Since this is a Manhwa; in Korean's old Kingdom's Emperors, it is normal to have concubines. So, this was normal that an Emperor has Empress, which is their legal wife, and then some concubines. This is not really emphasized anymore in Manhwas, but you still see it in Manhuas, the Chinese counter part.
Maybe since Koreans are somewhat introduced to western that there is only one Queen/Empress. They changed it to the Empress, which is the legal wife and then the Queen, which is somewhat a concubine but has higher rank among its peers, if the Emperor choose to have more concubines or if they love a women but they can't marry it as Empress due to Political reasons.
In the Chinese Manhua counterpart, the Queen (which is called as Noble lady concubine if I am not mistaken) is the leader of the Harem, while the Empress is the Legal Wife and Master of the Harem which the Noble Ladies should still respect.
This is solely my opinin based on all the Manhwas and Manhuas I read so far. So please do correct me if I am wrong :3
If I'm not wrong, a Queen can only be called an Empress when they gave an heir to the Empire in this manhwa, so at this rate since Patrizia haven't fulfill that role she's still the Queen
I thought emperor = empress
as king = queen
So why does the writer keep calling her queen when she's an empress?
Anyway I do wonder if lizzie told the nurse or doctor to put her down as infertile so she wouldn't be picked as the empress and go back home. And that's why they assume she can't have children? With that information she should have failed and not have been chosen.
I'm guessing that's why rose b!@ch had everyone killed so there wouldn't be evidence.
It's going to be funny when she gets knocked up and he can't question the medical staff cause there already gone to heaven.