Endometriosis is one of the most common gynecological and systemic diseases, with a remarkable immune background. Patients suffer from pain and fertility reduction. Due to the distinct immune component, an immunotherapeutic approach may gain importance in the future. In endometriosis, shifts in the cell fractions of the immune system are well known. Moreover, hypoxia concomitant with inflammation causes a disturbed immune response. The removal of endometriosis has a therapeutic effect, normalizes the immune disorders, and remains the most effective causative treatment in terms of pain and infertility. A key issue is whether a similar effect can be achieved for fertility with non-invasive immunotherapy where surgery is inadvisable or cannot be performed for various reasons. Numerous immunotherapy trials, including vaccines, were conducted on animals only, although the research is encouraging. Among the promising methods of non-specific immunotherapy is the administration of an ethiodized oil contrast. Moreover, due to the significant successes of immunotherapy in oncology, the possibility of immunotherapy affecting NK cells has been postulated. NK cells are responsible for the surveillance and apoptosis of ectopic cells. Expanding the arsenal of endometriosis treatment by immunotherapy is promising due to the significant contribution of immunological factors and the limitations of current treatment methods.

Gestational diabetes mellitus (GDM) is one of the most commonly diagnosed metabolic disorders in pregnancy, affecting between 5% and 20% of patients worldwide, depending on the diagnostic criteria and population. Although GDM pathogenesis is predominantly based on insulin resistance mechanisms resulting from the influence of pregnancy hormones, an increasing number of studies point to a significant role of immunological factors in the process of GDM development. In some GDM patients, autoantibodies targeting pancreatic beta cells are detected. Consequently, autoimmune processes may constitute an important element of GDM etiology, particularly in cases where GDM is a transitive condition leading to type 1 diabetes mellitus (T1DM) after the pregnancy. Disorders causing the destruction of beta cells within the pancreas precipitate permanent hyperglycemia in patients with autoimmune GDM (gestational diabetes mellitus with autoantibodies). characteristics. Genetic factors also play a significant role in this process, including single-nucleotide polymorphisms associated with the tissue compatibility system, such as HLA, CTLA-4, PTPN22 and IL2RA, which cause predisposition to T1DM. The following article discusses the current state of knowledge and presents GDM pathogenesis from the standpoint of immune mechanisms capable of affecting the development of this condition. It discusses potential markers that may help identify GDM patients at risk of progressing to permanent diabetes mellitus as well as possible diagnostic and therapeutic strategies based on the latest findings.

Obstetric forceps have played a pivotal role in perinatal medicine for centuries, representing one of the most significant innovations in the history of obstetrics. As a life-saving instrument, forceps revolutionized the management of complicated labours by offering an alternative to destructive procedures and maternal mortality, thereby transforming the outlook for both mothers and newborns. Throughout their history, however, forceps have provoked both admiration and controversy —praised for their ability to facilitate safe delivery, yet criticized for their potential risks and the technical skill required for their proper use. This article provides a comprehensive overview of obstetric forceps, addressing not only their origins and the secretive circumstances of their invention by the Chamberlen family, but also the successive stages of their design evolution, from early concealed prototypes to the sophisticated instruments used in modern practice. We also examine the cultural, social, and medical impact of forceps across different eras, highlighting their central role in shaping the practice of operative vaginal delivery and the broader history of perinatal care. Finally, current debates surrounding the role of forceps in contemporary obstetrics are discussed, offering insight into the future of this instrument in the context of alternative techniques such as vacuum extraction and cesarean section. Keywords: obstetric forceps operative vaginal delivery history of obstetrics

Objective: This study aimed to analyze peripartum glycated hemoglobin (HbA1c) concentration and glycemic variability parameters using continuous glucose monitoring (CGM) in pregnant women with type 1 diabetes (T1D) treated with continuous subcutaneous insulin infusion (CSII). Material and methods: Forty-five pregnant women with T1D managed at two centers in Poland were included. CGM records from the 14 days preceding delivery were evaluated to determine glycemic variability parameters and circadian profiles, and their relationship with HbA1c measured on the day of delivery was assessed. Results: A relationship was found between HbA1c values and 24-hour glycemic variability parameters [average glycemia (rho = 0.64; p < 0.001); median glycemia (rho = 0.60; p < 0.001); SD (rho = 0.52; p < 0.001); TBR < 54 (rho = –0.38; p = 0.009); TBR < 63 (rho = –0.36; p = 0.016); TIR 63–140 (rho = –0.53; p < 0.001); TAR > 140 (rho = 0.65; p < 0.001); GMI (rho = 0.63; p < 0.001)] as well as at night 24.00–06.00 [average glycemia (rho = 0.53; p < 0.001); median glycemia (rho = 0.54; p < 0.001); SD (rho = 0.51; p < 0.001); CV (rho = 0.35; p = 0.020); TIR 63-140 (rho = –0.47; p = 0.001); TAR > 140 (rho = 0.57; p < 0.001)]. However, no correlation was found to exist during the daytime. Conclusions: Peripartum night-time glycemic variability has a greater influence on HbA1c levels than 24 hours glycemic variability in pregnant patients with T1D. This indicates the need to pay more attention to the glycemia course during the night hours and not limit the assessment of the level of glycemia control only to the overall analysis of the results available from CGM and HbA1c. Keywords: pregestational type diabetes mellitus peripartum glycemic control CGM HbA1c

Objectives:  Large for gestational age (LGA) is defined as a birth weight equal to or higher than the 90^th centile for a certain gestational age. Despite the efforts to optimize therapeutic goals to stabilize diabetes, there is still a high rate of LGA in type 1 diabetes mellitus (T1DM) mothers. The aim of this paper is a literature review of the data on predictors of LGA incidence in pregnancies complicated by type 1 diabetes mellitus. Results: Potential LGA predictors in pregestational diabetes include glucose concentration during pregnancy, maternal age, diabetes duration, increased body weight both at the beginning of gestation and at the time of delivery, as well as the weight gain in pregnancy. LGA risk is also associated with the use of an insulin pump (CSII), especially without the support of a continuous glucose monitoring system (CGMS). Significant glycaemic control parameters among others include average fasting glycaemia in the 3^rd trimester, HbA_1c in the 1^st and 3^rd trimesters, and among CGMS parameters — shorter TIR (time in range), shorter TBR (time below range) in the 2^nd and 3^rd trimesters, longer TAR (time above range) > 140 and average glycaemia in each trimester of gestation. Conclusions: There is still a need for identification of new predictors and theraputic goals in pregnancy in T1DM women to reduce the prevalence of LGA newborns. Keywords: large for gestational age pregestational type1 diabetes mellitus glycaemic control