Objective. To investigate whether the use of epidural analgesia during induced labour was a risk factor for instrumental vaginal delivery and caesarean section (CS) delivery. Study Design. This was a retrospective case series of primigravidae women being induced at term for all indications with a normal body mass index (BMI) at booking and under the age of 40 years. Results. We identified 1,046 women who fulfilled the inclusion criteria of which 31.2% had an epidural analgesia. Those with an epidural analgesia had significantly greater maternal age, higher BMI, greater percentage of oxytocin usage, and a longer first and second stage of labour. Women with an epidural analgesia had a higher instrumental delivery (37.9% versus 16.4%; p<0.001) and CS delivery rate (26% versus 10.1%; p<0.001). Multivariable analysis indicated that the use of an epidural was not a risk factor for a CS delivery but was a risk factor for an instrument-assisted delivery (adjusted OR = 3.63; 95% CI: 2.51–5.24; p<0.001). Conclusion. Our study supports the literature evidence that the use of an epidural increases the instrumental delivery rates. It has also added that there is no effect on CS delivery and the observed increase is due to the presence of confounding factors.

Background: A cesarean section (CS) is a method of childbirth involving a surgical cut made in the abdominal and uterine wall to deliver the infant. But while it saves the lives of women and infants, it has been implicated in several immediate and long-term complications and adverse consequences as a result of its ineffective use. This study attempts to address the major public health issue of the inappropriate use of CS by exploring its impact on maternal, neonatal, and child health. More specifically, the study aims to investigate the immediate and long-term health impacts on the mother, including her physical and mental health, as well as the immediate and long-term psychosomatic consequences on the neonate’s, infant’s, and child’s health as a result of the inappropriate use of CS. Methods: A scoping review was conducted spanning from 2015 to 2025 according to the PRISMA criteria and checklist. Searches were performed in PubMed, Scopus, and Google Scholar. The inclusion criteria comprised original articles with clear exposure and outcome written in English, and studies that did not involve reviews of any kind or letters to the editors. Results: The review identified 42 relevant studies. The results showed several immediate and long-term complications of CS in mothers, neonates, infants, and children, while its ineffective use carries equally high risks, such as high levels of morbidity and mortality. Conclusions: This scoping review presents the problems that arise in the immediate and long-term health of mother and child from the improper use of cesarean section and underlines the need for immediate action and measures to be taken by health policy makers.

Objectives To identify whether mast cell densities in vulvar biopsies from the vestibule are associated with vulvodynia. Methods We enrolled 100 women aged 19 to 59 years with confirmed vulvodynia cases, 100 racially matched controls, and 100 black control women. All had vulvar biopsies performed at the 7 o'clock position of the vestibule, which were then immunostained to detect c-KIT protein. The numbers of c-KIT positive mast cells per ×400 magnification field were manually counted, and t tests and logistic regression were used to assess the association with case-control status. Results Of the biopsies, 235 were adequate samples for c-KIT testing for mast cells. The mast cell density was substantially lower in black control women (13.9 ± 10.9) in comparison to white control women (22.5 ± 13.2 p < 0.001): hence the analysis was confined to white cases and racially matched control women. Compared with racially matched controls, cases were younger, more likely to be married, and reported a higher household income. The average number of mast cells per ×400 magnification field overall was 19.1 ± 13.2 (range, 0–62). There was no difference in the mast cell count between racially matched cases (22.4 ± 13.9 per ×400 field) and controls (22.5 ± 13.2) in either the univariate or multivariable analyses. Within the group of cases, there was no difference in mast cell density based on the presence or absence of a variety of urogenital symptoms. Conclusions No difference in mast cell density in biopsies of the vestibule was found between white cases and racially matched controls. Black control women have a lower mast cell density compared with white control women.

Purpose: To investigate the long-term psychosexual outcomes in women following excisional cervical treatment. Materials and methods: Women with cold-knife conization (CKC) or large loop excision of the transformation zone (LLETZ) treatment were interviewed after a follow-up colposcopy visit. Their demographics, treatment and psychosexual characteristics were recorded. Results: One hundred and forty six women with a mean age of 35.2 ± 5.4 years underwent either LLETZ (68.5%) or CKC (31.5%) treatment within 4.7 ± 2.7 years (range: 2–15) before the interview. 27.4% of women were less interested in sexual intercourse following treatment in comparison with their interest before. Those women with less interest in sexual intercourse after treatment had higher anxiety and depression scores and were more worried about disease progression. Women with post-treatment complications were at risk of less interest in sexual intercourse and of greater anxiety and depression. Women with abnormal smears at follow-up were at risk of greater anxiety. The type of treatment and grade of dysplasia did not affect their interest in sexual intercourse or the anxiety and depression scores. Conclusions: Approximately, one-third of women at more than two years post-treatment may suffer from less interest in sexual intercourse, have relatively greater anxiety and depression, and might still be concerned about the possibility of disease progression.