Myoma expulsion after minimally invasive therapeutic strategies: a systematic review.

Background: Uterine leiomyomas are very common benign tumors of the myometrium which often occur in women in fertile age. They can cause pain, heavy bleeding, fertility impairment. Historically, the treatment available for this condition was only the surgical one.

Sailing Across Contraception, Pregnancy, and Breastfeeding: The Complex Journey of Women with Cardiomyopathies.

Gender-specific cardiology has gained increasing recognition in recent years, emphasizing the need for tailored management strategies for women with cardiovascular disease. Among these, cardiomyopathies-dilated, arrhythmogenic, hypertrophic, and restrictive-pose unique challenges throughout a woman's reproductive life, affecting contraception choices, pregnancy outcomes, and breastfeeding feasibility. Despite significant advances in cardiovascular care, there is still limited guidance on balancing maternal safety and neonatal well-being in this complex setting.

Increasing Antimicrobial Resistance to First-Line Therapies in Chronic Endometritis: A 2020-2024 Cross-Sectional Study.

In the context of the global rise in antimicrobial resistance (AMR), this study aimed to investigate temporal trends in AMR among pathogens isolated from endometrial cultures of patients diagnosed with chronic endometritis (CE). This cross-sectional study included 244 women consecutively diagnosed with CE at the Gynecology Unit of the University of Bari, Italy, between January 2020 and June 2024. Exclusion criteria were (i) previous CE diagnosis or treatment; (ii) antimicrobial use in the month prior to hysteroscopy and biopsy; (iii) use of oral or vaginal prebiotics/probiotics or contraceptives in the three months prior; (iv) known immunosuppression; and (v) hypersensitivity to quinolones or macrolides.

Disparities in Toxoplasmosis, "Other" Infections (Syphilis, HIV, Hepatitis Viruses, Varicella-Zoster Virus, and Parvovirus B19), Rubella, Cytomegalovirus, and Herpes Simplex Virus Seroprevalence and Childbirth Experiences between Migrant and Nonmigrant Pregnant Women in Italy: A Single-Center Study.

The toxoplasmosis, "other" infections (syphilis, HIV, hepatitis viruses, varicella-zoster virus, and parvovirus B19), rubella, cytomegalovirus, and herpes simplex virus (TORCH) complex poses significant risks for maternal and neonatal outcomes. Additionally, the childbirth experience, particularly for migrant women, is shaped by sociocultural and linguistic factors. This study evaluated the prevalence of TORCH infections and compares childbirth experiences between migrant and nonmigrant pregnant women in Italy.

Efficacy, safety, and feasibility of the treatment of intrauterine pathologies with the hysteroscopic morcellator: A systematic review.

Background: Hysteroscopy has evolved from a diagnostic to a diagnostic and operative tool, and currently represents the reference standard for both the diagnosis and treatment of intrauterine diseases. In this context, the hysteroscopic morcellator is increasingly gaining popularity because of its simplified approach.

Objectives: To evaluate the efficacy, safety, and feasibility of the hysteroscopic morcellator for the treatment of intrauterine pathologies.

Oocyte cryopreservation for patients with endometriosis: where are we now? A systematic review.

The ambiguity of current recommendations on the use of oocyte cryopreservation in patients with endometriosis reflects the lack of comprehensive studies evaluating its efficacy. This review seeks to summarize all available data on the outcomes of oocyte cryopreservation and subsequent IVF, while taking patient characteristics into account. The review protocol was registered in PROSPERO (CRD42023486774).

High prevalence of chronic endometritis in women with nonstructural abnormal uterine bleeding and benefits of antimicrobial treatment on blood loss pattern: A prospective, observational study.

Objective: The causal link between chronic endometritis (CE) and nonstructural abnormal uterine bleeding (AUB) has been poorly investigated and requires further clarification. This study aimed to evaluate the prevalence of CE in women with nonstructural AUB and to assess the effect of CE cure on the menstrual blood loss pattern.

Methods: This prospective study was conducted between 2022 and 2024 at the Department of Obstetrics and Gynecology, University of Bari, Italy.

Perinatal outcome in pregnant women: the impact of blood transfusion.

Background: Obstetric hemorrhage is a life-threatening complication of pregnancy. Systematic collection of data on transfusion practice during pregnancy and post-partum period are scarce, as well as data on fetal or neonatal outcomes of women transfused during pregnancy.We examined the prevalence of obstetric hemorrhage and outcome of pregnancies in hospitalized transfused women.

The Impact of Uterine Disorders on Embryo Implantation and Early Survival: From Molecular Insights to Clinical Evidence.

Background: Embryo implantation and early survival in a synchronized, receptive endometrium are critical for establishing a successful pregnancy, but uterine pathologies can present challenges to reproductive success by significantly impacting this complex process.

Objectives: The purpose of this review was to analyze the impact of uterine pathologies on embryo implantation, early embryo survival, and finally on the development of infertility, with references to reproductive outcomes and the main evidence related to therapeutic strategies.

Methods: The relevant publications were identified after queries of the following sources: PubMed, Google Scholar, Web of Science, and publishers' databases, complemented by a cross-check of the reference lists.

Chronic Endometritis and Antimicrobial Resistance: Towards a Multidrug-Resistant Endometritis? An Expert Opinion.

Chronic endometritis (CE) is a persistent inflammatory condition of the endometrium characterized by abnormal infiltration of plasma cells into the endometrial stroma. Frequently associated with repeated implantation failure, recurrent pregnancy loss, and infertility, CE significantly impacts women's health, contributing to conditions such as abnormal uterine bleeding and endometriosis. Treatment typically involves antibiotic therapy; however, the efficacy of these treatments is increasingly compromised by the rise of antimicrobial resistance (AMR).

Step-by-step hysteroscopic treatment of International Federation of Gynaecology and Obstetrics type 3 myoma with the cold loop technique.

Objective: To demonstrate the "cold loop technique" for the hysteroscopic treatment of International Federation of Gynaecology and Obstetrics (FIGO) type 3 myomas.

Design: Step-by-step demonstration of the technique using educative video.

Exposure: FIGO type 3 myomas exhibit complete myometrial development while encroaching on the endometrium.

PAS or Not PAS? The Sonographic Assessment of Placenta Accreta Spectrum Disorders and the Clinical Validation of a New Diagnostic and Prognostic Scoring System.

This study aimed to evaluate our center's experience in diagnosing and managing placenta accreta spectrum (PAS) in a high-risk population, focusing on prenatal ultrasound features associated with PAS severity and maternal outcomes. We conducted a retrospective analysis of 102 high-risk patients with confirmed placenta previa who delivered at our center between 2018 and 2023. Patients underwent transabdominal and transvaginal ultrasound scans, assessing typical sonographic features.

Abnormalities of Oocyte Maturation: Mechanisms and Implications.

The elucidation of oocyte maturation mechanisms is paramount for advancing embryo development within the scope of assisted reproductive technologies (ART). Both cytoplasmic and nuclear maturation represent intricate processes governed by tightly regulated cellular pathways, which are essential for ensuring the oocyte's competence for fertilization and subsequent embryogenesis. A comprehensive grasp of these mechanisms is vital, as the maturation stage of the oocyte significantly influences chromosomal integrity, spindle formation, and its ability to support the initial stages of embryonic development.

Reproductive and oncologic outcomes in young women with uterine sarcoma undergoing fertility-sparing treatment: a systematic review.

Background: Uterine sarcomas (US) are rare cancer of possible occurrence even in women of childbearing age. To date, total hysterectomy is the standard treatment in the early stages. The possibilities of carrying out fertility-sparing treatments (FST) to save the fertility of women with unfulfilled reproductive desires are described in the literature, but to date, they can only be considered experimental.

AIDA (Artificial Intelligence Dystocia Algorithm) in Prolonged Dystocic Labor: Focus on Asynclitism Degree.

Asynclitism, a misalignment of the fetal head with respect to the plane of passage through the birth canal, represents a significant obstetric challenge. High degrees of asynclitism are associated with labor dystocia, difficult operative delivery, and cesarean delivery. Despite its clinical relevance, the diagnosis of asynclitism and its influence on the outcome of labor remain matters of debate.

Four-handed Technique for Total Laparoscopic Hysterectomy: An Italian Experience.

Objectives: In our previous article, we proposed the novel four-handed technique (FHT) for total laparoscopic hysterectomy (TLH), which, according to us, is more helpful compared to the traditional TLH route. The objectives of the study were to analyze the FHT-TLH feasibility and efficiency by comparing some surgical outcomes recorded from 750 FHT-TLH performed in our hospital to literature data about the traditional TLH route and to underline the great opportunity this novel technique offers to the young specialists and residents to be more confident with gynecological laparoscopy.

Materials And Methods: This was a retrospective analysis carried out by collecting data regarding patient characteristics and surgical outcomes (operative time, blood loss, surgical complications, use of analgesics, and length of hospitalization) from 750 hospital records of women who underwent FHT-TLH (with or without adnexectomy) due to benign or malignant pathology from January 2015 to December 2021 at our hospital.

Reproductive outcomes in women with BRCA 1/2 germline mutations: A retrospective observational study and literature review.

Objective: To evaluate the reproductive outcomes of patients bearing BRCA-1 and BRCA-2 mutations.

Methods: In this retrospective observational cohort study, we assessed data from BRCA-1 and BRCA-2 carriers, analyzing demographics, oncological history, and reproductive outcomes. Statistical analysis compared BRCA-1 and BRCA-2 carriers.

Placental ACE2 Expression: A Possible Pathogenetic Mechanism for Infantile Hemangiomas.

ACE2 is a mono-carboxypeptidase with remarkable vasculo-protective properties, and its expression in the human placenta plays a central role in blood pressure homeostasis and fetal perfusion. Therefore, an alteration in the placental expression of ACE2 could be responsible for reduced placental perfusion and infantile hemangioma (IH) development. Study placentae were collected from patients affected by IHs who were referred to our Dermatology Clinic from 2016 to 2022, while control placentae were randomly collected while matching cases for gestational age.

Endometrial Cancer: A Pilot Study of the Tissue Microbiota.

Background: The endometrium remains a difficult tissue for the analysis of microbiota, mainly due to the low bacterial presence and the sampling procedures. Among its pathologies, endometrial cancer has not yet been completely investigated for its relationship with microbiota composition. In this work, we report on possible correlations between endometrial microbiota dysbiosis and endometrial cancer.

Localization of Catecholaminergic Neurofibers in Pregnant Cervix as a Possible Myometrial Pacemaker.

In eutocic labor, the autonomic nervous system is dominated by the parasympathetic system, which ensures optimal blood flow to the uterus and placenta. This study is focused on the detection of the quantitative presence of catecholamine (C) neurofibers in the internal uterine orifice (IUO) and in the lower uterine segment (LUS) of the pregnant uterus, which could play a role in labor and delivery. A total of 102 women were enrolled before their submission to a scheduled cesarean section (CS); patients showed a singleton fetus in a cephalic presentation outside labor.

Artificial Intelligence, Intrapartum Ultrasound and Dystocic Delivery: AIDA (Artificial Intelligence Dystocia Algorithm), a Promising Helping Decision Support System.

The position of the fetal head during engagement and progression in the birth canal is the primary cause of dystocic labor and arrest of progression, often due to malposition and malrotation. The authors performed an investigation on pregnant women in labor, who all underwent vaginal digital examination by obstetricians and midwives as well as intrapartum ultrasonography to collect four "geometric parameters", measured in all the women. All parameters were measured using artificial intelligence and machine learning algorithms, called AIDA (artificial intelligence dystocia algorithm), which incorporates a human-in-the-loop approach, that is, to use AI (artificial intelligence) algorithms that prioritize the physician's decision and explainable artificial intelligence (XAI).

Dystrophic Epidermolysis Bullosa (DEB): How Can Pregnancy Alter the Course of This Rare Disease? An Updated Literature Review on Obstetrical Management with an Additional Italian Experience.

Epidermolysis Bullosa (EB) is an extremely rare and disabling inherited genetic skin disease with a predisposition to develop bullous lesions on the skin and inner mucous membranes, occurring after mild friction or trauma, or even spontaneously. Within the spectrum of EB forms, dystrophic EB (DEB) represents the most intriguing and challenging in terms of clinical management, especially with regard to pregnancy, due to the highly disabling and life-threatening phenotype. Disappointingly, in the literature little focus has been directed towards pregnancy and childbirth in DEB patients, resulting in a lack of sound evidence and guidance for patients themselves and clinicians.