Abnormal uterine bleeding (AUB) is a common gynecological complaint among premenopausal women, encompassing a wide range of underlying disorders that complicate diagnosis and management. The evolving paradigms in medical science now incorporate advanced imaging techniques, personalized medicine, and molecular diagnostics to improve the accuracy of diagnoses and the effectiveness of treatment plans. This review examines recent advancements in the diagnostic approach, including the use of transvaginal ultrasonography, hysteroscopy, and biomarker analysis, which have significantly refined the identification of endometrial pathologies. Furthermore, we discuss the shift towards individualized treatment strategies that consider patient-specific factors such as age, reproductive plans, and comorbidities, facilitating tailored therapies. Special attention is given to the role of medical therapies ranging from hormonal treatments to novel non-hormonal drugs, as well as the consideration of minimally invasive surgical options as part of a comprehensive management strategy. By integrating current research findings with clinical practice guidelines, this article aims to provide a synthesized view of the dynamic field of AUB management, proposing a multidisciplinary approach to enhance patient outcomes in premenopausal women.

This retrospective study evaluates the effectiveness of artificial intelligence (AI) models and integrated scoring systems in assessing endometrial receptivity during in vitro fertilization (IVF). We combine AI-driven image analysis for automated endometrial segmentation (U-Net with VGG16 encoder) and embryo quality classification (VGG16) with a patient-specific clinical probability metric (SART) to generate a composite score. Ultrasound images of the endometrium were processed using a standardized pipeline (denoising, normalization, ROI cropping, augmentation), enabling automated quantification of thickness, echogenicity/pattern, and derived measures. Embryo quality was assessed by a fine-tuned classifier benchmarked against expert embryologists. The composite score is defined as: CS = (EQS + ERS)/2 × PSART/10 where EQS is the AI-derived embryo quality score (0–10), ERS is the AI-derived endometrial receptivity score (0–10), and PSART is the SART pregnancy probability scaled to 0–10. In internal validation, the composite score demonstrated higher discriminative performance for biochemical pregnancy than individual components (AUC 0.94 vs. EQS 0.88 and ERS 0.85). While integrated scoring improved prediction relative to single-source models, generalizability is limited by the single-center, retrospective design and modest dataset size augmented synthetically. Prospective, multi-center validation with live-birth outcomes and incorporation of explainable AI (e.g., saliency/attribution maps) are needed to support clinical deployment. These findings suggest that AI-based models, when embedded in multidimensional scoring frameworks, may help optimize embryo transfer timing and support precision IVF, complementing—not replacing—clinical expertise.

Background/Objectives: This study investigates the correlation between the serum levels of Sestrin 2 and the presence of endometrial polyps or uterine leiomyomas, aiming to enhance the understanding of the pathophysiology underlying these gynecological conditions and evaluate the potential of Sestrin 2 as an early diagnostic biomarker. Methods: In a prospective case-control format, patients with preliminary diagnoses of endometrial polyps or uterine leiomyomas confirmed by histopathological analysis following surgery were included. This study analyzed serum Sestrin 2 levels across different patient groups, revealing significant variations that underscore the diagnostic value of Sestrin 2. Results: Elevated serum Sestrin 2 levels were observed in patients with endometrial polyps and uterine leiomyomas compared to the control group, suggesting its utility as a novel marker for early detection. Conclusions: The study indicates the promising role of serum Sestrin 2 levels as a valuable biomarker for early diagnosis of endometrial polyps and uterine leiomyomas, advocating for further research into its diagnostic and therapeutic potential.

Tubo-ovarian abscesses (TOAs) are identified as a severe and complex form of inflammatory disorder, marking an advanced progression of pelvic inflammatory disease (PID), mainly resulting from the escalation of polymicrobial infections within the female genital tract. This literature review is dedicated to elucidating the contemporary management strategies and associated complications of TOAs, amalgamating the current scholarly discourse while spotlighting the emerging therapeutic trends. The inherent complexity of TOAs, manifesting through a broad array of clinical presentations from mild symptoms to acute pelvic discomfort and fever, necessitates a comprehensive, multidisciplinary approach to achieve effective management. Traditional management has predominantly focused on antibiotic therapy, the cornerstone of initial treatment modalities. Nonetheless, this review expands on the increasing acknowledgment of minimally invasive surgical interventions, like ultrasound-guided drainage, especially in scenarios where medical therapy falters or in the presence of sizable abscesses, underscoring scenarios where antibiotic treatment may be insufficient. The discourse further explores the pivotal decision-making concerning surgical interventions, juxtaposing the benefits of abscess resolution against potential risks and complications, such as damage to adjacent structures and implications for future fertility. The review emphasizes the criticality of addressing PID’s risk factors and root causes to avert TOA development. It also ventures into the ramifications of the emergence of antibiotic-resistant bacterial strains for empirical antibiotic therapy selection, highlighting the imperative for continuous research and the adaptation of therapeutic guidelines. The complications associated with TOAs, including sepsis, infertility, and chronic pelvic pain, are meticulously examined to underscore the potential for significant long-term morbidity. Advocating for prompt diagnosis and encompassing management strategies to curtail these adverse outcomes, the review ultimately calls for intensified, quality research to refine TOA management further, particularly against the backdrop of evolving microbial resistance and the advancements in minimally invasive surgical technologies.

The use of prophylactic antibiotics during cesarean sections (CS) significantly impacts neonatal health by influencing the early colonization of the gut microbiota. Administered before surgical incision, these antibiotics cross the placenta, exposing the fetus to microbial disruptions at a critical stage of immune system development. This study examines the effects of perinatal antibiotic exposure on neonatal gut microbiota composition and its long-term health implications. Findings indicate that antibiotics disrupt microbial diversity, reduce beneficial bacteria like Bifidobacterium, and promote colonization by opportunistic pathogens. Such alterations have been linked to increased risks of obesity, inflammatory bowel disease, and metabolic disorders later in life. Maternal antibiotic use also affects vertical microbial transmission, altering the maternal vaginal and gut microbiota and exposing newborns to antibiotic residues through breast milk. While prophylactic antibiotics effectively reduce perinatal infections, their widespread use raises concerns about antibiotic resistance and long-term health consequences. Experimental studies show that even a single dose during critical developmental windows can predispose neonates to chronic diseases. This study highlights the need for careful evaluation of antibiotic use during the perinatal period to minimize adverse effects on neonatal microbiota and optimize long-term health outcomes. Identifying modifiable risk factors and refining clinical guidelines are essential steps toward balancing the benefits of infection prevention with the risks of microbiota disruption.

Cesarean delivery, a common surgical procedure worldwide, is associated with a significantly increased risk of postoperative infections compared to vaginal births. This risk is notably higher in developing countries due to varying practices in antibiotic prophylaxis and differences in healthcare settings. This study aims to evaluate the current practices and potential improvements in antibiotic use in cesarean sections within these regions. Our analysis revealed that cesarean sections are performed at an increased rate in developing countries, with infection rates ranging from 10% to 40%, primarily due to inconsistent and often inadequate antibiotic prophylaxis. The most common postoperative infections include endometritis, wound infections, and urinary tract infections, largely influenced by factors such as the timing of antibiotic administration, the choice of antibiotic, and the presence of risk factors like prolonged labor and membrane rupture. The standard practice in many developing countries involves the administration of antibiotics post-cord clamping, which has been challenged by recent studies suggesting that preoperative administration can significantly reduce infection rates without adverse effects on neonatal outcomes. A shift towards a single dose of broad-spectrum antibiotics such as cephalosporins administered 30-60 minutes before incision is recommended based on our findings. This approach aligns with the successful reduction of infectious morbidity observed in developed countries and supports the need for standardized guidelines. Furthermore, our study underscores the importance of healthcare provider education and the establishment of clear protocols for antibiotic prophylaxis in cesarean sections. By adopting these improvements, developing countries can achieve a significant reduction in maternal morbidity and contribute to safer childbirth practices.