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Medicina
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Advances in Obstetrics and Maternal-Fetal Medicine
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Advances in Obstetrics and Maternal-Fetal Medicine

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

Deadline for manuscript submissions: 28 February 2026 | Viewed by 7575

Special Issue Editors

Prof. Dr. Nicolae Suciu

E-Mail Website
Guest Editor
1. Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
2. Department of Obstetrics and Gynecology, National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania
Interests: maternal-fetal medicine; fetal ultrasound; gynaecologic oncology; laparoscopy
Dr. Catalin G Herghelegiu

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania
Interests: maternal fetal medicine; fetal ultrasound; gynaecologic oncology

Special Issue Information

Dear Colleagues,

We are pleased to announce the launch of a Special Issue titled "Advances in Obstetrics and Maternal-Fetal Medicine", which will highlight the latest technologies and clinical practices in the field. This Special Issue will gather experts and researchers globally to discuss innovations, address current challenges, and outline future directions in obstetrics and maternal-fetal medicine.

With rapid technological advancements, obstetrics and prenatal diagnosis have evolved remarkably. From conventional invasive genetic testing including amniocentesis, we have transitioned to modern genetic testing, including non-invasive prenatal testing. Recent advances in ultrasound imaging have improved our understanding of early anatomical developmental and the possibility to detect a wide spectrum of congenital abnormalities before birth. Also, ultrasound plays a central role in fetal assessment and management of high-risk pregnancies complicated by fetal growth restriction, preeclampsia, hypertension, cardiovascular disease, diabetes and other maternal medical conditions. These innovations have greatly enhanced both the accuracy and safety of prenatal diagnoses allowing adequate case management and counseling.

This Special Issue will focus on recent advances in genetic testing, fetal ultrasound and management of high-risk pregnancies, covering their underlying principles, clinical application and personal experience in using the latest diagnostic and imagistic methods. By analyzing key case studies, we aim to assess the benefits and limitations of these technologies, offering valuable insights and practical recommendations for clinicians.

In summary, "Advances in Obstetrics and Maternal-Fetal Medicine" will provide a comprehensive overview of cutting-edge research and technological developments, offering academic and clinical insights to support the continued evolution of obstetrics and maternal-fetal medicine.

We invite experts and scholars in this field to contribute and collaborate, furthering the advancement of prenatal technologies for the betterment of human health worldwide.

All types of manuscripts are welcome, including original articles and reviews (narrative and systematic with/without meta-analysis).

We look forward to your active participation.

Sincerely,

Prof. Dr. Nicolae Suciu
Dr. Catalin G Herghelegiu
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. 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

  • prenatal diagnosis
  • fetal ultrasound
  • maternal-fetal medicine
  • genomic sequencing
  • non-invasive prenatal testing (NIPT)
  • perinatal pathology
  • high-risk pregnancy

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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9 pages, 261 KiB  
Article
Evaluating Maternal Healthcare Quality Through the Lens of Maternal near Miss: A Retrospective Analysis from a High-Volume Tertiary Center
by İbrahim Polat and Tuğçe Arslanoğlu
Medicina 2025, 61(8), 1485; https://doi.org/10.3390/medicina61081485 - 19 Aug 2025
Abstract
Background and Objectives: As maternal mortality has become increasingly rare in developed countries, it is no longer a reliable metric for evaluating obstetric care quality. To address this limitation, the World Health Organization (WHO) introduced the concept of maternal near miss (MNM)—a term [...] Read more.
Background and Objectives: As maternal mortality has become increasingly rare in developed countries, it is no longer a reliable metric for evaluating obstetric care quality. To address this limitation, the World Health Organization (WHO) introduced the concept of maternal near miss (MNM)—a term adapted from aviation—to standardize the identification and analysis of severe maternal complications. In addition to MNM, various indices are used to assess both access to and the quality of healthcare services. Materials and Methods: This retrospective study evaluated all pregnant women who presented at Başakşehir Çam and Sakura City Hospital, including postpartum referrals, between May 2020 and May 2023. Given the ongoing COVID-19 pandemic during the study period, data from COVID-19-positive patients were reported separately. All definitions and classifications were based on the standardized WHO MNM criteria. Results: A total of 45,458 births occurred at our institution during the study period. Among the COVID-19-excluded cohort, we identified 223 life-threatening conditions (LTCs), 206 MNM cases, and 17 maternal deaths. The resulting mortality index was 7.62%. The most frequent primary diagnoses included placental invasion anomalies, severe preeclampsia, and uterine atony. The most common interventions among LTC cases were ICU admission, prolonged hospitalization, hysterectomy, and massive transfusion. Conclusions: Although the rates of LTCs, MNM, and maternal mortality (MM) are gradually declining, they remain essential metrics for assessing healthcare quality. This study reveals that, while tertiary centers may report higher-than-global-average indices, there remains a significant gap between current outcomes and ideal targets. Enhancing diagnostic training, optimizing intervention strategies, and implementing robust clinical algorithms are critical steps toward reducing severe maternal morbidity and mortality. Full article
(This article belongs to the Special Issue Advances in Obstetrics and Maternal-Fetal Medicine)
24 pages, 6020 KiB  
Article
Seasonal Patterns of Preterm Birth During the COVID-19 Pandemic: A Retrospective Cohort Study in Romania
by Paula Trif, Cristian Sava, Diana Mudura, Boris W. Kramer, Radu Galiș, Maria Livia Ognean, Alin Iuhas and Claudia Maria Jurca
Medicina 2025, 61(8), 1398; https://doi.org/10.3390/medicina61081398 - 1 Aug 2025
Viewed by 334
Abstract
Background and Objectives: Preterm birth and stillbirth are primary adverse pregnancy outcomes. Research during the COVID-19 pandemic revealed reductions in preterm birth in some countries, while stillbirth rates increased or remained unchanged. These findings suggest the presence of preventable risk factors associated with [...] Read more.
Background and Objectives: Preterm birth and stillbirth are primary adverse pregnancy outcomes. Research during the COVID-19 pandemic revealed reductions in preterm birth in some countries, while stillbirth rates increased or remained unchanged. These findings suggest the presence of preventable risk factors associated with changes in physical activity and lower exposure to community-acquired infections due to lockdown measures, altered social interaction patterns or reduced access to antenatal care. Assessing seasonal variation may offer insights into whether lifestyle changes during the COVID-19 lockdown period influenced preterm birth rates. Materials and Methods: This retrospective cohort study used data from the electronic medical records of Bihor and Sibiu counties. Preterm deliveries (<37 weeks) and stillbirths during the COVID-19 pandemic (2020 and 2021) were compared with the corresponding pre-pandemic (2018 and 2019) and post-pandemic (2022 and 2023) period. Preterm birth rates during summer and winter in the pre-pandemic, pandemic, and post-pandemic years were analyzed. A comparison with rates during strict lockdown was made. Results: Out of 52,021 newborn infants, 4473 were born preterm. Preterm birth rates remained stable across all three periods (p = 0.13), and no significant seasonal pattern was identified (p = 0.65). In contrast, stillbirth rates increased notably during the strict lockdown period, with the median incidence almost doubling compared to other periods (0.87%, p = 0.05), while remaining unchanged during the rest of the pandemic (p = 0.52). Conclusions: Our study found that preterm birth rates remained unaffected by the pandemic and lockdown periods, while stillbirths increased significantly during the strict lockdown. These findings highlight the importance of maintaining access to timely antenatal care during public health emergencies to prevent adverse perinatal outcomes. Full article
(This article belongs to the Special Issue Advances in Obstetrics and Maternal-Fetal Medicine)
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11 pages, 1825 KiB  
Article
Feasibility of Ductus Venosus Doppler Screening During First Trimester Ultrasound: Prospective Multicenter Study
by Félicia Joinau-Zoulovits, Anissa Bouzidi, Françoise Etienne and Christine Levêque
Medicina 2025, 61(8), 1391; https://doi.org/10.3390/medicina61081391 - 31 Jul 2025
Viewed by 329
Abstract
Background and Objectives: Doppler abnormalities in the ductus venosus (DV) during the first trimester can serve as an early marker for the detection of congenital heart defects (CHDs), but the feasibility of systematically assessing the DV remains underexplored. This study aimed to [...] Read more.
Background and Objectives: Doppler abnormalities in the ductus venosus (DV) during the first trimester can serve as an early marker for the detection of congenital heart defects (CHDs), but the feasibility of systematically assessing the DV remains underexplored. This study aimed to evaluate the feasibility of performing DV assessments during routine first-trimester ultrasound screenings. Materials and Methods: A multicenter, prospective, and descriptive study was conducted, including singleton pregnancies undergoing routine ultrasound screening between 11 + 0 and 13 + 6 weeks of gestation. Sonographers were instructed to acquire DV Doppler images during the scan, and each image was blindly reviewed by an expert using predefined quality criteria. The images were categorized as “good”, “medium”, or “unsatisfactory”, and feasibility was defined as the proportion of “good” images. Factors associated with feasibility were analyzed, including sonographer satisfaction, the Herman score and the acquisition time. Results: Of the 87 patients included in this study, a suitable DV Doppler image was feasible in 58.6% of cases. The feasibility was significantly higher when the sonographer was satisfied with the image, when the Herman score exceeded seven (p = 0.01), and when the acquisition time was less than five minutes. A strong correlation was observed between the expert’s assessment and the sonographer’s satisfaction. However, the gestational age, maternal BMI, parity, and operator-perceived image quality were not significantly associated with feasibility. Conclusions: The Doppler assessment of the ductus venosus during first-trimester ultrasound screening is feasible and reproducible in routine clinical practice without significantly increasing the examination time. This suggests DV measurements to enhance the early nuchal translucency measurement to enhance the early detection of congenital heart defects during the first trimester. Full article
(This article belongs to the Special Issue Advances in Obstetrics and Maternal-Fetal Medicine)
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11 pages, 280 KiB  
Article
Prevalence and Risk Factors of Gestational Diabetes Mellitus in Romania: Maternal and Fetal Outcomes
by Ait El Haj Iman, Anca Huniadi, Mircea Sandor, Ioana Alexandra Zaha, Ioana Rotar and Cristian Iuhas
Medicina 2025, 61(2), 194; https://doi.org/10.3390/medicina61020194 - 23 Jan 2025
Cited by 1 | Viewed by 3695
Abstract
Background and Objectives: Gestational diabetes mellitus (GDM) is a prevalent condition associated with maternal and fetal complications, including preeclampsia, preterm birth, and neonatal risks. This study investigates the prevalence, risk factors, and socio-demographic and medical determinants of GDM in a Romanian cohort. [...] Read more.
Background and Objectives: Gestational diabetes mellitus (GDM) is a prevalent condition associated with maternal and fetal complications, including preeclampsia, preterm birth, and neonatal risks. This study investigates the prevalence, risk factors, and socio-demographic and medical determinants of GDM in a Romanian cohort. Materials and Methods: This retrospective study analyzed 200 pregnant women aged 22–43, grouped by demographic and health factors. Data included glucose tolerance tests, hypertension, obesity, and socio-demographic evaluations. Statistical analysis, performed in SPSS with p < 0.05, used logistic regression to assess variable associations. Results: GDM prevalence was 10%, with higher rates in women with obesity (25%, p = 0.03) and hypertension (12%, p = 0.01). Urban living was significantly linked to obesity and hypertension (p = 0.02). Cesarean deliveries occurred in 30% of cases (p = 0.02), and term births accounted for 85% (p = 0.01). Factor analysis identified two key patterns, with urban-related health risks (obesity and hypertension) and socio-demographic vulnerabilities (marital status and rural residence) increasing GDM risk. Conclusions: GDM prevalence underscores the impact of medical and socio-demographic factors, stressing the need for tailored interventions like weight management, glycemic control, and equitable healthcare access to reduce risks and improve outcomes for mothers and infants. Full article
(This article belongs to the Special Issue Advances in Obstetrics and Maternal-Fetal Medicine)

Review

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15 pages, 1099 KiB  
Review
Advances in Prenatal Diagnosis of Placenta Accreta Spectrum
by Qiuming Chen, Kuifang Shen, Yating Wu, Jianling Wei, Jingrui Huang and Chenlin Pei
Medicina 2025, 61(3), 392; https://doi.org/10.3390/medicina61030392 - 24 Feb 2025
Cited by 2 | Viewed by 2193
Abstract
Placenta accreta spectrum (PAS) involves abnormal placental attachment and can lead to severe complications such as postpartum hemorrhage and hysterectomy. Ultrasound is the main tool used to screen for PAS due to its non-invasive nature and convenience, although its accuracy depends on the [...] Read more.
Placenta accreta spectrum (PAS) involves abnormal placental attachment and can lead to severe complications such as postpartum hemorrhage and hysterectomy. Ultrasound is the main tool used to screen for PAS due to its non-invasive nature and convenience, although its accuracy depends on the skill of the operator. Magnetic Resonance Imaging has emerged as a supplementary tool, especially for complex cases or posterior placentas, providing more accurate anatomical detail and enabling the invasion depth and location to be assessed. This review summarizes recent advances in prenatal imaging for PAS, aiming to improve diagnostic accuracy and guide future research. Full article
(This article belongs to the Special Issue Advances in Obstetrics and Maternal-Fetal Medicine)
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