ACTA ENDOCRINOLOGICA (BUC)

Background. High-risk-HPV, metabolic disorders, and prior cesarean scar have been linked with adverse obstetric outcomes, but their combined effects are unclear. Methods. Retrospective cohort of 185 pregnancies at a Romanian tertiary center (2021–2024) with highrisk HPV DNA testing ≤24 weeks and thyroid profiling. Exposures: HPV status and comorbidities (gestational hypertension, gestational diabetes, prior cesarean scar). Primary outcome: cesarean delivery; secondary: preterm birth <37 weeks, major placental pathology, NICU admission. Multilevel logistic regression adjusted for age, BMI, parity, smoking, and twin gestation; interaction terms assessed HPV×comorbidity. Results. 41/185 (22.2%) HPV-positive. Cesarean odds were higher for HPV-negative with any comorbidity (aOR 2.9, 95% CI 1.5–5.6) and highest for HPV-positive with comorbidity (aOR 4.3, 1.8–10.2) versus HPV-negative without comorbidity. HPV-positive status was associated with a modest TSH increase (max Δ+0.25 mIU/L in T3, 95% CI 0.05–0.44; p = 0.013), with similar FT4/FT3 and values largely within pregnancy-specific ranges. A significant interaction was observed for HPV × prior cesarean scar on preterm birth (p_interaction = 0.008; aOR 2.9, 1.2–7.2); interactions with gestational hypertension or diabetes were non-significant. Conclusions. High-risk HPV combined with maternal comorbidity was associated with increased cesarean and preterm-birth risk. Findings support incorporating HPV status into antenatal risk assessment and warrant larger prospective studies.

Context. The growing use of home monitoring devices during pregnancy has raised concerns about their reliability and psychological impact. From an endocrine perspective, early modulation of maternal stress through the hypothalamic–pituitary–adrenal (HPA) axis may influence fetal neuroendocrine programming. Identifying safe, reassuring tools that stabilize maternal emotional state in early gestation may support healthier endocrine adaptation for both mother and fetus. Objective. To evaluate the feasibility and psychological effects of handheld Doppler use for fetal cardiac monitoring in early pregnancy and to explore correlations between maternal–fetal cardiac coupling and maternal anxiety. Design. Prospective, observational, single-center study conducted between January 2019 and December 2023 at Polizu Clinical Hospital, Bucharest. Subjects and Methods. One hundred women ≤14 weeks’ gestation completed questionnaires evaluating handheld Doppler and pulse oximeter use. 54 received the DASS-21 anxiety subscale online; 26 provided valid responses. Comparative and correlational analyses were performed using IBM SPSS v29. Results. Fetal heart rate was detected in 67% of cases, with higher detection at increasing gestational ages. Women who detected the heartbeat had higher gestational age (10.4 ± 1.8 vs. 8.6 ± 1.9 weeks, p < 0.01). Anxiety scores inversely correlated with gestational age (p = 0.019). Most participants (68%) found the Doppler reassuring. Conclusions. Handheld Doppler monitoring during early pregnancy is feasible and provides emotional reassurance, potentially stabilizing maternal stress responses and supporting maternal–fetal endocrine adaptation.

Metastatic tumors account for 5-10% of all ovarian malignancies. They are usually bilateral tumors with a multinodular surface and extensive extra ovarian spread. Lung cancer is a rare source (0.3% of metastatic ovarian tumors). Among synchronous primary cancers, ovarian cancer is most frequently associated with endometrial cancer. The differential diagnosis between a primary ovarian carcinoma, synchronous primary cancers, and metastatic ovarian carcinoma is very important, as the treatment and prognosis are markedly different. We report the case of a 25-year-old woman who had been diagnosed and treated for stage IIIB small cell lung carcinoma (SCLC). Imaging undertaken for abdominal pain revealed a unilateral 8.5 cm ovarian tumor for which adnexectomy was performed. Histology and immunohistochemistry led to the diagnosis of ovarian metastasis from SCLC, a high-grade neuroendocrine lung tumor. This patient’s particular features, all infrequent in a metastatic tumor, are the lesion’s unilaterality (atypical for ovarian metastases in other cancers, but often observed in SCLC), the smooth ovarian surface with intact capsule, and the absence of intra-abdominal dissemination. The patient developed liver and vertebral metastases. This report focuses on the differential diagnosis between primary and metastatic ovarian neoplasms. We performed an extensive search of the literature on SCLC and ovarian metastases. Immunohistochemistry is essential for diagnosis when imaging and the pathological evaluation of the ovarian tumor cannot make the differential diagnosis.

Objective. This study assesses, in patients from counties with iodine deficiency (ID) and without ID, the concentrations of thyroid hormones in newborns (cord blood) and mothers at delivery, maternal and fetal thyroid volumes (less than 24 hours before delivery) and maternal urinary iodine at delivery. Another aim of this paper is to identify the interrelations between maternal and neonatal thyroid functions in the premature and full term delivery.\r\nMethods. In this study there were 83 mothers without thyroid pathology (goitre included) aged 26.51 ? 4.88 years, range 16-38 years) and their 83 newborns immediately after delivery. Four groups were identified: group A - 13 mothers from iodine sufficient area (IS) who delivered prematurely, group B - 13 mothers from iodine deficient area (ID), who delivered prematurely, group C - 38 mothers from IS area who delivered at term and group D - 19 mothers from ID area who delivered at term. The serum concentrations of TSH, total (T)T4, free (F)T4, TT3 and FT3 were evaluated by a microparticle enzyme immunoassay (MEIA). The thyroid volumes in mothers and their fetuses were measured by ultrasonography with a high resolution equipment (Accuvix XQ).\r\nResults. The values of TSH in newborns (cord blood serum), expressed as mean ? standard deviation (SD), were significantly higher in groups from ID areas (B+D) vs. groups from IS areas (A+C) (p<0.03). TSH levels were higher in group D vs. group C (6.62 ? 4.53 mU/L vs. 5.46 ? 2.83 mU/L [p<0.03]). The values of TT4 in newborns were significantly lower in group B vs group D (8.09 ? 1.68 ?g/dl vs. 9.45 ? 2.23 ?g/dl [p<0.05]), in premature group (A+B) vs term group (C+D) [p<0.007] and in groups from ID areas (B+D) vs. IS groups (A+C) vs [p<0.01]. Thyroid volumes (TV) in fetuses from IS areas (A+C) were lower than in ID areas (B+D) (p<0.002), but TV was similar in fetuses born at term or prematurely. Serum TSH levels in newborns (71.73 ? 26.54 ?g/l) were negatively correlated with maternal urinary iodine (r = -0.827, p<0.0001). Serum TSH in newborn was not correlated with maternal TSH in any group (A-D). The TV in fetuses (1.25 ? 0.1 ml) were highly correlated with TSH in newborns (r = 0.83, p<0.001), negatively correlated with maternal urinary iodine (r = -0.81, p<0.001) and correlated with maternal TV (17.12 ? 1.82 ml) (r = 0.44, p<0.02).\r\nConclusions. The status of the thyroid hormones and thyroid volumes in the newborn was dependent on the severity of iodine deficiency and in a less proportion on prematurity. The fetus is more sensitive to iodine deficiency than the mother.