Background and Objectives: The incidence of labor induction is steadily increasing worldwide. The main aim of this study was to evaluate the ultrasound parameters and their mutual correlation and to analyze the parameters’ predictive capability in assessing the success of labor induction. The secondary goal was to assess patients’ tolerability and acceptance of transvaginal ultrasound and digital gynecological examination. Materials and Methods: This prospective observational follow-up study included 252 women selected for labor induction. The transvaginal ultrasound examination measured the posterior cervical angle, cervical length, the length and width funneling of the cervix, the distance between the head of the fetus and the external uterine os, and the position of the fetal occiput. After the ultrasound, a digital vaginal examination was performed (according to the Bishop score), and the women were asked to rate their perception of pain for each procedure. Results: The most common indication for labor induction was post-term pregnancy (57.59%), and the most common method of labor induction was oxytocin with amniotomy (70%). The results showed that a significant independent prediction of vaginal delivery could be provided based on the Bishop score and cervical length. Other investigated ultrasound parameters, the length and width of the funneling of the cervix (p < 0.001), the fetal head stage (p < 0.001), and the size of the posterior cervical angle (p < 0.05), showed statistical significance in relation to the success of labor induction. Patients reported lower discomfort and pain during transvaginal ultrasound examination (mean score 2, IQR 3) compared to digital examination (mean score 5, IQR 4), with p < 0.001. Conclusions: The results imply that the assessment of ultrasound parameters before induction of labor is necessary to predict the outcome and reduce the possibility of complications. In terms of tolerability and choice by the patients, the transvaginal ultrasound examination was better rated than the vaginal gynecological examination.

This study investigates the bioactivity profile of wood-rotting fungal species Daedaleopsis confragosa (Bolton) J. Schröt. 1888, focusing on its antioxidant, cytotoxic, and genotoxic activities and enzyme modulation properties with respect to its possible application in terms of enhancing women’s reproductive health. Two types of extracts, including those based on EtOH extraction (DC) and hydrodistillation (DCHD), were investigated. The results indicate that the radical scavenging capacity against the DPPH radical and reduction potential were stronger in the DC extracts owing to the higher total phenolic content (TPC) and total flavonoid content (TFC) (25.30 ± 1.05 mg GAE/g d.w. and 2.84 ± 0.85 mg QE/g d.w., respectively). The same trend was observed in the protein phosphatase-1 (PP1) activity and in the genotoxic activity against the δ virus since only the DC extract exhibited DNA disintegration regarding a dilution of 1:100. Conversely, the DCHD extract exhibited increased hemolytic and cytotoxic effects (339.39% and IC₅₀ = 27.76 ± 0.89 μg/mL—72 h incubation, respectively), along with greater inhibition of the AChE enzyme (IC₅₀ = 3.11 ± 0.45 mg/mL) and hemolytic activity. These results suggest that terpenoids and steroids may be responsible for the observed activity in DCHD as these compounds could potentially be extracted following the HD procedure. This comprehensive bioactivity profiling offers valuable insights into the potential therapeutic applications of D. confragosa from Serbia and underscores the importance of further investigations for harnessing its pharmacological potential.

Gestational hypertension (GH) and preeclampsia (PE) are associated with the onset of hypertension. This study aimed to investigate whether the blood pressure (BP) pattern in GH is associated with the prevalence of hypertension later in life. In this prospective cohort study pregnant women screened for GH underwent medical history, laboratory analysis, ambulatory blood pressure monitoring (AMBP), and transthoracic echocardiography (with left ventricular global longitudinal strain (LVGLS)) assessment. Overall, 138 GH (67 non-dippers and 71 dippers), 55 preeclamptic, and 72 normotensive pregnant controls were included. Women were followed in the postpartum period, first after 6 weeks and later on, for the occurrence of hypertension. The median follow-up was 8.97 years (8.23; 9.03). Non-dippers and PE compared with normotensives and dippers had a higher prevalence of hypertension onset (p < 0.01), as well as significantly reduced absolute values of LVGLS during pregnancy, after delivery, and at the time of onset of hypertension during follow-up (p < 0.01). Night-time diastolic BP, LVGLS, age, and left ventricular ejection fraction were the strongest predictors of postpartum onset of hypertension. The non-dipping BP pattern in GH was significantly associated with the onset of hypertension later in life, as well as with decreased systolic function.

Introduction. Uterine rupture is a rare complication of induced termination of pregnancy in the second trimester. We report a case of a patient with a rupture of the unscarred uterus during a prostaglandin-induced abortion in the second trimester of pregnancy. Case Report. A 26-year-old pregnant woman was admitted to the Clinic of Gynecology and Obstetrics in the 22nd week of gestation of her fourth pregnancy due to complete absence of amniotic fluid. The patient denied previous surgeries and other diseases. Due to a poor prognosis for the fetus, the Ethics Committee approved the termination of pregnancy. The induction of abortion was started by applying two dinoprostone gels intracervically and continued by using carboprost tromethamine intramuscularly. The patient aborted after 38 hours from the start of induction. During instrumental revision of the uterine cavity, a rupture of the right side of the uterus was suspected. Ultrasound examination showed a parametrial hematoma. Laparotomy was indicated due to suspected uterine rupture. The intraoperative findings showed a hematoma located in the right parametrium and a complete rupture of the posterior wall of the uterus extending from the right vaginal fornix to the right uterine horn. A total abdominal hysterectomy with preservation of both ovaries was performed. Conclusion. Since ruptures of the unscarred uterus are rare, almost at the chance level, it is important to always keep them in mind as a potential complication of induced termination of pregnancy in the second trimester.

Background: Hypertensive disorders in pregnancy (HDP) are associated with adverse pregnancy outcomes. Three-dimensional (3D) echocardiography provides greater accuracy for assessing cardiac geometry and function during pregnancy. The aim was to assess the impact of the 3D left ventricle (LV) systolic function in HDP on pregnancy outcomes. Methods: The prospective cohort study included primiparous with singleton pregnancies, without previous comorbidities who underwent medical history assessment, laboratory tests, ambulatory blood pressure monitoring (ABPM), and transthoracic echocardiography at baseline and six weeks after delivery. Participants were divided into a HDP group and a control group. Pregnancy outcomes (intrauterine growth restriction (IUGR), preterm delivery, and birth weight) were recorded and analyzed. Results: The study involved 174 HDPs and 64 controls, with a median gestational age of 34 weeks (31; 36). Compared to controls HDP exhibited significantly impaired values in both two-dimensional (2D) and 3D parameters for the systolic and diastolic function of the LV. They had higher LV mass index values and lower absolute values for 2D global longitudinal strain and 3D LV strain in all directions (p < 0.001). Multivariable regression analysis revealed that body mass index (BMI) with odds ratio (OR) of 0.751 (95% confidence interval (CI): 0.666–0.847, p < 0.001) and 3D LV global area strain (GAS) with OR of 0.234 (95% CI: 0.155–0.352, p < 0.001) were the strongest predictors of IUGR, while BMI with OR of 0.832 (95% CI: 0.758–0.914), nighttime systolic blood pressure (SBP) with OR of 1.055 (95% CI: 1.032–1.079, p < 0.01) and 3D LV ejection fraction (EF) with OR of 0.780 (95% CI: 0.687–0.885) were the strongest predictors of preterm delivery. The receiver operating characteristic (ROC) curve showed that the model with BMI and 3D LV GAS can be a good predictor for IUGR with an area under the curve (AUC) 0.951 (0.925–0.976) with 89.5% sensitivity and 86.4% specificity, p < 0.001, while the model with BMI, nighttime SBP and 3D LV EF is a predictor for preterm delivery with AUC of 0.835 (0.776–0.893) with 79.1% sensitivity and 73.7% specificity, p < 0.001. Person correlation showed a significant positive correlation between birth weight and 3D GAS, r = 0.485; p < 0.001. Conclusions: LV GAS is significantly associated with IUGR and birth weight, while 3D LV EF strongly predicts preterm delivery.

Introduction. In in-vitro fertilization pregnancies, the precise date of conception is known. Relying solely on the embryo transfer date for pregnancy dating can lead to inaccuracies and mismanagement in prenatal care. This study aimed to compare gestational age estimated by first-trimester ultrasound measurements with gestational age determined by the known date of embryo transfer. Material and Methods. This retrospective study included 30 patients who conceived through in-vitro fertilization. Only patients with singleton pregnancies who underwent first-trimester ultrasound screening by a single sonographer between January 2008 and March 2024 were included. Gestational age was calculated for each patient based on ultrasound measurements of crown-rump length and the date of embryo transfer. Results. Gestational age estimated by ultrasound in our study was statistically significantly higher than that determined by the embryo transfer date. The mean difference was 0.9 days (?2.14, 95% confidence interval [0.1, 1.7]) (p<0.05), and a median difference was 0.5 days (interquartile range 0-2.75) (p<0.05). Conclusion. Gestational age estimated by crown-rump length was higher than that calculated by the known date of conception. For pregnancies conceived through in-vitro fertilization, it is advisable to consider both the date of embryo transfer and the gestational age calculated from ultrasound measurements for more accurate pregnancy dating.