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Objectives: Misoprostol has been used before intrauterine contraceptive device (IUCD) insertion to prime the cervical os. As the literature about this topic is controversial, we aimed to ev...

The purpose of this study is to investigate the effect of hormone therapy (HT) on the oncological outcomes of endometrial cancer (EC) survivors. A systematic literature review was conducted in July 2021 to identify studies detailing the effect size for the relationship between HT use in EC and oncological outcomes (survival and disease recurrence). This included studies that evaluated the different recurrence rates among women treated for EC who subsequently underwent HT and those who did not. The collected studies were evaluated for quality, heterogeneity, and publication bias, and a pooled odds ratio (OR) or hazard ratio (HR) was calculated with a confidence interval of 95% (95% CI). In total, 5291 studies were collated, and after the review process, one randomized trial and seven observational studies were included, comprising 1801 EC survivors treated with HT and 6015 controls. The time-dependent analysis could be conducted for four studies, and considering the disease-free survival, the pooled HR of 0.90 (95% CI 0.28 to 2.87) showed no significant differences. However, among Black American women treated with continuous estrogen HT, the HR was 7.58 (95% CI 1.96 to 29.31), showing a significantly increased risk of recurrence for women in this ethnic group. Considering the pooled OR of all included studies 0.63 (95% CI 0.48 to 0.83), a significantly reduced risk of recurrence was found among EC survivors treated with HT. Considering the type of HT, the most risk-reducing was combined estrogen and progestin therapy and the cyclic regimen. Although supporting evidence is based mainly upon observational studies, evidence of no increased risk or even decreased risk was generally found, apart from in Black American women where a significantly increased recurrence risk was evident. The data are rather reassuring for the short-term administration of HT to symptomatic EC survivors. Future studies with a longer follow-up are necessary to better clarify the long-term effects of HT.

During pregnancy, supply of nutrients and exposure of the mother to environmental factors can influence fetus phenotype, possibly modifying growth of fetal tissues and organs. Few studies inconsistently reported that fetuses exposed to an insufficient energy supply, as those born small for gestational age, may have a reduced volume of uterus and ovaries. A retrospective analysis was performed on ultrasound data performed between 2012 and 2018 in 69 young premenarchal girls, 5 to 9 years of age, attending our endocrine–gynecologic clinic for a suspect of early puberty. Length of pregnancy and birthweight was also retrieved. When corrected for age, and presence of ovarian follicles, ovarian volume was positively (R2 = 0.210; p = 0.001) related to percentiles of birthweight (beta coefficient 0.012; 95% CI, 0.002–0.021). Similarly, uterine volume was positively (R2 = 0.237; p = 0.005) related to percentiles of birthweight (beta coefficient 0.067; 95% CI, 0.021–0.114). Ovarian (p = 0.034) and uterine (p = 0.014) volume was higher in the upper 3rd distribution of birthweight percentiles. In conclusion, development of ovarian and uterine volume increases progressively with the increase of birthweight percentiles. The data indicate an association between birthweight and the volume of uterus and ovary at 5–9 years of age.

Group B streptococcus (GBS) is the leading cause of neonatal morbidity and mortality in developed countries. This study aims primarily to estimate the prevalence of maternal GBS positivity and secondarily to evaluate the compliance and the effectiveness of the current GBS prevention protocol.This retrospective study has considered 27382 single pregnancies carried to delivery between 2001 and 2014 at our Obstetrics and Gynecology clinic. All women carrying a singleton pregnancy in the considered period were eligible to be included in this study.The GBS swab was positive in 17.66% of cases, negative in 51.93%, and unknown in 30.41%. Data collected revealed that out of the total of GBS-positive women, 3362 were treated with antibiotic prophylaxis, and 1331 were not. There were no differences between cases admitted to NICU (neonatal intensive care unit) and perinatal deaths between treated and non-treated GBS-positive pregnancies. Moreover, the data showed that 74.62% of patients between 34 and 37 weeks of gestation at the time of delivery were treated with antibiotic prophylaxis unnecessarily, and 25.38% of patients 37 weeks of gestation whose GBS status at delivery was unknown would have required intrapartum antibiotic prophylaxis. The only risk factor for chorioamnionitis among GBS-positive women in multivariate logistic regression analysis was an early gestational age (OR 0.61; CI.95 0.56 - 0.66; p0.05).GBS prevalence was found to be 17.66%, and prophylaxis in colonized patients was carried out correctly according to our internal procedure allowing a low incidence of adverse outcomes. Finally, the only risk factor associated with chorioamnionitis in GBS patients was early gestational age at delivery.