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Prenatal Genetic Consultation and Testing. 产前遗传咨询和检测。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-06-04 DOI: 10.1097/GRF.0000000000000957
Sarah Araji, Lauren Westerfield, Roni Zemet, Ignatia B Van den Veyver
{"title":"Prenatal Genetic Consultation and Testing.","authors":"Sarah Araji, Lauren Westerfield, Roni Zemet, Ignatia B Van den Veyver","doi":"10.1097/GRF.0000000000000957","DOIUrl":"https://doi.org/10.1097/GRF.0000000000000957","url":null,"abstract":"<p><p>The evolution of prenatal genetic testing has transformed prenatal diagnosis into a more precise and individualized approach. Advanced tools such as chromosomal microarray analysis and exome sequencing have enabled the prenatal diagnosis of more genetic conditions, including anomalies and disorders eligible for fetal therapy. When in utero therapy is considered, accurate genetic diagnosis is essential for guiding providers' and patients' decisions regarding management and outcomes. This chapter reviews available prenatal genetic screens and tests, their indications, and counseling strategies. It also explores genetic abnormalities associated with fetal structural anomalies and their implications for decision-making in fetal interventions.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anesthetic Considerations and Blood Utilization for Placenta Accreta Spectrum. 胎盘增生谱的麻醉注意事项和血液利用。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-06-01 Epub Date: 2024-12-11 DOI: 10.1097/GRF.0000000000000921
Philip E Hess, Yunping Li
{"title":"Anesthetic Considerations and Blood Utilization for Placenta Accreta Spectrum.","authors":"Philip E Hess, Yunping Li","doi":"10.1097/GRF.0000000000000921","DOIUrl":"10.1097/GRF.0000000000000921","url":null,"abstract":"<p><p>The anesthetic management of the patient with placenta accreta spectrum begins before surgery by assessing the patient and their comorbidities and providing psychological preparation for the perioperative period. Choosing neuraxial or general anesthesia for surgery balances the procedure's clinical needs with the patient's desires. Intraoperatively, management of homeostasis during acute blood loss requires assessments of central volume to avoid over-transfusion. Viscoelastic testing may be useful to assess coagulation to target the replacement of coagulation factors. Postoperative care is an essential continuum of the procedure, and the availability of bedside ultrasound can aid rapid decision-making.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"275-282"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recent Advances in Diagnosis and Management of Cesarean Scar Pregnancy. 剖宫产瘢痕妊娠的诊断与治疗新进展。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-06-01 Epub Date: 2025-04-21 DOI: 10.1097/GRF.0000000000000943
Lorenza Della Valle, Alessandro Lucidi, Marina Piergianni, Francesco D'Antonio
{"title":"Recent Advances in Diagnosis and Management of Cesarean Scar Pregnancy.","authors":"Lorenza Della Valle, Alessandro Lucidi, Marina Piergianni, Francesco D'Antonio","doi":"10.1097/GRF.0000000000000943","DOIUrl":"10.1097/GRF.0000000000000943","url":null,"abstract":"<p><p>Cesarean scar pregnancy (CSP) is among the most severe iatrogenic complications of cesarean delivery (CD) and is associated with a high risk of severe hemorrhage, uterine rupture, and progression towards placenta accreta spectrum disorders. Prenatal diagnosis of CSP has been recently standardized through a modified Delphi consensus, which also allows risk stratification according of this anomaly. However, several issues on the management of CSP are still under debate. The aim of the present review is to provide an up-to-date on the diagnosis and management of CSP.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"234-241"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Imaging Modalities for the Diagnosis of Placenta Accreta Spectrum. 胎盘增生谱的影像学诊断。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-06-01 Epub Date: 2025-04-21 DOI: 10.1097/GRF.0000000000000940
Jerri Waller, Alfred Abuhamad
{"title":"Imaging Modalities for the Diagnosis of Placenta Accreta Spectrum.","authors":"Jerri Waller, Alfred Abuhamad","doi":"10.1097/GRF.0000000000000940","DOIUrl":"10.1097/GRF.0000000000000940","url":null,"abstract":"<p><p>Placenta accreta spectrum (PAS) is the result of the invasion of the placental trophoblasts into the myometrium. The rate of PAS continues to increase due to the increased number of cesarean sections. Other risk factors include increasing maternal age, multiparity, uterine surgeries, and placenta previa. Due to the high risk of maternal morbidity and mortality, prenatal diagnosis is essential to ensure proper resources and surgical planning before delivery. Ultrasound is considered the gold standard for diagnosis of PAS. Ultrasound findings include placental lacuna, loss of placental clear space, lower uterine segment thickness, and increased vascularity between the placenta and bladder.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"242-250"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trichomoniasis and Other Sexually Transmitted Parasitic Diseases in Women. 妇女的滴虫病和其他性传播寄生虫病。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-06-01 Epub Date: 2025-04-14 DOI: 10.1097/GRF.0000000000000945
Christina A Muzny, Sheridan George, Patricia J Kissinger, Olivia T Van Gerwen
{"title":"Trichomoniasis and Other Sexually Transmitted Parasitic Diseases in Women.","authors":"Christina A Muzny, Sheridan George, Patricia J Kissinger, Olivia T Van Gerwen","doi":"10.1097/GRF.0000000000000945","DOIUrl":"10.1097/GRF.0000000000000945","url":null,"abstract":"<p><p>Parasitic sexually transmitted infections are spread through sexual contact (vaginal, oral, and/or anal sex). The majority of parasitic STIs involve protozoan pathogens (ie, Trichomonas vaginalis, Entamoeba histolytica, and Giardia duodenalis ); however, ectoparasitic infections ( Pthirus pubis and Sarcoptes scabiei ) are also included in this group. The purpose of this review is to provide a comprehensive summary of the epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of parasitic sexually transmitted infections, with a particular focus on their impact on women.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"194-205"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sexually Transmitted Infection Considerations for Transgender and Gender Expansive Persons. 变性人和性别膨胀者的性传播感染问题。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-06-01 Epub Date: 2025-03-06 DOI: 10.1097/GRF.0000000000000934
Lydia A Fein, Staci Marbin, Rebecca Barnett, Makella Coudray
{"title":"Sexually Transmitted Infection Considerations for Transgender and Gender Expansive Persons.","authors":"Lydia A Fein, Staci Marbin, Rebecca Barnett, Makella Coudray","doi":"10.1097/GRF.0000000000000934","DOIUrl":"10.1097/GRF.0000000000000934","url":null,"abstract":"<p><p>Transgender and gender expansive persons (TGE) are at increased risk for sexually transmitted infections (STIs) compared with other demographic groups and face barriers to health care access that may limit their ability to obtain testing and treatment. Herein, we highlight unique, yet vital, aspects of STI screening and treatment in TGE persons utilizing a gender-affirming care approach, including best practices for gender-inclusive care and special considerations for TGE persons who have undergone gender-affirming hormone therapy and/or surgery. Opportunities exist to improve sexual health in TGE persons, which can be achieved through culturally competent, gender inclusive STI testing and treatment.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"213-222"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sexually Transmitted Infection Considerations Following Sexual Assault. 性侵犯后性传播感染的考虑。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-06-01 Epub Date: 2025-02-18 DOI: 10.1097/GRF.0000000000000928
Karley Dutra, Ariana L Lewis, Rachel Counts
{"title":"Sexually Transmitted Infection Considerations Following Sexual Assault.","authors":"Karley Dutra, Ariana L Lewis, Rachel Counts","doi":"10.1097/GRF.0000000000000928","DOIUrl":"10.1097/GRF.0000000000000928","url":null,"abstract":"<p><p>Sexual assault is common, disproportionately impacting women, persons of color, and young adults. Evaluation should include a history and exam, collection of forensic evidence, and evaluation for mental health disorders. Management of sexually transmitted infections (STI) is important, as 15% will acquire an STI. Prophylaxis is recommended for gonorrhea, chlamydia, and, for individuals with vaginas, trichomonas. HIV and hepatitis B post-exposure prophylaxis are indicated in high-risk scenarios. HPV vaccination is recommended. Follow-up and lab monitoring is indicated for up to 6 months. We aim to summarize up-to-date evidence on the screening, evaluation, and management of STIs following sexual assault.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"223-231"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pathologic Diagnosis of Placenta Accreta Spectrum. 胎盘增生谱的病理诊断。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-06-01 Epub Date: 2025-03-20 DOI: 10.1097/GRF.0000000000000924
Katelyn Dannheim
{"title":"Pathologic Diagnosis of Placenta Accreta Spectrum.","authors":"Katelyn Dannheim","doi":"10.1097/GRF.0000000000000924","DOIUrl":"10.1097/GRF.0000000000000924","url":null,"abstract":"<p><p>In an effort to parallel the terminology and guidelines adopted by the International Federation of Gynecology and Obstetrics (FIGO) and published in July 2019, a panel of expert obstetric and perinatal pathologists (the Placenta Accreta Task Force) was convened within the Perinatal Subcommittee of the Society for Pediatric Pathology (SPP) in October 2019 to create consensus recommendations for the pathologic diagnosis and reporting of Placenta Accreta Spectrum (PAS). This chapter will discuss the approach to gross and histopathologic examination of PAS, standardized pathologic classification system, and reporting guidelines.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"301-309"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Management of Placenta Accreta Spectrum Disorder. 胎盘增生谱系障碍的处理。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-06-01 Epub Date: 2025-04-17 DOI: 10.1097/GRF.0000000000000942
Bridget M Donovan, Lisa C Zuckerwise
{"title":"The Management of Placenta Accreta Spectrum Disorder.","authors":"Bridget M Donovan, Lisa C Zuckerwise","doi":"10.1097/GRF.0000000000000942","DOIUrl":"10.1097/GRF.0000000000000942","url":null,"abstract":"<p><p>This chapter provides insight into current management strategies for the placenta accreta spectrum (PAS). PAS is one of the most morbid conditions of pregnancy, with significant maternal hemorrhage and surgical morbidity risks, and its increasing incidence. Here, we review the available data to help guide the clinical management of PAS, from time of diagnosis through delivery and postpartum care, while acknowledging the many areas of continued uncertainty. The evidence is strong for the importance of team-based, patient-centered, and multidisciplinary care for patients with PAS. However, much else remains uncertain and is predominantly guided by expert opinion. Ultimately, we aim to provide a current understanding of available literature and to emphasize that continued research is paramount to explore management and surgical approaches to move toward optimization of patient outcomes, including the patient experience.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"251-265"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Updates and Knowledge Gaps in Placenta Accreta Spectrum Biology. 胎盘增生谱生物学的最新进展和知识空白。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-06-01 Epub Date: 2025-04-21 DOI: 10.1097/GRF.0000000000000929
Lior Kashani-Ligumsky, Olivia Scott, Guadalupe Martinez, Anhyo Jeong, Ophelia Yin, Sohum Shah, Amanda Wang, Yazhen Zhu, Yalda Afshar
{"title":"Updates and Knowledge Gaps in Placenta Accreta Spectrum Biology.","authors":"Lior Kashani-Ligumsky, Olivia Scott, Guadalupe Martinez, Anhyo Jeong, Ophelia Yin, Sohum Shah, Amanda Wang, Yazhen Zhu, Yalda Afshar","doi":"10.1097/GRF.0000000000000929","DOIUrl":"10.1097/GRF.0000000000000929","url":null,"abstract":"<p><p>Placenta accreta spectrum (PAS) disorders have traditionally been characterized based on histopathologic grading, emphasizing the invasion of trophoblasts into the myometrium, and uterine serosa. Recent research has shifted the etiological understanding of PAS, moving away from the concept of aggressive trophoblast invasion to focusing on the critical role of scarred decidual-myometrial interface. This shift highlights the importance of defective scar tissue as a primary factor, reshaping prevention strategies, diagnostic accuracy, and treatment approaches for this increasingly prevalent iatrogenic and morbid pregnancy complication.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"310-316"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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