Background/Objectives: Multidrug-resistant urinary tract infections (MDR UTIs) constitute an important public health problem, especially in pregnant patients. The aim of this retrospective study was to characterize the bacterial spectrum and the profile of microbial resistance in cases of UTIs occurring in pregnant women, as well as their impact on obstetrical and neonatal outcomes. Methods: A total of 371 pregnant patients with UTIs were included in the analysis and were segregated into the following groups based on the type of bacterial resistance to antibiotics: MDR UTIs (70 patients, group 1), UTIs resistant to one class of antibiotics (108 patients, group 2), UTIs resistant to two classes of antibiotics (102 patients, group 3), and sensitive UTIs (91 patients, group 4). We used descriptive statistics for characterizing and comparing the microbial spectrum and the clinical characteristics of the patients. A multinomial logistic regression model for evaluating the relationship between the type of urinary tract infection and adverse obstetric or neonatal outcomes was employed. Results: In the case of MDR UTIs, the bacterial spectrum mainly included Escherichia coli, Enterococcus faecalis, and Klebsiella species. We found almost universal resistance to ampicillin. Our data confirmed an increased risk of preterm birth, premature rupture of membranes, neonatal respiratory distress syndrome, and neonatal intensive care unit admission for patients with MDR infections. Conclusions: The increased incidence of pathogens resistant to commonly used antibiotic classes in pregnancy suggests the need for the development of local and national protocols that adapt therapeutic and prophylactic regimens to clinical realities.

The link between endometriosis and ovarian carcinoma has been recognized early on, initially termed endometriosis-associated ovarian carcinoma and subsequently referred to as endometriosis-associated ovarian carcinoma (EAOC). The relationship between endometriosis and cancer is well supported by epidemiological evidence, highlighting common risk factors. Two potential mechanisms have been proposed: one involving the direct malignant transformation of endometriotic lesions, and the other suggesting a shared origin in precursor mechanisms or risk factors, followed by distinct molecular pathways. This chapter explores the epidemiological links, molecular mechanisms, and clinical implications of endometriosis-associated ovarian carcinoma, highlighting its distinct subtypes and risk factors.

Background: Preoperative stress is a multifactorial phenomenon shaped by physiological, psychological, and social influences, with a substantial impact on postoperative recovery. This study aimed to quantify preoperative stress levels, identify associated factors, and rank their predictive importance. Methods: A prospective study was conducted on 197 patients scheduled for general surgery, orthopedics, neurosurgery, or otorhinolaryngology procedures between December 2024 and June 2025 at Suceava County Emergency Clinical Hospital. Stress levels were assessed using the Brief Measure of Emotional Preoperative Stress (B-MEPS), translated and culturally adapted into Romanian. Statistical analyses included nonparametric tests, generalized linear modeling, and Random Forest regression. Results: The mean B-MEPS score was 21.42 ± 6.04 (range: 11–34), indicating a moderate level of preoperative stress. Higher stress scores were significantly associated with female sex (p < 0.001), lower educational attainment (p = 0.003), divorced marital status (p = 0.007), a history of cancer (p = 0.002), and the type of surgical intervention (p = 0.003). Random Forest analysis identified the type of surgery, educational level, and sex as the strongest predictors. Conclusions: Preoperative stress is chiefly influenced by the type of surgical procedure, educational level, and sex, with potential synergistic effects among these factors. Early identification of high-risk patients enables targeted, personalized interventions to mitigate anxiety and improve perioperative outcomes. Further research should include formal validation of the Romanian version of B-MEPS and the integration of additional psychosocial variables.

Background: Low-grade endometrial stromal sarcoma (LG-ESS) is a rare uterine mesenchymal neoplasm characterized by indolent progression and strong hormonal responsiveness. Accurate diagnosis remains challenging due to its overlapping clinical, pathological, and imaging features with other benign or malignant uterine entities. Case Presentation: This article presents a case of LG-ESS in a 50-year-old woman, encompassing the clinical presentation, imaging features, histopathological and immunohistochemical findings, the surgical management and postoperative course, as well as a focused synthesis of the current literature on this pathology. The patient presented with recurrent abnormal uterine bleeding and secondary anemia. Imaging data, including magnetic resonance imaging (MRI), revealed a heterogeneous intracavitary lesion with cystic components, suggestive of submucosal fibroids. Surgical management via total hysterectomy with bilateral salpingo-oophorectomy was performed due to suspicion of sarcoma and the need to suppress hormonal stimulation. Histopathological and immunohistochemical evaluation confirmed LG-ESS. The patient had no lympho-vascular invasion, presenting a favorable postoperative evolution. Conclusions: This case highlights the need to maintain a strong clinical suspicion for uterine sarcomas in patients presenting with atypical bleeding and presumed fibroids, especially among perimenopausal women. A multidisciplinary approach, including imaging, surgery, pathology, molecular profiling, and oncology, is essential for accurate diagnosis and optimal management.

The new developments in hysteroscopic surgery are increasing the advantages and decreasing the risks related to electrosurgical surgery. One of the most promising such device in the mechanical tissue removal hysteroscopic system (MTRHS), which uses simple mechanic energy to cut and aspirate intrauterine pathologies: myomas, polyps, uterine septum, retained products of conception. The advantages, when compared to the classical electrical resectoscope, are related to a minimal risk of perforation, less risk of intravasation (TURP syndrome), and faster removal. The disadvantages are pathologies that are not inside the uterine cavity, bleeding, and the need to collaborate with a pathologist because of the small fragments that are sent for examination. We critically evaluate the literature data, adding some personal experience, and conclude that the MTRHS is a promising device that could encourage young hysteroscopists to use the surgical approach.

Background: Adolescent pregnancy is associated with increased maternal and neonatal morbidity, particularly in the context of inadequate prenatal care. Understanding the distribution of maternal and obstetrical complications in this population is important for improving clinical management and pregnancy outcomes. Methods: This retrospective observational study included primiparous adolescent patients (≤18 years) and focused on the assessment of maternal and obstetrical complications. The analysis compared the frequency of these complications between adolescents with adequate prenatal care and those without adequate prenatal follow-up, aiming to identify the most common complications and their distribution according to antenatal care status. Results: Significant differences were identified between groups. Maternal infections were more frequent among patients without adequate prenatal care (24.1% vs. 9.3%, p = 0.039). Hemorrhage was significantly more frequent among patients with adequate prenatal care (59.3% vs. 35.2%, p = 0.012). Among obstetrical complications, cephalopelvic disproportion showed a significant association with prenatal care status (p = 0.034), occurring more frequently in patients without antenatal follow-up. Hypertensive disorders, including gestational hypertension and preeclampsia, were identified only among patients without adequate prenatal care; however, no statistically significant association was observed (p = 0.118). Placenta previa (p = 0.057) and placental abruption (p = 0.495) were also observed only among patients without adequate prenatal care. Conclusions: Primiparous adolescent patients without adequate prenatal care showed a higher frequency of maternal and obstetrical complications, particularly infections and delivery-related disorders. Prenatal monitoring was associated with earlier identification and management of maternal and obstetrical risk factors. These findings highlight the importance of improving access to antenatal care among adolescent populations.