Case Presentation: A 32-year-old pregnant woman in her 21st week of gestation, G3P2A0, with both deliveries by C-section, presented with a diagnosis of fetal demise confirmed by US. She underwent medical termination with a high dose of misoprostol tablets. At a private hospital, she complained of worsening lower abdominal pain and tenderness. The transabdominal US revealed a bulky uterus with a heterogeneous mass composed of macerated fetal parts and placenta emerging through the left lower uterine segment near the scar site. To confirm the diagnosis, MRI showed a large, non-enhancing structure measuring 90 × 90 mm, communicating with the uterine cavity through the C-section scar, supporting the diagnosis of uterine dehiscence and hematoma formation. Emergency laparotomy confirmed the diagnosis of uterine dehiscence with extrusion of macerated fetal tissue through the defect. Surgical repair was performed, and the postoperative period was uneventful.

Conclusion: This case reinforces the cautious use of uterotonic drugs, such as misoprostol, in patients with repeated C-sections. MRI was a valuable adjunct in confirming the diagnosis when US findings were inconclusive. A multidisciplinary approach, utilizing judicious imaging tools, especially MRI in complex cases, and timely intervention, is crucial for preventing life-threatening outcomes and preserving patient fertility.

Case Report: A 31-year-old woman with a history of previous 2 cesarean sections presented with a chronic on-and-off pus discharge from the transverse scar. She received multiple courses of antibiotics previously. Pus culture for microbiological analysis was found to be negative for organisms, including Mycobacteria species. Magnetic resonance imaging with contrast revealed a likely vascular/ inflammatory collection along the rectus sheath, indicating a utero-vesico-cutaneous sinus tract. A methylene blue-stained tract facilitated its complete removal. A final histopathological staining concluded the possibility of a suture granuloma.

Discussion: Tuberculosis is known to present with similar symptoms, especially years after abdominal surgery, and needs a thorough preoperative exclusion. In our case, the presence of a nontubercular granulomatous inflammation with a suture seen along the tract confirmed the diagnosis. The patient did not report any recurrence of symptoms during the six-month follow-up.

Conclusion: Imaging the entire tract and performing complete excision, followed by judicious use of subcutaneous drains and closure with delayed absorbable monofilament sutures, are preferable to avoid recurrence. This case emphasizes the importance of timely diagnosis in improving the quality of life of the affected patients.

Methods: This article presents a narrative overview of recent literature published over the past 10 years. Relevant sources were identified through searches in scientific databases such as PubMed, Scopus, Web of Science, and Google Scholar.

Results: Emerging tools (liquid biopsy, molecular imaging, next-generation sequencing) and AI algorithms enhance early detection. Targeted screening is recommended for high-risk women, particularly those with autoimmune thyroid disease or TPO antibodies. Therapeutic strategies include selenium/ iodine supplementation, hormone replacement, and immunomodulatory agents. Telemedicine shows potential for individualized care.

Discussion: Our findings indicate that PPTD remains underdiagnosed (5-10% prevalence) despite clear autoimmune involvement (60% TPOAb-positive). Symptom overlap with normal postpartum recovery and inconsistent screening protocols contribute to diagnostic delays. While novel tools show diagnostic potential, their validation remains incomplete. The 20-30% progression to permanent hypothyroidism warrants targeted screening and personalized management. Future studies should optimize screening cost-effectiveness and evaluate long-term child development outcomes.

Conclusion: Despite advancements, PPTD diagnosis remains challenging due to non-specific symptoms. A multidisciplinary approach integrating emerging technologies and public health initiatives is essential. Future research should focus on predictive models and long-term prevention strategies.

Case Presentation: We report a case of a 24-year-old primigravida at 38 weeks of gestation who presented with vaginal bleeding and was diagnosed with complete placenta previa. During cesarean delivery, the placenta failed to detach spontaneously and was firmly adherent to the lower uterine segment and posterior uterine wall. Attempts at piecemeal removal left residual tissue, resulting in severe haemorrhage. Haemostatic sutures, uterine artery ligation, and bilateral internal iliac artery ligation were performed, but bleeding persisted, necessitating a life-saving cesarean hysterectomy. Estimated blood loss was 3500 mL, requiring multiple blood component transfusions. Gross examination revealed extensive placental adherence to the posterior uterine wall, lower segment, and cervix. Histopathology showed no chorionic villi invading the myometrium, ruling out placenta accreta spectrum.

Conclusion: This case highlights that significant placental adherence causing life-threatening haemorrhage can occur even in the absence of PAS. Clinicians should be prepared for massive obstetric haemorrhage and complex surgical interventions in such scenarios, despite the lack of histopathological myometrial invasion.

Case Presentation: A 16-year-old female presented to the gynaecology outpatient department with a complaint of primary amenorrhea. Secondary sexual characteristics were not well developed, with breast development being Tanner stage I and absent axillary and pubic hair. External genitalia, including labia majora, labia minora, and clitoris, were normal for age. Investigations revealed hypergonadotropic hypogonadism with absent uterus and ovaries, and a small blind vaginal pouch at the lower end. She was put on estrogen replacement therapy for the development of secondary sexual characteristics and for her bone, cardiovascular, and psychosocial health.

Conclusion: The present case highlights the diagnostic dilemma faced by clinicians encountering such cases and reinforces the important role of estrogen in the development of Müllerian ducts. The deficiency of estrogen in cases of pure gonadal dysgenesis can closely resemble the clinical profile of patients with MRKH.

Methods: A descriptive-analytical study was conducted in 2024 on 320 high-risk pregnant women in Ahvaz, Iran, using multi-stage stratified cluster sampling. Participants were selected through multi-stage stratified cluster sampling. Data were collected through Health-seeking Behavior Questionnaire (HSBQ), Perceived Stress Scale (PSS-4), Social Support Scale (OSSS-3), and Coping Strategies Questionnaire (CSQ).

Results: Most participants (86%) sought care immediately after confirming pregnancy, yet 84.7% did not attend prenatal classes, and 65.9% lacked preconception care. While 72% reported stress during pregnancy, only 21.3% sought mental health support. Support from husbands (65%) and doctors (48%, with 83.4% trust) was common. Social support levels varied, with 50% experiencing poor support, 37% average, and 12% good support. Social support was significantly associated with antenatal checkups (χ² = 35.66, p < 0.0001), preconception care (χ² = 6.66, p = 0.03), counseling (χ² = 20.11, p < 0.0001), mental health support (χ² = 87.98, p < 0.0001), and information seeking (χ² = 30.30, p < 0.0001). A significant relationship was also found between stress and social support (p < 0.0001, r = -0.39) as well as coping behaviors (p < 0.0001, r = 0.22).

Discussion: Social support plays a key role in promoting health-seeking behaviors and reducing stress, consistent with prior evidence. Yet, low use of psychosocial and educational services, due to stigma, limited awareness, and access issues, highlights the need for targeted interventions to strengthen support systems, expand education, and improve access to comprehensive care.

Conclusion: High-risk pregnant women generally demonstrated appropriate health-seeking behaviors, but engagement with educational and mental health services was low. Strengthening social support and addressing barriers are essential for improving maternal outcomes.

Methods: This prospective observational study was conducted over 18 months at a tertiary care center. Antenatal women between 32 and 40 weeks of gestation diagnosed with late-onset FGR were included. Pulsatility indices (PI) of the fetal middle cerebral artery and umbilical artery were obtained via Doppler ultrasound to calculate CPR and UCR. Thresholds used were CPR ≤1.76 and UCR ≥1. Patients were followed until delivery, and perinatal outcomes were analyzed.

Results: Of the 75 women enrolled, abnormal CPR was present in 58 (77.3%) and abnormal UCR in 31 (41.3%). Adverse perinatal outcomes were significantly more frequent among those with abnormal CPR and UCR, including NICU admission, preterm birth, and perinatal mortality.

Discussion: The present study suggests integrating CPR and UCR together into routine Doppler surveillance of pregnancies with suspected FGR, especially in late gestation. An abnormal CPR should prompt close monitoring and possibly early delivery planning to prevent stillbirths or NICU admissions. Elevated UCR, given its correlation with low Apgar and perinatal death, may serve as an early warning for escalating fetal compromise.

Conclusion: CPR and UCR are valuable tools for monitoring pregnancies complicated by lateonset FGR. Used together, they enhance the prediction of adverse perinatal outcomes, allowing timely and targeted clinical interventions.

Methods: Relevant publications were identified through a systematic search of Cochrane CENTRAL, PubMed, EMBASE, and Google Scholar, encompassing publications up to July–August 2025. Inclusion criteria were randomised controlled trials, cohort studies, case-control studies, and systematic reviews concentrating on breastfeeding, galactagogues, and the newborn microbiota. Data were synthesised thematically: influence of breastfeeding, mechanisms, efficacy, milk composition, population-specific effects, and safety.

Results: Components of human milk, particularly human milk oligosaccharides and immunoglobulins, modulate newborn microbiota during exclusive breastfeeding. Domperidone enhances milk production; however, infant safety and long-term effects require further investigation. Herbal galactagogues such as fenugreek and moringa show small and inconsistent increases in milk volume, with limited evidence on safety and compositional alterations. Major gaps include long-term infant outcomes and data from low-resource settings.

Discussion: Current evidence supports breastfeeding as a key regulator of early-life microbiome development through its bioactive matrix, but the contribution of galactagogues to microbiomerelated benefits remains unclear. Uncertain safety profiles and limited mechanistic data, particularly in diverse and low-resource populations, constrain confident recommendations and guideline integration.

Conclusion: Breastfeeding effectively regulates the early microbiome, but the impact of pharmaceutical and herbal galactagogues on milk quality and infant health is still inadequately defined. Comprehensive longitudinal studies among heterogeneous groups are required to clarify benefits, risks, and tailored recommendations for galactagogues.