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Optimizing Outcomes: Perioperative Strategies for Patients With Chronic Pelvic Pain. 优化结果：慢性骨盆疼痛患者的围手术期策略。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2026-12-01 Epub Date: 2026-07-20 DOI: 10.1097/GRF.0000000000001042
Adeoti E Oshinowo, Rukset Attar, Rebecca Thompson, Innie Chen, Michael S Kinson
{"title":"Optimizing Outcomes: Perioperative Strategies for Patients With Chronic Pelvic Pain.","authors":"Adeoti E Oshinowo, Rukset Attar, Rebecca Thompson, Innie Chen, Michael S Kinson","doi":"10.1097/GRF.0000000000001042","DOIUrl":"10.1097/GRF.0000000000001042","url":null,"abstract":"<p><p>Chronic pelvic pain (CPP) severely impacts quality of life, presenting distinct perioperative management challenges. Patients face heightened anxiety, severe postoperative pain, prolonged recovery from fear of movement, and persistent pain amplified by concurrent chronic overlapping pain conditions (COPCs). While data on preoperative pain's precise impact remains limited, surgery often triggers severe flares. Consequently, comprehensive preoperative screening is crucial. Evaluating risk factors-including central sensitization, substance use, smoking, COPCs, specific pain generators, and psychological comorbidities-allows clinicians to manage expectations effectively. Ultimately, this targeted risk assessment equips patients with the necessary strategies and tools to optimize their surgical recovery.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"422-428"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520069","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
Against Recommending History Indicated Cerclage. 反对推荐有病史的结扎术。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2026-12-01 Epub Date: 2026-06-26 DOI: 10.1097/GRF.0000000000001029
Ilaria Paladino, Vincenzo Berghella
{"title":"Against Recommending History Indicated Cerclage.","authors":"Ilaria Paladino, Vincenzo Berghella","doi":"10.1097/GRF.0000000000001029","DOIUrl":"10.1097/GRF.0000000000001029","url":null,"abstract":"<p><p>Cerclage was originally devised by Shirodkar and McDonald for individuals who develop cervical changes in the second trimester. RCT data have confirmed the efficacy of ultrasound-indicated cerclage (UIC). After 70 years of research, the only evidence-based indications for history-indicated cerclage (HIC) are ≥3 early spontaneous preterm births (SPTBs) or early second-trimester losses, and UIC followed by preterm birth <32 weeks. All patients should undergo transvaginal ultrasound cervical length (TVU CL) screening, with UIC considered if the TVU CL shortens before 24 weeks to ≤20 mm in singletons without prior SPTB, ≤25 mm with prior SPTB, or ≤15 mm in twins.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"466-471"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338180","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
Favoring Elective Hospitalization in Pregnancies With Vasa Previa. 妊娠期Vasa Previa首选选择性住院治疗。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2026-12-01 Epub Date: 2026-06-29 DOI: 10.1097/GRF.0000000000001041
C Andrew Combs
{"title":"Favoring Elective Hospitalization in Pregnancies With Vasa Previa.","authors":"C Andrew Combs","doi":"10.1097/GRF.0000000000001041","DOIUrl":"10.1097/GRF.0000000000001041","url":null,"abstract":"<p><p>There is international agreement that third-trimester hospitalization is indicated for the one-third of patients with vasa previa who have risk factors for preterm birth. For the remaining two-thirds, it is controversial whether elective hospitalization or outpatient management should be recommended. There are no randomized trials comparing outcomes of the 2 strategies. Observational studies report similar outcomes with elective hospitalization and outpatient management, but are fraught with biases and are underpowered to permit a confident conclusion that outpatient management is safe. Elective hospitalization may be safer because cesarean can be performed immediately if bleeding occurs. Elective hospitalization should be the norm.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"452-458"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344115","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
Against: Treating All Pregnant Women With Aspirin to Prevent Pre-eclampsia. 反对：给所有孕妇服用阿司匹林以预防先兆子痫。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2026-12-01 Epub Date: 2026-08-25 DOI: 10.1097/GRF.0000000000001054
Madeleine P Kendall, Fabricio da Silva Costa, Yinka Oyelese, Daniel L Rolnik
{"title":"Against: Treating All Pregnant Women With Aspirin to Prevent Pre-eclampsia.","authors":"Madeleine P Kendall, Fabricio da Silva Costa, Yinka Oyelese, Daniel L Rolnik","doi":"10.1097/GRF.0000000000001054","DOIUrl":"10.1097/GRF.0000000000001054","url":null,"abstract":"<p><p>Pre-eclampsia is a pregnancy disorder associated with substantial maternal and perinatal morbidity and mortality worldwide. Low-dose aspirin initiated during the first trimester can reduce the risk of preterm pre-eclampsia, leading some to advocate universal prophylaxis during pregnancy. Although simple in principle, this approach would unnecessarily expose many low-risk women to treatment while providing limited absolute benefit. Moreover, the effectiveness of aspirin depends on treatment adherence, which may be reduced without individualized risk assessment. Current evidence supports targeted aspirin prophylaxis following first-trimester risk stratification rather than universal treatment, an approach that has not been evaluated in adequately powered randomized trials.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"434-440"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812107","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
In Favor: Treating All Pregnant Women With Aspirin to Prevent Pre-eclampsia. 赞成：用阿司匹林治疗所有孕妇以预防先兆子痫。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2026-12-01 Epub Date: 2026-07-20 DOI: 10.1097/GRF.0000000000001049
Kirat Sandhu, Alissa Prior, Adina Kern-Goldberger, David Hackney
{"title":"In Favor: Treating All Pregnant Women With Aspirin to Prevent Pre-eclampsia.","authors":"Kirat Sandhu, Alissa Prior, Adina Kern-Goldberger, David Hackney","doi":"10.1097/GRF.0000000000001049","DOIUrl":"10.1097/GRF.0000000000001049","url":null,"abstract":"<p><p>Large, randomized control trials have shown the efficacy of low-dose aspirin (ldASA) in reducing rates of clinically significant severe preterm pre-eclampsia in high-risk populations. Multiple societies have recommended varying risk-stratifying criteria over the last decade. Unfortunately, current approaches to risk-based administration have failed to improve outcomes in an overall high-risk population in the US. Increasing evidence has shown universal ldASA prescription as a practical approach to bridging known gaps in health care for the highest risk patients. This review addresses the benefits of implementing a universal protocol for the administration of ldASA in pregnancy to reduce maternal morbidity and mortality.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"430-433"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520029","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
Should Maternal-Fetal Medicine Physicians Staff Labor Floors? Or: Obstetricians We Were, Obstetricians We Are, and Obstetricians We Should Be. 妇产科医生应该在产房工作吗？或者：我们曾经是产科医生，我们现在是产科医生，我们应该成为产科医生。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2026-12-01 Epub Date: 2026-08-10 DOI: 10.1097/GRF.0000000000001052
Steven J Ralston
{"title":"Should Maternal-Fetal Medicine Physicians Staff Labor Floors? Or: Obstetricians We Were, Obstetricians We Are, and Obstetricians We Should Be.","authors":"Steven J Ralston","doi":"10.1097/GRF.0000000000001052","DOIUrl":"10.1097/GRF.0000000000001052","url":null,"abstract":"<p><p>Maternal-fetal medicine specialists face strong financial incentives to absent themselves from labor floors and the management of laboring patients. Nevertheless, health care systems and medical education benefit from MFM involvement in every aspect of obstetrical care, and their presence on the labor floor will benefit patients, learners, and themselves.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"483-484"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700760","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
In Favor: Conservative Management of Placenta Accreta. 赞成：保守治疗胎盘增生。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2026-12-01 Epub Date: 2026-06-15 DOI: 10.1097/GRF.0000000000001034
Hugo Madar, Beth L Pineles, Loïc Sentilhes
{"title":"In Favor: Conservative Management of Placenta Accreta.","authors":"Hugo Madar, Beth L Pineles, Loïc Sentilhes","doi":"10.1097/GRF.0000000000001034","DOIUrl":"10.1097/GRF.0000000000001034","url":null,"abstract":"<p><p>Conservative management of placenta accreta spectrum is increasingly recognized as a clinically valid, evidence-based alternative to cesarean hysterectomy, enabling reduction of maternal morbidity, particularly for women desiring fertility preservation. Prospective studies demonstrate that conservative management is associated with substantially reduced hemorrhagic morbidity and lower organ injury rates compared with cesarean hysterectomy. Trade-offs include delayed postpartum hemorrhage, higher infection, and readmission rates. Conservative management involves prolonged clinical and ultrasound follow-up. Its success requires patient selection, and its safe implementation demands geographic proximity to a referral center, and availability of a multidisciplinary team 24/7 to manage potential acute complications.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"472-477"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249527","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
Routine Hospitalization for Vasa Previa in the Third Trimester: Evidence Review and Clinical Implications. 妊娠晚期Vasa Previa的常规住院治疗：证据回顾和临床意义。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2026-12-01 Epub Date: 2026-08-17 DOI: 10.1097/GRF.0000000000001053
Andrei Rebarber
{"title":"Routine Hospitalization for Vasa Previa in the Third Trimester: Evidence Review and Clinical Implications.","authors":"Andrei Rebarber","doi":"10.1097/GRF.0000000000001053","DOIUrl":"10.1097/GRF.0000000000001053","url":null,"abstract":"<p><p>Vasa previa is a life-threatening pregnancy complication in which unprotected fetal vessels traverse or are adjacent to the internal cervical os. This condition puts the fetus at risk of death if these vessels rupture in labor. Although prenatal diagnosis has improved our ability to identify these cases, optimal prenatal management remains controversial. Routine hospitalization at 30 to 34 weeks has been advocated but outpatient management achieves equivalent perinatal outcomes in recent publications. Routine hospitalization may be excessive and potentially wrought with maternal complications, therefore, an individualized, risk-stratified approach determining hospitalization may be warranted in light of more recent literature.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"459-461"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757884","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
Serving Those Who Served: Tailored Approaches for Military and Veteran Women With CPP. 为那些服役的人服务：为患有CPP的军人和退伍军人量身定制的方法。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2026-12-01 Epub Date: 2026-06-04 DOI: 10.1097/GRF.0000000000001026
Alexander Wang, Julie Taggart, Chensi Ouyang
{"title":"Serving Those Who Served: Tailored Approaches for Military and Veteran Women With CPP.","authors":"Alexander Wang, Julie Taggart, Chensi Ouyang","doi":"10.1097/GRF.0000000000001026","DOIUrl":"10.1097/GRF.0000000000001026","url":null,"abstract":"<p><p>Eighteen percent of active-duty personnel are women, and 11% of Veterans are women. Chronic pelvic pain (CPP) is found in 30% of women Veterans. We utilized the International Federation of Gynecology and Obstetrics and the International Pelvic Pain Society \"R U MOVVING SOMe\" classification system as a framework to review the increased prevalence of CPP risk factors among women Veterans and active-duty service women. This framework, along with increased awareness of military-specific risks, will enable clinicians of varying specialties to diagnose CPP and improve cross-specialty communication to provide comprehensive CPP treatment to women Veterans and active-duty service women.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"409-413"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155565","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
From Cramps to Chronicity: Rethinking Dysmenorrhea on the Spectrum of Chronic Pelvic Pain. 从痉挛到慢性：痛经在慢性盆腔疼痛谱上的反思。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2026-12-01 Epub Date: 2026-06-03 DOI: 10.1097/GRF.0000000000001025
Laura A Payne, Joëlle Lucas
{"title":"From Cramps to Chronicity: Rethinking Dysmenorrhea on the Spectrum of Chronic Pelvic Pain.","authors":"Laura A Payne, Joëlle Lucas","doi":"10.1097/GRF.0000000000001025","DOIUrl":"10.1097/GRF.0000000000001025","url":null,"abstract":"<p><p>Dysmenorrhea is pain associated with menstrual bleeding; however, recent research has shown that dysmenorrhea is a risk factor for chronic pelvic pain in some individuals. Shared etiological factors associated with pain, such as central sensitization, have also been shown in both conditions. This paper will highlight our current diagnostic conceptualizations and treatment approaches for each dysmenorrhea and chronic pelvic pain, and review evidence of pathways involved in the transition from cyclic to chronic pelvic pain. Clinical recommendations for individualized treatment approaches based on patient phenotypes and areas of future research are also discussed.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"389-396"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155536","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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