Search Results (107)

Background/Objectives: Postpartum depression and anxiety affect up to 20% of women worldwide, yet remain understudied in Eastern Europe. Romania, one of Europe’s most religious countries, provides a unique context for examining how coping strategies and religiosity influence perinatal mental health. This cross-sectional study characterized coping styles, depressive and anxiety symptoms, and religiosity among postpartum women from two western Romanian counties (Bihor and Timiș) and examined associations between coping dimensions and psychological outcomes. Methods: A cross-sectional study was conducted among 201 postpartum women recruited from two public maternity hospitals between 2024 and 2025. Sociodemographic, obstetric, neonatal, coping (COPE Inventory), depressive (EPDS; PHQ-9), anxiety (GAD-7), and religiosity (RCI-10) data were collected through questionnaires and medical record extraction. Associations between coping dimensions and psychological symptoms were examined using Pearson correlations. Analyses were performed in RStudio. Results: Prevalence of possible depression (EPDS ≥ 10) was 32.8% overall, with no regional difference (Bihor 32.0% vs. Timiș 33.7%, p = 0.920). EPDS demonstrated strong convergent validity with PHQ-9 (r = 0.58, p < 0.001) and GAD-7 (r = 0.61, p < 0.001). In bivariate analyses, avoidant coping showed the strongest association with depressive symptoms (r = 0.28, p < 0.001), particularly in Bihor (r = 0.35, p < 0.001). Multiple regression analysis (R² = 0.196, p < 0.001) identified avoidant coping as the strongest independent predictor (β = 2.82, 95% CI [1.16, 4.48], p < 0.001), followed by social support coping (β = 2.46, 95% CI [1.09, 3.83], p < 0.001). Emotion-focused coping showed an unexpected protective effect (β = −2.97, p = 0.004). Problem-focused coping and religiosity were not significant predictors. Critically, county was non-significant after controlling for coping strategies (p = 0.732), indicating regional differences are mediated by coping patterns rather than geographic location. Conclusions: Postpartum depression prevalence in Romania aligns with international estimates. Avoidant coping emerged as the primary modifiable risk factor. Findings support integrating coping assessment into postpartum screening and developing interventions targeting avoidant strategies in Romanian perinatal care. Full article

Background: Primary fallopian tube carcinoma (PFTC) is a rare gynecologic malignancy, and data describing its biopsychosocial characteristics remain limited. Understanding the biological, psychological, and social features of affected women may support patient-centered care and inform future research. Methods: This retrospective, single-center, descriptive pilot study included 20 patients with histopathologically confirmed PFTC treated in 2024–2025. Demographic, reproductive, clinical, preventive, and record-documented psychosocial variables were extracted from medical records. Categorical variables were analyzed using chi-square tests (or Fisher’s exact test where appropriate), and effect sizes were summarized using Cramér’s V. Proportions were reported with 95% confidence intervals using the Wilson method. Results: Half of the women were aged ≥70 years (50.0%; 95% confidence interval (CI): 29.9–70.1) and 65.0% had never been pregnant. Normal body mass index (BMI) predominated (65.0%). International Federation of Gynecology and Obstetrics (FIGO) stage was available for 12/20 patients; among those with documented staging, 58.3% were FIGO stage III. Preventive behaviors documented in medical records suggested suboptimal screening patterns: cervical cytology was classified as occasional in 75.0% of patients. Psycho-oncological support was documented in 45.0% of patients, and sleep problems were documented in 25.0%. An age-group difference in documented psycho-oncological support was observed (χ² = 14.007; p = 0.007; Cramér’s V = 0.751); however, given the very small sample size and the distribution of observations across age categories, this finding should be interpreted as hypothesis-generating rather than confirmatory evidence. No association was observed between place of residence and FIGO stage in the subset with available staging data. Conclusions: In this small retrospective, single-center cohort, patients with PFTC were predominantly older and frequently nulligravid, while normal BMI was common. Record-documented psychosocial needs (including psycho-oncological support and sleep problems) were observed in a subset of patients and underscore the importance of systematic psychosocial assessment using validated tools in future studies and clinical pathways. Findings are preliminary and hypothesis-generating and support the need for larger prospective multicenter studies integrating comprehensive clinical and standardized psychosocial data in PFTC populations. Full article

Fetal growth restriction (FGR) remains a significant problem in obstetrics and is a key risk factor for perinatal brain injury. The fetal neuronal vesicles (FNVs) isolated from maternal blood represent an innovative approach—a “fetal brain liquid biopsy”—enabling early diagnostics of neuronal dysfunction in FGR. Western blotting was used to evaluate the protein pattern expression of FNVs isolated from the blood of pregnant women with FGR and uncomplicated pregnancy. Significant changes in the neurotrophic proteins levels (pro-BDNF, pro-NGF) and presynaptic neurotransmission proteins (SYN1, SYP, SYNPO) were identified. New data were obtained on changes in the expression of proteins of sumoylation (SUMO2/3/4) and neddylation (NAE1, UBC12), which differs in early-onset and late-onset FGR. Moreover, increased SUMO2/3/4 levels can be considered as an endogenous neuroprotective response to cerebral hemodynamic reaction in fetuses with late-onset growth restriction. An association has been established between changes in the expression of the studied proteins and intraventricular hemorrhage (IVH) in newborns with late-onset growth restriction. Full article

Complex or difficult cesareans are associated with significant short- and long-term complications. The complication rate increases with the increasing number of cesareans, and the incidence of cesarean section is increasing. To accurately identify women at high risk of surgical difficulty during a cesarean, ultrasound, in addition to clinical assessment, can be used to evaluate many risk factors, including placenta previa, placenta accreta spectrum (PAS) disorders, fibroids, severe pelvic adhesions, and membranous fetal vessels. The role of preoperative ultrasound is to identify ultrasonographic signs of anatomic changes that may affect the risk of intraoperative complications in subsequent cesarean sections. It is important to look for maternal problems as well as fetal problems. Ultrasound is a well-established practice in obstetrical care as it is easily available, accessible, easy to perform, and well accepted by women. However, there are few studies on the role of preoperative ultrasound in the management of complex or difficult cesareans beyond the risk assessment of PAS. Currently, preoperative ultrasound is mostly performed in selected cases only, with the exception in some settings. The aim of this review article is to discuss the benefits and the use of ultrasound assessment before different types of complex or difficult cesareans. Whether ultrasound assessment should be performed before all cesarean sections will also be discussed. Full article

Background and Objectives: Preterm birth is a common obstetric problem. Attention-deficit hyperactivity disorder (ADHD) affects an increasing number of children. There is evidence that all subcategories of preterm birth are related to the occurrence of ADHD. The present article reviews the findings of the last two years regarding this association. Materials and Methods: PubMed was screened for relevant articles published in English between January 2024 and November 2025. Keyword combinations of the words “preterm birth”, “prematurity”, “attention deficit disorder”, “attention disorders”, “ADHD”, “preterm” and “attention deficit hyperactivity disorder” were used. A total of 28 articles were retrieved, reviewed and selected. Results: Preterm birth results in higher risk of ADHD, while early preterm births are characterized by an even higher risk of ADHD. Additionally, postnatal complications commonly experienced by preterm infants are associated with the presence of ADHD. It seems that the maternal use of ADHD medications during pregnancy is associated with a high risk of preterm birth, although there is a concern about the role of other psychotropic medications during pregnancy. Various neurodevelopmental disorders are also associated with preterm birth. Maternal use of glucocorticoids combined with preterm birth leads to higher risk of ADHD. However, the outcome of ADHD is shaped by a wide range of social, familiar and biological factors. Conclusions: Prematurity is a significant risk factor for the development of ADHD symptoms in children. However, many biological, environmental, and psychosocial factors, such as neurodevelopmental vulnerability, perinatal complications, maternal health and adverse psychosocial factors, act as regulators in this relationship. Researching and understanding these associations will help in implementing preventive measures in children who are at increased risk of developing ADHD. Full article

Preeclampsia (PE) and intrauterine growth restriction (IUGR) are obstetric complications associated with placental dysfunction, which represent a public health problem due to high maternal and fetal morbidity and mortality. Early detection is crucial for timely interventions. Therefore, this study proposes the development of models based on fuzzy cognitive maps (FCM) optimized with metaheuristic algorithms (particle swarm optimization (PSO) and genetic algorithms (GA)) for the prediction of PE and IUGR. The results showed that FCM-PSO applied to the PE dataset achieved excellent performance (accuracy, precision, recall, and F1-Score = 1.0). The FCM-GA model excelled in predicting IUGR with an accuracy and F1-Score of 0.97. Our proposed models outperformed those reported in the literature to predict PE and IUGR. Analysis of the relationships between nodes allowed for the identification of influential variables such as sFlt-1, sFlt-1/PlGF, and uterine Doppler parameters, in accordance with the pathophysiology of placental disorders. FCM optimized with PSO and GA offer a viable clinical alternative as a medical decision support system due to their ability to explore nonlinear relationships and interpretability of variables. In addition, they are suitable for scenarios where low computational resource consumption is required. Full article

The use of health monitoring software applications (apps) and devices is gaining popularity in obstetrics. The attitude and acceptance of different healthcare professionals regarding telemonitoring during pregnancy and the early phase of labor have not been sufficiently investigated. This study aims to assess healthcare professionals’ views on telemonitoring during pregnancy and childbirth, as well as data processing in the telemonitoring process. The study is part of an international project called `Newlife`, funded by the European Council and nationally funded by the Swiss State Secretariat for Education, Research and Innovation and Innosuisse. Eleven physicians from the fields of obstetrics and neonatology and five prenatal care nurses and five midwives were interviewed. First, participants were asked to fill out a written questionnaire with open and closed-ended answers, containing questions with a 5-point Likert scale. In a second step, a personal oral interview was conducted with all respondents. The study had an exploratory, qualitative focus. Questionnaire responses were summarized using descriptive statistics, while interview recordings were transcribed verbatim and systematically coded to identify recurring themes. Of the respondents (n = 20), five (25.0%) reported previous experience with telemonitoring in their professional practice, and all of them considered it useful. Regarding attitudes and acceptance, 57.1% (n = 12) of respondents would welcome telemonitoring during pregnancy and 52.4% (n = 11) during the early phase of labor, while 33.3% expressed no clear opinion. Rejection of telemonitoring was indicated by 9.6% (n = 2) during pregnancy, and 19.0% (n = 4) during early labor. In terms of perceived benefits, respondents highlighted early detection of problems (n = 13, 61.9%), improved prenatal care (n = 11, 52.4%), and better opportunities for data analysis and research (n = 12, 47.1%). Perceived risks included technical challenges and susceptibility to errors (n = 14, 66.7%), the lack of human contact and personal support (n = 14, 66.7%), and potentially inaccurate measurements (n = 12, 57.1%). This study offers insights into healthcare professionals’ attitudes and acceptance of telemonitoring in healthcare during pregnancy and the early stages of labor. There is a generally positive outlook but concerns and preferences exist. Addressing these considerations is essential for developing effective and user-friendly telemonitoring systems that benefit both healthcare professionals and pregnant women. Full article

Objectives: Pelvic organ prolapse (POP) disorders are a significant problem with a society-wide dimension, affecting the quality of life of many women around the world. The purpose of this study is to assess the influence of sociodemographic factors on health-preserving behaviors in relation to pelvic organ prolapse in women of reproductive age. Method: The survey was conducted using a questionnaire made available electronically and a paper questionnaire distributed to female patients of the Gynecology and Obstetrics Clinical Hospital of the Karol Marcinkowski Medical University in Poznan. In total, 160 women aged 15–49 years voluntarily participated in the study. The distribution of variables was assessed using the Shapiro–Wilk test. The Mann–Whitney U and Kruskal–Wallis ANOVA tests were used for comparisons between groups. Comparisons between assessment scores and self-assessment of knowledge were made using Wilcoxon’s paired rank order test and the Chi2 NW (highest reliability) test. A p-value < 0.05 was considered statistically significant. Results: The level of knowledge about POP prevention and conservative treatment methods is low. The group with a higher level of knowledge was characterized by younger age, higher education, and living in areas with a large population. Conclusions: The results suggest only a partial understanding of the topic of pelvic organ prolapse, while lacking full awareness of prevention. Full article

Background/Objectives: Polycystic ovary syndrome (PCOS) is one of the most frequently diagnosed endocrine and metabolic disorders in women of reproductive age before menopause. It is associated with excess androgens and ovarian dysfunction, reduced fertility, the presence of obstetric disorders, but also metabolic disorders, and, among others, insulin resistance, obesity and type II diabetes. Its close relationship with changes in the diversity of the vaginal microbiome, vaginal inflammation and changes in the vaginal microenvironment, which can pave the way for pathogenic microorganisms, is emphasized. Methods: The research in the presented paper focuses on a group of women with PCOS (n = 490) of reproductive age (26–43 years), in whom the frequency of infections of the reproductive system caused by atypical pathogens, Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma spp., were analyzed, and then the immune system response was assessed in terms of the level of serum proinflammatory cytokines, IL-1β, IL-6 and TNF-α. Results: Our results showed a 40% infection rate in the studied group of patients with PCOS, with C. trachomatis being the most common pathogen (17.7%), followed by Ureaplasma spp. (10%) and M. hominis (4.9%). In some cases, co-infections such as Mycoplasma and Ureaplasma were also observed in 3.1% or all three atypical bacteria, M. hominis, Ureaplasma spp. and C. trachomatis, in 4.3% of patients with PCOS. In our study, in women with PCOS and confirmed infection with any atypical pathogen (n = 196), we analyzed the levels of proinflammatory cytokines, IL-1 β a, IL-6 and TNF-α. The results were compared with a control group (control group A) consisting of patients with the same underlying disease, i.e., PCOS (n = 39), who did not experience infection with atypical pathogens or symptoms of gynecological infection. Additionally, a control group B (n = 28) consisting of healthy women (without PCOS and without infection) was introduced. The results regarding the levels of cytokines studied in this work (IL-1β, IL-6, TNF-α) may suggest that the presence of intracellular C. trachomatis in the infection will play a dominant role in the immune system response. In the infections with atypical pathogens analyzed in this study in patients with PCOS, no characteristic clinical features were observed, apart from indications in the form of an increase in the number of leukocytes in the assessment of the vaginal biocenosis, suggesting cervicitis and reported reproductive failure or lower abdominal pain. An additional problem is the inability to detect the presence of atypical pathogens in routine microbiological tests; therefore, confirmation of such etiology requires referral of the patient for targeted tests. Conclusions: Invasion of host cells by atypical pathogens such as C. trachomatis and infections with “genital mycoplasmas” can disrupt the function of these cells and lead to many complications, including infertility. The immune response with the production of proinflammatory cytokines such as TNF-α, IL-1β, and IL-6, observed in response to infection with C. trachomatis, M. hominis, and Ureaplasma spp., induces or amplifies inflammation by activating immune cells or controlling infection, but may lead to the facilitation of the survival of pathogenic microorganisms and irreversible damage to fallopian tube tissues. Especially in the case of the proinflammatory cytosine TNF-α, there seems to be a close correlation with infections with atypical pathogens and a marked immune response, as well as with increased IL-1β and IL-6 values compared with the absence of infection (both in the presence and absence of PCOS). The presented study may suggest the importance of extended diagnostics to include atypical pathogens in the case of PCOS and the importance of research in this area also from the point of view of the immune response. Full article

Background: Prenatal anxiety is a common problem affecting a large number of women. The presence of anxiety during pregnancy is associated with adverse consequences for both the mother and the baby. The main objective of this review was to determine the risk factors associated with anxiety during pregnancy in European women. Specifically, we wanted to know if these factors are the same as those found in other continents and if they are similar to those associated with depression during this stage. Methods: A literature review was carried out on studies that were published in the last 10 years in the PsycInfo, Medline, and SCOPUS databases. Thirteen studies were selected for the purposes of this review. Results: Sociodemographic risk factors associated with a higher level of anxiety during pregnancy included having a lower educational level and socioeconomic status. Obstetric and pregnancy-related risk factors included having had complications during pregnancy. Having a history of mental health problems, low social support, high levels of stress, and being exposed to adverse life events were the most relevant psychological factors for presenting prenatal anxiety. Furthermore, these factors are largely common to those associated with prenatal anxiety in other continents of the world and to those associated with prenatal depression. Conclusions: This review shows that there are multiple factors that contribute to women experiencing prenatal anxiety. Most can be identified at the beginning of pregnancy, and some factors, such as psychological ones, are potentially modifiable. This underlines the importance of carrying out a proper screening for anxiety during pregnancy in order to prevent its onset or treat it appropriately. Furthermore, the fact that risk factors are common for both prenatal anxiety and depression implies that the same intervention could reduce the probability of the onset of both pathologies and the possible consequences associated with them. Full article

Background: Unfulfillment of maternity rights in healthcare is a global problem associated with abuse, neglect and discrimination, known as obstetrics and gynecology (OB/GYN) vulnerability. Women’s perceptions of their experience are a keystone to improving maternity healthcare. The aim of this study was to evaluate the women’s perceptions of the vulnerability of maternity rights and the associated risk and protective factors. Methods: This study was carried out by qualitative techniques based on the analysis of a semi-structured interview applied to six women in the postpartum period with pregnancy assistance and birth in Spain and Colombia between February and August of 2024. A triangulation analysis was performed about the perceptions of the concept, experiences and risk and protective factors of OB/GYN vulnerability. The free-access ATLAS.ti software was used. Results: OB/GYN vulnerability is generally perceived by women with a psychological impact. Women think that their own factors (emotion management, social support, attitude to change and beliefs), health professional factors (burnout, empathy and social skills) and health institution factors (workload, centralization in technical and protocols, humanization, quality and access to recourses) have an influence to modulate the vulnerability of rights in maternity healthcare. Conclusions: It is necessary for health systems to move from a protocol-centered to a person-centered model, particularly in maternity healthcare. This model should include the biopsychosocial needs of women and allow for their participation. Health institutions need to evaluate their processes and minimize burnout in health professionals. In addition, there are factors affecting OB/GYN vulnerability not only in childbirth but also during pregnancy and postpartum. Full article

Pregnancy involves extracellular vesicles (EVs) through mechanisms that are poorly understood to date. Furthermore, it is not surprising that EVs may also be involved in the pathophysiology of pre-eclampsia (PE) and gestational hypertension, two clinical conditions with high morbidity and mortality, given their capacity to mediate intracellular communications and regulate inflammation and angiogenesis. We searched major online scientific search engines (PubMed, Google Scholar, Scopus, WES, Embase, etc.) using the terms “Preeclampsia”, “Pregnancy”, “Hypertension”, “Pregnancy-related hypertension”, “Extracellular vesicles”, “Biomarkers”, “Gestation” AND “Obstetrics”. Finding potential early biomarkers of risk or illness progression would be essential for the optimum care of expectant mothers with the aforementioned conditions. Nevertheless, none of the various screening assays that have been discovered recently have shown high predictive values. The analysis of EVs in the peripheral blood starting from the first trimester of pregnancy may hold great promise for the possible correlation with gestational hypertension problems and represent a marker of the early stages of the disease. EVs use may be a novel therapeutic approach for the management of various illnesses, as well. In order to define EVs’ function in the physiopathology of pregnancy-associated hypertension and PE, as well as their potential as early biomarkers and therapeutic tools, we have compiled the most recent data in this review. Full article

Background and Objectives: Infertility is a global problem. The interaction between depression and infertility seems bidirectional, and depression may negatively influence IVF outcomes. The Beck Depression Inventory (BDI) is one of the most extensively used instruments for diagnosing depression. The aim of this study was to assess the dynamics of depression in patients undergoing IVF utilizing the BDI. Materials and Methods: This prospective cohort study was conducted at the Clinic for Gynecology and Obstetrics of the University Clinical Center of Serbia in Belgrade, Serbia during the year 2019. Both partners in the IVF program were required to complete the paper-based BDI 5 to 10 days before starting ovarian stimulation, within the 48 h preceding oocyte aspiration and four weeks after embryo transfer. We sought to identify potential predictors of a favorable IVF outcome by using logistic regression modeling. Results: Our study enrolled 86 couples. The overall IVF efficacy in our cohort was 18.6%. A statistically significant logistic regression model (p = 0.001) managed to explain 47.6% of the variability. Increasing patient age, the presence of depression (BDI > 16) and the number of failed IVF cycles were found to be significant negative predictors of ongoing IVF success. Conclusions: Depression is more common in patients undergoing IVF than in the general population. Depression might increase the odds of IVF failure, lending credence to the idea that depression screening using BDI should be a routine part of the IVF process. Full article

Obstetric violence during pregnancy and childbirth is unfortunately a major problem throughout the world. Neuroleptanalgesia is a classic form of analgesia which consists in administering analgesics and neuroleptics, such as haloperidol, simultaneously. Haloperidol is still occasionally used during childbirth and, in most cases, without informed consent in Spain. It is used with the excuse of being an antiemetic, but the reality is that it is a form of obstetric violence called chemical submission. The combination of haloperidol with opioids leads to a potentiation of the sedative effects of both drugs, which may lead to multiplied risks for both mother and baby. At present, the use of haloperidol during childbirth is a practice exclusive to Spain. In fact, the association El Parto es Nuestro (Birth Is Ours) launched an awareness campaign in February 2021 aimed at eradicating the use of haloperidol during childbirth without informed consent. The present essay aims to bring awareness about the ongoing practice of using haloperidol. It is of great importance to eradicate this practice that is so harmful to mothers and their babies, as well as educate health personnel regarding this situation. Full article

Background/Objectives: Postsurgical lower urinary tract dysfunction (LUTD) is a common problem following deep infiltrating endometriosis (DIE) resection. The condition may be caused either by surgically induced damage to the bladder innervation or by pre-existing endometriosis-associated nerve damage. The aim of this study is to evaluate the efficacy of preoperative and postoperative multichannel urodynamic testing (UD) in identifying pre-existing or surgically induced LUTD among patients with DIE. Methods: Women with suspected DIE and planned surgical resection of DIE at the Department of Obstetrics and Gynecology at the University Hospital of Bern from September 2015 to October 2022 were invited to participate in this prospective cohort study. UD was performed before and 6 weeks after surgery. The primary outcome was the maximum flow rate (uroflow), an indicator of LUTD. Secondary outcomes were further urodynamic observations of cystometry and pressure flow studies, lower urinary tract symptoms (LUTS) as assessed by the International Prostate Symptom Score (IPSS), and pain as assessed by the visual analog scale (VAS). Results: A total of 51 patients requiring surgery for DIE were enrolled in this study. All patients underwent surgical excision of the DIE. The cohort demonstrated a uroflow of 22.1 mL/s prior to surgery, which decreased postoperatively to 21.5 mL/s (p = 0.56, 95%CI −1.5–2.71). The mean bladder contractility index (BCI) exhibited a notable decline from 130.4 preoperatively to 116.6 postoperatively (p = 0.046, 95%CI 0.23–27.27). Significant improvements were observed in the prevalence of dysmenorrhea, abdominal pain, dyspareunia, and dyschezia following surgical intervention (p = <0.001). The IPSS score was within the lower moderate range both pre- and postoperatively (mean 8.37 vs. 8.51, p = 0.893, 95%CI −2.35–2.05). Subgroup analysis identified previous endometriosis surgery as a significant preoperative risk factor for elevated post-void residual (43.6 mL, p = 0.026, 95%CI 13.89–73.37). The postoperative post-void residual increased among participants with DIE on the rectum to 54.39 mL (p = 0.078, 95%CI 24.06–84.71). Participants who underwent hysterectomy exhibited a significantly decreased uroflow (16.4 mL/s, p = 0.014, 95%CI 12–20) and BCI (75.1, p = 0.036, 95%CI 34.9–115.38). Conclusions: Nerve-respecting laparoscopy for DIE may alter bladder function. UD is not advisable before surgery, but the measurement may detect patients with LUTD. Full article