Preeclampsia (PE) is one of the leading causes of mortality and morbidity in pregnant women. Pregestational diabetes (PGDM) patients are prone to vascular complications and preeclampsia, whereas vascular exposure to hyperglycemia induces inflammation, vascular remodeling, and arterial stiffness. Corin is a serine protease, converting inactive pro-atrial natriuretic peptide (pro-ANP) into an active form. It also promotes salt and water excretion by activating atrial natriuretic peptide (ANP), and significantly increases trophoblast invasion. The study aimed to determine whether corin may be a predictor of PE in a high-risk group—women with long-term PGDM. The nested case-control prospective study involved 63 patients with long-term pregestational type 1 diabetes (PGDM). In total, 17 patients developed preeclampsia (the study group), whereas 43 patients without PE constituted the control group. To assess corin concentration, blood samples were collected at two time points: between 18th–22nd week of gestation and 28th–32nd week of gestation. PE patients presented significantly higher mid-gestation corin levels, urine protein loss in each trimester, serum creatinine in the third trimester, and lower creatinine clearance in the third trimester. The results of our study indicate that serum corin assessment may play a role in predicting preeclampsia. Thus, it may be included in the PE risk calculator, initially in high-risk groups, such as patients with PGDM.

Intima-media thickness (IMT) measurement is a non-invasive method of arterial wall assessment. An increased IMT is a common manifestation of atherosclerosis associated with endothelial dysfunction. In the course of pregnancy, various maternal organs, including the endothelium, are prepared for their new role. However, several pre-gestational conditions involving endothelial dysfunction, such as diabetes, chronic hypertension, and obesity, may impair the adaptation to pregnancy, whereas vascular changes may also affect fetal development, thus, influencing the fetal IMT. In the conducted studies, a correlation was found between an increased fetal abdominal aorta IMT (aIMT) and placental dysfunctions, which may subsequently impact both the mother and the fetus, and contribute to gestational hypertension, preeclampsia (PE), and fetal growth restriction (FGR). In fact, data indicate that following the delivery, the endothelial dysfunction persists and influences the future health of the mother and the newborn. Hypertensive disorders in pregnancy increase the maternal risk of chronic hypertension, obesity, and vascular events. Moreover, individuals born from pregnancies complicated by preeclampsia or fetal growth restriction are at high risk of obesity, diabetes, hypertension, and cardiovascular disease. Therefore, understanding the pathomechanism underlying an increased aIMT in preeclampsia and FGR, as well as subsequent placental dysfunctions, is essential for developing targeted therapies. This review summarizes recent publications regarding IMT and demonstrates how IMT measurements affect predicting perinatal complications.

Preterm prelabor rupture of membranes (pPROM) accounts for nearly half of premature births. Although several risk factors have been identified, no markers allowing for effective prevention have been discovered. In this study, we investigated how the maternal serum levels of galectin-1 and galectin-9 change in patients with pPROM in comparison to uncomplicated pregnancies. A total of 75 patients were enrolled to both study and control group (37 vs. 38, respectively). The serum concentration of galectin-1 and galectin-9 were assayed in duplicate using an enzyme-linked immunoassay. All analyses were performed using PQ Stat v. 1.8.4 software. Galectin-1 levels were significantly higher in the controls (13.32 vs. 14.71 ng/mL, p = 0.02). Galectin-9 levels were similar in both groups (13.31 vs. 14.76 ng/mL, p = 0.30). Lower galectin levels were detected for early pPROM (before 32nd GW) in comparison to late pPROM and the controls (8.85 vs. 14.45 vs. 14.71 ng/mL, p = 0.0004). Similar trend was observed in galectin-9 levels, although no statistical significance was found (11.57 vs. 14.25 vs. 14.76 ng/mL, p = 0.26). Low galectin-1 maternal serum level is associated with the incidence of preterm prelabor rupture of membranes. Galectin-9 maternal serum levels were not significantly correlated with pPROM. However, in order to investigate gal-1 and gal-9 levels as potential, promising markers of pPROM, further clinical studies on larger groups are required.

Parvovirus B19 is a virus that causes a common and usually harmless infection in both children and adults. If the virus is transmitted transplacentally during pregnancy, it can have serious consequences for both the pregnant woman and the fetus. Potential complications include severe fetal anemia, which can lead to intrauterine fetal death. A common ultrasound finding in fetuses affected by parvovirus B19 is fetal edema, which is associated with a poor prognosis. Additionally, a rare but serious complication in pregnant women with parvovirus B19 infection is mirror syndrome. The diagnosis of parvovirus B19 infection during pregnancy necessitates close monitoring of the fetal condition. If fetal anemia is suspected, intrauterine transfusion is indicated to increase fetal survival. This study presents eight cases of parvovirus B19 infection in pregnant women, highlighting the various maternal-fetal complications encountered, along with diagnostic and treatment strategies.

Objectives: The objective of the study is to evaluate the potential role of the sFlt‐1/PlGF ratio in predicting preeclampsia (PE) in pregnant women with diabetic kidney disease (DKD) during the second and third trimesters of pregnancy. Study Design: This study included 102 patients with DKD. All participants had a history of pregestational diabetes of at least 20 years’ duration and/or onset before the age of 10 or pregestational diabetes complicated by hypertension or diabetic retinopathy (classified as D, R, or F according to White’s classification). All patients exhibited elevated urinary protein loss (30–299 mg/24 h) or overt proteinuria (≥ 300 mg/24 h) during the first trimester of pregnancy. All participants were treated with intensive insulin therapy, either via multiple daily insulin injections (MDIs) or continuous subcutaneous insulin infusion (CSII). Serum levels of sFlt‐1, PlGF, and the sFlt‐1/PlGF ratio were assessed at both the 20th and 30th weeks of gestation. Main Outcome Measures: The serum levels of sFlt‐1, PlGF, and the sFlt‐1/PlGF ratio during the second and third trimesters were compared between women who developed PE and a control group without PE. Results: In DKD patients who developed PE, serum sFlt‐1 levels were significantly higher, while PlGF levels were significantly lower, compared to those who did not develop PE. The sFlt‐1/PlGF ratio was also markedly elevated in the PE group compared to controls during both the second and third trimesters. Increased sFlt‐1 levels, decreased PlGF levels, and an elevated sFlt‐1/PlGF ratio were significant predictors of PE development at both 20 and 30 weeks of gestation. The sFlt‐1/PlGF ratio demonstrated a sensitivity of 72.7% and specificity of 75.7% at 20 weeks (sFlt‐1/PlGF cut‐off > 10.1) and a sensitivity of 84.6% and specificity of 82.0% at 30 weeks for predicting PE (sFlt‐1/PlGF cut‐off > 37). The positive predictive values were 47.1% and 50.0%, while the negative predictive values were 90.3% and 96.0% at 20 and 30 weeks, respectively. Conclusions: The assessment of antiangiogenic and proangiogenic markers, particularly the sFlt‐1/PlGF ratio, appears to be a valuable tool for predicting PE in patients with long‐lasting diabetes complicated by DKD.

Preeclampsia disproportionately affects women with pregestational type 1 diabetes (T1D). This study aims to determine whether continuous glucose monitoring (CGM)-derived metrics during the first trimester predict the development of preeclampsia in pregnancies complicated by pregestational T1D, comparing their predictive capability against standard glycemic markers. This single-center, retrospective cohort study analyzed data from 2019 to 2023 at a tertiary center in Poland. Participants included women with T1D on sensor-augmented insulin pump (SAP) therapy, initiating monitoring by 13 weeks/6 days. Sensor mean glucose, TIR, CV%, GMI and time spent over 140, 180 and 250 mg/dL were analyzed and preeclampsia diagnosis adhered to ISSHP criteria, with data compared. Of 70 women, 13 (18.6 %) developed preeclampsia. Baseline HbA1c was similar. Sensor-derived glucose metrics revealed higher first-trimester mean glucose (121.6 mg/dL vs. 112.3 mg/dL, p = 0.0012), decreased TIR 63.3% (54.3-68.46) vs 70.16 % (67.31-76.57), p = 0.03, and coefficient of variation 38.42% vs 34.29, p = 0,055 for the PE group. Good glycemic control existed in both groups during later trimesters. Elevated first-trimester mean glucose and glucose variability could be linked with preeclampsia in T1D, in our study. Findings support CGM to refine risk models and strategies addressing early glycemic imbalances in T1D pregnancies.