Background/Objective: Preeclampsia is a hypertensive disorder associated with pregnancy that has a significant impact on maternal and neonatal health and has the potential to result in significant perinatal adverse outcomes. Maternal education has been proposed as a protective factor during pregnancy; however, its role in preeclamptic pregnancies remains unclear. This study aimed to explore the relationship between maternal education level, as defined by ISCED classification, and neonatal outcomes (birth weight, gestational age, and APGAR score) in pregnancies complicated by preeclampsia. Methods: A retrospective case-control analysis was conducted on 674 deliveries at a single tertiary center in Western Romania between January 2022 and August 2024. Neonatal outcomes, specifically birth weight, gestational age, and APGAR scores were studied and stratified into three ISCED-based maternal education subgroups. Statistical analyses, including ANOVA, chi-square tests, and logistic regression, were used to analyze the effect of maternal education, with confounders such as maternal age and chronic hypertension being controlled for. Results: Preeclampsia was associated with lower birth weight (p < 0.001), gestational age at birth (p < 0.001), and APGAR scores (p < 0.001) than the control group. Maternal level of education was associated with better neonatal outcomes in the preeclamptic group, with lower odds of fetal growth restriction (OR = 0.68, p = 0.03) and preterm birth; however, the effect was less pronounced in the control group. Conclusions: Maternal education partially mitigates the adverse effects of preeclampsia on neonatal well-being, birth weight, and gestational age at birth. These findings underscore the importance of incorporating maternal education into prenatal care programs to improve perinatal outcomes, with a special focus on high-risk pregnancies.

Background: Pre-eclampsia is a significant hypertensive disorder affecting 2–8% of pregnancies globally, significantly contributing to maternal/perinatal deaths. Early identification of at-risk patients is crucial for reducing these mortalities, yet first-trimester screening remains inaccessible in many low-resource settings. This study aims to develop a second-trimester risk stratification model based on clinical parameters to assist in managing pre-eclampsia in diverse healthcare contexts. Methods: This retrospective cohort study analyzed medical records from 700 pregnancies (350 with preeclampsia, 350 controls) between January 2021 and August 2024 at a tertiary medical center in western Romania. Sample size was calculated to achieve 90% power with α = 0.05 for detecting clinically significant differences between groups. Data analysis focused on clinical variables such as maternal age, hypertension, diabetes, and socioeconomic factors. A scoring model was developed using logistic regression and validated for predictive accuracy using ROC curve analysis, with AUC as the primary metric. Calibration was assessed using the Hosmer–Lemeshow test. Results: The risk stratification model demonstrated an AUC of 0.91 (95% CI: 0.88–0.94), indicating high discriminative capability. The model showed good calibration (p = 0.78). Sensitivity was 74.4%, and specificity reached 97.8%. Patients were categorized into low (0–4 points), moderate (5–7 points), and high-risk (≥8 points) groups based on optimized cut-off values. High-risk patients showed significantly higher rates of adverse outcomes, including eclampsia (12.3% vs. 0% in low-risk, p < 0.001) and HELLP syndrome (8.7% vs. 0.5% in low-risk, p < 0.001). Neonates born to high-risk mothers had lower birth weight (mean difference: 486 g, p < 0.001), smaller head circumference (mean difference: 2.3 cm, p < 0.001), and lower APGAR scores (median difference: 2 points, p < 0.001). Conclusions: This novel model offers a practical second-trimester risk assessment tool that leverages routine clinical data available after 20 weeks of gestation. It facilitates targeted care and resource allocation, particularly benefiting settings lacking early screening access. Implementation of risk-stratified management protocols could significantly improve maternal and neonatal outcomes in diverse healthcare environments.

Background: Hereditary cancer syndromes such as BRCA1/2 and Lynch syndrome significantly increase the lifetime risk of ovarian, fallopian tube, and endometrial cancers. Risk-reducing salpingo-oophorectomy (RRSO) and hysterectomy are standard preventive strategies. Vaginal natural orifice transluminal endoscopic surgery (vNOTES) has recently emerged as a minimally invasive, scarless alternative that may enhance patient acceptance while maintaining oncologic safety. Objective: This narrative review aims to synthesize the current evidence regarding the role of vNOTES in risk-reducing gynecologic surgery for women with hereditary cancer syndromes, focusing on surgical feasibility, technical considerations, oncologic safety, and patient-reported outcomes. Methods: A structured literature search was conducted in PubMed and Web of Science for studies published between January 2000 and April 2025, using terms related to vNOTES, prophylactic gynecologic surgery, BRCA mutations, and Lynch syndrome. Inclusion criteria focused on studies reporting outcomes of vNOTES in risk-reducing or oncologic contexts. A total of eight studies were included for qualitative synthesis. Results: vNOTES has demonstrated technical feasibility and favorable surgical outcomes in risk-reducing procedures such as RRSO and hysterectomy in BRCA and Lynch syndrome carriers. Comparative studies report lower postoperative pain, faster recovery, and high patient satisfaction, with oncologic standards maintained through specimen containment, peritoneal inspection, and adherence to the SEE-FIM protocol. Limitations include the learning curve and restricted access to the upper abdomen, which may necessitate hybrid approaches in selected cases. Conclusions: vNOTES offers a promising, patient-centered surgical approach for hereditary cancer prevention, combining oncologic safety with enhanced recovery and cosmetic benefits. Further research is needed to standardize protocols, evaluate long-term outcomes, and define its role within broader personalized cancer prevention strategies.