Erik Dosedla

The contribution addresses the complex issues and legal dilemmas that arise—or will increasingly arise in the future—for courts when dealing with questions of liability related to surrogacy. As explained in the article, the very arrangement per se entails certain risks associated not only with assisted reproduction procedure followed by potential obstetric complications during the childbirth but also generally with the protection of the health of the pregnant woman and the foetus. The contribution explores how questions of liability could be approached through the loss of chance doctrine in tort law, a concept originating in the common law tradition. However, it emphasizes that these approaches are far from straightforward, given the significant evidentiary challenges in establishing causation in medical disputes, as well as the ethical and moral considerations regarding the allocation of responsibility. By analysing these issues, the article aims to provide a conceptual framework for understanding the legal and ethical complexities surrounding surrogacy liability, highlighting the potential role of comparative perspectives and doctrinal analysis in informing future judicial decisions.

This study evaluates the intrinsic osteogenic potential of β-tricalcium phosphate (β-TCP)-containing composite scaffolds (PLCL–TCP, PLGA–TCP, and ZnO–TCP) on chorion-derived mesenchymal stem cells (CMSCs) under non-osteogenic in vitro conditions. CMSCs were cultured on the three biomaterials for 35 days without osteogenic supplements to isolate the material-driven cellular response. Cell viability was assessed via MTT assay, while osteogenesis-associated markers (alkaline phosphatase, type I collagen, and osteocalcin) were quantified using ELISA. Scaffold surface morphology and elemental composition were characterized before and after cultivation utilizing SEM and EDX. All investigated scaffolds supported long-term CMSC viability and induced measurable osteogenic responses. PLCL–TCP demonstrated a consistently strong biological response, characterized by sustained metabolic activity, elevated ALP and COL I production, and increased osteocalcin levels at later stages of cultivation. ZnO–TCP also exhibited favorable osteogenesis-associated responses, particularly with respect to late-stage osteocalcin production, while maintaining high structural stability. In conclusion, β-TCP composites can intrinsically modulate CMSC behavior without biochemical supplements. Osteogenic outcomes depend on a complex interplay of surface chemistry, scaffold architecture, and degradation profiles, with PLCL–TCP demonstrating favorable overall performance among the investigated biomaterials.

Introduction: The global rise in maternal obesity presents a growing public health challenge, with significant implications for pregnancy outcomes. This study offers a comprehensive retrospective analysis of changes in Body Mass Index (BMI) among pregnant women during labor over four decades. Material and methods: BMI data were retrospectively collected from 13,193 pregnant women divided into three cohorts: Group 0 (1986–1990), Group 1 (2009–2013), and Group 2 (2024). Results: Mean BMI increased significantly from 23.75 kg/m² in Group 0 to 27.33 kg/m² in Group 2 ( p < 0.001). The prevalence of obesity rose more than fivefold, from 4.87% to 25.76%. Regression analysis confirmed a linear and statistically significant upward trajectory across all groups. Conclusions: The sustained increase in maternal BMI underscores the urgency of implementing targeted interventions, including preconception counseling and personalized antenatal care, to mitigate the adverse maternal and neonatal outcomes associated with elevated BMI.

Multipotent hematopoietic stem cells (HSC) reside in specialized niches of the bone marrow (BM). The maintenance of their stemness requires a precisely regulated bone marrow microenvironment (BMM), supported by mesenchymal stem cells (MSCs), stromal reticular cells, and endothelial and nerve cells located within the vascular and endosteal niches. The heterogeneity of the niche environment is caused by the diversity of cell populations from HSCs to more mature hematopoietic cell types and MSCs, which collectively influence the complex intercellular interactions involved in hematopoiesis. MSC subclusters in BM are characterized by the phenotypes of CXC-chemokine ligand 12, leptin receptor, neuron-glial antigen 2, and Nestin+ cells. The article presents a detailed characterization of individual stem cell types in the BM, their reciprocal interaction, and the possibility of in vitro simulation of the bone marrow niche as a dynamic structure. Development of a suitable simulation of the BMM is essential for advancing research into both physiological and pathological processes of hematopoiesis. The main goal is to simulate 3D cell culture using biomaterials that mimic the BM niche in the form of hydrogels and scaffolds, in combination with extracellular matrix components.

Recent decades have seen a notable increase in cesarean section rates. Although lifesaving, cesarean delivery is associated with an elevated risk of adverse health outcomes in newborns, including respiratory diseases, atopic disorders, obesity, diabetes, and severe autoimmune conditions. The exact mechanisms underlying these associations remain elusive; however, epigenetic modifications have emerged as a plausible molecular basis linking perinatal factors with future disease susceptibility. This review summarizes current literature, revealing that the delivery method may influence epigenetic markers in neonates, primarily through alterations in global DNA methylation and gene-specific methylation patterns. Key words: epigenetics – DNA methylation – cesarean section

Amidst a global landscape where transgender individuals face unprecedented challenges in accessing equitable sexual health care, our review breaks new ground by exploring the intricacies of sexual health within the transgender community. Unveiling the critical gaps in current health care practices, our research not only amplifies the voices of those often marginalised in health narratives but also pioneers a comprehensive, culturally sensitive approach to transgender sexual health. The literature review tries to find medical and subsequent legal justifications for PRO and CONS of participation of transgender and intersex athletes in the category of the opposite sex. It tries to analyse which differences in life can be relevant in defining competitive advantages, which nowadays lead to very controversial, often politically motivated conclusions. The opinions of the professional and sports public do not go along with some decisions of sports associations and authorities. It therefore also deals with the recent decision of the European Court of Human Rights in the case of Caster Semenya, as well as the participation of athletes across different sports disciplines and categories. It does not ignore the question of the adequacy of anti-discrimination measures. Furthermore, it evaluates the impact of such participation on the integrity and fairness of competitive sports, highlighting the need for a balanced approach that respects the rights of all athletes. This study stands at the forefront of transforming sexual health care for transgender individuals worldwide.

Summary: Caesarean section on request, a request that we have been encountering more and more recently. This can be interpreted as a primary caesarean section performed as a request of the mother without any relevant obstetrical or other medical indications in order to avoid vaginal delivery. The most common reason for mothers’ requests for caesarean section is the fear of childbirth and the associated pain. Currently, medicine recognises the patient’s right to actively participate in the choice of treatment procedures, including methods of delivery. We have accepted patients’ claim for various aesthetic surgical interventions, in case they provide informed consent. The same principle should be maintained for caesarean sections on request. Key words: caesarean section – choice of birth – maternal request – labor pain – informed consent

The human placenta serves as a vital barrier between the mother and the developing fetus during pregnancy. A defect in the early development of the placenta is associated with severe pregnancy disorders. Despite its complex development, various molecular processes control placental development, and the specialization of trophoblast cells is still not fully understood. One primary obstacle is the lack of suitable cell model systems. Traditional two-dimensional (2D) cell cultures fail to mimic in vivo conditions and do not capture the intricate intercellular interactions vital for studying placental development. However, three-dimensional (3D) organoid models derived from stem cells that replicate natural cell organization and architecture have greatly improved our understanding of trophoblast behavior and its medicinal applications. Organoids with relevant phenotypes provide a valuable platform to model both placental physiology and pathology, including the modeling of placental disorders. They hold great promise for personalized medicine, improved diagnostics, and the evaluation of pharmaceutical drug efficacy and safety. This article provides a concise overview of trophoblast stem cells, trophoblast invasion, and the evolving role of organoids in gynecology. Key words: trophoblast stem cells – trophoblast invasion – organoids – pregnancy complications

A birth plan is a document that defines mother’s preferences and expectations regarding childbirth and early puerperium. The purpose of the birth plan is to establish communication about mother’s birth wishes and to properly convey them to the health care providers. With increasing computerization of society, birth plan is currently the subject of heated debate. In this article, we present historical view of the birth plan, as well as current legislation regarding the birth plan, as we do not consider legal awareness of obstetricians to be sufficient at the moment. The purpose of this article is to appeal to the professional public so they have up-to-date information about the birth plan, especially in discussions with patients, but also during forensic procedures. The preservation of excellent perinatological results under our circumstances is only possible by providing professional, empathetic and very intimate health care in hospital institutions. Key words: birth plan – labor – maternal choice – informed consent

This study investigates the ethical and legal considerations associated with Cesarean Section on Demand (CSD), focusing on the principles of patient autonomy and informed consent within obstetrics. As elective cesarean sections become more prevalent, this research analyzes the consequences of allowing patients to choose their mode of childbirth, contrasting this with medical necessity and potential conflicts arising from healthcare professionals' commitment to do no harm.