Background/Objectives: Ovarian and endometrial cancers present significant health burdens due to their substantial morbidity and mortality. Surgery delay is hypothesized to negatively impact patient outcomes, yet evidence remains inconsistent. This systematic review aims to comprehensively evaluate current evidence regarding the effects of treatment delay on survival and quality of life in these patients. Methods: A systematic literature search was conducted in MEDLINE (PubMed), Cochrane Library, Scopus, and ClinicalTrials.gov databases, complemented by a manual screening of reference lists, with studies included up to March 2025. Two independent reviewers screened and assessed the methodological quality using the ROBINS-E tool and extracted the data from the studies. Due to substantial methodological and clinical heterogeneity, results were synthesized qualitatively through narrative synthesis. Results: Twenty-one studies met the inclusion criteria, comprising predominantly retrospective cohort analyses. Treatment delays consistently correlated with decreased survival and advanced disease stages. Among studies, optimal intervals from diagnosis to treatment were varied from 2 to 8 weeks. Patient-reported outcomes indicated heightened anxiety, increased distress, and poor satisfaction with prolonged delays. Healthcare system factors such as resource allocation, geographic disparities, and socioeconomic inequalities significantly contributed to delays. Quantitative survival metrics supported a clear negative association between treatment delays and survival, although paradoxical outcomes in select subgroups highlighted underlying complexities. Conclusions: This systematic review underscores the critical importance of minimizing delays in the treatment of ovarian and endometrial cancers to improve patient survival and psychological outcomes. Identified healthcare system barriers demand targeted policy interventions to ensure timely and equitable access to tertiary healthcare infrastructures. Future research should prioritize standardizing delay definitions to strengthen and homogenize evidence.

Background: Patients with ovarian cancer often require intensive care unit (ICU) admission after surgery due to the complexity of the operation and the higher risk of complications. However, not all patients require a prolonged stay in the ICU. To identify factors that may predict extended stay in the ICU following surgery for ovarian cancer. Methods: A retrospective review was conducted of patients who underwent surgery for ovarian cancer and were admitted to the ICU at a single tertiary hospital center between January 2004 and December 2023. Patient demographics, clinical characteristics, and perioperative variables were analyzed. Results: Of the 74 patients included, 36.5% had an ICU stay of at least 48 h. Factors associated with prolonged ICU stay included higher Body Mass Index (BMI) and time of surgery duration. In contrast, a greater body temperature at the end of the operation was linked to a decrease in the length of ICU stay. Conclusions: These findings provide valuable insights for preoperative counseling and resource allocation, enhancing postoperative care for ovarian cancer patients. Additional research is required to confirm these data and investigate any other factors that may predict extended stay in the ICU.

Background/Objectives: Dichorionic triamniotic (DCTA) triplet pregnancies are associated with increased rates of placenta-specific complications primarily attributed to vascular anastomoses in the monochorionic (MC) pair. Selective fetal reduction to twins (of one of the MC pair) is a complex and not a widely available procedure. Multifetal reduction (MFR) to singleton pregnancy can reduce adverse pregnancy outcomes but is controversial due to medico-legal and socio-ethical issues. The aim of this study is to identify the rate of miscarriage < 24 weeks or preterm birth < 34 weeks following MFR to singleton pregnancy in DCTA triplets and compare the results with expectant management. Methods: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in the Prospective Register of Systematic Reviews System (ID: CRD42023422585). Results: Overall, from 21 citations of relevance, 6 studies with a total of 548 DCTA triplet pregnancies fulfilled the inclusion/exclusion criteria. In comparison with expectant management (n = 336), meta-analysis demonstrated that MFR to singleton pregnancy (n = 212) was associated with a lower rate (9.4% vs. 48.5%) of preterm birth (RR = 0.19, 95%CI 0.07–0.51), whereas the rate of miscarriage (14.6% vs. 9.2%) did not significantly increase (RR = 1.53, 95%CI 0.91–2.55). Conclusions: In DCTA triplet pregnancies, MFR to singleton pregnancy was associated with a reduced preterm birth rate and not associated with an increased miscarriage rate. Given the fact that the MC pair is reduced only to lower the rate of preterm birth, appropriate counselling and justification are important. In the absence of randomized controlled trials, data from systematic reviews are the best available evidence for counseling on the different management options.

Preeclampsia (PE), a multi-system disorder, is not confined to the puerperium and may represent a sentinel event leading to increased maternal risk for future cardiovascular disease (CVD). Early-onset PE appears to carry a distinct, and possibly more pronounced, vascular signature than late-onset PE. Accumulating data consistently link previous early-onset PE, to an elevated lifetime risk of CVD. Arterial stiffness (AS), most commonly quantified by carotid-femoral pulse wave velocity (cf-PWV) and augmentation index (AIx, or AIx corrected to a heart rate of 75 beats per minute, AIx-75), is an established, independent predictor of CVD in the general population and has therefore attracted interest as a candidate marker for postpartum CVD risk stratification. However, whether AS remains elevated once the puerperium has resolved, has been a persistently unsettled question. Existing literature is inconclusive regarding the association between postpartum AS measurements and previous early-onset PE. This comprehensive review synthesizes the available literature on oscillometric AS measurements before and after delivery in pregnancies complicated by early-onset PE and attempts to quantify the differences between ante- and postpartum oscillometric AS measurements. Although not a systematic review, this quantitative review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-Analysis of Observational Studies in Epidemiology) guidelines. The study protocol was registered at PROSPERO (Prospective Register of Systematic Reviews System) (ID CRD42020167749) a priori. Only longitudinal studies reporting on both pregnancies complicated by early-onset PE (case group) and normotensive pregnancies (control group) were included. cf-PWV, Alx and Alx-75 were assessed both ante- and postpartum. Quantitative synthesis was performed for indices presented among at least 2 studies. Data were presented as standardized mean differences (SMDs) and 95% confidence intervals (95%CIs). Overall, from 14 citations of relevance, 3 studies with a total of 35 cases and 155 controls fulfilled the inclusion/exclusion criteria. In pregnancies complicated by early-onset PE assessed both ante- and postpartum with either cf-PWV (SMD: -0.61, 95%CI: -1.3 to 0.07) and/or Alx (SMD: -0.32, 95%CI: -2.83 to 2.2) and/or Alx-75 (SMD: -0.61, 95%CI: -1.27 to 0.05), there was no statistically significant difference in AS measurements. In conclusion, current literature suggests that AS measurements (cf-PWV, AIx and AIx-75) are not significantly altered in pregnancies complicated by early-onset PE. Alx and Alx-75 should be further evaluated. Substantial heterogeneity in study design, small sample sizes, and inconsistent postpartum follow-up windows continue to limit firm conclusions, underscoring the need for larger, standardized, and adequately powered longitudinal studies before AS measurements can be recommended for routine postpartum CVD risk stratification.