Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women’s individual requirements, to strengthen obstetricians’ knowledge in guiding decision-making for women in childbirth.

Background Physiologically, the spermatozoa are exposed to reactive oxygen species (ROS), and those ROS can strongly affect sperm's function through sperm capacitation. However, producing a high level of ROS reduces the sperm anti-oxidation system that may cause infertility, especially in cases with normal sperm count. Purpose To investigate the expression of the CYP24A1 gene in human spermatozoa and other oxidation-related biomarkers, including vitamin E, ROS, and catalase as added tools to predict male infertility. Method The study included 50 infertile men and 50 young volunteers from the general Iraqi population. Blood samples were drawn from all included men, and semen samples were collected by masturbation. All the samples of semen were investigated for CYP24A1 expression, and routine semen analysis was performed. In addition, the serum was separated and used to assess other biochemical parameters, namely catalase, reactive oxygen species, and vitamin E, which were measured by ELISA. Results Serum ROS levels were higher in patients than control groups, while the serum catalase and vitamin E levels were significantly lower in patients than controls. CYP24A1 gene expression is significantly higher in infertile men with sperm count higher than 70 million and reaches twofold times the control. Conclusion CYP24A1 gene expression is significantly higher in infertile men and can be used as a marker of infertility, especially in infertile males with normal sperm count. At the same time, the serum catalase and vitamin E levels were significantly lower, which can be added as tools to predict male infertility. .

Objective: The aims of the study are to describe the association of coronavirus disease (COVID-19) with the abnormal histopathological findings in human placenta and to highlight the potential predictors of these histopathological findings. Methods: A retrospective cohort study, held in two obstetric units from January 2021- 2022, 34 patients who were confirmed cases of […] Abstract Objective: The aims of the study are to describe the association of coronavirus disease (COVID-19) with the abnormal histopathological findings in human placenta and to highlight the potential predictors of these histopathological findings. Methods: A retrospective cohort study, held in two obstetric units from January 2021- 2022, 34 patients who were confirmed cases of […]

Background: Polycystic ovary syndrome (PCOS) is a leading cause of infertility. Insulin resistance is a key element in pathogenesis. The insulin receptor causes phosphorylation of the insulin receptor substrate (IRS); IRS-1 rs1801278G > A polymorphism variant is the most common genetic variant associated with IR and PCOS. Objective: We aimed to examine the frequency of IRS-1 rs1801278G > A polymorphism variant and test its value in evaluating infertile PCOS women. Methods: A case-control study recruited 140 age and body-mass-matched participants in the university hospital, subdivided according to Rotterdam criteria into PCOS cases (70/140) and healthy controls (70/140). We collected demographic data, ultrasonic [antral follicles and endometrial thickness], hormonal [FSH, LH, AMH, E2], and genetic data by polymerase chain reaction for analysis. Result: Wild GG SNP rs1801278 G was meaningfully higher among controls (58.57%, PA polymorphism, statistical differences were found with AFC, LH/FSH ratio, and serum testosterone. As for the AMH, E2, and endometrial thickness, they failed to have a statistical value. Conclusion: The significant correlation of genetic polymorphism to infertility parameters among PCOS women opens a new therapeutic and prognostic avenue that helps gynecologists tailor manganate for a better and safer outcome.

Background: Fibrovascular stromal polyps (fibroepithelial polyps; FEPs) are benign tumors occurring in many parts of the body and are infrequently reported in the vulva. They tend to be small, but few present in giant sizes, which adds diagnostic challenges. Case presentation: A 24-year-old female with a five-year history of a right vulval mass that reached a massive size (35×15×10 cm), complained of a large, painless, soft, pedunculated mass causing discomfort and interference with daily activities. On examination, the mass was firm, not tender, and associated with surface ulceration and infection. The mass was surgically removed and subjected to histological examination to exclude any malignancy. The observation indicated the presence of a fibroepithelial (fibrovascular) polyp; thus, follow-up was advised. Conclusion: This case report has explored giant FEPs’ presentation, diagnosis, therapeutic approaches, and possible consequences, and comprehensively discussed the findings of earlier studies. A better understanding of giant FEPs can improve their management and guide prescription for tailored treatment, which must involve evaluation of the psychological impact on patient mental health for a comprehensive holistic patient approach.

Uterine smooth muscle tumors of undetermined malignant potential (STUMPs) are an uncommon kind of uterine smooth muscle tumor. It is distinguished by histopathologic and morphologic characteristics that are in between those of a benign leiomyoma and a malignant leiomyosarcoma. From a clinical standpoint, the clinical presentation of STUMP is similar to that of a fibroid. The diagnosis is usually confirmed after surgery. Here, we report the case of a 39 -year -old woman who experienced increased menorrhagia, back pain, and pressure sensations during the past six months. She had a well-defined, freely movable lump in her lower abdomen, measuring the size of a 22 -cm uterus. The patient exhibited pallor, and her imaging scan showed the presence of an intramural posterior uterine solid mass indistinguishable from fibroid measuring 8.5 x 9 cm. Goserelin acetate (Zoladex 3.6 mg implant) was recommended for a duration of six months. The patient experienced a significant amelioration in menorrhagia and discomfort. However, no reduction in the size of the mass was observed. Myomectomy was made for the suspicion of a malignant transformation. The histology examination confirmed the diagnosis of a STUMP; a hysterectomy was undergone, and the procedure went smoothly. The patient was discharged home in good condition with instructions for longterm follow-up due to a risk of recurrence of about 7%. The lack of standardized and clear clinical and diagnostic criteria for STUMP adds challenges to their management.