Topics in Obstetrics & Gynecology最新文献

A Review of Placental Abnormalities 胎盘异常回顾

Topics in Obstetrics & Gynecology Pub Date : 2024-07-31 DOI: 10.1097/01.PGO.0001025336.48769.e0

Barraza Allan, Gagnon Amy J., Alston Meredith J.

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Approaches to Prenatal Genetic Testing 产前基因检测方法

Topics in Obstetrics & Gynecology Pub Date : 2024-07-15 DOI: 10.1097/01.PGO.0001024380.96363.84

M. Hopkins, J. Kuller, Lorraine Dugoff

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Optimizing Operative Hysteroscopy in the Office Setting: Updated Techniques and Technology 优化诊室环境中的宫腔镜手术：最新技术与科技

Topics in Obstetrics & Gynecology Pub Date : 2024-01-30 DOI: 10.1097/01.PGO.0000998088.06847.5a

Ntami P. Echeng, D. Burrell, Kate Zaluski

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Diagnosis of Venous Thromboembolism in Pregnancy 妊娠期静脉血栓栓塞症的诊断

Topics in Obstetrics & Gynecology Pub Date : 2024-01-15 DOI: 10.1097/01.PGO.0000997432.60569.1c

Jack FitzSimmons, Laura Hart, Emily Oliver, Wadia R. Mulla

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Care for the Transgender and Gender-Diverse Patient Population: A Review for the Obstetrician/Gynecologist 变性和性别多元化患者的护理：妇产科医生综述

Topics in Obstetrics & Gynecology Pub Date : 2023-12-31 DOI: 10.1097/01.PGO.0000997000.66558.cf

Shayna Rubenstein, Beth Cronin

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Perioperative Pain Control for Patients Undergoing Cesarean Delivery 剖腹产患者围手术期疼痛控制

Topics in Obstetrics & Gynecology Pub Date : 2023-11-30 DOI: 10.1097/01.pgo.0000992704.95503.4f

Abigail Barnes, Meredith Alston

{"title":"Perioperative Pain Control for Patients Undergoing Cesarean Delivery","authors":"Abigail Barnes, Meredith Alston","doi":"10.1097/01.pgo.0000992704.95503.4f","DOIUrl":"https://doi.org/10.1097/01.pgo.0000992704.95503.4f","url":null,"abstract":"opioid-induced hyperalgesia, indicating that patients who receive more opioids intraoperatively become sensitized and thus require more opioids postoperatively.1 These concerns also translate into the peripartum period, especially for patients requiring cesarean deliveries. In 2019, Peahl and colleagues2 reviewed rates of new persistent opioid use in recently delivered patients and found that 75% of patients who underwent cesarean delivery were discharged with an opioid prescription. Of these women, 1% to 2% became persistent users. When compared with the nationwide cesarean delivery rate, that is an astonishing number of new persistent opioid users. Obstetricians have a responsibility to manage pain effectively, while also working to decrease the risk of patients becoming persistent opioid users. This article presents options to support a multimodal approach to peripartum and perioperative pain management for patients undergoing cesarean delivery. It is the physician’s role to evaluate each patient and personalize their pain control regimen, so patients may effectively meet postoperative milestones, care for their newborns, be discharged home from the As physicians and surgeons, obstetricians are acutely aware of the nationwide opioid crisis and the importance of decreasing opioid use both inside and outside of the hospital setting. In one review of perioperative use, it was found that 6% to 10% of patients who underwent either minor or major surgery, not specific to obstetrics and gynecology procedures, were still using opioids 1 year after their procedure.1 This same review noted that opioid dosing during the operative procedure was positively correlated with the postoperative opioid requirement for analgesia. This is thought to be due to acute tolerance secondary to Perioperative Pain Control for Patients Undergoing Cesarean Delivery","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"44 ","pages":"1 - 5"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139203096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Diagnosis and Management of Vulvar Ulcers: Part I—Common Vulvar Ulcers 外阴溃疡的诊断和治疗:第一部分-常见外阴溃疡

Topics in Obstetrics & Gynecology Pub Date : 2023-09-30 DOI: 10.1097/01.PGO.0000977892.92495.7e

H. Lerner

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Updates in Endometrial Ablation: Office Approaches 子宫内膜消融的最新进展:办公室入路

Topics in Obstetrics & Gynecology Pub Date : 2023-09-15 DOI: 10.1097/01.PGO.0000966992.08325.9b

Kate M Zaluski, D. Burrell

{"title":"Updates in Endometrial Ablation: Office Approaches","authors":"Kate M Zaluski, D. Burrell","doi":"10.1097/01.PGO.0000966992.08325.9b","DOIUrl":"https://doi.org/10.1097/01.PGO.0000966992.08325.9b","url":null,"abstract":"fluid overload and electrolyte disturbances. Since the 1990s, the FDA has approved several nonresectoscopic endometrial ablation systems (often referred to as global endometrial ablation), which have short ablation cycles and require less user expertise with similar effectiveness compared with resectoscopic methods.1 Although patient satisfaction between resectoscopic and nonresectoscopic techniques seems to be equivalent, nonresectoscopic techniques are associated with shorter operative times and are more often performed under local anesthesia.1 As such, they are much more feasible for use in the outpatient setting. Success of endometrial ablation is primarily measured by patient satisfaction rates and rates of additional intervention including hysterectomy in the months and years after the procedure. It is therefore critical to properly identify candidates for endometrial ablation and counsel them regarding risk factors for dissatisfaction and for subsequent hysterectomy. This article aims to review available nonresectoscopic endometrial ablation systems, to identify ideal candidates for this procedure, to optimize success in the outpatient setting, and to describe risk factors for endometrial ablation failure. Endometrial ablation is an attractive management option for many premenopausal patients with heavy menstrual bleeding as an alternative to medical therapy or hysterectomy. The goal of endometrial ablation is to reduce menstrual bleeding by local destruction of the endometrium. Resectoscopic endometrial ablation, although an effective treatment for heavy menstrual bleeding, requires specific hysteroscopic skills by the operator and carries the risk of Updates in Endometrial Ablation: Office Approaches","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128057086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Bariatric Surgery and Pregnancy 减肥手术和怀孕

Topics in Obstetrics & Gynecology Pub Date : 2023-07-31 DOI: 10.1097/01.PGO.0000944416.34212.a6

J. Cervino, D. Dang

{"title":"Bariatric Surgery and Pregnancy","authors":"J. Cervino, D. Dang","doi":"10.1097/01.PGO.0000944416.34212.a6","DOIUrl":"https://doi.org/10.1097/01.PGO.0000944416.34212.a6","url":null,"abstract":"who have bariatric surgery are adults, teenagers can also be candidates for weight-loss surgery if they have been evaluated by a multidisciplinary team and meet the criteria. In the United States, the 3 most commonly performed weight-loss surgeries are a sleeve gastrectomy (SG), Rouxen-Y gastric bypass (GB), and an adjustable gastric band (AGB). Other less common weight-loss surgeries include the biliopancreatic diversion with duodenal switch (BPD/DS), which is no longer commonly performed, and a single anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S), which is a relatively newer procedure. An SG is a restrictive type of weight-loss surgery where approximately 80% of the stomach is removed. This aids weight loss through a restrictive process, by altering the size of the stomach and thereby reducing the quantity of food the patient can eat, while also removing the portion of the stomach that produces important metabolic hormones including leptin and ghrelin. This surgery is relatively quick, simple, and highly effective, making it the gold standard for weight-loss surgery. A benefit of this surgery is that it can be performed on certain patients who may be considered “high risk” with medical comorbidities. It can also act as a Overview of Bariatric Surgery Bariatric surgery is a class of weight-loss surgery that works by altering the anatomy of the gastrointestinal tract. According to the National Institutes of Health, candidates for bariatric surgery are: (1) patients with a body mass index (BMI) of 40 or more, or (2) a BMI of 35 or more with a serious health condition linked to obesity including type 2 diabetes, sleep apnea, or heart disease, or (3) a BMI of 30 or more with type 2 diabetes that is difficult to control with medication and lifestyle changes.1 Different institutions may have different criteria or protocols for which patients are candidates for bariatric surgery. Although most patients Bariatric Surgery and Pregnancy","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"92 19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125014002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Use of the Levonorgestrel Intrauterine Device for Noncontraceptive Indications 左炔诺孕酮宫内节育器在非避孕适应症中的应用

Topics in Obstetrics & Gynecology Pub Date : 2023-07-15 DOI: 10.1097/01.PGO.0000943028.26626.ab

Swati Rajprohat, Dung Dang

{"title":"Use of the Levonorgestrel Intrauterine Device for Noncontraceptive Indications","authors":"Swati Rajprohat, Dung Dang","doi":"10.1097/01.PGO.0000943028.26626.ab","DOIUrl":"https://doi.org/10.1097/01.PGO.0000943028.26626.ab","url":null,"abstract":"after copper was found to have spermicidal effects. The levonorgestrel IUD (LNG-IUD) was developed in the 1970s after research by Dr. Antonio Scommegna demonstrated intrauterine progesterone could induce endometrial atrophy. This concept was used by Dr. Jouni Valter Tapani Luukkainen to develop Progestasert, the first hormonecontaining IUD, marketed in 1976, which was effective for 1 year. Progestasert resembled modern-day IUDs; it was T-shaped and made with polydimethylsiloxane (PDMS) coated with progesterone to allow for slow/controlled release of hormone. The natural hormone progesterone was later replaced with levonorgestrel (LNG), a synthetic progestin with more potent progesterone receptor (PR) agonistic effects that lasted for 5 years. This device is now known as Mirena (LNG-20).1 At the time of writing, there are 4 types of LNG-IUDs currently available in the United States: Mirena (LNG-20) and Liletta (LNG-18.6) both containing 52 mg of LNG and releasing 20 and 18.6 μg of LNG per day, respectively, Kyleena (LNG-19.5) containing 19.5 mg of LNG and releasing 17.5 μg Before the 20th century, there were no clear data with regard to use of intrauterine devices (IUDs) for contraception or for other indications in humans. Dr. Richard Richter from Germany first documented the use of silk worm gut rings in the uterus to prevent pregnancy in 1909. After this, Dr. Ernst Grafenberg developed the “silver ring,” a spiral wound circular nonhormonal IUD made of silk suture and wrapped in silver wire in 1928. Development of the contraceptive copper IUD in the 1960s occurred Use of the Levonorgestrel Intrauterine Device for Noncontraceptive Indications","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130807942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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