Current Women's Health Reviews - Volume 22, Issue 1, 2026

Acute Fatty Liver of Pregnancy (AFLP) is a rare obstetric condition that can lead to maternal and perinatal complications.

This research aimed to study the pregnancy outcome in acute fatty liver of pregnancy (AFLP). In particular, this study aimed to study the clinical features of the condition and its effect on maternal and perinatal outcomes.

A retrospective analysis of seven cases diagnosed with AFLP over a span of three years was performed. The clinical records of these women were reviewed for clinical features, laboratory investigations, and maternal and perinatal outcomes.

A total of 6 (85.7%) women presented during the third trimester of pregnancy. A total of 4 (57%) of them presented after 36 weeks of gestation. A total of 6 (85.7%) women presented with jaundice, and all presented with sudden onset nonspecific symptoms, including abdominal pain and vomiting. Pregnancy was terminated by cesarean section in 6 cases. Maternal mortality was noted in 6 (85.7%) of women. All six women were diagnosed with Acute kidney injury and coagulopathy. One woman had developed encephalopathy and altered sensorium. Further, 2 (28.5%) women had intrauterine fetal demise at the time of presentation, and 1 (14.3%) had an early neonatal death.

AFLP is a rare clinical syndrome with rapid and dramatic progression, beginning initially with non-specific symptoms and evolving into coagulopathy, acute kidney injury, and death, resulting in alarming maternal and perinatal mortality. Early diagnosis is challenging due to the non-specificity of symptoms, but crucial and prompt termination of pregnancy is the need of the hour. Nonetheless, supportive treatment and a multidisciplinary approach may significantly improve prognosis.

Nerve injuries during gynecologic surgery are infrequent but distressing complications that can result in significant patient discomfort and disability. This retrospective case analysis aims to highlight the occurrence and possible causes of nerve injuries during laparoscopic or robotic gynecologic surgery. We present seven cases of nerve injuries, with four involving upper limb damage and three involving lower limb damage, all of whom experienced nerve injuries in relation to their surgical procedures.

The ages of the patients ranged from 42 years to 71 years, and the duration of the operations varied from 125 to 350 min. Neurological examination revealed motor and sensory dysfunction in the affected limbs, with varying degrees of severity. The prognosis and recovery differed among the cases, with continuous physical therapy being required for durations ranging from several months to up to 2 years.

The probable cause of nerve injury is most often attributed to the patient’s posture during surgery. Prolonged operation time, high ASA scores, the presence of comorbidities, and elevated body mass index were identified as risk factors for nerve damage. Measures to prevent nerve injuries include maintaining precise patient positioning during surgery, avoiding the overextension of arms and hips, and utilizing advanced leg stirrups for better adjustment in the lithotomy position. Our results emphasize the significance of meticulous surgical positioning and continuous monitoring to avoid neurological complications during laparoscopic and robotic gynecologic surgeries. By implementing appropriate posture and positioning techniques, surgeons can significantly reduce the risk of nerve injuries and thereby improve patient outcomes. Attention to these preventive measures is critical for ensuring positive surgical outcomes and patient well-being.

A comprehensive search was conducted to investigate the effect of social support interventions on menopausal symptoms. The search covered studies published from March 2010 to March 2022.

A comprehensive search was conducted using the keywords “educational interventions”, “menopause”, “social support”, and “clinical trial” in the PubMed, Scopus, Web of Science, Science Direct, Cochrane, and Google Scholar databases.

Out of 23 randomized controlled trials (RCT) included in this review, one focused on postmenopausal women over 30, four on women over 40, 14 on women over 45, and four did not report age. Social support interventions varied widely, with nine targeting vasomotor symptoms (hot flashes), seven focusing on improving knowledge, performance, physical and mental health, and relationships, and the rest addressing nutrition, exercise, and depression. Sample sizes ranged from 42 to 4974 participants aged between 40 and 70 years, and the duration of the interventions was from two weeks to two years.

The results suggest that supportive and educational interventions, especially those involving spousal support and training of healthcare professionals can effectively reduce menopausal symptoms. Studies with longer duration reported greater effects. It is suggested to consider a comprehensive approach that includes educational interventions, emotional intelligence, nutrition and exercise, cultural factors, quality of life, and marital satisfaction to reduce menopausal symptoms.

Retained products of conception (RPOC) are a common cause of secondary postpartum haemorrhage. They pose both immediate and long-term health risks, such as abnormal bleeding, infection, and fertility issues. Ultrasound (USG) is the first line of imaging used to diagnose RPOC. Enhanced myometrial vascularity (EMV) is thought to result from placental site subinvolution due to remnants of conception products. In ultrasound imaging, endometrial vascularity (EMV) is characterized by a network of enlarged, twisted blood vessels that extend from the myometrium into the endometrium. On spectral Doppler, these vessels can exhibit varying degrees of elevated peak systolic velocities and increased diastolic flows. On ultrasound, EMV can appear ominous and is often mistaken for an arteriovenous malformation (AVM).

A 25-year-old woman presented with continuous bleeding per vagina following a surgical termination of a 10-week gestation. Transvaginal ultrasound showed a heterogeneous lesion in the endometrial cavity and multiple dilated vessels in the subjacent myometrium. Doppler imaging showed a high velocity and low resistance pattern suggestive of EMV. Ipsilateral parametrium showed enlarged uterine artery branches. Imaging differentials include RPOC with EMV and AVM. In this case, we discuss the imaging features of RPOC, EMV, and their differentials. We also discuss the implications of the imaging findings on treatment protocols.

Treatment options for RPOC should be tailored to individual clinical circumstances and the grade of RPOC. Enhanced myometrial vascularity is a physiological phenomenon observed in the placental bed and should not be mistaken for AVM.

It was suggested that prenatal use of the Stange test in combination with fetal biomechanics monitoring would provide an early diagnosis of excessively low fetal resistance to hypoxia, which could be a criterion for timely cesarean section to prevent stillbirths and perinatal encephalopathy.

The purpose of this study was to investigate the movement dynamics of fetuses and aquarium fish during acute model hypoxia, which revealed that the duration of their immobility phase may serve as a biomarker of resistance to hypoxia.

This manuscript is a review of scientific articles and inventions using major international databases, taking into account the selected keywords.

The use of the modified Stange test has been shown to provide real-time assessment of fetal resistance to hypoxia for physicians and pregnant women. It has been shown that in normal pregnancy and high fetal resistance to hypoxia, the fetus maintains a state of immobility for at least 30 seconds during maternal apnea. In the presence of severe feto-placental insufficiency, the duration of fetal immobility during maternal apnea is less than 10 seconds. Therefore, fetal immobility during maternal apnea with a duration close to zero indicates excessively low fetal resistance to hypoxia. In such a case, an emergency cesarean section is recommended to prevent stillbirth and encephalopathy.

The duration of fetal immobility during maternal apnea may serve as a biomarker of fetal resistance to hypoxia. Prenatal screening of fetal resistance to hypoxia can improve the outcome of pregnancy and childbirth.

Visfatin is a 52-kDa protein produced mainly by adipose tissue. It is one of the cytokines known as adipokines. There is a correlation between visfatin and female reproductive health, pregnancy complications, and gynecological cancers. This mini-review summarizes the existing knowledge of the role of visfatin in female reproduction and in various types of gynecological cancers.

We performed a literature search in the PubMed database up to December 2023. We reviewed the identified articles and included those that were relevant to our objective.

Visfatin has been implicated in the pathogenesis of polycystic ovary syndrome, while alterations in visfatin levels have been correlated with pregnancy complications, including gestational diabetes mellitus, acute pyelonephritis, preeclampsia, and reduced fetal growth. First trimester maternal visfatin levels are associated with infant weight. The role of visfatin has also been investigated in relation to steroidogenesis as well as breast, ovarian, and endometrial cancers. In those types of gynecological cancers, high visfatin levels were observed. Visfatin has also been detected in the follicular fluid, and it has been correlated with the number of retrieved oocytes in in vitro fertilization.

The results from published studies are contradictory because visfatin levels vary across conditions due to its complex mode of action. Visfatin could potentially serve as a prognostic biomarker in various reproductive conditions and as a therapeutic target in various types of gynecological cancers. Additional studies are needed to clarify visfatin’s role in female reproduction because its effects can vary depending on the tissue in which it is present.

Antenatal anxiety is one of the most common problems during pregnancy. Identifying the effective factors in reducing antenatal anxiety is one of the ways to mitigate the negative consequences.

The present study aimed to determine the association between maternal lifestyle and antenatal anxiety.

This is an analytical-cross-sectional study, and its study population included 201 eligible pregnant women referred to Al-Zahra Hospital in Rasht. A convenience sampling method was used. Data collection tools included the Demographic and obstetrics questionnaire, The Health Promoting Lifestyle Profile (HPLP), and the standard pregnancy-related anxiety questionnaire (PRAQ). Data analysis was performed using statistical tests including the Spearman correlation coefficient, Mann-Whitney test, and Kruskal-Wallis in SPSS. A P<0.05 was considered significant.

Data analysis showed that the mean score of maternal lifestyle and antenatal anxiety was 67.8 ± 10.9 and 43.2 ± 20.1, respectively. There was a weak significant negative correlation between antenatal anxiety scores and the total maternal lifestyle score (r= - 0.204, P= 0.004). The results of the multiple linear regression analysis also showed that with an increase in the total score of maternal lifestyles, the antenatal anxiety score decreases significantly after controlling the Demographic and obstetrics variable. That is, with a unit increase in the total lifestyle score, the total anxiety score decreases on average by 0.20 units (b= 0.20, P= 0.004).

A weak but significant negative correlation exists between maternal lifestyle and antenatal anxiety, indicating that higher lifestyle scores are associated with lower anxiety levels. Thus, healthcare providers can play an important role in alleviating antenatal anxiety through lifestyle education, positively impacting maternal well-being.