The role of hysteroscopy in cases of chronic or subclinical endometritis remains uncertain. Reevaluating the clinical relevance of diagnostic hysteroscopic in these cases will improve the level of case in women's health worldwide. The objective of this systematic review was to assess the suitability of hysteroscopy in detecting and diagnosing female patients with chronic or subclinical endometritis, as a first‐line diagnostic tool. For this systematic review, five major search engines PubMed, Embase, MEDLINE, Google Scholar, as well as ResearchGate were searched using MeSH (medical subject headings) without language or year restrictions up to November 2019. All types of scientific papers were taken into consideration, with a priority to randomized control trials enrolling women with chronic or subclinical endometritis and compared with standard diagnostic tools such as histology or immunohistochemistry, in order to ensure the efficacy of the method. Risk of bias was assessed using the recommended Cochrane Collaboration criteria. In order to gather more information and data, we have decided to include all the scientific evidence regardless of study design. Data collection and analysis were performed according to PRISMA protocol. Hysteroscopy is an important diagnostic tool in cases of endometritis when accompanied by endometrial samples assessment techniques. In cases of high suspicion endometritis facilitates greater diagnostic accuracy. Hysteroscopy facilitates also the assessment of antibiotic administration efficacy in cases of confirmed endometritis. Micropolyposis, stromal edema or congestion, diffuse or focal hyperemia are the dominant hysteroscopic features that are considered by most studies as suggestive of chronic or subclinical endometritis. The heterogeneity of the included studies presents a high risk of bias as assessed according to Cochrane Collaboration criteria. Hysteroscopy is not suitable as a first‐line diagnostic tool in cases of chronic or subclinical endometritis. Further randomized controlled trials need to be conducted in order to define the role of hysteroscopy as a first‐line diagnostic tool in cases of chronic or subclinical endometritis.

Objective Nowadays, smartphones are becoming an indispensable tool due to the popular use of useful applications (apps) that can be downloaded and installed to aid our everyday lives. The quantity of apps manifested as tools for mobile health (mHealth) is undoubtedly high. The mHealth apps are very popular and cover various and different aspects of health. The first app for women in menopause was presented in 2014. Since then, more apps have been developed. The aim of this study is to identify mHealth apps that address the menopause with a focused view on the degree of medical professional involvement and documented evidence base practice in their design, as well as, underline their potential role in raising awareness regarding health in the community. Methods The official app stores by Google, Apple, Windows and Blackberry were chosen to pool the apps. The keywords used were ‘apps for menopause’, ‘women in menopause’ and ‘menopause’. Eligible apps were selected based on the target consumer, each app’s price, documentation of evidence base practice and documentation of medical professional involvement. Results This search revealed 35 relevant apps, of which 10 were excluded as they were identified as duplicates available for download by more than one app store. Authors excluded also further three mHealth apps, since they were not written in English, and the assessment was difficult due to the language barrier. A total of 22 mHealth menopause apps were included in this study. Medical professional involvement was noted in 27.3% of the mHealth menopause apps, and 22.7% of the total apps used evidence-based information. The mHealth menopause apps were free of charge in 86.4%. Ninety-one percent of the apps were designed for the consumers, while only 9% of them were suitable for medical professionals. Conclusions In conclusion, there is a need to improve the mHealth apps available for menopause, by including more medical staff in their development and by establishing clear regulation around the development and the context of an mHealth app.

High-grade serous ovarian carcinoma (HGSOC) is a leading cause of mortality among women worldwide. Currently, there is no clear consensus over the regime these patients should receive. The main two options are upfront debulking surgery with adjuvant chemotherapy or neoadjuvant chemotherapy followed by interval debulking surgery (IDS). The former approach is proposed to be accompanied by lower chemoresistance rates but could lead to severe surgical comorbidities and lower quality of life (QoL). Optimizing patient's selection for upfront debulking surgery might offer higher progression-free and overall survival rates. Further studies need to be conducted in order to elucidate the predictive factors, which are favorable for patients undergoing upfront debulking surgery in cases of high-grade serous ovarian cancer.

Background: In Greece the population-level impact of HPV vaccination is unknown due to lack of official registries. This study presents in a pragmatic frame the comparison of cervical pathology data between HPVvaccinated and unvaccinated women referred for colposcopy. Patients and Methods: This is an observational prospective cohort study performed in 7 academic Obstetrics and Gynaecology Departments across Greece between 2009-2019. Cases were women that had completed HPV vaccination before coitarche and were referred for colposcopy due to abnormal cytology. For each vaccinated woman an unvaccinated matched control was selected. Results: A total of 849 women who had been vaccinated before coitarche and 849 unvaccinated controls were recruited. The combination of cytological, colposcopic and molecular findings necessitated treatment in only a single case among vaccinated (0.1%) and in 8.4% among unvaccinated. Conclusion: HPV vaccination at a proper age can markedly reduce development of severe cervical precancers and consequently the need for treatment, as well as their long-term related obstetrical morbidity.

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Objective: This narrative review aims to identify alternative ways to improve the symptoms of primary dysmenorrhea (PD). Background: PD refers to endometrial painful cramps during the premenstrual period. This condition affects a lot of women worldwide and is accompanied with absenteeism and high economic costs, thus, risk-free, and effective therapeutic approaches are needed. Pharmacological agents such as non-steroidal anti-inflammatory drugs (NSAIDs) and oral contraceptive pills (OCPs), which are widely prescribed for these women, demonstrate adequate efficacy in alleviating pain and discomfort. The long natural course of the disease dictates remedies that focus on lifestyle changes and on improvement of Quality-of-Life (QoL) for women suffering with PD. Materials and Methods: Five major search engines, namely MEDLINE, PubMed, EMBASE, and Cochrane Library were searched for articles published prior to October 2020 focused in PD. A total of 74 paper were included. Discussion: Physical activity, for instance yoga, aromatherapy massage, and other forms of relaxation, vitamins and dietary changes, acupressure and acupuncture,a and some psychological interventions are just few of the proposed health behavior targeted approaches in cases of PD. This review focuses on lifestyle changes and alternative methods that could potentially result in minimizing symptoms of PD and in improving overall QoL for these patients, by providing current scientific evidence on their efficacy. Conclusion: Complementary and alternative medicine practices (CAM) are widely accepted by women. International literature provides controversial scientific evidence, thus further studies need to be conducted in order to prove or disregard their efficacy in cases of PD.

INTRODUCTION A significant proportion of pregnant women and women in the early postpartum period suffer from mental health problems. The COVID-19 pandemic represents a unique stressor during this period and many studies across the world have shown elevated rates of postpartum depression (PPD). METHODS In this multicenter two-phase observational prospective cohort study, we aim to assess the prevalence of anxiety prior to labor (Generalized Anxiety Disorder-7), as well as PPD at 6–8 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). RESULTS Of the 330 women analyzed, 13.2% reported symptoms of depression using EPDS cut-off score ≥13. High antenatal levels of anxiety (24.8% scored ≥10 in GAD-7) were documented. A significant proportion of postpartum women reported a decrease in willingness to attend antenatal education courses (36%) and fewer antenatal visits to their obstetrician (34%) due to pandemic. Higher antenatal anxiety increased the odds of being depressed at 6–8 weeks postpartum (EPDS ≥13). CONCLUSIONS Compared to reported prevalence of PPD from previous studies before the COVID-19 era in Greece, we did not find elevated rates during the first wave of the pandemic. High anxiety levels were observed indicating that there is a need for close monitoring in pregnancy during the pandemic and anxiety screening to identify women who need support in the pandemic era. A well-planned maternity program should be employed by all the associated care providers to maintain the proper antenatal care adjusted to the pandemic strains as well as a follow-up after labor.