FIGO-GCH joint consensus statement on the current status and recommendations for the use of blind intrauterine procedures in the evaluation and management of women with suspected intrauterine pathologies

IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Juan Diego Villegas-Echeverri, Rachel Pope, Magali Robert, Ivo Meinhold-Heerlein, Sergio Haimovich, José Carugno, Luis A. Pacheco, Attilio Di Spiezio Sardo
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Abstract

Historically, blind intrauterine procedures such as dilation and curettage (D&C) and blind endometrial biopsies have been the primary approach for diagnosing and managing intrauterine pathologies. However, these techniques lack direct visualization, leading to diagnostic limitations, incomplete treatment, and increased complication rates. Despite substantial advances in hysteroscopic technology, including high-definition imaging and minimally invasive instruments, blind procedures remain widely used. This paper examines the limitations of blind intrauterine procedures, underscoring the advantages of hysteroscopy, which provides real-time visualization and allows for more accurate, targeted interventions. With the adoption of the “See and Treat” philosophy, hysteroscopy enables nearly 90% of procedures to be performed in an office setting, enhancing both patient convenience and outcomes. FIGO and GCH advocate for the gradual replacement of blind procedures with hysteroscopic approaches whenever feasible, noting that hysteroscopy improves diagnostic accuracy, reduces risks, and minimizes the need for repeat interventions. Recommendations include expanding access to hysteroscopy through targeted training, especially in low- and middle-income countries, where financial and logistical barriers limit access to advanced gynecological care. Furthermore, this paper emphasizes the importance of patient-centered care, encouraging transparent counseling to support informed decision-making.

FIGO-GCH关于在评估和管理疑似宫内病变妇女时使用盲宫内手术的现状和建议的联合共识声明。
从历史上看,盲宫内手术,如扩张和刮除(D&C)和盲子宫内膜活检一直是诊断和管理宫内病变的主要方法。然而,这些技术缺乏直接可视化,导致诊断局限性、治疗不完全和并发症发生率增加。尽管宫腔镜技术取得了长足的进步,包括高清晰度成像和微创仪器,但盲目检查仍被广泛使用。本文探讨了盲宫内手术的局限性,强调了宫腔镜的优势,它提供了实时可视化,允许更准确,有针对性的干预。由于采用了“看和治疗”的理念,宫腔镜使近90%的手术在办公室环境中进行,提高了患者的便利性和结果。FIGO和GCH倡导在可行的情况下逐步用宫腔镜方法取代盲手术,并指出宫腔镜可提高诊断准确性,降低风险,并最大限度地减少重复干预的需要。建议包括通过有针对性的培训扩大宫腔镜的可及性,特别是在财政和后勤障碍限制获得先进妇科护理的低收入和中等收入国家。此外,本文强调以患者为中心的护理的重要性,鼓励透明的咨询,以支持知情决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.80
自引率
2.60%
发文量
493
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecology & Obstetrics publishes articles on all aspects of basic and clinical research in the fields of obstetrics and gynecology and related subjects, with emphasis on matters of worldwide interest.
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