Adequate iodine intake is of crucial importance in pregnancy to meet the thyroid hormone needs of both mother and fetus. In the present study, undertaken as a part of the surveillance actions following the introduction in Italy of a national salt iodination program in 2005, the iodine intake was investigated in 123 pregnant women and 49 control women living in the same area of central Italy. All the participants were screened for urinary iodine concentration (UIC), serum level of thyrotropin, free-thyroxine, free-triiodothyronine, and thyroid volume. Moreover, they were provided with a questionnaire on the use of iodine-containing salt or supplements. Control women had a median UIC of 102 µg/L, consistent with an iodine sufficiency, while in pregnant women the median UIC value was 108 µg/L, lower than the endorsed UIC of 150 µg/L. In addition, pregnant women showed a significantly increased median thyroid volume compared to controls. Interestingly, the median UIC did not differ between pregnant women not using iodine-containing salt or supplements and those regularly consuming iodized salt alone, while pregnant women with a daily intake of iodine-containing supplements had an adequate median UIC (168 µg/L). In conclusion, the data reported here showed that pregnant women and their fetuses are still exposed to the detrimental effects of iodine deficiency and that the consumption of iodine-containing supplements should be recommended in pregnancy.

During pregnancy, there is increased risk of ascending urinary tract infection (UTI) resulting in pyelonephritis and associated preterm delivery and low birth weight. It is therefore important that pregnant women who are at high risk of pyelonephritis because of the presence of asymptomatic bacteriuria (ASB) or cystitis receive appropriate antibiotic therapy. The aim of this position paper is to propose a risk-factor-based approach for the treatment of ASB and cystitis in pregnancy to help ensure that antibiotic treatment is prescribed only when necessary, and that the benefits of antibiotic treatment outweigh potential harms for pregnant women and neonates. Rather than advocating ASB screen-and-treat for all pregnant women who have ready access to healthcare, this risk-factor-based approach involves selective screening for ASB in pregnant women with other risk factors for UTI (previous UTI, diabetes mellitus, urinary tract abnormalities, or immunosuppression) and/or a history of preterm birth. Antibiotic treatment is indicated for persistent ASB confirmed with two urine cultures during selective high-risk screening, and for all pregnant women with cystitis confirmed by urine culture, with empiric treatment considered for symptoms of dysuria and urinary frequency. Evidence suggests that such a risk-factor-based approach will prevent progression to pyelonephritis in pregnant women with ASB and cystitis while complying with the principles of antimicrobial stewardship.

Hereby, the case of a low obstetrical risk nulliparous 25-years-old woman, presenting with chest pain and subcutaneous emphysema on face, neck and sternum four hours after spontaneous vaginal delivery has been reported.

Genitourinary syndrome of menopause (GSM), which includes vulvovaginal atrophy (VVA) and other bothersome genitourinary symptoms, affects over half of postmenopausal women and has a considerable impact on quality of life. This study aimed to evaluate the efficacy and safety of an injectable combination of hyaluronic acid and amino acids for treating GSM-related symptoms. In this prospective, multicenter study, 84 women aged 46–60 with moderate to severe VVA confirmed by gynecological examination received three intradermal treatments at 21-day intervals, targeting the vestibule, introitus, lower vaginal wall, and labia majora. Symptom severity was assessed using a visual analog scale (VAS), while tolerability and satisfaction were evaluated via a five-point Likert scale. Quality of life was measured using the Satisfaction With Life Scale (SWLS). Assessments were conducted at baseline, after each injection, and at 3- and 6-month follow-up visits. After three months, significant improvements were noted in vaginal dryness, itching, burning, and dyspareunia (all p < 0.001). Patient satisfaction increased from 59.0% to 80.7%, and SWLS scores rose from 4.57 ± 1.76 to 6.53 ± 1.10, reflecting enhanced quality of life. The treatment was well tolerated and demonstrated a favorable safety profile. These findings suggest that this injectable formulation may represent an effective, non-hormonal option for women with VVA, particularly those who are not candidates for hormone therapy.