This retrospective study aimed to compare the effects of two hysteroscopic procedures-cold knife resection (HCK) and electrosurgical resection (HER)-on postoperative recovery and quality of life in patients with endometrial polyps (EMP). A total of 120 patients were included, with 53 in the HCK group and 67 in the HER group. The study assessed operative time, intraoperative bleeding, hospital stay, endometrial thickness recovery, complications, recurrence, and quality of life using Short Form 36 Health Survey Questionnaire (SF-36) scores. Results showed that HER had shorter operative times, less bleeding, and quicker recovery, but HCK led to better endometrial thickness recovery. Both procedures were similarly effective in treating EMP, with no significant difference in complication or recurrence rates. At six months postoperatively, HER patients reported significantly better quality of life scores. Multivariate regression identified HER as an independent factor for favorable postoperative quality of life. We conclude that while both methods are safe and effective, HER is superior for faster recovery and improved quality of life. In contrast, HCK appears to be more suitable for women with fertility concerns due to better endometrial preservation. Individualized treatment selection based on patient needs is recommended.
This study aimed to evaluate the value of combined platelet distribution width, neutrophil-to-lymphocyte ratio, and alanine aminotransferase detection in predicting recurrence risk among patients with recurrent pregnancy loss in early pregnancy. A retrospective case-control study was conducted among 305 patients with early pregnancy RPL from January 2024 to May 2025. Patients were divided into a pregnancy loss group (n=116) and a live birth group (n=189). Peripheral blood platelet distribution width, neutrophil-to-lymphocyte ratio, alanine aminotransferase, and related laboratory parameters were compared between the groups. Platelet distribution width, neutrophil-to-lymphocyte ratio, and alanine aminotransferase levels were significantly higher in the pregnancy loss group than in the live birth group. Multivariate logistic regression identified platelet distribution width, neutrophil-to-lymphocyte ratio, and alanine aminotransferase as independent risk factors for recurrent pregnancy loss. Receiver operating characteristic analysis showed that the combined platelet distribution width+neutrophil-to-lymphocyte ratio+alanine aminotransferase model had an area under the curve of 0.706, outperforming any single marker. These findings suggest that combined detection of platelet distribution width, neutrophil-to-lymphocyte ratio, and alanine aminotransferase may provide a simple and effective tool for early risk stratification in patients with recurrent pregnancy loss, reflecting potential platelet activation, inflammatory immune imbalance, and hepatic metabolic stress.
This qualitative descriptive study explored the physical, emotional, psychological, and social experiences of women undergoing infertility treatment in Turkey. Semi-structured online interviews were conducted with 21 women who had received infertility treatment within the previous year. Data were analysed using inductive thematic analysis. Six main themes were identified: healthcare professionals' approach, treatment environment, treatment-related challenges, medication issues, treatment outcomes, and overall experiences. Participants reported a lack of information, financial burdens, physical and psychological side effects of medications, health concerns, and disappointment after treatment failure. Conversely, positive experiences and hopeful outcomes strengthened psychological resilience, while spousal and social support were of critical importance. The findings demonstrate that infertility treatment is not only a medical procedure but also a multidimensional life experience, underlining the need for healthcare professionals to adopt a sensitive and holistic approach.
This study explores how ideological and political education contributes to equipping medical students with ethical sensitivity in providing adolescent reproductive healthcare. Using a quantitative cross-sectional design, the research surveyed Chinese medical students through a structured questionnaire assessing their exposure to such education, along with measures of ethical competence, empathy, empowerment orientation, and preparedness for care delivery. Data analysis encompassed descriptive statistics, correlation assessments, regression analysis, and mediation modeling. Results indicated a positive link between ideological and political education and enhanced preparedness for adolescent care. Ethical competence, empathy, and empowerment orientation served as mediators in this relationship, with empathy emerging as the most significant mediator. The findings highlight the importance of integrating values-based training into medical curricula to enhance students' readiness for ethical, gender-sensitive, and adolescent-centered care. This approach aligns strongly with the objectives of Sustainable Development Goals 3 and 5.
Africa cannot achieve universal health coverage, gender equality, or sustainable development while millions of women, adolescents, and couples continue to experience preventable sexual and reproductive health and rights (SRHR) problems. The continent has made important progress, but the pace is far too slow. In 2023, sub-Saharan Africa accounted for approximately 70% of global maternal deaths, with about 182,000 women dying from pregnancy-related causes.1 Although maternal mortality in the region fell by 40% between 2000 and 2023, Africa would need a dramatic acceleration in the annual rate of decline to achieve the Sustainable Development Goal target by 2030.1,2.
Maternal healthcare performance varies widely across South Africa, shaped by uneven resources, staffing constraints, and service-delivery pressures. This study explored how healthcare providers experience the conditions that influence maternal care, focusing on infrastructure, staffing, and quality-of-care processes. Using a qualitative case study design, semi-structured interviews were conducted with nurses, midwives, and medical officers working in public-sector maternity services. Data were analysed using an interpretative phenomenological approach. Participants described persistent infrastructure limitations, high workloads linked to inadequate staffing, and challenges in maintaining consistent, timely care. They also highlighted inconsistencies in guideline adherence and communication barriers that affected patient experience. These intersecting factors varied across facilities but collectively shaped the day-to-day delivery of maternal services. The findings underscore the need for context-sensitive strategies that address resource gaps, strengthen staffing capacity, and support more reliable quality-of-care practices.
Globally, thousands of women die due to pregnancy-related complications. The World Health Organization recommends at least eight or more antenatal visits during pregnancy to reduce infant and maternal mortality. This study examined the factors influencing eight or more antenatal visits among South African women aged 15-49, using data from the 2016 South Africa Demographic and Health Survey (weighted sample of 3036 women). A two-level binary logistic regression model was used to identify the factors determining the use of eight or more antenatal visits. The findings revealed a low use (17.1%) of eight or more antenatal care visits. Age at birth, birth order, population group, marital status, employment status, media exposure, place of residence, household wealth and province were statistically associated with eight or more antenatal care visits. Women whose age at birth was 20-34, those exposed to the media, those from rich households, and those from the Western Cape had higher odds of eight or more antenatal care visits. Media campaigns may play a valuable role in informing women about the advantages of attending the recommended antenatal care visits.
This study evaluated the effect of increasing the critical value threshold for hyponatremia combined with systematic intervention on sodium regulation in patients undergoing myomectomy. A retrospective analysis was performed. Patients who underwent myomectomy and received conventional care between March 2014 and March 2019 (n=844) served as the reference group (threshold: 120 mmol/L), while those treated between March 2019 and March 2024 (n=1385) formed the observation group. In the observation group, the hyponatremia critical threshold was raised to 129 mmol/L, alongside targeted interventions including patient education, dynamic sodium monitoring, use of normal saline as the oxytocin solvent, and dietary management. The observation group showed a significantly lower overall incidence of hyponatremia compared with the reference group (21.3% vs. 25.8%, P<0.05). The reduction was more pronounced for moderate-to-severe hyponatremia, decreasing from 5.6% (0.9% severe, 4.7% moderate) to 2.2%, with no severe cases observed. Symptomatic episodes were also reduced (8/31 vs. 25/48). Acute moderate-to-severe hyponatremia occurred predominantly in patients receiving intravenous oxytocin. In conclusion, elevating the hyponatremia critical threshold combined with multidimensional intervention effectively reduces both the incidence and severity of postoperative hyponatremia following myomectomy, supporting its value in early warning and clinical management.
Maternal healthcare is vital for women of reproductive age, but underutilisation contributes to poor health outcomes. Nigeria's maternal mortality remains high despite efforts to strengthen reproductive health services. There is a paucity of empirical evidence on how occupational engagement and health insurance enrolment shape health service utilization in Nigeria. This study analysed pooled data from 49,415 women in the 2018-2024 Nigeria Demographic and Health Surveys to investigate the influence of occupational status and health insurance on reproductive health service utilisation. Findings showed employed women, particularly professionals, demonstrated better healthcare-seeking behaviours. Health insurance coverage increased the odds of attending ≥8 antenatal care visits (aOR: 1.49, CI: 1.24-1.79) and using skilled delivery assistance (aOR: 1.56, CI: 1.19-2.05), but reduced postnatal health check (aOR: 0.78). Pragmatic policies promoting women's employment, economic empowerment, and universal health insurance are needed to improve outcomes and meet Sustainable Development Goal 3 targets in Nigeria.
This research examines numerical data that reflects gender gap and underrepresentation of women in top-rated Netflix Originals during 1st January to 1st December, 2025 to find out if Netflix follows Diversity, Equity and Inclusion (DEI) pledges in its original content. We conducted mixed-method analysis on the 4 shortlisted films with 7.5 or above IMDb ratings, and used quantitative content analysis approach to find gender disparity and qualitative content analysis approach (Bechdel Test) to evaluate women's representation in films. The study found that men dominate as lead actors, writers, directors and producers, 75% of the films have a male-driven story, and 3 out of 4 films do not pass the Bechdel Test. The findings indicate imbalance within the selected high-rated sample. The research argues that the relation between streaming platforms and diverse content is more complex than they present in their discourse and aims to contribute to the discussion around this imbalance by encouraging critical thinking.
This narrative review synthesises evidence on South African men's perspectives, experiences, and involvement in termination of pregnancy (TOP), an area that remains underexplored in sexual and reproductive health and rights (SRHR) research and policy. A systematic search from PubMed, EBSCOHost, Web of Science, Sabinet, Scopus, and Google Scholar identified ten English-language studies published between 2013 and 2025. Data were analysed using thematic synthesis resulting in emergence of four themes: attitudes, beliefs, and knowledge regarding TOP; relational and socioeconomic contexts shaping men's experiences; emotional and psychological responses; and roles in decision-making and support. Limited reproductive health knowledge, socio-economic pressures, dominant norms of masculinity, and marginalisation within healthcare settings constrained men's ability to provide effective support. The review highlights a critical gap in African SRHR practice and underscores the need for gender-sensitive approaches that recognise men as emotional stakeholders while safeguarding women's reproductive autonomy. (Afr J Reprod Health.
Ovarian cancer (OC) is a leading cause of gynecologic cancer-related mortality and is frequently diagnosed at advanced stages due to the absence of effective early detection tools. Epigenetic alterations, particularly DNA methylation, play a critical role in tumorigenesis and represent promising non-invasive biomarkers. This study investigated the methylation status of the ANKRD23 gene in OC and evaluated its diagnostic potential using peripheral blood samples. A total of 385 serous OC patients, 50 individuals with benign ovarian conditions, and 99 healthy controls were included. DNA methylation was assessed using methylation-sensitive restriction enzymes followed by real-time PCR. ANKRD23 methylation was significantly associated with clinical stage (p = 0.029), histological grade (p = 0.009), and ethnicity (p = 0.024). Moreover, methylation levels differed significantly among OC patients, benign cases, and healthy controls (p = 0.026). These findings support blood-based ANKRD23 methylation as a promising biomarker for non-invasive ovarian cancer diagnosis and risk stratification.
This randomized comparative study investigated the effects of free-position delivery guidance combined with prenatal intervention on pain levels, delivery outcomes, and maternal-neonatal outcomes in primiparous women. A total of 80 primiparous women admitted to the hospital between April 2023 and October 2025 were included in the study. Participants were randomly divided into two groups of 40 each using a random number table. The control group received conventional supine delivery with basic guidance, while the study group received free position delivery guidance combined with prenatal intervention. Labor duration, pain scores, delivery outcomes, and the incidence of adverse maternal-neonatal outcomes were compared between the two groups. The study group showed significantly shorter labor duration and total labor time compared to the control group (P<0.05). The study group also demonstrated significantly lower pain scores (P<0.05). The study group exhibited a significantly higher rate of natural delivery and a significantly lower rate of cesarean section compared to the control group (P<0.05). The incidence of adverse maternal-infant outcomes in the study group was significantly lower than that in the control group (P<0.05). The combination of free-position delivery guidance and prenatal intervention can effectively improve delivery outcomes, alleviate labor pain, and reduce adverse maternal-neonatal outcomes in primiparous women.
For more than three decades, sub-Saharan Africa has invested heavily in the five WHO pillars of safe motherhood.1,2 Governments, development partners, professional associations and civil society organizations have promoted family planning, strengthened antenatal care, expanded skilled birth attendance, improved postnatal care, and, where permitted by law, advocated for safe abortion services. These interventions have undoubtedly contributed to improved maternal and newborn health and have saved countless lives. Yet the region continues to account for approximately 70% of global maternal deaths.3 The persistence of this unacceptable burden raises an important question: why have these investments not translated into the dramatic reductions in maternal mortality that many had anticipated?
Contraception is essential for preventing unintended pregnancies, averting about 230 million births and saving over 272,000 mothers' lives globally each year. Although 40% of pregnancies worldwide are unintended, contraceptive use in Africa remains low, increasing only from 23.9% in 2012 to 28.5% in 2017. In contrast, Rwanda has seen a major rise in contraceptive uptake, from 17% in 2005 to 64% in 2020. This retrospective study examined factors influencing contraceptive use among Rwandan women of reproductive age using data from the 2019-2020 Demographic and Health Survey. Most participants were 35-39 years old, lived in rural areas, had primary education, were married, and had 4-6 children. Multivariate analysis showed that age, marital status, number of children ever born, education, religion, and wealth index were significantly associated with modern and current contraceptive use (p < .001), while residence showed no association. These findings underscore the importance of sociodemographic factors for strengthening family planning policies in Rwanda.
This study aimed to explore disparities in MMR across China's provincial administrative regions from 2005 to 2020. We undertook spatial autocorrelation analysis to quantify the spatial distribution pattern of MMR and conducted Bayesian spatial modeling to explore factors influencing its spatiotemporal differences. The results showed a significant overall decline in MMR during the study period, with reduced regional inequality in its distribution. Spatial autocorrelation analysis confirmed significant positive spatial clustering (global Moran's I: 0.155-0.367, all P<0.001). Most included variables exerted significant effects on MMR, except the Disease Detection Rate in Women Undergoing Pre-Marital Health Checks. Notably, despite the overall downward trend, persistent geographic disparities existed: MMR was higher in western China and lower in eastern China, with per capita consumer expenditure the most influential factor. This study clarifies the spatiotemporal evolution and key influencing factors of provincial MMR in China, providing insights for targeted interventions to reduce regional disparities.
The expansion of women in employment warrants more focus on reproductive health and occupational well-being. In Indonesia, the Gerakan Pekerja Perempuan Sehat Produktif (GP2SP) program has been developed to promote the health of female workers. However, the implementation of the program is still limited due to the absence of an integrated operational structure. This research is intended to create a Continuous Health Examination Network (CHEN) model in an effort to improve women's reproductive health by revitalising the GP2SP program. While traditional workplace interventions focus on episodic services, the CHEN model incorporates ongoing monitoring, engagement with many stakeholders and promotive, preventive, curative and rehabilitative approaches. The model is useful for low- and middle-income nations, especially African settings, where workplace reproductive health services are generally fragmented. This study used a research and development design based on the ADDIE model. The investigation was cross-sectional and included 104 married female workers from two companies in Riau Province, Indonesia. Data were acquired through structured questionnaires and analyzed using descriptive statistics and chi-square testing. Model development consisted of needs assessment, model drafting, and expert validation through a two-round Delphi technique. Workers' attitudes were substantially related to program knowledge (p = 0.027). The CHEN model proved viable and may be useful for enhancing women's reproductive health and productivity in office settings.
Eswatini records the world's highest HIV burden, with female HIV prevalence markedly elevated compared to males. Understanding the socioeconomic structural drivers of this epidemic is essential for evidence-based prevention policy. This cross-sectional longitudinal study used secondary annual data from the World Development Indicators (WDI) database (World Bank, 2000-2022; n=23 annual observations) to examine the effects of female unemployment (FUMP), female secondary school enrolment (EDU), urban population share (URB), and income inequality (GINI) on female HIV prevalence (HIVP). A three-stage analytical approach was employed: descriptive statistics, graphical co-movement trend analysis, and multivariable Ordinary Least Squares (OLS) regression to identify independent predictors of female HIV prevalence while controlling for confounding. Female HIV prevalence declined from 16.0% in 2000 to 8.2% in 2022. The multivariable OLS regression revealed that female secondary school enrolment (β=-0.103, p<0.001) and female unemployment (β=-0.194, p<0.001) are the dominant independent predictors of female HIV prevalence. Income inequality exerted a positive effect (β=+0.594, p=0.074), while urbanization was negatively associated (β=-1.237, p=0.069). Female secondary school enrolment and female unemployment are the dominant socioeconomic determinants of HIV prevalence among women in Eswatini. Integrated policies combining education investment, economic empowerment, and income inequality reduction are essential for sustainable HIV prevention.
This research explores the intersection of music education and gendered emotional labor in China, focusing on the impact of this intersection on the mental health of women educators. Utilizing theories of emotional labor, gendered care work, and mental health literacy, the study implemented an integrated model through a quantitative cross-sectional survey involving 312 women music educators from urban primary, secondary, and tertiary institutions. Using structural equation modeling, the study revealed that gendered emotional labor significantly contributes to professional identity strain while diminishing mental health awareness. Professional identity strain further dampens mental health consciousness, whereas enhanced mental health awareness predicts improved psychological well-being, resilience, and reduced burnout and anxiety. Mediation analysis demonstrated that the influence of emotional labor on mental health primarily occurs via identity strain and mental health awareness. The study advances emotional labor theory by pinpointing professional identity strain as a critical psychological pathway, reconceptualizes music education as simultaneously nurturing and demanding for women educators, and identifies mental health awareness as a modifiable protective factor. These findings emphasize the importance of culturally attuned, gender-responsive institutional strategies to foster psychological well-being and professional sustainability for women educators in China.
This study aimed to assess anxiety levels and marital relationships among women undergoing infertility treatment. A descriptive observational design was conducted involving 300 infertile women over nine months at Zagazig University Hospital. Data were collected using a Structured Interview Questionnaire, the Female Sexual Function Index (FSFI), and the Taylor Anxiety Scale. Reliability analysis showed high internal consistency (Cronbach's alpha: 0.923 for FSFI; 0.845 for Taylor Scale). Results indicated that 32.6% of participants sought services after one year of marriage, 30.5% visited more than five centers, and 47.5% used IVF. Nearly half of the subjects experienced varying degrees of anxiety (moderate to very severe), which significantly impacted sexual arousal, orgasm, and satisfaction. In conclusion, anxiety and psychosexual dysfunction are highly prevalent among women during fertility treatments, underscoring the critical need to integrate psychological counseling and standardized screening protocols within routine reproductive healthcare.
