Background and Objectives: Predictive performance of the modified myocardial performance index (Mod-MPI) for emergency cesarean delivery secondary to intrapartum fetal compromise (IFC) was examined in late-onset fetal growth restriction (FGR) or small-for-gestational-age (SGA) pregnancies. Materials and Methods: This prospective observational cohort comprised 120 singleton term pregnancies affected by late-onset FGR or SGA, classified in line with the Delphi consensus criteria, for whom a trial of vaginal delivery was planned. The primary endpoint was emergency cesarean delivery indicated by IFC, while the secondary endpoint was the development of composite adverse perinatal outcomes (CAPO). Measurements of Mod-MPI, the umbilical artery, the middle cerebral artery, and the cerebroplacental ratio (CPR) were performed within the final 72 h before delivery and were blinded to the clinicians managing the intrapartum period. Results: IFC constituted 28.3% (n = 34) of the study cohort. The IFC group exhibited significantly higher Mod-MPI values and lower CPR values (p < 0.001). In multivariable analysis, elevated Mod-MPI (≥0.61) and reduced CPR (<5th percentile) were identified as independent predictors of IFC. On receiver operating characteristic analysis, Mod-MPI demonstrated superior discriminative performance compared with CPR for predicting IFC (area under the curve [AUC]: 0.835 vs. 0.759). In contrast, CPR showed the highest diagnostic performance for predicting CAPO (AUC: 0.779). Conclusions: Mod-MPI reflects subclinical cardiac dysfunction in fetuses with late-onset FGR and SGA and represents a valuable parameter for predicting tolerance to acute intrapartum stress. Rather than routine implementation, it appears most appropriate as a complementary tool contributing to intrapartum risk assessment in selected high-risk cases.

Aims: To evaluate the diagnostic and therapeutic role of colposcopy in patients with negative cervical cytology but positive for high-risk human papillomavirus (hrHPV) types other than HPV 16 and 18, in light of current guideline recommendations. Methods: This retrospective study included 428 women aged 21-65 who underwent colposcopy at a tertiary care center between June 2020 and December 2024. All patients had negative cytology and tested positive exclusively for high-risk HPV types other than HPV 16/18. Cervical biopsy and endocervical curettage (ECC) were performed during colposcopy. Histopathological evaluations were conducted by experienced gynecologic pathologists using the Lower Anogenital Squamous Terminology (LAST) system. Demographic and clinical data were recorded and analyzed using SPSS version 27. Results: Among the 428 patients, 281 (65.7%) had no dysplasia, 126 (29.4%) had CIN 1, 15 (3.5%) had CIN 2, and 6 (1.4%) had CIN 3. No cases of invasive cervical cancer were detected. ECC results showed CIN 1 lesions in 11 patients (2.6%) and no high-grade lesions. The overall rate of CIN2+ lesions was 4.9%. Most patients with CIN2+ lesions were multiparous, premenopausal, and had a mean age of 40 years. Conclusion: Current ASCCP guidelines recommend follow-up with co-testing after one year for patients with negative cytology and non-16/18 hrHPV positivity. However, the 4.9% rate of CIN2+ lesions observed in this study suggests that immediate colposcopy may be clinically beneficial in this patient group. Especially in populations with low adherence to follow-up, colposcopy may represent an alternative management approach.