Fetal and placental growth are influenced by multiple maternal and fetal factors, including fetal sex and maternal parity. Accurate knowledge of these determinants is essential for growth monitoring and perinatal risk assessment. This study aimed to evaluate the effects of fetal sex and maternal parity on birth weight, placental weight, and the fetal-to-placental weight ratio in a large single-center cohort. We conducted a retrospective cohort study of 4,642 singleton live births between 28 and 40 weeks of gestation at a tertiary hospital in the Wielkopolska region, Poland. Birth weight, placental weight, and fetal-to-placental weight ratios were analyzed according to fetal sex and maternal parity. Percentile charts were generated, and differences were assessed using appropriate statistical tests with p < 0.05 considered significant. Male newborns had higher birth weights than females, with significant differences from 36 to 40 weeks. Placental weight increased with gestational age, with males showing higher values at 38-40 weeks. Fetal-to-placental weight ratios were higher in males at 30, 36, 37, and 40 weeks, indicating greater placental efficiency. Multiparous women delivered newborns with higher birth and placental weights compared to primiparas, particularly in late gestation. Correspondingly, fetal-to-placental ratios were higher among multiparas, reflecting enhanced placental efficiency in subsequent pregnancies. Fetal sex and maternal parity significantly influence fetal and placental growth and fetoplacental efficiency. Male newborns and offspring of multiparas had higher birth weights and more favorable fetal-to-placental weight ratios. The provided percentile charts may serve as practical references for obstetric and neonatal care in the Wielkopolska region.
To assess long-term efficacy and safety of uterine artery embolization for symptomatic uterine fibroids. This retrospective cohort study included women undergoing uterine artery embolization for symptomatic fibroids from 2012 to 2023. A validated questionnaire assessed symptoms (e.g., heavy menstrual bleeding, pelvic pain) pre- and post- uterine artery embolization. Data on fibroid characteristics, follow-up duration, menopause status, and complications were collected. Patients were stratified into follow-up terciles. Statistical analyses included Wilcoxon signed-rank tests, linear regression with menopause adjustment, and Spearman correlations tests (p < 0.05). Uterine artery embolization significantly reduced symptoms, particularly bleeding-related complaints, with sustained efficacy across short-, mid-, and long-term follow-up, even after menopause adjustment. Menopause enhanced symptom relief. No correlations were found between symptom reduction and age, fibroid size, or prior treatment. Complications, mostly minor, occurred in a notable proportion, with rare major events. A small subset achieved successful pregnancies post-embolization. Uterine artery embolization is an effective, minimally invasive treatment for fibroid-related symptoms, with sustained benefits over time; menopause significantly predicts greater symptom improvement.
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Intraoperative frozen section (FS) analysis is widely used during surgery for ovarian tumors to guide the extent of the operative procedure. It plays a particularly significant role in young women, in whom fertility-sparing surgery is considered. Despite its high clinical utility, FS has technical limitations that may result in discrepancies compared with final histopathological diagnosis. To assess the concordance between intraoperative frozen section diagnosis and final histopathological examination of ovarian tumors, and to evaluate the diagnostic accuracy, sensitivity, specificity, and predictive values of FS. The analysis included finally 100 women aged 11-78 years from among 114 who were hospitalized and underwent surgery for ovarian tumors conducted at a tertiary Gynecology and Obstetrics Clinical Hospital from January to June 2025. Frozen section diagnoses were compared with final histopathological results. Concordance rates, patterns of diagnostic discrepancies, and diagnostic performance parameters (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) were calculated using final histopathology as the reference standard. Overall concordance between frozen section and final histopathology was 85%. Diagnostic discrepancies were observed in 15% of cases, with only 2% considered clinically significant. Frozen section showed excellent diagnostic performance for benign tumors (sensitivity 100%, specificity 94.1%) and malignant tumors (specificity and PPV 100%). The lowest diagnostic accuracy was observed for borderline tumors, which accounted for most clinically relevant discrepancies. The most frequent source of discordance involved hemorrhagic cysts, which were ultimately diagnosed as endometriotic cysts on final histopathology. Intraoperative frozen section analysis is a reliable and safe diagnostic tool that effectively supports surgical decision-making in ovarian tumors. Its high diagnostic accuracy and predictive values confirm its clinical value, particularly in tailoring the extent of surgery. Special caution is warranted in the interpretation of borderline tumors, for which final histopathological examination remains essential.
To show the relationship between antral follicular count (AFC) levels and ovulation and pregnancy rates in sub-fertile women with polycystic ovarian syndrome who received clomiphene citrate and gonadotropin-based ovulation induction therapy. A cohort study conducted from 1st February 2023 to 1st April 2025. A hundred sub-infertile women with polycystic ovarian syndrome were included. During days 3-5 of the menstrual cycle, a blood sample to measure basal anti-mullerian hormone (AMH), estradiol E (2), luteinizing hormone (LH) and follicular stimulating hormone (FSH).Antral follicular count (AFC) was measured for both ovaries through transvaginal ultrasound. All patients received Clomiphene citrate tablets and gonadotropins during a single cycle. Patients with at least 18 mm follicle received 5000 IU of human chorionic gonadotropin. Anovulation diagnosed when mid-luteal serum progesterone is below 10 pmol/L. Two weeks later, B-hCG levels were measured. The average number of antral follicles was 26.90 ± SD 9.73. The length of infertility was closely related to the groups of antral follicle count (p ≤ 0.001). Antral follicular count is a statistically significant predictor of ovulation (p =≤ 0.001). A strong association was found between antral follicular count and pregnancy, which was statistically significant (p ≤ 0.001). Antral follicular count can be used to assess response to treatment of subfertile polycystic ovarian syndrome women to ovulation induction by drugs, the rate of ovulation and pregnancy.
Breasts play a significant role in body image and are perceived as a symbol of femininity and sexuality, which makes a cancer diagnosis particularly difficult on an emotional level. Subjective experiences of depression significantly and negatively affect the sexual lives of patients who have undergone mastectomy, thereby reducing their quality of life by influencing physical, social, and emotional aspects. The study was conducted among 151 women diagnosed with breast cancer and took place from September 2025 to January 2026. The diagnostic survey method was employed, along with the following research tools: Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI), Perceived Stress Scale (PSS-10), the Coping Inventory-Mini-COPE, and self-administered questionnaire. Among the studied group of patients, 47% reported a subjective feeling of depression, and 68.2% were observed to have sexual dysfunction. The FSFI scale domains correlated significantly negatively with the PSS-10 and Beck Depression Scale. The total FSFI score correlated significantly positively with the Mini-COPE scale. Only one domain, namely self-blame, correlated significantly negatively. Factors influencing sexual dysfunction included the type of treatment (immunotherapy), depressive factors, and the coping strategy of self-blame. The Female Sexual Function Index (FSFI) showed a negative correlation with both PPS-10 and BDI. Among the coping strategies assessed by the Mini-Cope, only one domain negatively correlated with total FSFI. Mental state and the type of treatment were significant factors influencing sexual dysfunction in women with breast cancer treated surgically.
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To evaluate the applicability of the INTERGROWTH-21st prescriptive fetal growth standards for thirdtrimester biometry and estimated fetal weight (EFW) assessment in a Polish population. This retrospective single-center cohort study included 594 uncomplicated singleton pregnancies with reliable firsttrimester crown rump length dating and one routine thirdtrimester ultrasound performed at a tertiary center in Poland (2014-2021). Standard biometry and EFW were obtained per international guidelines, and EFW was calculated using the INTERGROWTH-21st formula. Zscores and centiles were derived from INTERGROWTH-21st standards. EFW Zscores were grouped into < 3rd, 3rd ≤ 10th, 10th-90th, 90th-97th and > 97th centile categories; observed vs expected proportions (3%, 7%, 80%, 7%, 3%) were compared using the chisquare test. Mean Zscores approximated zero for all parameters (HC 0.00 ± 1.01, AC 0.00 ± 1.02, FL 0.00 ± 1.08, BPD 0.00 ± 1.01, EFW 0.00 ± 0.93); 95% confidence intervals included zero, indicating minimal bias. For EFW, proportions were 1.0%, 4.7%, 85.2%, 6.2%, and 2.9%, respectively, significantly deviating from the theoretical distribution (χ² = 14.8, df = 4). Third trimester fetal size in lowrisk Polish pregnancies is well described by the INTERGROWTH-21st standards regarding central tendencies. A slight underrepresentation of fetuses at the extremes suggests mild compression, warranting local audit and linking of centiles with perinatal outcomes to refine diagnostic thresholds.
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Iron deficiency is a common nutritional deficiency. Improved laboratory results, good tolerance, and improvement in deficiency symptoms are associated with patients' decisions to start or continue supplementation. The aim of the study was to assess the tolerance of iron preparation and the impact of supplementation on the laboratory test results and symptoms of iron deficiency in patients aged 19-70. The study included 119 patients with iron deficiency who started supplementation with micronized and emulsified ferric pyrophosphate. After signing informed consent, patients completed iron deficiency symptoms questionnaire. A follow-up visit was scheduled after 3 months (+/-14 days) of supplementation. During follow-up visit laboratory results were reviewed, patients completed the iron deficiency symptoms questionnaire and tolerance questionnaire. Of 63 women, an increased iron levels were observed in 39 patients (61.9%; p < 0.001), an increase in ferritin levels in 38 from among 66 patients (57.6%; p < 0.001). Decreased total score for iron deficiency symptoms was reported by 103 patients of 108 (95.4%). In this group, 41 (38%) reported discomfort during supplementation. Overall, 83.2% of participants rated the preparation as good or very good. At the follow-up visit regular medical history was collected from the patients, no hospitalizations nor deaths were reported. Dietary supplementation with micronized and emulsified ferric pyrophosphate is effective in iron deficiency, in terms of improving laboratory test results and reducing the severity of deficiency symptoms. Good tolerance with few - and mainly low grade - side effects encourage patients to continue supplementation as recommended.
This review article explores the psychological dimension of gynecological disorders in girls and young women, emphasizing the need for interdisciplinary approaches in medical care. Gynecological conditions such as endometriosis, polycystic ovary syndrome (PCOS), and disorders of sex development (DSD) often co-occur with psychological challenges including depression, anxiety, body image issues, and identity-related stress. The chronic nature of symptoms, delayed diagnosis, and potential implications for fertility intensify the emotional burden, particularly during adolescence - a developmental stage crucial for self-esteem and identity formation. Psychological interventions such as cognitive-behavioral therapy (CBT), progressive muscle relaxation (PMR), mindfulness, psychoeducation, and family support are reviewed for their therapeutic potential. The integration of psychologists into gynecological teams improves communication, treatment adherence, and emotional well-being. The paper also discusses the importance of tailored communication with young patients and their families, addressing stigma, and ensuring privacy and autonomy. Incorporating psychological care into gynecological treatment contributes to a holistic model that not only addresses physical symptoms but also enhances psychological resilience, quality of life, and long-term health outcomes. The authors advocate for routine psychological screening in gynecological settings and the implementation of interdisciplinary standards of care.
To evaluate the limitations of fixed risk thresholds in first-trimester CST for T21, with a focus on age-related inflation of false-positive results, and to assess whether alternative threshold strategies can mitigate this effect. This retrospective study included 13,668 singleton pregnancies with first-trimester CST and confirmed prenatal or postnatal karyotype (13,540 euploid; 128 T21). Screening performance was evaluated using the standard 1:300 high-risk cut-off and two strategies targeting an approximately 5% FPR - a global threshold (5th percentile of euploid risk denominators, approximately 1:55) and an age-dependent threshold derived from age-specific 5th percentiles smoothed using locally estimated scatterplot smoothing. DR and FPR were calculated overall and stratified by maternal age (≤ 34, 35-39, and ≥ 40 years), with paired comparisons performed using McNemar's test. The standard 1:300 cut-off yielded an overall FPR of 16.1% (2,181/13,540), increasing from 9.7% in individuals aged ≤ 34 years to 38.5% in those aged ≥ 40 years. The global 5% FPR strategy substantially reduced false-positive classifications but decreased DR from 90.6% (116/128) to 79.7% (102/128) (p < 0.001). The age-dependent strategy-maintained a near-constant FPR across age groups (overall 5.4%), achieved a DR of 81.3% (104/128), and demonstrated higher diagnostic efficiency than the 1:300 threshold (diagnostic odds ratio 75.23; 95% confidence interval 48.15-117.55). Fixed risk thresholds in first-trimester CST lead to pronounced age-related inflation of false-positive results. Thresholds targeting an approximately 5% FPR - particularly age-dependent calibration - substantially reduce unnecessary screen-positive classifications with only moderate loss in detection. However, threshold adjustment alone does not address the fundamental limitation of binary classification based on a single posterior risk estimate. In contingent screening pathways where CST serves as triage before cell-free DNA or invasive testing, age-adapted thresholds offer a pragmatic approach to reducing avoidable escalation among pregnant individuals of advanced maternal age.
The aim of this study is to review the current state of knowledge on the role of melatonin in the pathophysiology and treatment of intrauterine growth restriction (IUGR) based on recent clinical and experimental studies. A systematic review of scientific literature published between 2012-2025 in PubMed, Cochrane Library and Web of Science databases was conducted. Studies on melatonin mechanisms of action, their levels in IUGR, and results of experimental and clinical studies were analyzed. Melatonin is synthesized not only by the pineal gland but also by the placenta, where it plays a crucial role as an antioxidant and modulator of inflammatory processes. Women with IUGR showed significantly lower melatonin levels in umbilical cord blood. The MT2 melatonin receptor regulates placental angiogenesis through the STAT3/VEGFR2/PI3K/AKT pathway. Experimental studies demonstrated that melatonin improves fetal oxygenation, reduces oxidative stress, and protects the brain and heart from damage. Melatonin shows promising neuroprotective and cardioprotective properties in IUGR fetuses. The PROTECT Me trial, which completed recruitment in 2025, will provide crucial data on melatonin's clinical efficacy. Until then, melatonin use in IUGR should be limited to controlled clinical trials.
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To gain insight into the attitudes of bereaved mothers targeting the impact of the autopsy on parents experiencing stillbirth. The design was a population based, cross-sectional study using semi-structured interviews. Setting included mothers with confirmed stillbirth in a Tertiary University Hospital involving the Department of Pastoral and Spiritual Care and the Department of Pathology. Participants included forty-five mothers, who were interviewed. Postmortem examinations are accepted if communication between healthcare providers and mothers is maintained. In 39 out of 45 mothers, the stillbirth was experienced as a sudden unexpected event. Thirty-two of 45 mothers found the interview with the pathologist helpful in clarifying the autopsy report. In 37 out of 45, the in-person meeting was found beneficial for the grieving process. The pathologist may represent an integral component for the grieving process of families experiencing loss. Despite misconceptions, pathologists may play a crucial role in the well-being of families experiencing stillbirth.