Adenomyosis is a benign gynecologic disease that mainly affects women aged 30–50 years old. Background: This pathology is characterized by glands and stroma of the endometrium that enter the myometrium and is confirmed through histopathological examination after hysterectomy. Transvaginal ultrasound is the most accepted imaging approach for the diagnosis and classification of adenomyosis. Existing medical treatments are not curative and are associated with several side effects. Uterine artery embolization is an alternative treatment for controlling the symptoms of adenomyosis with less trauma while preserving the uterus. Methods: The aim of our study was to observe the utility of uterine artery embolization (UAE) compared to hysterectomy in specific cases of adenomyosis. A retrospective cohort study was carried out between February 2024 and April 2025. We included 52 patients in our study: 27 opted for hysterectomy, while the other 25 chose to receive uterine artery embolization between January 2017 and December 2018. Clinical follow-up was assessed using a questionnaire regarding symptomatic changes in menorrhagia, pelvic pain, and quality of life before and after the surgical procedure. Statistical analyses were performed. Results: Patients opted for hysterectomy in cases of severe abnormal uterine bleeding before surgery that severely affected quality of life (p < 0.03 and p < 0.001). After surgery, pelvic pain improved for women who underwent UAE, but patients also reported no pelvic pain after hysterectomy. Furthermore, mild to moderate abnormal uterine bleeding was reported in cases of UAE, and bleeding stopped completely for women who had their uterus removed (p < 0.001). Quality of life improved for both groups and was reported as being good after the interventions. Conclusions: Embolization remains an alternative therapeutic option in adenomyosis but not a substitute for hysterectomy. This was concluded based on a case-by-case evaluation, depending on the desire for pregnancy, with a focus on improved clinical outcomes.

Preeclampsia is a common pregnancy complication that may threaten the health of pregnant women and their fetuses. Intrauterine growth restriction is the most serious complication in fetal development observed in preeclampsia. In their later years, women with preeclampsia are at risk of cardiovascular disease. The use of multiple biomarkers can usually improve diagnostic performance. Currently, S100A8 and S100A9 are gaining increased attention as inflammatory markers of preeclampsia. Our review aims to present an integrated view of the potential role of S100A8/A9 in the physiopathology of preeclampsia. We also explored the potential role as biomarker or in targeted treatment. At the moment, there is no efficient treatment for PE other than birth. Understanding the pathological mechanisms and the importance of calprotectin can shape a new strategy for large-scale approaches to change diagnostic and therapeutic management. The value of the calcium binding proteins S100A8/A9 as a potential prognostic biomarker in placental disfunctions based on malperfusion has not yet been investigated. Encouraging results have been obtained in experimental and clinical interventional studies with S100A8/A9 blockers as a form of therapeutic management for autoimmune disease and cancer. It may also be limited because of safety issues for the fetus. However, future investigations can emerge.

Background and objectives: The prevalence of uterine malformations, affecting up to 7% of the general population, is associated with high rates of pregnancy complications, such as infertility, miscarriage, preterm delivery, malpresentation, ectopic pregnancy, and other complications, with high rates of both maternal and fetal morbidity and mortality. Surgical procedures have been proposed to remediate these anomalies, with different outcomes. In this context, our study aimed to emphasize the complications encountered in our department and the pregnancy results. Materials and Methods: A retrospective cohort study was performed on all the women who delivered in one university-affiliated medical center between 2010 and 2017 with congenital uterine malformations. A total of 62 women were included: 26 with uterine malformations and 36 as controls. Statistical analyses were performed with the level of statistical significance set at p < 0.05. Results: Only 53.8% of the pregnancies in women with uterine malformations ended in a live birth. The cesarean section rate was 64.3% in the study group. The only successful surgical procedure performed to restore fertility was cerclage. A lower Apgar score and a higher rate of neonate admission into the intensive care unit were observed in the study group, at 11.5% compared to 0 in the control group. The most important complication encountered with statistical significance was preterm delivery. Conclusions: This study demonstrated that uterine congenital malformations are an independent risk factor for pregnancy complications.

The fetal fraction (FF) of cell-free DNA determines the reliability of non-invasive prenatal testing (NIPT); whether first-trimester placental biomarkers add information beyond maternal factors is unclear. We linked NIPT samples from a single fetal medicine center over ten years (1162 pregnancies) to first-trimester screening records and modeled log FF with hierarchical regression (maternal/technical covariates → PAPP-A → free β-hCG), cluster-robust standard errors, and an order-independent bootstrapped partition of the biomarker contribution. In the primary complete-case model (n = 292), FF was 3.4% lower per kg/m² of BMI (95% CI −4.4 to −2.3) and 24% lower after IVF/ICSI. Free β-hCG was independently associated with FF (+11.0% per doubling of MoM, 95% CI +5.3 to +16.9; semi-partial R² = 0.046), whereas the PAPP-A association was weaker and less consistent (+4.8%, 95% CI −0.6 to +10.4; semi-partial R² = 0.010). The β-hCG association persisted after excluding high-risk NIPT calls, documented multiple gestation and IVF/ICSI, within platform-restricted subsets and with a restricted documentation-to-draw interval. No independent association with gestational age was identified in the primary model; low-FF and no-call results were too few for adjusted inference. Free β-hCG carries independent information on FF, consistent with, but not proof of, a link to syncytiotrophoblast biology.

Background/Objectives: First-trimester screening for preeclampsia (PE) with the Fetal Medicine Foundation (FMF) competing-risks algorithm assigns each pregnancy a numeric risk (1:X), which is compared against a threshold to decide aspirin eligibility. What proportion of a real-world screened population a given numeric threshold actually selects—its screen-positive rate (SPR)—depends on which markers were available and on the population’s underlying risk distribution, independently of how well that threshold detects PE. We audited this relationship directly from routine data from a single centre. Methods: Retrospective cohort of 5493 singleton pregnancies with a first-trimester PE risk calculated at 11–14 weeks (2020–2026) in one Romanian fetal-medicine centre. Pregnancies were stratified into five groups according to which markers were available at screening (maternal factors ± biochemistry [PAPP-A] ± uterine artery pulsatility index [UtA-PI] ± mean arterial pressure [MAP]), and the centre-specific SPR at fixed risk thresholds and the risk threshold corresponding to fixed SPR targets of 5%, 10%, 15% and 20% were computed for each group. The operational clinical threshold (1:150 before and 1:100 after the introduction of systematic MAP measurement in October 2023) was benchmarked against this map. Outcome ascertainment was quantified to determine whether these data could support any estimate of detection performance. Results: Among pregnancies screened with the maternal factors + MAP + UtA-PI + PAPP-A combination now used in routine practice (n = 1797), the operational threshold of 1:100 corresponded to an SPR of 16.7%, closer to the 15% than the 10% mapping point (local threshold for SPR = 10%: 1:66); the same numeric threshold corresponded to an SPR of only 11.0% among pregnancies screened with maternal factors and UtA-PI alone (n = 317). The historical reduction in SPR from 25.0% (pre-October 2023, threshold 1:150) to 16.1% (post-October 2023, threshold 1:100) was attributable mainly to the threshold change itself, since a same-era comparison at an identical fixed threshold (1:100) showed little difference in SPR between examinations with and without MAP (16.2% vs. 16.0%). Documented pregnancy outcome was available for only 13.5% of pregnancies (742/5493) and was strongly enriched for complicated pregnancies (documented PE prevalence 5.53% in this subset versus 0.87% in the whole cohort and 0.87–1.2% in published Romanian single-centre series). Consequently, outcome data in this dataset were considered unsuitable for local estimation of detection performance or treatment effect, and no such estimate is offered. Conclusions: The numeric risk threshold used clinically does not correspond to a fixed screen-positive rate across marker combinations in routine practice; local mapping of this relationship is a low-cost, outcome-independent audit that any screening centre can perform on its own data before, and independently of, any attempt to validate detection performance.

Background and Objectives: The 11–13⁺⁶-week scan has evolved from a nuchal translucency (NT) measurement into an early anatomical survey, and the anomalies it identifies increasingly shape prenatal counselling and management. Data from Central and Eastern European screening populations are scarce. Materials and Methods: Retrospective cohort of all pregnancies undergoing first-trimester combined screening in a single fetal medicine centre in Romania between August 2009 and April 2026, with a crown–rump length of 45–84 mm. The centre provides routine screening but also receives women referred after an abnormal finding elsewhere; the cohort is therefore described as a screening population with referral enrichment. Structural anomalies recorded prospectively in the ultrasound database at the first-trimester scan were classified by organ system and by first-trimester detectability category. NT, combined risk, karyotype and pregnancy outcome were extracted from the same database. Associations were quantified with odds ratios (OR) from logistic regression with cluster-robust standard errors by woman. Results: 11,229 pregnancies (10,015 women; 408 multiple pregnancies) were included. A structural anomaly was identified at 11–13⁺⁶ weeks in 197 (17.5 per 1000; 95% CI 15.3–20.1); 16.1 per 1000 (13.8–18.7) after exclusion of the years 2009–2012 and 16.9 per 1000 (14.6–19.5) in singleton pregnancies. A further 44 pregnancies had isolated cystic hygroma/hydrops or soft markers only. Cardiac defects (81; 7.2 per 1000) and abdominal-wall defects (74; 6.6 per 1000, of which 67 exomphalos) were present in 145 pregnancies (74%), followed by central nervous system (27), facial (23), skeletal (23), thoracic (10) and urogenital (10) anomalies; 37 pregnancies (19%) had anomalies in two or more systems. NT ≥ 3.5 mm was present in 59/197 (30%) anomalous versus 203/11,032 (1.8%) non-anomalous pregnancies (OR 22.8, 95% CI 16.3–31.9), and in 51% of cardiac defects. Among 37 karyotyped fetuses, 15 (41%) had a chromosomal abnormality. Pregnancy outcome was known for 87 anomalous pregnancies: 46 terminations, 33 live births and 8 fetal or neonatal deaths; 17 of 30 exomphalos cases with known outcome were live-born. Conclusions: In a screening population with referral enrichment, about 1 in 57 pregnancies had a structural anomaly identified at the 11–13⁺⁶-week scan, dominated by cardiac and abdominal-wall defects; the figure describes prenatally identified anomalies in this setting and is not a population-based prevalence. One third of these fetuses had increased NT and a high proportion of those tested had an abnormal karyotype, supporting the integration of systematic anatomical assessment and genetic evaluation into first-trimester screening.