Hysteroscopic approaches

This edition of our journal emphasizes maternal aspects, highlighting in the first paper that gestational diabetes mellitus identifies women at an increased risk of type 2 diabetes, but the postpartum screening remains incomplete. The narrative review examines test selection, timing and continuity of care using guidelines and selected diagnostic, intervention and implementation studies.

As infertility represents a major public health concern, with significant physical and psychological impact for patients and affected couples, the gynecology section brings to the front a retrospective study proving the role of hysteroscopy in the evaluation and treatment of female infertility.

The next paper presents a very interesting study carried out in the 2^nd Obstetrics and Gynecology Clinic, Târgu Mureș, Romania, between 2019 and 2026, which compares myomectomy outcomes between the Hysteroscopic Tissue Removal (HTR) device and bipolar resectoscopy, with particular attention to procedure duration, success rates and complication profiles, concluding that, although the HTR device has certain limitations, it remains a rapid and safe option for hysteroscopic myomectomy.

Women with chronic kidney disease receiving maintenance hemodialysis after renal transplantation pose significant perioperative challenges. The evidence describing the perioperative management of hysteroscopic procedures in this population remains limited. The next paper is even more challenging, presenting a case report of perioperative multidisciplinary management of hysteroscopic polypectomy in a dialysis-dependent renal transplant recipient.

Moving on, fertility transition has emerged as a defining demographic shift in the 21^st century, characterized by declining birth rates, delayed childbearing and population ageing. The study presented in this paper at the interdisciplinary section critically examines global, regional and national fertility patterns, highlighting key socioeconomic, demographic and reproductive health determinants in Sri Lanka.

The first paper of the neonatology section focuses on an important cause of invasive candidiasis in preterm neonates, particularly in those exposed to central venous catheters, parenteral nutrition and prolonged antimicrobial therapy. This case highlights the difficulty of diagnosing neonatal central nervous system (CNS) candidiasis and the importance of integrating microbiological, cerebrospinal fluid, clinical and neuroimaging findings.

As breastfeeding provides benefits beyond nutrition, influencing maternal metabolic, endocrine, cardiovascular, psychological and reproductive health, the study presented in the following paper point to the benefits of breastfeeding, the role of human milk in hospitalized neonates, challenges associated with breastfeeding in the neonatal intensive care unit and the importance of multidisciplinary support strategies.