Background: Recurrent pregnancy loss (RPL) remains etiologically unexplained in 40–50% of cases following standard diagnostic workup. Non-criteria antiphospholipid antibodies (non-criteria aPL) are increasingly considered potential markers of seronegative obstetric antiphospholipid syndrome (APS); however, their diagnostic value in this clinical setting requires further investigation. Objective: To assess the diagnostic value of non-criteria aPL in women with RPL and to construct an exploratory immunological scoring model for diagnostic stratification. Methods: Antiphospholipid antibody detection was performed using a single-measurement semi-quantitative line immunoblot assay (Anti-Phospholipid 10 Dot, Generic Assays, Germany). Statistical analysis included χ², Fisher’s exact test, Mann–Whitney U test, binary logistic regression, and ROC analysis. Results: Statistically significant associations with RPL were observed for anti-prothrombin antibodies (OR = 11.1; 95% CI 1.8–68.0; p = 0.022 [Haldane–Anscombe correction]), anti-annexin V (OR = 4.28; 95% CI 1.18–15.6; p = 0.023), and anti-β₂GP I (OR = 3.31; 95% CI 1.18–9.28; p = 0.019). The exploratory composite immunological score demonstrated moderate discriminatory performance (AUC = 0.701; 95% CI 0.588–0.814; p = 0.005). The overall logistic regression model was statistically significant (χ² = 8.564; p = 0.036), although none of the individual predictors retained independent significance, indicating a contribution of cumulative immunological burden rather than any single marker. Conclusions: In this single-center cross-sectional study, non-criteria aPL were frequently detected in women with RPL and were statistically associated with the condition. The findings should be interpreted as hypothesis-generating only, given the cross-sectional design, single-measurement immunoblot, small control group, and absence of external validation. Confirmation in larger prospective multicenter cohorts using ELISA-based assays with the internationally recommended 12-week repeat measurement is required before any clinical implementation.

Background: Endometriosis is a chronic estrogen-dependent inflammatory disease estimated to affect up to 190 million women of reproductive age worldwide based on clinical and population-based estimates, although only 22.3 million prevalent cases were formally documented—a gap that itself reflects substantial under-diagnosis. Despite an exponential increase in systematic reviews (SRs) and meta-analyses (MAs), the evidence base remains fragmented across clinical domains. An umbrella review provides the methodologically highest level of evidence synthesis and allows critical appraisal and hierarchical classification of published SRs and MAs. Objective: The aim of this study was to conduct a comprehensive critical synthesis of published SRs and MAs on the epidemiology, pathogenesis, diagnosis, treatment, and long-term consequences of endometriosis and to assess their methodological quality using AMSTAR-2. Methods: Systematic searches were conducted in PubMed, Embase, Cochrane Library, and Scopus (2016–2026). Eligibility: SRs with or without MA covering any clinical aspect of endometriosis in women were considered eligible. Quality was assessed using AMSTAR-2. Association strength was classified as convincing (Class I), highly suggestive (Class II), suggestive (Class III), weak (Class IV), or non-significant (NS). Results: Fifty-two SRs and MAs were included (total sample > 6,000,000 participants). AMSTAR-2 quality: high 25% (n = 13), moderate 40% (n = 21), low 29% (n = 15), critically low 6% (n = 3). Class I evidence: short menstrual cycle (<27 days) associated with endometriosis risk (OR 1.68; 95% CI 1.48–1.89). Class II: post-operative dienogest reduces recurrence by 70% (OR 0.30; 95% CI 0.18–0.53); the risks of anxiety (RR 2.82; 95% CI 1.69–4.68) and depression (RR 2.78; 95% CI 1.63–5.25) are markedly elevated. Diagnostic delay persists at 4–12 years globally. Multi-biomarker platforms and AI-assisted imaging (e.g., PromarkerEndo and IMAGENDO) have shown promising preliminary diagnostic performance (reported AUCs of 0.997 and 0.906, respectively) in initial validation studies, although external validation in larger and more diverse cohorts is required before clinical implementation can be recommended. Conclusions: Endometriosis is a systemic, chronically under-diagnosed disease requiring a multidisciplinary approach. The available evidence supports dienogest as one of the preferred options for post-operative maintenance therapy, identifies multi-biomarker platforms as a promising—though not yet clinically validated—avenue for non-invasive diagnosis, and underscores the importance of incorporating psychological assessment into multidisciplinary management.

Background/Objectives: Obstetric hemorrhage remains a leading cause of maternal morbidity and mortality. We examined five-year institutional trends in the recorded hemorrhage rate, cesarean delivery, uterus-preserving hemostatic procedures, uterotonic and antifibrinolytic use, and blood product consumption at a high-volume tertiary maternity center in Kazakhstan. Methods: This was a retrospective time-series analysis of aggregated annual and monthly records for 2018–2022 (46,554 deliveries). The outcome was hemorrhage as entered on the hemorrhage line of the institutional register against the national threshold of 500 mL after vaginal birth and 1000 mL after cesarean; measured blood loss and severity grade were not recorded, so the study describes incidence rather than severity, and blood product figures are hospital-wide adult transfusion volumes. We calculated rates per 1000 deliveries with Wilson confidence intervals, fitted Poisson regression with delivery volume as an offset to estimate incidence rate ratios (IRRs), compared recorded hemorrhage by delivery route with Fisher’s exact test, screened for seasonality and out-of-limit months with process control charts, and correlated the monthly hemorrhage rate with service-use variables before and after detrending, with false-discovery-rate correction. Results: The recorded hemorrhage rate fell from 11.39 to 3.62 per 1000 deliveries (rate ratio 0.318, 95% CI 0.217–0.466; 68.2% relative reduction), an average decline of 27.6% per year (IRR 0.724, 95% CI 0.665–0.788, p < 0.001). No reproducible seasonal pattern was found. The cesarean rate declined from 24.90% to 19.36%. Carbetocin and tranexamic acid use rose several-fold, while red cell volume per delivery fell by about 48%. Raw inverse correlations between medication use and hemorrhage were explained by the shared time trend and did not survive detrending and correction. Conclusions: The center recorded a substantial, statistically robust decline in recorded obstetric hemorrhage alongside expanded pharmacologic prophylaxis and reduced transfusion. Because the data are aggregate and neither placental pathology nor other patient case mix could be measured, the parallel trends cannot show that any intervention caused the fall, and a shift in documentation practice cannot be excluded. The findings support prospective monitoring and patient-level study. Because severe hemorrhage and the surgery used to control it may compromise later fertility, the reproductive outcomes of these women are a priority for further research.

Background and Objectives: Preeclampsia (PE) and gestational arterial hypertension (GAH) are major hypertensive disorders of pregnancy with overlapping clinical manifestations, which may complicate their differential diagnosis. Circulating microRNAs (miRNAs) are emerging as potential minimally invasive biomarkers reflecting placental dysfunction, hypoxia, impaired trophoblast invasion, angiogenic imbalance, and endothelial dysfunction. This study aimed to evaluate the expression profile of circulating miRNAs in women with PE and GAH and to identify candidate molecular markers capable of differentiating these conditions. Materials and Methods: A case-control study included 101 pregnant women: 39 women with physiologic pregnancy (control group), 23 women with GAH, and 39 women with PE. Plasma levels of 15 candidate miRNAs were quantified using TaqMan-based quantitative reverse-transcription PCR. Results: Twelve of the 15 investigated miRNAs demonstrated significant differences between PE and the control group and between PE and GAH after multiple-testing correction. The most pronounced decrease in PE was observed for miR-210-3p, with a log2 fold-change of −2.06 versus controls and −2.12 versus GAH. In ROC analysis, miR-210-3p showed the highest discriminatory performance for both comparisons, with an area under the curve (AUC) of 0.830 (95% CI, 0.735–0.925) for PE versus controls and 0.823 (95% CI, 0.720–0.925) for PE versus GAH. Other miRNAs, including miR-144-3p, miR-363-3p, miR-29a-3p, and miR-16-5p, also demonstrated moderate-to-good discriminatory performance. Conclusions: PE is characterized by a distinct circulating miRNA profile that differs from both physiologic pregnancy and GAH, whereas the molecular profile of GAH was broadly comparable to that of controls. Among the investigated candidates, miR-210-3p demonstrated the most consistent discriminatory performance and may represent a promising biomarker candidate for differentiating PE from GAH. A combination of several miRNAs may provide greater diagnostic value than individual markers.