Background and Objectives: Preterm birth is the leading cause of neonatal mortality worldwide and may be responsible for lifelong morbidities in the survivors. Cervical shortening is one of the common pathways to preterm birth associated with its own diagnostic and management challenges. The preventive modalities that have been tested include progesterone supplementation and cervical cerclage and pessaries. The study aimed to assess the management strategies and outcomes in a group of patients with a short cervix during pregnancy or cervical insufficiency. Materials and Methods: Seventy patients from the Riga Maternity Hospital in Riga, Latvia, were included in the prospective longitudinal cohort study between 2017 and 2021. Patients were treated with progesterone, cerclage, and/or pessaries. The signs of intra-amniotic infection/inflammation were assessed, and antibacterial therapy was given when the signs were positive. Results: The rates of PTB were 43.6% (n = 17), 45.5% (n = 5), 61.1% (n = 11), and 50.0% (n = 1) in progesterone only, cerclage, pessary, and cerclage plus pesssary groups, respectively. The progesterone therapy was associated with a reduced preterm birth risk (x2(1) = 6.937, p = 0.008)), whereas positive signs of intra-amniotic infection/inflammation significantly predicted the risk of preterm birth (p = 0.005, OR = 3.82, 95% [CI 1.31–11.11]). Conclusions: A short cervix and bulging membranes, both indicators of intra-amniotic infection/inflammation, are the key risk factors in preterm birth risk predictions. Progesterone supplementation should remain at the forefront of preterm birth prevention. Among patients with a short cervix and especially complex anamnesis, the preterm rates remain high. The successful management of patients with cervical shortening lies between the consensus-based approach for screening, follow-up, and treatment on the one side and personalising medical therapy on the other.

Background: Preterm births occur in approximately 12% of pregnancies worldwide and in 5.6% of pregnancies in Latvia, and the incidence has increased. Prematurity poses the major challenge in perinatology and pediatrics, accounting for 75% of perinatal mortalities and 50% of long-term complication. The placenta is a unique organ in explaining the incomprehensible pathogenesis of prematurity.Methods: The retrospective case-control study was conducted to determine placental histological and microbiological findings associated with gestational age and neonatal morbidity.Results: Histological chorioamnionitis was the most prevalent lesion in extremely preterm and very preterm birth groups compared with moderate to late preterm and term birth groups (P=0.027). A higher rate of funisitis was detected among extremely preterm and very preterm birth cases (P=0.001). Microbiological examination of placentas in preterm birth cases most commonly revealed Streptococcus agalactiae, Staphylococcus epidermidis, Staphylococcus haemolyticus. Umbilical cord vessels thrombosis and placental thrombotic vasculopathy were found mostly in moderate to late preterm birth category (P=0.032; P=0.008, respectively). Intrauterine growth restriction was linked to chorionic villous edema (P=0.007) and chorionic villous fibrinoid necrosis (P=0.014). Chorion-decidual hemorrhage and deciduitis were significantly associated with respiratory distress syndrome (P=0.036; P=0.022, respectively). Chorion-decidual hemorrhage was the main predisposing factor for hypoxic-ischemic encephalopathy (P=0.058).Conclusions: Comprehension of the pathogenic mechanisms of prematurity of the placenta and preterm births, and the impact of placental prematurity on neonatal morbidity may lead to improved prenatal diagnostic and enhanced preventive care for both the mother and the child.

Pregnancy- and lactation-associated osteoporosis (PLO) is a rare disorder, usually occurring in late pregnancy and the early post-partum period. The prevalence, etiology, pathogenesis and therapy remains unclear. Three clinical cases of PLO present patients with multiple severe osteoporotic fractures during the peri-pregnancy period and different treatment strategies.

Introduction: Latvia, alongside other Baltic and Nordic countries, exhibits some of the world's lowest preterm birth (PTB) rates. We sought to identify the factors sustaining this stability and to examine how PTB structure, trends, and risk factors have evolved in Latvia over time, amid the nation's significant socioeconomic transformation in recent decades.Material and Methods: This retrospective study analyzed all term and PTBs in Latvia from 2000 to 2023, using data from the Disease Prevention and Control Centre's Health Statistics database. We evaluated records at 5‐year intervals, assessing temporal trends in PTB and term birth outcomes, including neonatal and perinatal mortality, labor onset (spontaneous or indicated), and prematurity subgroups, alongside known PTB risk factors (n = 16). Joinpoint regression identified significant trend shifts, with statistical significance set at p < 0.05.Results: Latvia's overall PTB rate remained stable at 5.5% from 2000 to 2023, with no significant trend, while the proportion of spontaneous versus indicated PTB changed over time. Spontaneous extremely PTB decreased by 0.7% every 5 years, from 8.5% in 2000 to 5.2% in 2023 (p = 0.005), and very to moderate PTB declined by 1.3% every 5 years, from 26.2% to 19.5% over the same period (p = 0.011). A significant upward trend was identified in the total indicated PTB rate, with an increase of 3.3% every 5 years, rising from 12.5% in 2000 to 29.2% in 2023 (p = 0.036), driven by the increase in late indicated PTBs. Perinatal mortality for PTB in Latvia declined significantly by 1.21% every 5 years, from 13.15% in 2000 to 7.09% in 2023 (p = 0.005). Primiparity, smoking, urinary tract infections, and lower education levels among PTB mothers decreased significantly, while maternal age, previous cesarean sections, and intrauterine growth restriction as PTB risk factors increased.Conclusions: Despite PTB structure and risk factor shifts, Latvia's 5.5% PTB rate remained stable over two decades, with indicated PTB rising due to expanded late preterm indications. Improved neonatal and perinatal mortality reflect effective guidelines, socioeconomic growth, and care investments, countering adverse trends.

Summary: Among HIV-infected women prevalence and incidence of HPV infection are higher, and the risk for developing cervical cancer is increased. We present a case of HIV and HPV co-infection in woman with invasive cervical cancer and cervical and vaginalcondyloma acuminatain association with vaginal bleeding during pregnancy.

The absence of both the classic risk factors for pelvic inflammatory disease (PID) and the triad of cervical motion, uterine or adnexal tenderness does not preclude the diagnosis of PID and tubo-ovarian abscess. The clinical case demonstration presents the perimenopausal woman with complicated clinical course of acute PID.