Consensus conference results on contraception in women beyond 40 years of age.

The objective is to develop expert consensus to inform clinical decision-making in the use of hormonal contraceptives in women over 40 years of age. A multidisciplinary panel organised by the Italian Society of Contraception performed a systematic literature review up to October 2024, defining the priorities in the choice of a contraceptive and its effects on cardiovascular risk, menstrual bleeding, bone health, and sexual function associated with hormonal contraception in women over 40. Statements summarising the findings were discussed and refined in a dedicated expert meeting.

Antenatal Corticosteroids in Early and Late Fetal Growth Restriction.

Antenatal corticosteroids are widely used to prevent newborn morbidity and mortality in special obstetric circumstances, especially in preterm birth, but there are ongoing concerns about possible neutral or even detrimental short- and long-term effects in pregnancies complicated by fetal growth restriction. Fetuses with growth restriction may be a subset of preterm infants with a particular vulnerability to steroid exposure. The current scientific evidence on exogenous antenatal corticosteroid effects in this population is not conclusive.

Vaginal contraception with NuvaRing decreases symptoms and uterine features of adenomyosis: A prospective evaluation.

Objective: We aimed to assess the effects of contraception with NuvaRing on ultrasound signs and symptoms of women with adenomyosis.

Study Design: We conducted a prospective self-controlled observational study on women with adenomyosis who required contraception with NuvaRing. Exclusion criteria were actual use or contraindications to hormonal contraception.

A role of the uterine cervix in the pathogenesis of adenomyosis and endometriosis?

Data indicate a link between the cervix and pathologies like adenomyosis and endometriosis. Uterine flexion on the cervix, diameter and stiffness of the internal cervical orifice represent an obstacle to downstream menstrual flow, that when excessive increases the intensity of uterine contractions. Evidence indicates that intense uterine contractions damage the endometrial myometrial junction, favoring endometrial entrance into the myometrium, to induce adenomyosis, and retrograde menstrual flow into the peritoneal cavity, to induce endometriosis.

Retrospective Case-Cohort Study on Risk Factors for Developing Distant Metastases in Women With Breast Cancer.

Objective: This study aimed to identify risk factors associated with the development of metastases in breast cancer patients, to investigate survival rates, and the relationship between local recurrences and distant metastases.

Methods: This retrospective case-cohort study included women with breast cancer who were treated at a certified Breast Unit between 2001 and 2015. Cases who developed distant metastases were compared to controls based on diagnosis year, stage, and age at diagnosis.

Pilot Clinical and Radiomic Analysis of Deep Infiltrating Endometriosis of the Parametrium Using Shannon Entropy: A Retrospective Cohort Study.

Objective: Ultrasound techniques for diagnosing deep infiltrating endometriosis (DIE) currently lack a quantitative method to assess microstructural heterogeneity in relation to diagnosis and clinical symptoms. This study evaluates Shannon entropy-based radiomics for differentiating DIE lesions from adjacent tissue and correlating these features with pain severity.

Methods: In this retrospective cohort study (2020-2024), fertile women with histologically confirmed parametrial endometriosis and high-quality ultrasound images were evaluated.

Evaluation of Long-COVID Syndrome in a Cohort of Patients with Endometriosis or Adenomyosis.

: Long-COVID is characterized by the persistency of COVID-19 symptoms beyond 12 weeks, and it is probably consequent to immune dysregulation induced by SARS-CoV-2 infection. Immune dysregulation is associated with and probably involved in the pathogenesis of chronic gynecological conditions like endometriosis and adenomyosis. This study evaluated whether the presence of endometriosis or adenomyosis increases the risk of long-COVID, i.

Breast cancer care for the aging population: a focus on age-related disparities in breast cancer treatment.

Objective: Breast cancer is a significant health issue for women worldwide and poses unique challenges for all ages. Older women face many concerns about breast cancer treatment and outcomes. This study aims to compare breast cancer management and outcomes across various age groups within a single-center experience in a region with an aging population, focusing specifically on women aged 70 and older to identify potential disparities in treatment and prognosis.

Vaginal oxygen plus hyaluronic acid on lower urinary tract symptoms in breast cancer survivors.

Objective: This study aimed to evaluate the effect of vaginal oxygen and hyaluronic acid on lower urinary tract symptoms (LUTS) in breast cancer survivors.

Method: A prospective trial was conducted at a university hospital's Menopause Outpatient Clinic. Breast cancer patients experiencing LUTS received intravaginal natural oxygen for 15 min, coupled with a 2% hyaluronic acid solution during the last 5 min.

Hormonal Contraception and Bone Metabolism: Emerging Evidence from a Systematic Review and Meta-Analysis of Studies on Post-Pubertal and Reproductive-Age Women.

Background/objectives: This study aims to assess the effects of combined hormonal contraceptives (CHCs) on bone metabolism markers. It primarily measures osteocalcin and additionally examines other bone health markers, seeking to determine their responses to estrogen-progestogen treatments.

Methods: This study involved a comprehensive evaluation of the pertinent literature and a meta-analysis explicitly conducted on data describing women of reproductive age.

Menopausal symptoms in breast cancer survivors on adjuvant endocrine therapy compared with those of menopausal women.

Objectives: To compare menopausal symptoms of breast cancer survivors on adjuvant endocrine therapy with those of menopausal women.

Study Design: In a retrospective nested case-control study menopausal symptoms were compared of breast cancer survivors in pre-, peri- or post-menopause at the time of diagnosis, on tamoxifen or an aromatase inhibitor, plus a gonadotrophin-releasing hormone analogue, if pre- or peri-menopausal, and age-matched control women either in the late peri-menopause, or in surgical or in physiological post-menopause on no hormone replacement therapy. Differences between women on tamoxifen and those on aromatase inhibitors were also evaluated.

Routine ultrasound does not improve instrument placement at operative vaginal delivery: An updated systematic review and meta-analysis.

Routine ultrasound before operative vaginal delivery does not improve the accuracy of instrument placement.

Exploring the mystical relationship between the Moon, Sun, and birth rate.

Objective: The Moon has a noticeable influence on the Earth due to its gravity, the most visible manifestation of which are tides. We aimed to see if the Moon's daily cycle, like the Sun's, affects the prevalence and incidence of childbirth.

Methods: In this retrospective cohort study, we examined all deliveries at the Academic Hospital of Udine between 2001 and 2019.

Breast cancer and the steadily increasing maternal age: are they colliding?

Background: Pregnancy-related cancers are mostly breast cancers, and their incidence is likely to increase as a result of the modern trend of delaying childbearing. In particular, advanced maternal age increases breast cancer risk, and younger breast cancer patients are more likely to die and metastasize. This study compared a population with a high incidence of delayed childbearing with another population with a lower mean age at childbirth in order to determine whether breast cancer diagnosis and childbearing age overlap.

Elasticity of the Cervix in Relation to Uterus Position.

Strain elastography allows the evaluation of tissue elasticity. Tissue elasticity depends on the content and distribution of collagen fibers and is shaped by the applied tensile forces that may differ in uteri with a different angle of flexion of the corpus on the cervix. The objective was to investigate whether the angle of uterine flexion is related to cervical tissue elasticity.

Timing of cesarean delivery for fetal heart rate abnormalities in hypertensive pregnancies induced with oral misoprostol or Foley catheter: Secondary analysis of a randomized clinical trial.

Objective: The study aims to assess how oral misoprostol for cervical ripening affects the time of cesarean delivery (CD) for fetal heart rate (FHR) abnormalities in pre-eclampsia patients. Secondary goals include determining the role of uterine hyperstimulation, comparing misoprostol with Foley catheter, and identifying risk factors for FHR abnormalities associated with CD.

Methods: A previously published randomized clinical trial was subjected to a secondary analysis (NCT01801410).

Gut Microbiota and Endometriosis: Exploring the Relationship and Therapeutic Implications.

Endometriosis is a common inflammatory disease affecting women of reproductive age, characterized by the growth of endometrial tissue beyond the uterus. In addition to gynecological manifestations, many endometriosis patients experience gastrointestinal symptoms, indicating a potential association between gut health and the disease. Recent studies have revealed alterations in the gut microbiota of individuals with endometriosis, including reduced diversity, microbial composition imbalances, and pathogenic bacteria.

Oxidative Stress: The Role of Estrogen and Progesterone.

The effect of estrogen and progesterone on oxidative status is not yet very clear, improvements and detrimental effects having been reported with the use of menopausal hormone therapy or hormonal contraceptives, respectively. In this study, we evaluated the role played by estrogen and progesterone separately, on the oxidative status of 32 women, 18 to 43 years old, by inducing high levels of estrogen and then adding high levels of progesterone. During a cycle of in vitro fertilization, blood samples were collected prior to gonadotrophin stimulation (low estradiol levels), on the day of oocyte retrieval (high levels of estrogen), and on the day of embryo transfer (high levels of estrogen and progesterone).

Does transperineal ultrasound predict the risk of perineal trauma in women with term pregnancy? A prospective observational study.

Purpose: This study was conducted to evaluate the prevalence of perineal trauma during childbirth and to assess the correlations of the pelvic floor dimensions and fetal head station with obstetric trauma in a prospectively recruited cohort of women.

Methods: The study included women with a gestational age of at least 37 weeks, who were carrying a single fetus in a cephalic presentation. Transperineal ultrasound (TPU) was performed prior to the onset of labor or labor induction.

Examining the Aryl Hydrocarbon Receptor Network in the Placental Tissues of Pregnancies Complicated by Pre-Eclampsia: An Explorative Case-Control Analysis.

Severe maternal and newborn morbidity and mortality associated with pre-eclampsia, which are caused partly by premature delivery, affect a factual proportion of pregnancies. Despite its prevalence, the underlying causes of pre-eclampsia remain elusive, with emerging evidence implicating the aryl hydrocarbon receptor (AhR) in its pathogenesis. This study sought to elucidate the involvement of the AhR and its associated pathway in pre-eclampsia by comparing placental components of the AhR pathway in pregnant individuals with and without pre-eclampsia.