Proteinuria is a widely used biomarker for risk stratification in hypertensive pregnancies, with potential predictive value for adverse maternal and perinatal outcomes. This study evaluated the predictive value of 24-hour urine protein levels for adverse maternal and perinatal outcomes in hypertensive pregnancies. A retrospective cohort of 213 pregnant women with hypertension was categorized into four groups based on proteinuria severity: 2000 mg (n = 19). Higher proteinuria levels were significantly associated with increased rates of oligohydramnios (p = 0.001) and fetal growth restriction (FGR; p = 0.005), particularly in the > 2000 mg group (44.0% and 68.4%, respectively). Gestational age at delivery decreased with worsening proteinuria (p < 0.001), with the lowest mean age (32.84 ± 3.82 weeks) in the > 2000 mg group. Postpartum hospital stays were prolonged in chronic hypertension (p = 0.002) and severe proteinuria groups (p = 0.007). ROC analysis identified a 24-hour urine protein cutoff of 135 mg (AUC: 0.635, p = 0.001) for predicting fetal distress. The > 2000 mg group had universal magnesium sulfate use, earlier deliveries, and higher FGR rates. Chronic hypertension correlated with longer postpartum stays (p = 0.002) and higher postpartum renal disease (p = 0.040). These findings underscore proteinuria as a prognostic marker for adverse outcomes, supporting its role in risk stratification for hypertensive pregnancies. Future research should validate thresholds and explore targeted interventions.

Preeclampsia (PE) is characterized by systemic inflammation and endothelial dysfunction, contributing to adverse maternal and neonatal outcomes. Antenatal corticosteroids (ACS) therapy is widely used to enhance fetal lung maturity in women at risk of preterm birth. However, little is known about the dynamic changes in maternal inflammatory markers after ACS administration in PE and their potential predictive value for perinatal outcomes. This retrospective cohort study included 206 pregnant women with PE who received ACS therapy due to preterm birth risk. Complete blood count (CBC) parameters and systemic inflammatory indices were recorded before and after ACS. Delta (Δ) values were calculated to reflect the percentage change between pre- and post-ACS measurements. Correlations between Δ inflammatory markers and perinatal outcomes were analyzed, and predictive performance was assessed using receiver operating characteristic (ROC) curve analysis. Following ACS administration, neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and aspartate aminotransferase-to-platelet ratio (APRI) increased significantly, while lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) decreased. Δ mean platelet volume (MPV), Δ aspartate aminotransferase (AST), Δ Lactate Dehydrogenase (LDH), ΔNLR, and ΔAPRI showed low-level positive correlations with umbilical cord blood pH. ROC analysis indicated that ΔMPV ≤ 1.81 (area under the curve (AUC) = 0.664) and ΔAPRI ≤ 1.81 (AUC = 0.605) moderately predicted neonatal intensive care unit (NICU) admission. Dynamic changes in maternal inflammatory markers occur after ACS therapy in preeclamptic pregnancies. ΔMPV and ΔAPRI demonstrated potential predictive value for NICU admission, highlighting their possible clinical utility in risk stratification. These findings provide novel insight into the maternal inflammatory response to ACS in PE and its implications for perinatal outcomes.

The coexistence of adenomyosis and cancer of the endometrium has attracted heightened scrutiny, leading to inquiries regarding their possible interactions and clinical ramifications. This study sought to assess the influence of adenomyosis on tumor features and survival outcomes in patients with endometrioid-type endometrial carcinoma. A retrospective cohort analysis was performed on 422 patients who underwent surgical intervention for endometrioid-type endometrial carcinoma. The cohort was categorized into two groups according to the presence or absence of adenomyosis. Clinical and pathological data were gathered and evaluated to compare tumor features and survival outcomes between the two cohorts. Adenomyosis was present in 144 (34.1%) patients. Patients in the adenomyosis group demonstrated significantly higher gravidity and parity compared to those without adenomyosis. Lymphovascular space invasion was detected in 8.3% of the adenomyosis group compared to 17.6% in the non-adenomyosis group (a 53% reduction, p = 0.010). Similarly, rates of myometrial invasion (81.3% vs. 65.5%, p = 0.001), cervical stromal invasion (9.0% vs. 14.1%, p = 0.005), and lymph node metastasis (4.2% vs. 14.4%, p = 0.001) were significantly lower in patients with adenomyosis. The five-year overall survival rate was 90.8% in the adenomyosis group and 87.1% in the non-adenomyosis group, although this difference was not statistically significant (p = 0.689). This study demonstrates that adenomyosis is associated with a significant reduction in aggressive tumor characteristics such as myometrial invasion, lymphovascular space involvement, and lymph node metastasis in patients with endometrioid-type endometrial cancer. These findings emphasize that adenomyosis may be a potential protective factor in endometrial cancer prognosis and should be considered in clinical risk assessment. Prospective studies with larger cohorts are needed to confirm the long-term effects of adenomyosis on survival.

OBJECTIVE: The objective of the study was to investigate the predictive value of red blood cell distribution width-standard deviation (RDW-SD) and another complete blood count (CBC) derived blood markers in patients presenting with threatened abortion concerning miscarriage. STUDY DESIGN: This retrospective cross-sectional study included a cohort of 222 women with threatened abortion in the first trimester. The study group consisted of 114 patients who underwent miscarriage, and the control group included 108 pregnant women who delivered at term. The prognostic potential of RDW-SD and other CBC indices, readily obtainable from blood counts at the presentation of threatened abortion, was examined in the context of miscarriage development. The predictive value was calculated using the Receiver Operating Characteristic (ROC) curve. RESULTS: The analysis revealed a statistically significant decline in RDW-SD within the miscarriage cohort compared to the control group. Notably, no statistically significant differences were identified in the neutrophil-lymphocyte ratio (NLR), derived NLR (DNLR), systemic inflammatory immune index (SII), platelet-to-lymphocyte ratio (PLR), and delta neutrophil index (DNI). CONCLUSION: In this study, we found that RDW-SD, as a novel inflammatory mediator may be a useful marker for miscarriage in first trimester bleeding. However, it should be noted that traditional CBC indices, including NLR, DNLR, SII, PLR, and DNI, were found to be unsuitable indicators for miscarriage in threatened abortion.