Background: Violence against women is a pressing global issue that poses a number of significant health risks. The influence of violence on women's health has been underestimated, especially its impact on gynaecological disorders.

Objective: To analyze whether experiencing any type of violence increases the risk of gynaecological disorders.

Method: This cross-sectional observational study recruited 15 premenopausal women who had suffered from violence in their lifetimes. A control group consisted of 33 premenopausal women who attended the same clinic on the same date and who had not experienced violence against women.  

Results: Women who had experienced violence reported intra-partner psychological violence (100%), economic violence (26.7%), 40% physical violence (40%),  sexual violence (33%).  Violence was associated with increased prevalence of amenorrhoea, sexually transmitted infection, reproductive difficulties, sexual dysfunctions, and less use of contraceptive methods. Upon odds ratio calculation a significative higher risk of amenorrhoea (OR 19.9; 95% CI= 4.23-93.9, p <0.001) and sexual dysfunction of any kind (OR 27.5; 95% CI= 5.28-143; p <0.,001) were observed in women who experienced violence. Conclusion: Experiencing any form of violence at any point in a ’woman’s life can have a detrimental impact on her overall health, particularly amenorrhoea and sexual dysfunction. The importance of amenorrhoea is not only because of the lack of menstruation but also because of the long-term repercussions of hypoestrogenism.

Perineal scar endometriosis is a very rare entity occurring following only about 0.01% of vaginal deliveries and usually reported in the literature as a single case report or small series. A 39-year-old female patient presented with complaints of cyclic pain in perineal region for 1 year, increased during menstruation. Examination revealed a 2×2cm nodular mass with induration felt at the site of episiotomy scar. Based on characteristic history and examination findings, a probable diagnosis of episiotomy scar endometriosis was considered, additional investigations were requested. A wide excision was performed, and histopathology confirmed the diagnosis based on the presence of endometrial glandular epithelium and stroma. Although, Perineal endometriosis is a rare entity. the diagnosis must be evoked in front of cyclic pain at the level of the episiotomy scar.

Background and aim: To update the mechanisms involved in the process of ovarian aging with a focus on premature ovarian insufficiency (POI). Both the endocrinological and the fertility functions will be reviewed.
Methods: Update of the most relevant publications up to 2023.
Results: The ovary is an organ that has a dual role, as an endocrinological gland for the secretion of steroid hormones, and as a reproductive gonad as a source of oocytes. A main feature of the ovary is that the structures enclosing both the oocytes and the somatic cells, the follicles, which are capable of producing most of the ovarian hormones, replicate only until mid-term of the fetal life. The steroidogenic stromal cells that produce androgens, slowly decrease their activity until late in women’s life. The follicular endowment experiences a progressive wastage up to mid-life, around 50 years of age. The oocytes contained in the follicles of cycles occurring in the later functional reproductive years, suffer a functional impairment that conditions a lower fertility potential. The endocrinological output of follicles extends up to more advanced stages, at the end of the menopausal transition. Dysfunctions in the hormonal output of follicles determine changes in the cycle, including both irregular bleeding and amenorrhea. Women with POI may reproduce similar changes, although the details depend on the etiology and the pathophysiological substrate. The potential underlying mechanisms of ovarian aging are unclear, although oxidative stress seems to have a determining role. Recent data have aided to clarify the molecular details for this effect.
Conclusions: The aging of the ovary translates to mechanisms that condition functional impairment of the oocyte and somatic endocrinological cells, although the progression is dissimilar. Oxidative stress emerges as a potential mechanism conditioning the process of ovarian aging. It is unclear whether the same mechanisms operate, if only to a lesser extent, in the older age group among women with POI.

Background and Purpose: Transgender people often experience suboptimal contraception counseling due to clinicians’ insufficient experience in this topic, and practitioners themselves report lack of satisfactory training. We aim to summarize the current literature on contraception counselling in transgender men and nonbinary people assigned female at birth.
Methods: The present article is a narrative review. Searches were performed in Pubmed and Google Scholar databases using the terms ‘transgender’, ‘transmen’, ‘contraception’, ‘family planning’, ‘reproductive care’. Only English and Portuguese written articles published in the last six years were considered. A manual search of references from identified studies was also conducted and international guidelines were searched for information of interest.
Results: Existing literature suggests that transgender men and nonbinary people assigned female at birth experience significant barriers to health services that can compromise their reproductive health. Regarding contraceptive options, all methods can be offered, according to the same eligibility criteria used for cisgender women. Nevertheless, specificities must be considered: differential acceptance of side effects, potential emotional and physical discomfort inherent to pelvic examination. Both patients and their healthcare providers may be unaware of the fact that ovulation may occur during testosterone treatment, even if the person is in amenorrhea. Hence, it should not be considered for effective contraception. Also, it has known teratogenic effects, which highlights the need for preventing unplanned pregnancies. Until date, there is no evidence that testosterone use is a contraindication to any contraceptive method, therefore, transmen on this medication should be offered all options.
Conclusions: All contraceptive methods can be offered to transgender men and nonbinary individuals assigned female at birth, but the specific needs and concerns of these individuals should be considered in counseling. Literature on this field is still scarce and more studies are needed to evaluate preferences and satisfaction rates.

Background: Currently, a fetal nuchal translucency (NT) ≥ 99th percentile is an indication for invasive testing, often followed by chromosomal microarray analysis. However, there are no international guidelines for screening of NT between the 95th-99th percentiles.
Objective: To identify the chromosomal anomalies detected in the subgroup of NT between the 95th and 99th percentiles and to evaluate the accuracy of genome-wide cell-free DNA (cfDNA) testing for their detection.
Methods: This retrospective cohort study was performed at the Antenatal Diagnosis Unit in the Centre Hospitalier Universitaire (CHU) of Liège. Our cohort included all pregnancies with increased NT ≥ 95th percentile, that underwent invasive sampling using microarray analysis for genetic testing between January 2017 and December 2023. We compared the results of invasive testing with the expected results from genome-wide cfDNA analysis.
Results: Fifty-nine pregnancies were identified, with 40 exhibiting isolated increased NT between the 95th and 99th percentiles. Among these 40 fetuses, 6 were found to have chromosomal abnormalities detected by microarray analysis, including 4 with Trisomy 21 and 2 with microdeletions. Theoretically, at least one of these six abnormalities would not have been detected by cfDNA screening.
Conclusion: Our data suggest that in the subset of fetuses with mildly increased NT (95-99th percentiles), undergoing an invasive procedure with microarray analysis remains recommended due to a 15% (6/40) positive predictive value and if genome-wide cfDNA was performed instead at least one of the six anomalies would be missed. Our data suggest that 3 mm would be the best cut-off for invasive diagnostic testing. If a pregnant woman declines the invasive procedure, genome-wide cfDNA can be an alternative. However, it is important to inform the pregnant woman that even if the results of the cfDNA testing are normal, there still exists a residual risk for a chromosomal abnormality in the fetus.

This article presents a case study involving a 32-year woman bearing a fetus diagnosed with achondrogenesis type 2 which is a rare and life-threatening skeletal disorder. Despite the challenges posed by its rarity and various phenotypic manifestations a multidisciplinary approach was performed to establish the diagnosis. This approach involved assessments, ultrasound imaging, radiographic findings, and genetic testing. The significance of these tools in differentiating achondrogenesis type 2 from skeletal disorders with similar clinical and radiological features is highlighted in this report. Additionally, the article emphasizes the role of counseling in managing these conditions providing invaluable support, education, and guidance to parents. The findings underscore the importance of accurate diagnosis for pregnancy management and informed decision making by parents. Further research is warranted to enhance our understanding of these conditions and develop efficient strategies for the early detection, diagnosis, and management.

Ovarian vein thrombosis is a rare postpartum complication that can potentially lead to significant morbidity and even mortality if not recognized and treated early. The presentation of ovarian vein thrombosis can be very similar to that of an acute abdomen and hence, should be included in the differential diagnosis. We present a case of a 34-year-old female who presented with right iliac fossa pain in the postpartum period. Diagnosis of ovarian vein thrombosis was confirmed on ultrasound and subsequent treatment with antibiotics and anticoagulation led to resolution of symptoms and recanalization of the thrombus. This case demonstrates the importance of prompt diagnosis and initiation of the treatment of ovarian vein thrombosis in order to avoid life threatening sequelae.