Current Women's Health Reviews - Volume 21, Issue 3, 2025

Urine incontinence is the involuntary leakage of urine. Its actual prevalence is underestimated. There is a general belief that vaginal delivery is a major risk. Elective cesarean delivery is increasing worldwide; one reason is to protect against pelvic floor disorders, including urine incontinence. Previous studies included small samples with controversial results. This study aimed to compare the risk of urine incontinence in women who had cesarean delivery with those who had vaginal delivery.

It was a retrospective study on 1751 women delivered in a university hospital over a 5-year period. Data collected on number of deliveries, age at first and last delivery, mode of each delivery, gestational age, birth weight, indication of cesarean section, induction of labor, episiotomy, perineal tears, smoking, chronic cough, chronic constipation, presence and severity of urine incontinence using ICIQ score. Patients were categorized into 2 groups: all cesarean section deliveries and at least one vaginal delivery.

A total of 600 respondents delivered only by cesarean section, and 1151 had at least one vaginal delivery. Urine incontinence prevalence in the cesarean group was 5.8%, and 6.9% in the vaginal group. Age, perineal tear, chronic cough, and chronic constipation were found to be significantly associated with urinary incontinence. After adjusting for all other variables, vaginal delivery was not found to be significantly associated with incontinence compared to cesarean.

Vaginal and cesarean deliveries have a comparable incidence of urinary incontinence. It is difficult to get a firm conclusion on whether cesarean is protective. Chronic constipation and cough are important factors regardless of delivery mode.

The scientific community has developed non-biodegradable progestational sub-dermal implants as a response to the need of some women for long-acting contraceptives that are effective and safe.

The aim of the study was to describe the socio-demographic characteristics of women who received the implant and explore the side effects and reason for discontinuation of subdermal implant.

A retrospective audit of all the clients who opted for contraceptive implants between January 1^st, 2011, to December 31^st, 2015, was carried out. This was done by a senior registrar in the Department of Obstetrics and Gynaecology from the clinic register. The card numbers of all the clients who agreed to use contraceptive implants were identified (589), and their case records were retrieved from the records unit and family planning clinics. Only Jadelle^R and Implanon were available in the clinic during the period of study. Using a proforma, information regarding the clients’ age, religion, place of residence, level of education, observed side effects, and reason for discontinuation was obtained.

The socio-demographic characteristics of the sub-dermal contraceptive implant acceptors revealed that the age range of clients was between 16 to 49 years. Acceptance was highest among the age group of 31-40 years (343; 58.2%). The various complications recorded revealed that most (527; 89.5%) of the clients reported no complication, while 3.4% (20) had increased menstrual flow and 2.7% (16) had menorrhagia. There was a significant association between educational qualification (X²=25.733, p=0.041), age (X²= 23.657, p= 0.001), parity (X²=81.264, p=0.001), and discontinuation of the implant.

The study findings revealed an increase in the sub-dermal contraceptive implant uptake. This may be due to its longevity. With adequate pre- and post-insertion counselling, the continuation rate could be increased.

Postpartum readmission is one of the metrics for assessing the quality of health services. There is inconsistent evidence about postpartum readmission and complications by mode of delivery.

We applied a meta-analysis to investigate whether the mode of delivery is associated with postpartum readmission or complications.

We systematically searched main English databases for studies published up to June 2022. The Newcastle–Ottawa scale (NOS) was used to assess the quality of observational studies. The heterogeneity of included studies was determined using the I² statistic and Begg’s and Egger’s tests for publication bias, respectively. Results of the random-effects meta-analysis were presented using odds ratio (OR) estimates with 95% confidence intervals (CI). The Stata software version 16 was used for data analysis.

In total, 18 studies with 514,577 subjects were suitable for reviewing maternal postpartum readmission by mode of delivery. Our findings show that cesarean delivery is a risk factor for increasing postpartum readmission than the vaginal delivery method (overall OR =1.42, CI 95% 1.22, 1.63, I²= 99.7%, p = 0.001). This chance was increased in primary cesarean (OR=2). Postpartum hemorrhage and breast infection did not have risk factors for postpartum readmission. While cardiopulmonary condition, deep vein thrombosis (DVT), genitourinary condition, and wound complication were risk factors among causes.

Cesarean delivery is one of the most important risk factors for postpartum readmission, especially both childbirth-related/non-related complications causes. Therefore, it is necessary to revise the schedule of postpartum visits based on the type of delivery.

Placenta accreta is an abnormal total or partial invasion of the trophoblast to the myometrium of the uterus, with a prevalence of 1 in 1000 births globally in 2018. Surgical treatment of PAS is known to have a high risk of urological injury. No study reports preoperative and intraoperative factors related to urological injury, especially in Indonesia.

A case-control study was conducted at Cipto Mangunkusumo General Hospital, Indonesia. Data were obtained through medical records dated from January 2012 to December 2020. Pregnant women with PAS treated with surgical management were recruited. The selection of the case group consists of participants with urological injuries, while the control group involves participants with no urological injuries. The case and control groups were matched according to the general characteristics with a ratio of 1:1.

Significant differences between groups were found in preoperative factors (history of urological symptoms, USG examination) and intraoperative factors (blood loss, multidisciplinary team, percreta placental invasion). Multivariate analysis showed an association between the history of urological symptoms and intraoperative bleeding to urological injury.

Preoperative factors such as ultrasonography examination and history of urological symptoms, along with intraoperative factors such as blood loss, multidisciplinary team, and degree of the placental invasion, were associated with urological injury in surgically treated PAS.

Pregnancy, childbirth, and the postpartum period are among the events that affect sexual behaviors and interactions, which are associated with many physical and emotional changes.

This study aims to examine the effect of sex education on Genital Self-Image (GSI), Sexual Quality of Life (SQOL), and sexual function among primiparous women.

This study was a randomized controlled trial conducted on 140 primiparous women referred to the Women's Clinic of Jahrom City from February to October 2020. Participants were assigned to an intervention group (n = 70) and a control group (n = 70). The intervention group received sexual education consisting of two sessions a week (90 min each) for eight consecutive weeks; the control group received none. Female Sexual Function Index (FSFI), Sexual Quality of life-Female (SQOL-F) questionnaire, and Genital Self-Image were completed before and four weeks after the end of the intervention in both groups. Questionnaires were used to assess the variables' dimensions both before and after each intervention. Descriptive statistics, Chi-square test, independent t-test, paired t-test, analysis of covariance, and regression analysis were used to examine the collected data in SPSS 21.

The total score of FSFI in the intervention group significantly increased from 24.14 ± 3.02 to 27.31 ± 2.59 (p<0.0001). Besides, there was a significant difference among the mean scores of the FSFI domains, including desire (4.82 ± 0.84 vs. 3.42 ± 0.98), arousal (4.91 ± 0.67 vs. 3.60 ± 1.12), orgasm (5.14 ± 0.82 vs. 3.53 ± 1.49), lubrication (5.94 ± 0.83 vs. 4.47 ± 0.97), satisfaction (5.50 ± 0.67 vs. 4.62 ± 1.09), pain (3.53 ± 1.01 vs. 4.26 ± 1.42), total Score FSFI (27.86 ± 3.56 vs. 24.02 ± 4.84), genital self-image (20.44 ± 3.16 vs. 10.41 ± 2.22), and sexual quality of life (52.37 ± 3.61 vs. 30.87 ± 3.47) between the intervention, and control groups after the educational intervention (p<0.05). There was no such difference before the intervention.

Sexual education improves sexual function, GSI, and SQOL in primiparous women. Therefore, sexual education workshops are suggested to prevent sexual problems in the postpartum period for all women, especially primiparous women.

Couples’ sexual communication is one of the contributing factors to the quality of couples’ sexual relationships. The aim of the present study was to psychometrically evaluate the Persian version of the Dyadic Sexual Communication Scale (DSCS) among married women of reproductive age.

In this psychometric study, translation was carried out using the back-translation method. The validity of the final version of the DSCS was performed using confirmatory factor analysis and Rasch analysis. Concurrent validity was examined using the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS) and Marital Intimacy Scale (MIS). Reliability was assessed by calculating Cronbach’s alpha coefficient. Data analysis was performed using SPSS and Mplus software.

The participants comprised 400 married women with a mean age of 35.66 years living in Qazvin, Iran. Construct validity was confirmed based on confirmatory factor analysis (χ²[df]: 113.49 (65), Tucker-Lewis index: 0.980, Composite Reliability: 0.87, SRMSR: 0.065, RMSEA: 0.043, CFI: 0.983. Concurrent validity was analyzed using Pearson correlation coefficients, and the DSCS was positively correlated with scores on the MIS (r=0.64) and FSFI (r=0.65) and negatively correlated with scores on the FSDS (r=-0.61). The internal reliability of the Persian DSCS was very good (Cronbach’s alpha=0.88).

Based on psychometric testing, the Persian DSCS has good validity and reliability. Therefore, the tool can be used to assess women’s sexual communication in the context of sexual relationships. Future research should include males, and compare and contrast results with females.

Religion plays an important role in a patient's decision to have an abortion, as well as in a country's abortion policy. However, a holistic understanding of the position of Asian Islamic countries has been less researched.

Contemporary jurisprudence and legal abortion in Asian Muslim countries; The politics of global abortion rights.

The article examined jurisprudence and legal issues of abortion in 12 Asian Muslim countries between 1990 and 2021, searching in reliable databases using the keywords of “abortion, civil law, criminal consequences.” The exclusion criteria were inadequate data in the study, editorial studies, and case reports.

Abortion at the mother's request is legal in Turkey, Tajikistan, Kyrgyzstan, Turkmenistan and the Republic of Azerbaijan. In Iran, Malaysia, Afghanistan, Brunei and Indonesia, abortion is forbidden at any stage of gestation but before 4 months (Iran) and up to 22 weeks (Malaysia). In Brunei and Indonesia, it is permitted if a mother’s life is in danger. Abortion is legal in Bangladesh under the heading of “menstrual regulation,” but a mother's request for abortion is illegal unless the mother's life is in danger. Termination of pregnancy is a crime and punishable in Pakistan unless it is done in good faith or to preserve the woman's life through “necessary treatment.”

The diversity of procedures in Asian Muslim countries depends on their legal system, whether it is exclusively based on Sharia law (Iran), a combination of Sharia law along with civil law (Saudi Arabia), or whether the legal system is not officially based on Sharia laws (Turkey).

Hysterectomy is the emergency removal of the uterus after a cesarean section (CS), usually performed after vaginal or cesarean deliveries, as a life-saving measure to control heavy bleeding during childbirth. This surgery has many complications. However, it has been increasing recently. The aim of this study is to determine the prevalence of hysterectomy over time and to explore factors associated with hysterectomy.

All patients with emergency hysterectomies following vaginal or cesarean delivery at the Fatemieh Medical and Educational Center were included in this study. Risk factors and indications for hysterectomy were recorded based on the study purpose.

The data indicated that out of 114175 deliveries, there were 60 hysterectomies over 14 years with the age range of 20-45 years. The incidence of hysterectomy increased from 0.34/1000 during 2009-2015 to 0.71/1000 deliveries in 2015-2022, with an overall incidence of 0.53 per 1000 deliveries during 14 years. The results indicated that the mean rate of hysterectomy (0.95% CI) increased significantly by 0.059 yearly, and by adjusting other variables, the history of CS (0.95% CI) and placenta accreta previa significantly increased the hysterectomy mean rate by 0.291 (0.053-0.529) and 0.284 (0.074-0.494), respectively.

The mean rate of hysterectomy represented an annual increase, especially during the last 7 years. In summary, the main reason can be the history of CS that leads to placental disorders and, thus, hysterectomy.

Psychological factors can affect sexual function. Symptoms of depression and anxiety may affect the sexual function of a woman after menopause.

The study aimed to assess the correlation between depression and anxiety with the sexual function of postmenopausal women.

This was a descriptive correlational study on 255 postmenopausal women. For sampling, a multi-stage method was used to recruit the eligible women from the health centers in Tehran-Iran. The questionnaires for data collection were the Female Sexual Function Index (FSFI), Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and a socio-demographic questionnaire.

The mean age of the women was 52.60 ± 5.11 years. The mean total scores of FSFI, depression, trait anxiety, and State anxiety were 54.05 ± 30.73, 19.00 ± 12.86, 40.73 ± 16.33, and 39.82 ± 16.57 percent, respectively. The female sexual dysfunction was reported in 65.5 percent of subjects. The total scores of FSFI and its dimensions had a significant negative correlation with the scores of depression, Trait-, and state anxiety. There was a negative correlation between the total score of FSFI with the age of women and their husbands and the duration of menopause. A significant positive correlation was found between FSFI with the education of women and the adequacy of their family income. The occupations of the women and their husbands were also related to FSFI. The multiple linear regression showed that state anxiety and depression are potential predictors of FSFI.

Depression and anxiety are associated with decreased sexual function in postmenopausal women. Therefore, adopting appropriate policies is necessary to reduce depression and anxiety among postmenopausal women to promote their mental health and sexual function.

Ovarian cancers are the third most common gynecological and 8^th most common cancer in women, associated with high mortality rates globally.

A 60-year-old postmenopausal woman presented to the Gynecological outpatient department with complaints of pain in the abdomen for 2-3 months and loss of appetite with weight loss for 1-2 months. She was diagnosed as a case of uterine leiomyosarcoma or left adnexal mass on ultrasound and MRI. Intra-operatively, she was diagnosed with a unilateral left ovarian malignant mass, predominantly solid in consistency with metastasis to the left fallopian tube, uterus, cervical stroma, and omentum. The right ovary and tube were healthy. On histopathological examination, the final diagnosis of primary mucinous ovarian carcinoma was made. The patient tolerated staging laparotomy (total abdominal hysterectomy with bilateral salpingo-oophorectomy and infracolic omentectomy) well and was started on six cycles of adjuvant chemotherapy with Paclitaxel and Carboplatin injections along with Bevacizumab.

Primary mucinous ovarian carcinomas are rare and distinct subtypes of epithelial ovarian carcinomas. Due to their strong resemblance to other ovarian tumors and leiomyosarcoma, their diagnosis becomes challenging. Hence, it is crucial to consider leiomyosarcomas in the differential diagnosis of ovarian masses, especially in postmenopausal women.