = 2.813 (95% CI:1.44–5.49, p = 0.002), both independently and as cofactors. Conclusions: We found that obesity and chronic hypertension are risk factors for both maternal and fetal–neonatal complications. It is essential to prevent and adequately treat these two factors among pregnant women to avoid the onset of GDM. Additionally, screening for GDM is necessary to prevent maternal and fetal complications. Our results highlight the importance of specialized medical care and tailored management protocols in mitigating risks and ensuring positive outcomes for both mother and child during and after childbirth. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases During Pregnancy: Third Edition)
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12 pages, 301 KB  
Article
Circulating Potassium/Magnesium Ratio, Thyroid Stimulating Hormone, Fasting Plasma Glucose, Oxidized LDL/Albumin Ratio, and Urinary Iodine Concentration Are Possible Entities for Screening for Preeclampsia in Low-Resource Settings
by Charles Bitamazire Businge, Benjamin Longo-Mbenza and Andre Pascal Kengne
Medicina 2025, 61(4), 600; https://doi.org/10.3390/medicina61040600 - 26 Mar 2025
Cited by 1 | Viewed by 1030
Abstract
Background and Objectives: Several micro- and macro-nutrient malnutrition states that are routinely assessed during clinical care of women in the antenatal period have been proposed as risk factors for preeclampsia. However, there is a paucity of data on the potential use of [...] Read more.
Background and Objectives: Several micro- and macro-nutrient malnutrition states that are routinely assessed during clinical care of women in the antenatal period have been proposed as risk factors for preeclampsia. However, there is a paucity of data on the potential use of these biomarkers for detection of preeclampsia. The aim of this case-control study was to investigate the association of biomarkers from routine clinical tests, and those specific to micro- and macro-nutrient malnutrition, with the risk of preeclampsia. Materials and Methods: Venous blood samples of 250 participants with preeclampsia and 150 pregnant women without preeclampsia were collected and assayed immediately for the full blood count, urea and electrolytes, high-density cholesterol (HDL), total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL), oxidized low-density lipoprotein cholesterol (OxLDL), and selenium, in addition to urine iodine concentration (UIC). Results: The serum potassium/magnesium ratio (K+/Mg2+), UIC, fasting plasma glucose (FPG), thyroid stimulating hormone (TSH), lymphocyte percentage (L/WBC%), and the oxidized LDL/albumin ratio (OxLDL/Alb) were identified as independent predictors of preeclampsia. Conclusions: Serum potassium/magnesium ratio and other analytes essential for various biological processes, some of which are assayed during routine care, were significantly associated with preeclampsia, warranting further exploration as potential screening biomarkers in low-resource settings. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases During Pregnancy: Third Edition)

Review

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15 pages, 310 KB  
Review
Prognostic Significance of Serial Ultrasonography in Placenta Accreta Spectrum and Its Impact on Perinatal Outcomes
by Antonia Varthaliti, Alexandros Psarris, Pelopidas Koutroumanis, Giwrgos Gkiaourakis, Maria Anastasia Daskalaki, Panos Antsaklis, George Daskalakis and Marianna Theodora
Medicina 2025, 61(9), 1612; https://doi.org/10.3390/medicina61091612 - 5 Sep 2025
Viewed by 1352
Abstract
Placenta accreta spectrum (PAS) disorders remain a major cause of maternal morbidity and adverse perinatal outcomes due to abnormal placental adherence and invasion. Early and accurate prenatal diagnosis is essential to optimize surgical planning and reduce complications. Although ultrasound is well established as [...] Read more.
Placenta accreta spectrum (PAS) disorders remain a major cause of maternal morbidity and adverse perinatal outcomes due to abnormal placental adherence and invasion. Early and accurate prenatal diagnosis is essential to optimize surgical planning and reduce complications. Although ultrasound is well established as the cornerstone for PAS detection, the potential role of serial ultrasonography in refining risk assessment and predicting outcomes is increasingly being explored. Monitoring with serial ultrasonographic imaging may offer valuable insights into the progression of sonographic features, such as placental lacunae, myometrial thinning, placental bulge, and bladder wall disruption, which can predict surgical complexity and perinatal risk and influence decision-making and management. However, there is still limited evidence about the prognostic value of serial scans, and the variability in interpreting ultrasound markers continues, presenting challenges. While scoring systems incorporating ultrasound features show promise for risk stratification, further validation in larger studies is needed. Future research should focus on standardizing ultrasound protocols, validating predictive models, and exploring technological innovations, including artificial intelligence, to enhance diagnostic precision. Incorporating serial ultrasound assessments thoughtfully into clinical practice may improve individualized care and outcomes for women affected by PAS, but more studies are required. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases During Pregnancy: Third Edition)
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