Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital condition characterizing females with absence of the uterus and part of the vagina. Several genetic defects have been correlated with the presence of MRKH; however, the exact etiology is still unknown due to the complexity of the genetic pathways implicated during the embryogenetic development of the Müllerian ducts. A systematic review (SR) of the literature was conducted to investigate the genetic causes associated with MRKH syndrome and Congenital Uterine Anomalies (CUAs). This study aimed to identify the most affected chromosomal areas and genes along with their associated clinical features in order to aid clinicians in distinguishing and identifying the possible genetic cause in each patient offering better genetic counseling. We identified 76 studies describing multiple genetic defects potentially contributing to the pathogenetic mechanism of MRKH syndrome. The most reported chromosomal regions and the possible genes implicated were: 1q21.1 (RBM8A gene), 1p31-1p35 (WNT4 gene), 7p15.3 (HOXA gene), 16p11 (TBX6 gene), 17q12 (LHX1 and HNF1B genes), 22q11.21, and Xp22. Although the etiology of MRKH syndrome is complex, associated clinical features can aid in the identification of a specific genetic defect.

Global exposure of children to sexual abuse is widespread. Disclosure may be extremely upsetting for both families and medical professionals. This review provides medical practitioners with practical tips for a stepwise approach of the child who discloses sexual abuse. Having secured a private examination room, the physician should approach the child and caregivers separately to determine the level of concern for abuse and the urgency of the situation. The medical evaluation is based on the information gathered, including a complete physical examination, inspection of the genitalia, collection of forensic evidence, and testing for sexually transmitted diseases. On a case-by-case basis, the need for surgical intervention, prophylactic treatment, and immunization is discussed. Finally, important questions for the medical team to address are outlined with the goal of supporting the child and his/her family and ultimately stopping the abuse.

OBJECTIVE: To assess the risk for obstetric complications in women with congenital uterine anomalies and the risk in each main class of uterine anomaly (U2 [septate], U3 [bicorporeal], U4 [hemi-uterus]), based on the 2013 classification by the ESHRE (European Society of Human Reproduction and Embryology) and the ESGE (European Society for Gynaecological Endoscopy). DATA SOURCES: MEDLINE, Scopus, and ClinicalTrials.gov were searched from inception until January 2021. The reference list of all included articles and previous systematic reviews were also screened to identify potential additional articles. METHODS OF STUDY SELECTION: Comparative and noncomparative studies that investigated the obstetric outcomes of women with any type of known congenital uterine anomaly were considered eligible for inclusion. Screening and eligibility assessment was performed independently by two reviewers. TABULATION, INTEGRATION, AND RESULTS: Forty-seven studies were included. The quality of included comparative studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Odds ratios (ORs), pooled proportions of each obstetric outcome, and 95{%} CIs were calculated in RevMan and Stata accordingly, using random effects models. Congenital uterine anomalies were associated with increased risk of preterm birth (OR 3.89, 95{%} CI 3.11-4.88); cervical insufficiency (OR 15.13, 95{%} CI 11.74-19.50); prelabor rupture of membranes (OR 2.48, 95{%} CI 1.38-4.48); fetal malpresentation (OR 11.11, 95{%} CI 5.74-21.49); fetal growth restriction (OR 3.75, 95{%} CI 1.88-7.46); placental abruption (OR 5.21, 95{%} CI 3.34-8.13); placenta previa (OR 4.00, 95{%} CI 1.87-8.56); placental retention (OR 1.71, 95{%} CI 1.16-2.52); and cesarean birth (OR 4.52, 95{%} CI 2.19-9.31); when compared with those without anomalies. Pooled estimated risks were 25{%} for preterm birth, 40{%} for fetal malpresentation, 64{%} for cesarean birth, 12{%} for prelabor rupture of membranes, 15{%} for fetal growth restriction, 4{%} for placental abruption, 5{%} for preeclampsia, 13{%} for cervical insufficiency, and 2{%} for placenta previa. Classes U2 (septate), U3 (bicorporeal), and U4 (hemi-uterus) were also associated independently with preterm birth, fetal malpresentation, cesarean birth, and placental abruption. CONCLUSION: Congenital uterine anomalies are associated with obstetric complications across all examined ESHRE and ESGE classifications. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42021244487.

Background: The regenerative efficacy of platelet-derived products has been recently investigated in the treatment of pelvic floor disorders (PFDs). We aimed to synthesize the current evidence of platelet-rich plasma (PRP) products used in urogynaecological disorders including vaginal atrophy, pelvic organ prolapse (POP), urinary incontinence, vaginal fistulas and vaginal mesh exposure. Methods: A meticulous search of the currently available literature on the use of PRP for the management of PFDs was performed using 3 electronic databases. Results: PRP could be a feasible alternative modality for the management of vaginal atrophy with favourable outcomes in vaginal atrophy parameters and patients' satisfaction, especially when hormone therapy is contraindicated. In patients with POP, an increase in collagen concentration after PRP application was observed while the use of PRP resulted in improvement of stress urinary incontinence symptoms. A considerable proportion of vesicovaginal fistulas were treated after application of PRP-based injections. Conclusions: There is only limited evidence of the use of PRP for PFDs. Platelet-rich plasma appears to be a promising, easy to apply, cost-effective and feasible alternative therapeutic modality for the management of various urogynaecological disorders. Future randomized trials are needed to confirm the efficacy of PRP in the treatment of urogynaecological disorders.

OBJECTIVE: The objective of this research was to evaluate how menstrual tracking applications can promote gynaecological health. MATERIALS AND METHODS: We performed a systematic review in Medline and Scopus, for papers evaluating menstrual tracking mobile applications. We excluded review articles and those not written in English. RESULTS: We identified 14 articles measuring the outcome resulting from the use of a single Fertility Tracking Application (FTA). Eight studies evaluated 2 different applications used as a contraception method. One study assessed a fecundity enhancing application. Five studies referred to applications, used to treat or monitor various gynaecologic issues. All studies reported efficacy for their intended use or a high satisfaction rate. DISCUSSION: There is a plethora of FTAs, however a minority of them are appraised by medical experts. Several safety and privacy concerns have been expressed regarding their use and these issues should be addressed in the future. All studies identified in our search demonstrated that FTAs can facilitate users in terms of contraception, fertility, and menstrual awareness. CONCLUSION: Menstrual tracking applications can serve as a valuable health tool, nevertheless, their content should be more vigorously evaluated.