Obesity is a major, modifiable driver of endometrial carcinogenesis. This review distills how excess adiposity promotes malignant change and synthesizes prevention strategies across the hyperplasia–cancer continuum. Three converging axes underpin risk: aromatase-mediated estrogen excess; insulin resistance with hyperinsulinemia activating PI3K–AKT–mTOR signaling; and adipokine-driven low-grade inflammation with downstream NF-κB/STAT3 activity. Within this framework, EIN is the key precursor in which these pathways coalesce. Risk can be attenuated through progestin-based therapy (levonorgestrel-releasing intrauterine system or continuous oral regimens), structured weight management, and metabolic adjuncts in selected phenotypes (e.g., metformin for insulin resistance; incretin-based anti-obesity agents as emerging options). Bariatric surgery produces substantial weight loss and favorable metabolic shifts, though evidence for cancer risk reduction is largely observational. Overall, a practical precision-prevention approach—combining progestins with durable weight control and metabolic optimization under guideline-concordant surveillance—appears feasible in routine gynecologic care. Future research should establish causal effects, durability, and optimal sequencing/combination of interventions in trials with endometrial endpoints.

Background and Objectives: We aimed to prospectively obtain data on pregnancies complicated with intrauterine growth restriction (IUGR) in the Prenatal Diagnosis Unit of the Emergency County Hospital of Craiova. We collected the demographic data of mothers, the prenatal ultrasound (US) features, the intrapartum data, and the immediate postnatal data of newborns. We aimed to assess the detection rates of IUGR fetuses (the performance of the US in estimating the actual neonatal birth weight), to describe the prenatal care pattern in our unit, and to establish predictors for the number of total hospitalization days needed postnatally. Materials and Methods: Data were collected from cases diagnosed with IUGR undergoing prenatal care in our hospital. We compared the percentile of estimated fetal weight (EFW) using the Hadlock 4 technique with the percentile of weight at birth. We retrospectively performed a regression analysis to correlate the variables predicting the number of hospitalization days. Results: Data on 111 women were processed during the period of 1 September 2019–1 September 2022. We confirmed the significant differences in US features between early- (Eo) and late-onset (Lo) IUGR cases. The detection rates were higher if the EFW was lower, and Eo-IUGR was associated with a higher number of US scans. We obtained a mathematical formula for estimating the total number of hospitalization days needed postnatally. Conclusion: Early- and late-onset IUGR have different US features prenatally and different postnatal outcomes. If the US EFW percentile is lower, a prenatal diagnosis is more likely to be made, and a closer follow-up is offered in our hospital. The total number of hospitalization days may be predicted using intrapartum and immediate postnatal data in both groups, having the potential to optimize the final financial costs and to organize the neonatal department efficiently.

Premature rupture of membranes (PROM) and cervical incompetence (CI) are major contributors to preterm birth, a leading cause of neonatal morbidity and mortality. Background/Objectives: Disorders of the vaginal microbiota, such as bacterial vaginosis, have been associated with an increased risk of PROM, CI, and subsequent preterm birth. Probiotics, particularly Lactobacillus strains, have been proposed as a preventive strategy to restore and maintain a healthy vaginal microbiome. This review aims to summarize the latest evidence on the role of probiotics in the prevention of PROM and CI. Methods: A comprehensive review was conducted to evaluate the effectiveness of probiotic interventions in the prevention of PROM and CI, yielding 1809 records from 2005 to 2024. Seven relevant studies were selected by searching medical databases and focusing on studies that investigated the restoration of healthy vaginal flora, the reduction of pathogenic bacteria colonization, and the modulation of immune responses by probiotics. Results: The studies analyzed suggest that probiotics may help restore healthy vaginal flora, reduce pathogenic bacterial colonization, and modulate immune responses, thereby reducing the risk of membrane rupture and cervical insufficiency. Evidence from randomized controlled trials and observational studies shows that the use of probiotics is associated with a lower incidence of PROM and preterm birth, especially in high-risk groups. Conclusions: Probiotics emerge as a potential non-invasive and cost-effective strategy to improve pregnancy outcomes in women at risk of preterm birth due to PROM. According to our research, probiotic prophylaxis of cervical insufficiency has not yet been sufficiently investigated. Despite the promising findings, further research is needed to determine standardized probiotic formulations, optimal timing, and routes of administration. Personalized probiotic therapies may represent the future of preterm birth prevention as they offer targeted interventions based on individual microbiome composition.

This is a single tertiary population-based study conducted at a center in southwest Romania. We retrospectively compared data obtained in two periods: January 2008–December 2013 and January 2018–December 2023. The global incidence of the transposition of great arteries in terminated cases, in addition to those resulting in live-born pregnancies, remained almost constant. The live-birth incidence decreased. The median gestational age at diagnosis decreased from 29.3 gestational weeks (mean 25.4) to 13.4 weeks (mean 17.2). The second trimester and the overall detection rate in the prenatal period did not significantly change, but the increase was statistically significant in the first trimester. The proportion of terminated pregnancies in fetuses diagnosed with the transposition of great arteries significantly increased (14.28% to 75%, p = 0.019).

This is a single tertiary center in southwest Romania, population-based, study. We retrospectively compared data obtained in two periods: January 2008 - December 2013 and January 2018 - De-cember 2023, respectively. The global incidence of transposition of great arteries (TGA) - the ter-minated cases added to the ones resulting in live-born pregnancies, remained almost constant. The live-born incidence of TGA decreased (0.34% to 0.013%). The prenatal detection rate increased slightly (71.42% to 87.5%). The median gestational age at the diagnosis decreased, from 29.3 ges-tational weeks (mean 25.4) to 13.4 weeks (mean 17.2). The proportion of terminated pregnancies significantly increased (14.28% to 75%, p = 0.019).

This chapter is dedicated to the main renal anomalies detectable by ultrasound. Anomalies of the lower urinary tract will be addressed in a separate chapter. The anomalies presented are renal agenesis, renal development variants, autosomal recessive polycystic kidney disease, multicystic dysplastic kidney disease, autosomal dominant polycystic kidney disease, obstructive cystic dysplasia, pelvis dilatation, renal tumors, and nonchromosomal syndromes associated with renal anomalies. All chapters are structured similar into definition, incidence, pathology, ultrasound findings, differential diagnosis, and clinical facts.