A 35-year-old primigravida with a history of adenomyosis enucleation was diagnosed with abnormal fetal position at 25 weeks of gestation. The patient presented with normal vital signs and no symptoms. A cardiotocogram and transabdominal ultrasound revealed a healthy fetus, normal amniotic fluid volume, and no intra-abdominal bleeding. Pelvic magnetic resonance imaging (MRI) indicated a ruptured muscular layer of the uterine fundus, with the fetus completely prolapsed into the abdominal cavity. An emergency cesarean section was performed, during which the fetus was found wrapped within the amniotic membrane in the abdominal cavity. The uterus exhibited extensive tearing along the line of the previous surgical scar; however, no hemorrhage was observed. In this case, despite uterine rupture, blood flow through the umbilical cord from the placenta in the uterus resulted in the survival of the fetus. In addition, MRI was essential in determining the appropriate timing to save the fetus.

Background/Objectives: Cervical intraepithelial neoplasia (CIN) exhibits heterogeneous clinical behavior, with some lesions regressing spontaneously, whereas others persist or progress to higher-grade disease. Identifying biomarkers that reflect lesion dynamics remains a major clinical challenge. This study aimed to evaluate the clinical significance of CD86 expression in cervical lesions by examining longitudinal changes and determining whether temporal alterations in CD86 expression are associated with lesion regression and epithelial-associated immune dynamics. Methods: Cervical samples were collected from patients with CIN, and gene expression was analyzed using reverse transcription–quantitative PCR. Longitudinal analyses were performed using paired samples to evaluate the temporal changes in CD86 expression. Regression status and time to regression were assessed, and associations with CD86 changes were evaluated using receiver operating characteristic analysis, logistic regression, and Cox proportional hazards models. Longitudinal patterns were further characterized using a spaghetti plot and slope analyses. Results: Baseline CD86 expression did not associate with regression status or CIN grade. However, longitudinal changes in CD86 expression differed significantly between the regression and non-regression group. CD86 change demonstrated moderate predictive performance for regression and was significantly associated with both regression and shorter time to regression. Longitudinal analyses revealed distinct temporal patterns between the regression and progression groups. Baseline CD86 expression was strongly correlated with FOXP3 expression, whereas CD86 dynamics were not independently associated with lymphocyte-related markers. Conclusions: Longitudinal changes in CD86 expression are significantly associated with lesion regression in CIN and may reflect lesion-associated immune dynamics during follow-up, particularly within epithelial-derived cervical cytology specimens.

Background/Objectives: Cervical cancer (CC) is usually caused by high-risk human papillomavirus (hrHPV); however, some hrHPV-negative cases are undetectable by current screening programs. We evaluated a previously established diagnostic model based on serum free fatty acids (FFAs) in an independent cohort including hrHPV-negative CC. Methods: We analyzed serum FFAs from 101 patients with CC (16 hrHPV-negative), 60 healthy donors, and 16 patients with benign gynecological diseases, none of whom were included in the previous study, and gene expression levels of fatty acid metabolism-related enzymes in 64 surgical CC and five normal cervix samples. Results: Levels of nine FFAs differed between CC and the non-cancer groups but not between hrHPV-negative and hrHPV-positive CC. Gene expression levels of acetyl-CoA carboxylase 1, fatty acid synthase, stearoyl-CoA desaturase 1, and monoacylglycerol lipase were increased in CC compared with normal tissues, with no significant differences between hrHPV-negative and hrHPV-positive CC. The previous model (diagnostic index = −5.631 + 0.030 × (stearic acid) + 9.188 × (dihomo-γ-linolenic acid)) distinguished CC from the non-cancer groups (area under the curve, 0.969). At the pre-specified cut-off value, sensitivity was 97.0% (hrHPV-negative CC, 93.8%) and specificity in healthy donors was 58.3%; at the cut-off value derived in this cohort, these were 82.2% (93.8%) and 98.3%, respectively. In hrHPV-negative CC, the positivity rate exceeded those of squamous cell carcinoma antigen, carcinoembryonic antigen, and CA125. Conclusions: The serum-FFA-based diagnostic model detected CC, including hrHPV-negative cases, in an independent cohort. With calibration of the cut-off value, this approach may complement existing HPV-based testing.