Marwan Habiba

Traditional laboratory medicine measures a defined analyte e.g., haemoglobin, CA125. Medical decision-making follows and assumes minimal or acceptable differences between analytical platforms. Such...

The phenomenon of neonatal uterine bleeding was observed over centuries. It was dismissed as having no clinical relevance. Alternatively, it was hypothesized to be associated with early-onset endometriosis, but its exact clinical significance remains unknown. We conducted a narrative review using an updated literature of Medline database to July 2026. We examined all identified articles on NUB and examined recent controversies. We explored the relevance of the phenomenon to early-onset endometriosis. We highlight NUB as a putative marker for endometrial maturation and development. The incidence of NUB varies with gestational age. The occurrence of bleeding originating in the uterus of some neonates is well documented. It is possible that some instances of bleeding may not be uterine in origin. The fetal and neonatal endometrium differ significantly from that of the adult. Thus, uterine bleeding in the neonate is not analogous to menstruation. While the factors affecting fetal endometrial development are largely unknown, the occurrence of bleeding in some, but not all, neonates call for a better understanding of the uterine development and the underlying mechanisms of bleeding. The observation that some, but not all, neonates exhibit bleeding may have implications on future uterine development and function. The hypothesis that NUB is associated with early-onset endometriosis, while plausible, has no proven evidence but is difficult to falsify. Whether or not an association exists between NUB and early-onset endometriosis, the phenomenon warrants focus on the physiological stages of early uterine development and maturation and how these may be affected by in utero and early neonatal events.

The term femicide, widely used in reference to the “killing of a woman because she is a woman,” has been questioned on the ground that it implies unequal dignity of men and women victims of gender related death. This position called for an analysis of the terminology used to describe and define the various forms of killing of women and men. We conclude that the use of the term “femicide” retains as a central facet the objective of raising awareness of this crime and combating violence directed at women by men. We also analyzed the current use of the word “androcide” and concluded that its present use is limited to situations where the killing of men is systematic, such as illegal war crimes. In this regard, we address the occurrence of deaths that may be related to gender within or outside relationships. We addressed the under reported issue of intimate partner violence (IPV) and killing of men. The latter has not attracted as much attention and remains a complex problem to understand and study. The issue is further compounded because domestic violence has also been a factor in cases of suicide. Violent behavior directed against men may occur in heterosexual or gay relationships. Estimates of the prevalence of IPV against men in heterosexual relationships, vary from 3.4% to 20.3%. The victim's own behavior is often advanced in mitigation. Although reports on violent behavior among gay and bisexual men have been relatively rare, IPV is at least as prevalent in this group. Indeed, some studies report alarmingly high incidence. In conclusion, there must be a continued focus on gender related death of women, but this should not distract from the occurrences when the victim is a man. There needs to be a drive to improve data collection from all countries with special focus on those in Africa and Asia that do not fully contribute to the global effort. There is also a need to better define the underlying causes and triggers for death, including by suicide, to enable the development of informed prevention strategies.

The rising worldwide trend toward legalization of termination of pregnancy has been accompanied by increased polarization around abortion. Two opposite broad coalitions emerged from this confrontation, generally known as the “pro‐life” and “pro‐choice” movements. The basic issue for pro‐life advocates is that the protection of “innocent, human life” is sacrosanct and must prevail over every other consideration. In contrast, the pro‐choice stance has at its core the notions that a woman should be able to make decisions when it comes to her reproduction and that a woman should have full control over her own body and life. Within this debate, the medical profession moved from an anti‐abortion stance at the beginning of the 20th Century to a stance often in favor of safe, legal pregnancy termination, motivated by a desire to reduce maternal and newborn mortality and morbidity by limiting unsafe illegal abortions performed by non‐medically qualified practitioners. Given this reality, it might seem impossible to search for a minimum common ground. At the same time, efforts in this direction have been made for decades, and it is time to renew such attempts. We have identified a few areas where an open discussion can, and therefore should, be initiated, starting from the concept that interrupting a pregnancy entails the suppression of a potential human life and that, therefore, decreasing the reasons leading to it should be considered a common priority for all. This goal should be achieved through increased efforts aimed at decreasing the number of unwanted or untimed pregnancies. In turn, this means expanding efforts to make available throughout the world access to safe and acceptable contraception and family planning. Within this overall scenario, an agreement should be reached about the biological strong evidence pointing to the fact that “emergency contraception” does not cause an abortion.

We carried out a comprehensive literature search for publications on the range of vascular events that have been linked to adenomyosis. This covered vascular diseases, blood coagulation disorders, thrombosis, hypercoagulation, stroke (embolic, ischemic, thrombotic, hemorrhagic), cerebrovascular episodes, cerebral infarction, cerebral hemorrhage) and renal disease. This review covers 63 articles. Nineteen articles reported clinical manifestations of intravascular thrombosis in women with adenomyosis. Eleven publications were identified that reported on cerebral involvement and adenomyosis, including cases of ischemic stroke or infarction. Dysregulation primarily seems to occur via local factors leading to altered angiogenesis. Five case reports were identified that reported on various vascular complications attributed to the presence of adenomyosis. The search also identified reports of cerebral complications in women with adenomyosis. Through a secondary search, we identified publications dealing with a possible connection between cardiac complications and renal pathology, which the authors attributed to adenomyosis. Vascular involvement in adenomyosis is documented in rare cases by the presence of endometrial tissue in myometrial vessels both in menstrual and non-menstrual uteri. Women with adenomyosis have a higher platelet count, a shorter thrombin and prothrombin time and an activated partial thromboplastin time. These findings has been applied to attempts to identify therapies for adenomyosis based on targeting the vasculature, but the existence of a link between the two conditions is under question for several reasons: only case reports (or very small series) have been published; all published cases come from one region of the world (the Far East); the published literature does not contain objective proof of a causal relationship between the two pathologies, except for the elevation of some markers. In summary, it is not possible to conclude that the presence of adenomyosis has a pathogenetic role in causing vascular events, first and foremost because available evidence consists mostly of case reports.

Abortion was practiced in most cultures for millennia, but was often disapproved and banned. The 20th century witnessed a progressive conditional legalization, often with limitations for the duration of pregnancy. Legalizing abortion was driven by multiple factors, including a desire to limit population growth, the emergence of movements that promoted reproductive freedom, women’s empowerment and control over their own bodies, and an increased awareness of the risks inherent in abortions carried out without proper medical care. Today, there is a definite trend towards safer and more efficient abortion methods. Access to abortion care is not universal: in 2022, 970 million women of reproductive age had access to abortion, whereas some 700 million lived under restrictive laws. In many parts of the world abortion rates have increased, while the ethical conflict around abortion remains and views on both sides have polarized and become more entrenched. Whether restrictive legislation reduces the number of women undergoing abortion and whether a realization that addressing the unplanned and unwanted pregnancies can reduce the number of women seeking abortion remains debatable. In conclusion, the 20th century witnessed the contradiction of a surge in both pro‐ and anti‐abortion sentiments.

Background: The nature and functions of the innermost layer of the myometrium, which is located immediately below the endometrium, coined the “junctional zone” (JZ), continue to be the subject of debate. The role and significance of the JZ have attracted little attention beyond its relation to the diagnosis of adenomyosis. Objectives: This review was conducted to update our current understanding of the role of the JZ as a specific uterine region. Methods: This is a comprehensive review of literature that was published in PubMed and MEDLINE platforms till April 2025 and that addresses the uterine JZ, excluding articles concerned with uterine adenomyosis. Outcome: It is not possible to reconcile JZ appearance on imaging with embryological or functional correlates. There are clear histological and immunohistological differences between the inner and outer myometrium, but the change is gradual with no demarcation of the transition. Whether the JZ has a different origin remains controversial because of the lack of supportive embryological evidence. There is evidence that JZ appearance on MRI is hormonally dependent, but it is not always recognizable and is often indistinct before puberty and after menopause. JZ seems to increase in thickness in the secretory and menstrual phases. Conclusion: While increased thickness is often considered a sign of adenomyosis, considerable uncertainty remains. We have not been able to identify studies that related features of the JZ per se to clinical outcomes. This supports the need for caution when interpreting the relevance of the JZ.

Induced abortion has religious, moral, and cultural dimensions that place it at the center of major ethical debates. The interest of women caught in the middle of this never‐ending controversy requires that a dialogue replaces current confrontation. To promote such dialogue, we decided to write a mini‐series to review important aspects of abortion. First, we will turn to history to explore the root of the controversy, which may enable the disentangling of the complexity of the issue. In the second essay we describe how the 20th century witnessed the progressive legalization of abortion. In the third essay we will articulate how we see the possibility of a common ground between those favoring and those opposing abortion. Induced abortion has been attempted from the dawn of civilization and it is mentioned in Egyptian, Greek, and Roman writings, although the frequency of the practice and its success are not known. The world's principal religions did not view abortion favorably, but the strength of prohibition was not uniform. Within Christianity, the Roman Catholic and Orthodox Churches are currently totally opposed, whereas Protestant denominations are more nuanced in their disapproval. The anti‐abortion stance of Muslim countries seems to be at variance with the view of the majority of traditional scholars, who would allow abortion in the early stages of pregnancy (up to 4 months, or in the first 40 days). The Orthodox Jewish view bans abortion except when the life of the mother is at risk, whereas Reformed Judaism is more open. Hinduism is also opposed to abortion with few exceptions: severe fetal abnormalities, presence of a life‐threatening condition for the woman, in case of rape or incest. Confucianism stresses the importance of the family and reverence for life but also shows concern and compassion for the welfare of the pregnant woman; these positions are balanced when responding to the challenge of deciding about abortion.

The article describes a case of recurrent umbilical endometriosis that was excised surgically. Following the first excision, the specimen was not subjected to biopsy. This is not in line with standard good practice. At the authors' institution, the l...

Pincus and his group's initial research on hormonal contraception focused on progesterone. However, the natural compound could not be utilized in clinical practice because of the high incidence of breakthrough bleeding and its low oral availability. This led to the introduction of orally active progestins. The estrogen was added to ensure proper cycle control. Concern about side effects of combined oral contraceptive pills (COC) and specifically the increased occurrence of thromboembolism was raised at the very early stages of clinical use. These were attributed to the estrogenic component, ethinyl estradiol (EE). The first pill scare followed the publication in 1977 of evidence of thromboembolism-related mortality in COC users. This and subsequent alarming publications acted as the engine for a successful attempt to substantially decrease the daily content of EE in a COC. Over time, adverse events were also reported for the newer progestins compared to levonorgestrel. Attempts have been made to utilize natural estrogens in COC based on the assumption that this will reduce adverse effects. The wide range of progestins available for use in COC renders comparisons between preparations more challenging. Each progestin has its own androgenic, antiandrogenic, antiestrogenic, and mineralocorticoid activity and, consequently, a unique risk and benefit profile.