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Outcomes and Metrics of Enhanced Recovery After Surgery (ERAS) in Gynecology. 妇科手术后增强恢复（ERAS）的结果和指标。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-09-16 DOI: 10.1097/GRF.0000000000000968
Kristin A Black, Gregg Nelson
{"title":"Outcomes and Metrics of Enhanced Recovery After Surgery (ERAS) in Gynecology.","authors":"Kristin A Black, Gregg Nelson","doi":"10.1097/GRF.0000000000000968","DOIUrl":"https://doi.org/10.1097/GRF.0000000000000968","url":null,"abstract":"<p><p>Enhanced recovery after surgery (ERAS) is an evidence-based, multimodal, perioperative care pathway that has been demonstrated to improve outcomes for patients undergoing surgery. In gynecology, there is evidence that ERAS is associated in reduction in length of stay, perioperative complications, and health care costs. The purpose of this narrative review is to discuss the outcome measures and metrics of ERAS in gynecologic surgery. Furthermore, to consider future directions for outcomes and metrics for ERAS in gynecologic surgery.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074626","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
Opioid Management in the Setting of Enhanced Recovery After Surgery (ERAS) Protocols. 阿片类药物在增强术后恢复（ERAS）方案中的管理。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-09-04 DOI: 10.1097/GRF.0000000000000965
Vienne Seitz, Kathryn Tighe, Emily R W Davidson
{"title":"Opioid Management in the Setting of Enhanced Recovery After Surgery (ERAS) Protocols.","authors":"Vienne Seitz, Kathryn Tighe, Emily R W Davidson","doi":"10.1097/GRF.0000000000000965","DOIUrl":"https://doi.org/10.1097/GRF.0000000000000965","url":null,"abstract":"<p><p>Enhanced Recovery After Surgery (ERAS) protocols have been implemented across multiple surgical specialties, including OB/GYN, to improve patients' perioperative experiences. ERAS protocols typically include multimodal pain regimens; opioids are frequently utilized. In the perioperative setting, nonopioid analgesics, including acetaminophen, NSAIDs, dexamethasone, gabapentinoids, ketamine, antidepressants, and local anesthesia may be used, which impacts perioperative opioid utilization. In some patients, opioid-sparing analgesia may be possible. Postdischarge, patients should utilize a multimodal pain regimen similar to that of their inpatient stay, with limited opioid quantities prescribed. Postoperative prescribing should balance optimal pain control while considering the risks and side effects of opioid analgesics.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991618","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
Monochorionic Twin Gestation. 单绒毛膜双胎妊娠。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-09-01 Epub Date: 2025-03-05 DOI: 10.1097/GRF.0000000000000927
Taylor Pitt, Ramen H Chmait, Martha A Monson
{"title":"Monochorionic Twin Gestation.","authors":"Taylor Pitt, Ramen H Chmait, Martha A Monson","doi":"10.1097/GRF.0000000000000927","DOIUrl":"10.1097/GRF.0000000000000927","url":null,"abstract":"<p><p>Care of the pregnant patient with monochorionic (MC) twin gestation entails specific steps that are imperative in recognizing complications that are unique to MC placentation. Here, we will review recommendations for care of the patient with known MC twin gestation, as well as discuss the pathophysiology, diagnosis, and management of these complications including, but not limited to, twin-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence (TAPS), selective fetal growth restriction (SFGR), and twin reversed arterial perfusion (TRAP) sequence.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"366-382"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556038","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
Using Biodesign Methodology for the Development and Initial Validation of a Novel Fetal Shunt: The Vortex Shunt. 利用生物设计方法开发和初步验证一种新型胎儿分流器：漩涡分流器。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-09-01 Epub Date: 2025-08-14 DOI: 10.1097/GRF.0000000000000954
Yair J Blumenfeld, Kunj R Sheth, Eric Johnson, Enrico Danzer
{"title":"Using Biodesign Methodology for the Development and Initial Validation of a Novel Fetal Shunt: The Vortex Shunt.","authors":"Yair J Blumenfeld, Kunj R Sheth, Eric Johnson, Enrico Danzer","doi":"10.1097/GRF.0000000000000954","DOIUrl":"10.1097/GRF.0000000000000954","url":null,"abstract":"<p><p>Fetal lower urinary tract obstruction (LUTO) is a severe malformation that is associated with significant neonatal and pediatric morbidity and mortality risk. Existing fetal shunts aimed at bypassing the obstruction and improving neonatal survival have significant limitations, primarily shunt dislodgement. Repeat in-utero invasive shunt replacement procedures are associated with maternal, fetal, and obstetric risks, highlighting a clinical need for a novel fetal shunt with improved performance. We used a biodesign approach to develop and validate a novel fetal shunt, the Vortex shunt, which can potentially reduce dislodgement and improve both neonatal and maternal outcomes. In this review, we will discuss our approach to assessing the clinical need, the initial prototyping and benchtop testing, and animal feasibility studies of the Vortex shunt. We will also discuss existing challenges and opportunities for innovation in the fetal medicine and surgery space, and how biodesign methodology can inform novel instrument development in high-impact small market areas.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":"68 3","pages":"442-447"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844776","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
Foreword: The Evolving Landscape of Fetal Therapy: From Vision to Practice. 胎儿治疗的发展前景：从愿景到实践。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-09-01 Epub Date: 2025-07-21 DOI: 10.1097/GRF.0000000000000963
Eyal Krispin, Jena Miller
{"title":"Foreword: The Evolving Landscape of Fetal Therapy: From Vision to Practice.","authors":"Eyal Krispin, Jena Miller","doi":"10.1097/GRF.0000000000000963","DOIUrl":"10.1097/GRF.0000000000000963","url":null,"abstract":"","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"365"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674021","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
Closing the Gap: Prenatal Repair and the Reimagined Future of Spina Bifida. 缩小差距：产前修复和脊柱裂的重新想象的未来。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-09-01 Epub Date: 2025-07-23 DOI: 10.1097/GRF.0000000000000960
Emrah Aydin, Jose Luis Peiro, Monuira Habli
{"title":"Closing the Gap: Prenatal Repair and the Reimagined Future of Spina Bifida.","authors":"Emrah Aydin, Jose Luis Peiro, Monuira Habli","doi":"10.1097/GRF.0000000000000960","DOIUrl":"10.1097/GRF.0000000000000960","url":null,"abstract":"<p><p>Spina bifida, particularly myelomeningocele (MMC), represents a severe congenital anomaly with lifelong consequences. Advances in imaging and screening have improved prenatal detection, enabling early counseling and intervention. Over the past 2 decades, fetal surgical repair has transformed outcomes, as demonstrated by the Management of Myelomeningocele Study (MOMS), with reduced cerebrospinal shunting and improved motor function. However, fetal surgery carries maternal and fetal risks, including preterm delivery and uterine complications. This review examines current evidence on fetal open spina bifida repair, discusses patient selection, long-term outcomes, and emerging innovations, and highlights ongoing ethical and accessibility challenges.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"383-386"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689010","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
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 : 2025-09-01 Epub 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":"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":"425-431"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","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
Contributors: The Evolving landscape of Fetal Therapy: From Vision to Practice. 贡献者：胎儿治疗的发展前景：从愿景到实践。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-09-01 Epub Date: 2025-08-14 DOI: 10.1097/01.grf.0001126332.32571.57
{"title":"Contributors: The Evolving landscape of Fetal Therapy: From Vision to Practice.","authors":"","doi":"10.1097/01.grf.0001126332.32571.57","DOIUrl":"https://doi.org/10.1097/01.grf.0001126332.32571.57","url":null,"abstract":"","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":"68 3","pages":"vii-x"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844772","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
Fetoscopic Laser Surgery for Vasa Previa: Feasibility, Safety, and Future Directions. 胎儿镜激光手术治疗前置血管：可行性、安全性及未来发展方向。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-09-01 Epub Date: 2025-04-24 DOI: 10.1097/GRF.0000000000000947
Yinka Oyelese, Ali Javinani, Eyal Krispin, Claudio Schenone, Ramen H Chmait, Alireza A Shamshirsaz
{"title":"Fetoscopic Laser Surgery for Vasa Previa: Feasibility, Safety, and Future Directions.","authors":"Yinka Oyelese, Ali Javinani, Eyal Krispin, Claudio Schenone, Ramen H Chmait, Alireza A Shamshirsaz","doi":"10.1097/GRF.0000000000000947","DOIUrl":"10.1097/GRF.0000000000000947","url":null,"abstract":"<p><p>Vasa previa is an uncommon, potentially life-threatening condition where fetal vessels traverse the membranes over the cervix without Wharton jelly protection, risking fetal exsanguination if undiagnosed. Prenatal ultrasound and planned preterm cesarean reduce perinatal mortality to under 1%, though concerns about prematurity persist. Fetoscopic laser photocoagulation, initially used for twin-twin transfusion syndrome, shows promise in select cases, potentially allowing vaginal delivery at term. This review examines vasa previa management, the feasibility of laser therapy, and its risks. While early data are promising, further studies, including the FLUMEN trial, are needed to determine the safety and efficacy of this intervention.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"453-458"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957194","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
Foreword: Gynecologic Care of the Transgender Patient. 跨性别患者的妇科护理。
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2025-09-01 Epub Date: 2025-06-23 DOI: 10.1097/GRF.0000000000000959
Cecile A Ferrando
{"title":"Foreword: Gynecologic Care of the Transgender Patient.","authors":"Cecile A Ferrando","doi":"10.1097/GRF.0000000000000959","DOIUrl":"10.1097/GRF.0000000000000959","url":null,"abstract":"","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"321"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367970","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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