Wound healing is a complex process influenced by age, systemic conditions, and local factors. The wound microbiota’s crucial role in this process is gaining recognition. This concise review outlines wound microbiota impacts on healing, emphasizing distinct phases like hemostasis, inflammation, and cell proliferation. Inflammatory responses, orchestrated by growth factors and cytokines, recruit neutrophils and monocytes to eliminate pathogens and debris. Notably, microbiota alterations relate to changes in wound healing dynamics. Commensal bacteria influence immune responses, keratinocyte growth, and blood vessel development. For instance, Staphylococcus epidermidis aids keratinocyte progression, while Staphylococcus aureus colonization impedes healing. Other bacteria like Group A Streptococcus spp. And Pseudomonas affect wound healing as well. Clinical applications of microbiota-based wound care are promising, with probiotics and specific bacteria like Acinetobacter baumannii aiding tissue repair through molecule secretion. Understanding microbiota influence on wound healing offers therapeutic avenues. Tailored approaches, including probiotics, prebiotics, and antibiotics, can manipulate the microbiota to enhance immune modulation, tissue repair, and inflammation control. Despite progress, critical questions linger. Determining the ideal microbiota composition for optimal wound healing, elucidating precise influence mechanisms, devising effective manipulation strategies, and comprehending the intricate interplay between the microbiota, host, and other factors require further exploration.

Background: Heterotopic pregnancy (HP) is a rare condition when at least two pregnancies are present simultaneously at different implantation sites and only one located in the uterine cavity. The majority of cases are diagnosed in the first trimester. Case presentation: We present a unique case of HP diagnosed at 26 weeks of spontaneous pregnancy in a patient without any relevant risk factors. We performed an extensive review of HP cases from MEDLINE (PUBMED) published in English between 2005-2019 to prove this case's uniqueness. A 24-year-old woman presented because of threatened preterm birth. Despite treatment, pain aggravated, without progression of labor. An emergency ultrasound exam revealed free fluid in the abdominal cavity. Suspicion of active bleeding prompted the medical team to perform an exploratory laparotomy. The surgery team found a ruptured heterotopic pregnancy. This was an unexpected cause of nontraumatic hemoperitoneum at such advanced gestational age. The postoperative period was uneventful, and the intrauterine pregnancy continued to term. The final review included 86 out of 124 records. A total number of 509 cases were identified, but not all of them had complete data. The maximum reported gestational age at the time of diagnosis was 16 weeks of pregnancy, while our case became symptomatic and was diagnosed at 26 weeks of pregnancy. Conclusions: Regardless of pregnancy age, HP can be a cause of hemoperitoneum, and it should be included in the differential diagnosis of acute abdomen in the second trimester.

Small for gestational age (SGA) fetuses and neonates are of great interest, while those who are too big are much less studied. The aim was to analyze the classifiers described by ACOG “Fetal macros...

Objectives: This study aimed to obtain the reference curves of birth weight for gestational age percentiles for the Polish population and to compare them to published charts in terms of detected proportions of small for gestational age (SGA) and large for gestational age (LGA). Methods: The reference curves of birth weight from 24 to 42 weeks of gestation were computed based on 39,092 singleton deliveries. The nomograms included the 3rd to the 97th percentiles and standard deviations. The percentiles were calculated for female and male newborns. The theoretical and true proportions of percentiles for the studied population were estimated based on six growth charts (Fenton, Intergrowth Project, global reference chart, Yudkin, Dubiel, and the World Health Organization chart). Results: The 50th percentile male and female newborns at 40 weeks weighed 3645.8 and 3486.7 g, respectively. The difference was 159.1 g. The ranges between the 3rd and 97th percentile at 40 weeks were 1481.5 g for males and 1423.5 for females. A total of 9.8% SGA and 10.27% LGA were defined, higher than that identified using the Fenton chart and even higher than that identified using the Intergrowth Project. Conclusion: Population growth charts identify more newborns with abnormal growth (both LGA and SGA). The similarity between charts in LGA above the 95th percentile is observed. The discrepancies in SGA are significantly greater, specifically in preterm births than in term births. Similar coverage is found in term pregnancies, regardless of birth weight for gestational age or intrauterine charts. The feasibility of a Polish population growth chart needs to be validated for predicting adverse perinatal outcomes.

Foetal growth restriction (FGR) complicates about 25–47% of twin pregnancies. One or both foetuses can be restricted. Pregnancies with discordant growth of foetuses are associated with a sevenfold increased risk of neonatal morbidity. This is a narrative or traditional literature review. A literature search was performed to present a comprehensive, critical and objective analysis of the current knowledge on growth restriction in twin pregnancies. The definitions of FGR in twin pregnancies and selective FGR (sFGR) differ between international societies. In 2019, the Delphi procedure aimed to unify the definitions of sFGR in twin pregnancies. Several growth charts for twins have been published. However, most societies recommend singleton growth charts as better in detecting hypoxic complications of FGR in twin pregnancies. Discordant growth in twins results from placental insufficiency, congenital anomalies, chromosomal aberrations and TORCH infections. Definitions and management of sFGR depend on chorionicity. The management aims to protect the properly growing foetus from ischemic complications or in utero death. In most cases, expectant management, strict surveillance and preterm labour are the methods of choice. Due to the co-existence of properly growing and small foetuses in one uterus, determining the appropriate time for delivery is challenging. In the case of preterm labour, even late preterm, antenatal corticosteroid therapy (ACT) in FGR twin pregnancies is beneficial because it decreases neonatal morbidity.