To evaluate the real-world effectiveness, safety, and tolerability of relugolix/estradiol/norethisterone acetate combination therapy (relugolix CT) for managing symptomatic uterine fibroids in routine gynaecological practice. A retrospective, observational study was conducted at a tertiary hospital in Spain between June 2023 and January 2025. Adult women with symptomatic uterine fibroids treated with relugolix CT were included, either as a long-term treatment or preoperative management. Clinical outcomes were assessed at baseline, 6 months, and in a subset of patients, at 12 months. Primary endpoints included changes in total bleeding days, heavy menstrual bleeding (HMB) days, and UFS-QoL symptom severity scores (SSS), as well as treatment adherence and adverse events. Among the 142 women who initiated treatment, Relugolix CT significantly reduced total bleeding days (from 12 to 2.2), HMB days (from 7.1 to 0.4), and UFS-QoL SSS (from 27.9 to 15.1) at 6 months (p < 0.05). Amenorrhea was achieved in 52.7 % at 6 months and 66 % at 12 months. Better clinical outcomes were linked to continued treatment. Adverse events were reported in 34.5 % of patients, primarily abdominal pain and vasomotor symptoms. Bone densitometry at 12 months showed no osteoporosis and mild osteopenia in a few patients. Discontinuation was most commonly due to planned surgery or perceived lack of efficacy. Relugolix CT demonstrates strong real-world effectiveness and tolerability for managing symptomatic uterine fibroids, with marked improvements in bleeding and quality of life, and a favourable safety profile.

Transvaginal radiofrequency ablation (TVRFA) is a minimally invasive, incisionless, outpatient procedure. This study evaluates the feasibility, outcomes, and complications of TVRFA in women with symptomatic uterine myomas (UMs). This preliminary single-center, retrospective study included 79 women treated with TVRFA between December 2021 and April 2024 in Quito, Ecuador. Women with 1-4 UMs of any size or type were eligible. Preoperative and follow-up assessments included transvaginal ultrasound (TVUS) for both uterine and myoma volume. Outcomes (uterine and myoma volume + complications) were assessed at 45 days and 6 months. Complications were classified by Clavien-Dindo. Statistical analyses used paired tests for baseline vs. follow-up comparisons, with missing data excluded from each analysis. The median baseline uterine volume was 160.0 mL. At 6 months, this decreased to 91.0 mL (-43.1 %, p < 0.001). The median baseline myoma volume was 22.5 mL, which decreased to 7.7 mL at 45 days (-55.1 %) and 3.7 mL at 6 months (-81.5 %, p < 0.001). Follow-up was completed by 68/79 patients (86.1 %) at 45 days and 59/79 (74.7 %) at 6 months. Minor complications occurred in 12.7 %, most commonly skin burns at the electrode site. Two patients (2.5 %) experienced intestinal perforation requiring surgery. TVRFA significantly reduced both uterine and myoma volumes, supporting its role as a minimally invasive alternative for fibroid management. However, the observed complication rate, particularly intestinal perforation, requires critical attention to operator training and procedural refinements. Prospective studies with standardized symptom measures are warranted.

The absence of gestational age-specific reference intervals for serum N-acetyl-β-D-glucosaminidase (NAG) in pregnant women may lead to clinical misinterpretation. This study aimed to establish trimester-specific reference intervals for serum NAG in healthy pregnant women from Hainan, China, and to characterize its dynamic changes throughout gestation. In this cross-sectional study, 2416 healthy women with singleton pregnancies were stratified by gestational age into three groups: first trimester (1–12 +6 weeks; n = 1295), second trimester (13–27 +6 weeks; n = 670), and third trimester (28–40 weeks; n = 451). Serum NAG levels were measured, and trimester-specific reference intervals were established using the 2.5th to 97.5th percentiles. Serum NAG concentrations increased significantly with advancing gestation (P < 0.0001). The established reference intervals were 12.0–40.0 U/L for the first trimester, 16.0–63.2 U/L for the second trimester, and 29.3–107.0 U/L for the third trimester—all substantially higher than those of the non-pregnant control group (8.0–23.4 U/L). The median NAG level in the third trimester (56.2 U/L) represented a 143 % increase compared to the first trimester (22.5 U/L). This study provides the first gestational age-specific reference intervals for serum NAG in pregnant women in a tropical region of China. The findings confirm that physiological NAG levels increase progressively with gestational age. The use of non-pregnant reference intervals in clinical practice may lead to misclassification of renal function during pregnancy, underscoring the necessity of adopting trimester-specific reference standards in prenatal laboratory settings.