Editorial
Dimitris Loutradis
Professor, Director of 1st Department of Obstetrics and Gynecology, School of Medicine National and Kapodistrian University of Athens
The latest issue of Hellenic Journal of Obstetrics and Gynecology presents a diverse collection of studies that advance our understanding of maternal-fetal health, obstetric management, and gynecologic oncology. These articles encompass innovative research on fetal hemodynamics, the impact of frailty in gynecologic cancers, embryonic cardiac development following assisted reproductive techniques (ART), and risk factors influencing neonatal outcomes.
In the first study Majeed et al investigated the hemodynamic alterations in the umbilical artery among third-trimester women with oligohydramnios, gestational hypertension, and their combination. Findings reveal that gestational hypertension significantly elevates umbilical artery resistive and pulsatility indices, suggesting increased vascular resistance, whereas oligohydramnios alone is associated with lower resistive index but higher pulsatility index, indicating complex vascular adaptations. These insights emphasize the importance of Doppler ultrasound in monitoring such pregnancies to optimize fetal outcomes.
Pergialiotis et al systematically reviewed the influence of frailty on treatment strategies and survival in vulvar cancer patients. The evidence suggests that non-frail patients have substantially better survival prospects and fewer complications, although current data are limited and heterogeneous. This underscores the necessity for further research to tailor management approaches for frail, often older, patients with vulvar malignancies.
In the field of ART, we selected a prospective cohort study that compares cardiac remodeling in singleton pregnancies conceived via ICSI, with or without embryo biopsy, against spontaneous conceptions. Results demonstrate significant differences in fetal cardiac parameters, with biopsied ICSI pregnancies exhibiting increased myocardial wall thickness and altered ventricular indices. These findings highlight potential implications of embryo manipulation on fetal cardiovascular development, warranting ongoing surveillance.
Lastly, Kripouri et al conducted a retrospective Greek study based on a population that was referred in a tertiary university center that identifies maternal smoking as a prominent independent risk factor for small-for-gestational-age (SGA) neonates, reaffirming the critical need for smoking cessation during pregnancy. Interestingly, maternal age, parity, and medication use showed no significant association, emphasizing smoking’s pivotal role in fetal growth restriction.
Together, these studies contribute valuable knowledge that can refine obstetric and gynecologic practices, from fetal monitoring to cancer management and neonatal risk assessment. Continued research in these areas promises to improve maternal and neonatal health outcomes. The Hellenic Journal of Obstetrics and Gynecology continues to serve as a vital platform for disseminating cutting-edge research, clinical insights, and innovations in women’s health. As we navigate an era marked by rapid advancements in medical science, it is imperative that HJOG remains at the forefront, fostering multidisciplinary collaboration and encouraging the exploration of novel approaches to obstetrics and gynecology.