Gynecological cancers pose a significant burden on women’s health worldwide, necessitating innovative treatment approaches. Immunotherapy has emerged as a promising strategy, harnessing the body’s immune system to combat cancer. This review aims to provide a comprehensive overview of the current landscape and future directions of immunotherapy in cervical and endometrial cancer. Methods: A thorough literature search was conducted to identify relevant studies and clinical trials. The main methods and treatments employed in immunotherapy for cervical and endometrial cancer, including immune checkpoint inhibitors, cancer vaccines, and adoptive cell therapies, are briefly described. Results: Immune checkpoint inhibitors, such as anti-PD-1/PD-L1 antibodies, have shown remarkable clinical efficacy in certain gynecological malignancies, particularly in advanced or recurrent cases. Additionally, ongoing research on cancer vaccines and adoptive cell therapies holds promise for personalized and targeted treatment options.

Endometriosis is a chronic, estrogen-dependent inflammatory condition affecting approximately 10% of women of reproductive age worldwide. It is characterized by the presence of endometrial-like tissue outside the uterine cavity, which frequently results in dysmenorrhea, chronic pelvic pain, dyspareunia, and infertility. While hormonal medications and surgical procedures are common treatments, they are often constrained by adverse effects and high recurrence rates. The aim was to systematically identify, critically appraise, and synthesize randomized controlled trials evaluating vitamin D, C, and E supplementation in women with endometriosis, focusing on their effects on pelvic pain, dysmenorrhea, dyspareunia, quality of life, oxidative and inflammatory biomarkers, and fertility-related outcomes, and to highlight methodological gaps that can inform future research and integrated therapeutic strategies. Following PRISMA guidelines, seven eligible RCTs were identified from databases including PubMed, Scopus, and ScienceDirect. The quality of these studies was assessed using the Jadad Scoring System and Cochrane RoB 2 tool. High-dose supplementation of vitamin D (50,000 IU) was found to significantly reduce pelvic pain and improve biochemical markers such as hs-CRP and total antioxidant capacity (TAC). Vitamin D appears to modulate endometrial pathways by reducing active β-catenin protein activity, which may disrupt signaling associated with lesion invasion and survival. Additionally, combined Vitamin C and E therapy (typically 1000 mg/day of Vitamin C and 800 IU/day of Vitamin E) acts synergistically to scavenge free radicals. This intervention significantly decreased oxidative stress markers, including malondialdehyde (MDA) and reactive oxygen species (ROS). Patients reported significant improvements in symptoms, including a 43% reduction in daily pelvic pain and a 37% reduction in dysmenorrhea. Despite physiological improvements, there was no statistically significant increase in pregnancy rates observed across the trials. Vitamin supplementation with D, C, and E represents a safe, low-cost adjunct therapy that can effectively mitigate endometriosis-related oxidative stress and pelvic pain. While these vitamins show promise for symptom relief, further research with larger sample sizes is required to determine their long-term impact on fertility outcomes and lesion regression.

Ovarian cancer (OC) is a highly lethal gynecologic malignancy, frequently diagnosed at advanced stages due to its silent onset and nonspecific clinical presentation. The use of talc-containing powders in the genital area has long been suspected to contribute to the development of OC through inflammatory and irritative pathways; however, the association remains controversial. This scoping review aims to decode the link between talc powder exposure and ovarian cancer by synthesizing findings from epidemiologic studies, public awareness surveys, and laboratory investigations. Epidemiologic analyses reveal that the use of genital powders is associated with a, modestly, 30–32% increase in the risk of OC, with similar risk patterns observed across racial subgroups. In contrast, studies on uterine cancer yield largely null associations after adjusting for confounders. Awareness surveys consistently report that only about 23% of respondents recognize talc use as a risk factor. Laboratory studies demonstrate that the dominant class of talc particles in commercially available powders—characterized by an aspect ratio of 1–3.9 and an area of 1–400 μm²—is nearly identical to those retrieved from pelvic tissues in OC patients, supporting the hypothesis of migration via retrograde and lymphatic pathways. The collective evidence supports the biological plausibility that talc from genital powders can migrate to pelvic tissues and potentially foster oncogenic inflammation. Further methodologically rigorous prospective and mechanistic studies are warranted to clarify the causal relationship and inform targeted public health and regulatory interventions.

Introduction: Gestational diabetes mellitus (GDM) is a form of hyperglycemia that develops during pregnancy and poses risks to both the mother and fetus. In other words, it is a glucose intolerance disorder first recognized during pregnancy, specifically in the second and third trimesters, with approximately 7–14% of pregnancies worldwide being affected. Methodology: A systematic literature search was conducted across three major well-established databases; PubMed, Scopus, and ScienceDirect. The search was conducted with the aim of identifying the most suitable studies for the evaluation of fetal cardiac function using Doppler ultrasound techniques in pregnancies affected by GDM. Results: Following a comprehensive full-text assessment, 186 papers were excluded, mainly due to discrepancies in the population, unsuitable study design, publishing type, or unavailability of full-text access. Ultimately, 12 studies met all the inclusion criteria and were incorporated into the scoping review. From the studies included it was found that the conventional pulsed-wave Doppler was the most frequently used modality, assessing parameters such as the E/A ratios, myocardial performance index (MPI), and the isovolumic relaxation time (IVRT). The advanced techniques of choice included tissue Doppler imaging (TDI), speckle-tracking echocardiography (STE), dual-gate Doppler, and automated MPI. Conclusions: Doppler ultrasound techniques, particularly the advanced modalities like TDI and STE, provide valuable insights into fetal cardiac function in GDM pregnancies. Their integration into routine prenatal surveillance may enhance the early detection of cardiac dysfunction and inform timely clinical interventions.

Background/Objectives: Open fetal repair of myelomeningocele (MMC) requires profound and sustained uterine relaxation to permit hysterotomy and to prevent preterm labor after closure. Magnesium sulfate (MgSO₄) has become the cornerstone postoperative tocolytic across North American fetal therapy centers, combined with volatile anesthetic-induced intraoperative tocolysis, indomethacin, and/or nifedipine. We synthesize the evidence on the mechanism, dosing, maternal safety, fetal/neonatal effects, and comparative performance of MgSO₄ as the core tocolytic in open fetal MMC repair. Methods: We conducted a narrative review of primary studies, consensus statements, and society guidelines published between 2010 and 2024, identified through PubMed, Scopus, ScienceDirect, society repositories (ACOG, SMFM, SPA, NAFTNet, and SOAP), and indexed proceedings of the International Fetal Medicine and Surgery Society. The search strategy, eligibility criteria, and selection process are reported and each contributing source was assigned a level of evidence adapted from the Oxford Centre for Evidence-Based Medicine hierarchy, so that randomized and meta-analytic data were distinguished throughout from case series, pharmacokinetic work, mechanistic studies, and consensus documents. Results: Across the MOMS cohort and post-MOMS series, the standard regimen is a 4–6 g intravenous loading dose followed by 1–3 g/h infusion for 24–48 h, layered on perioperative indomethacin and intraoperative volatile tocolysis. MgSO₄ provides effective myometrial quiescence and is associated with pulmonary edema in ~5–6% of mothers, near-universal lethargy and electrolyte disturbance, occasional high-grade atrioventricular block, transient neonatal hypotonia, and reduced fetal heart-rate variability. The neuroprotective effect of magnesium (cerebral palsy RR: 0.68; 95% CI: 0.54–0.87) is Level 1 but indirect: it was demonstrated in trials in which magnesium was given when preterm birth was planned or expected within approximately 24 h, and it cannot be assumed to persist when the 24–48 h perioperative course precedes delivery by several weeks, as it does after repair at 19–26 weeks with delivery at a mean of 34 weeks. In this population, neuroprotection, therefore, depends on a repeat course administered when preterm birth becomes imminent rather than on the operative infusion itself. Atosiban achieves comparable short-term tocolysis with minimal maternal adverse effects and has no intrinsic neuroprotective action; because neuroprotection in this setting requires magnesium re-administration close to delivery in any case, this difference is a smaller discriminator between the two agents than previously assumed. Conclusions: MgSO₄ remains the de facto standard postoperative tocolytic for open fetal MMC repair based on the strength of MOMS-era protocols and accumulated safety experience, supported by the availability of a neuroprotective regimen using the same agent should preterm birth threaten. This rationale rests predominantly on Level 4–5 evidence within the fetal surgery population itself. The optimal dose, duration, timing of initiation, and head-to-head performance against atosiban remain unresolved and warrant a multicenter randomized comparison. Because the species that crosses the placenta and mediates both tocolysis and neuroprotection is the free Mg²⁺ ion, the sulfate anion being a pharmacologically inert counter-ion, fetal exposure is determined by the maternal ionized-magnesium profile rather than by the salt administered. Only parenteral magnesium can reach tocolytic concentrations, and oral organic preparations such as magnesium glycinate cannot substitute for intravenous MgSO₄ or reduce pulmonary edema, which is driven by magnesium exposure and fluid balance and is mitigated by concentrated infusions, strict fluid restriction, the shortest effective duration, and avoidance of co-tocolytics.