Oxford Textbook of Obstetrics and Gynaecology最新文献

Hypertension 高血压

Oxford Textbook of Obstetrics and Gynaecology Pub Date : 2020-01-01 DOI: 10.1093/med/9780198766360.003.0021

L. A. Magee, P. von Dadelszen

{"title":"Hypertension","authors":"L. A. Magee, P. von Dadelszen","doi":"10.1093/med/9780198766360.003.0021","DOIUrl":"https://doi.org/10.1093/med/9780198766360.003.0021","url":null,"abstract":"Pregnancy hypertension is associated with an estimated annual toll of 46,000 maternal and 2 million fetal, neonatal, and infant deaths. Over 99% of these deaths occur in less developed countries. The most dangerous form of pregnancy hypertension is pre-eclampsia, which, by international consensus, is defined more broadly than solely by proteinuric gestational hypertension to include markers of systemic target organ damage. Severe pre-eclampsia is defined by adverse features that mandate delivery irrespective of gestational age. There are numerous risk factors for pre-eclampsia and low-dose aspirin and, in women with low intake, calcium replacement appear to reduce the risk of pre-eclampsia and its complications. Time-of-disease risk estimation for women and, to a lesser extent, their fetuses, is possible to guide personalized decision-making and counselling. Heavy proteinuria is not an indication for delivery. Severe pregnancy hypertension must be treated as a matter of urgency. For all women with pregnancy hypertension, blood pressure should be normalized. Magnesium sulphate is the treatment to prevent and treat the seizures of eclampsia. Beyond viability, expectant management of pregnancy hypertension should be offered until 36+6 weeks of pregnancy. Women with either pre-eclampsia or gestational hypertension at more than 37+0 weeks should be offered induction, while induction should be offered to women with chronic hypertension at 38–39 weeks. Blood pressure reaches its maximal postpartum levels on days 3–6 postpartum. All forms of pregnancy hypertension are risk factors for premature cardiovascular disease and mortality, especially if associated with either fetal growth restriction, preterm birth, and/or stillbirth.","PeriodicalId":325232,"journal":{"name":"Oxford Textbook of Obstetrics and Gynaecology","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123133042","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}

引用次数: 0

Urinary incontinence 尿失禁

Oxford Textbook of Obstetrics and Gynaecology Pub Date : 2020-01-01 DOI: 10.1093/med/9780198766360.003.0057

J. Iyer, A. Rane

{"title":"Urinary incontinence","authors":"J. Iyer, A. Rane","doi":"10.1093/med/9780198766360.003.0057","DOIUrl":"https://doi.org/10.1093/med/9780198766360.003.0057","url":null,"abstract":"According to the most recent definition of the International Continence Society, urinary incontinence (UI), a symptom of impaired storage, is ‘the complaint of any involuntary leakage of urine’. A condition that primarily affects women, UI is not a lethal condition; however, it significantly affects quality of life. Three types of incontinence are generally distinguished: stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence, which associates with the first two. Prevalence varies significantly due to variations in definitions and measurement, methodology of data collection, lack of self-reporting, and sampling/non-response issues. Age, parity, vaginal childbirth, and body mass index are important factors that affect the prevalence of urinary incontinence. In 2005, the ‘Evaluation of the Prevalence of urinary InContinence’ (EPIC) study, which was the largest population-based survey of 19,165 individuals, was conducted in five developed countries to assess the prevalence of lower urinary tract symptoms in men and women. Prevalence of overactive bladder overall was 11.8%; rates were similar in men and women and increased with age. Overactive bladder was more prevalent than all types of UI combined (9.4%). Besides the obvious issue of hygiene, UI results in ramifications that extend to the sufferer’s social and sexual life. This chapter focuses on mainly three types of female urinary incontinence commonly encountered in clinical practice—stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence—and discusses the anatomy and physiology of the continence apparatus, and the classification, evaluation, and management of urinary incontinence.","PeriodicalId":325232,"journal":{"name":"Oxford Textbook of Obstetrics and Gynaecology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125967469","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}

引用次数: 0

Polycystic ovary syndrome 多囊卵巢综合征

Oxford Textbook of Obstetrics and Gynaecology Pub Date : 2020-01-01 DOI: 10.1093/med/9780198766360.003.0042

Zhongwei Huang, E. Yong

引用次数: 0

Fetal growth 胎儿生长

Oxford Textbook of Obstetrics and Gynaecology Pub Date : 2020-01-01 DOI: 10.1093/med/9780198766360.003.0010

Jane E. Hirst, A. T. Papageorghiou

{"title":"Fetal growth","authors":"Jane E. Hirst, A. T. Papageorghiou","doi":"10.1093/med/9780198766360.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780198766360.003.0010","url":null,"abstract":"Fetal growth is a complex and highly orchestrated process. Monitoring fetal growth is one of the cornerstones of the evaluation of fetal well-being. This chapter explores the global epidemiology of poor fetal growth, the controversies around the definition of the condition, and the scientific validity of the multitude of growth charts and approaches to fetal growth currently in use around the world. In 2014, the accepted approaches to fetal growth were challenged by the findings of the international INTERGROWTH-21st Project. This major international project demonstrated that the growth of babies in utero and the size of babies around the world are remarkably similar if maternal environmental, social, and medical conditions are relatively optimal. From this study, the first standards for fetal and newborn growth have been produced. The management of babies detected to be large for gestational age (LGA) also remains controversial and a clinical challenge. With increasing rates of maternal obesity and gestational diabetes, a growing proportion of babies are born LGA or detected to be LGA in utero. Other than the treatment for gestational diabetes, the evidence for effective interventions to prevent the development of LGA during pregnancy is limited. Key issues regarding the management of LGA include the most appropriate timing and mode of delivery to prevent shoulder dystocia and birth trauma.","PeriodicalId":325232,"journal":{"name":"Oxford Textbook of Obstetrics and Gynaecology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116232323","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}

引用次数: 0

The menstrual cycle 月经周期

Oxford Textbook of Obstetrics and Gynaecology Pub Date : 2020-01-01 DOI: 10.1093/med/9780198766360.003.0040

L. Whitaker, K. Skorupskaite, J. Maybin, H. Critchley

引用次数: 0

Infertility 不孕不育

Oxford Textbook of Obstetrics and Gynaecology Pub Date : 2020-01-01 DOI: 10.1093/med/9780198766360.003.0051

S. Bhatta, S. Bhattacharya

引用次数: 0

Preterm birth 早产

Oxford Textbook of Obstetrics and Gynaecology Pub Date : 2020-01-01 DOI: 10.1093/med/9780198766360.003.0030

A. Care, Z. Alfirevic

引用次数: 0

Palliative care 姑息治疗

Oxford Textbook of Obstetrics and Gynaecology Pub Date : 2020-01-01 DOI: 10.1093/med/9780198766360.003.0069

J. Cain, S. Kibel

{"title":"Palliative care","authors":"J. Cain, S. Kibel","doi":"10.1093/med/9780198766360.003.0069","DOIUrl":"https://doi.org/10.1093/med/9780198766360.003.0069","url":null,"abstract":"Palliative care is an integrated approach that focuses on quality of life of ‘patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and treatment of other problems, physical, psychosocial, and spiritual’. This embraces the concept that quality care is embedded not only in individual health, but also the environment and setting of care and touches the domains included in the previous World Health Organization (WHO) definition. Palliative care focuses caregivers on the important goals of medicine—alleviating pain and suffering (at all levels), improving the experience of daily living, supporting psychological transitions with changing physical abilities, and advancing the patient’s and family’s understanding of the nature of the disease facing an individual and the outcomes. With that in mind, it represents a basic tenet of care for all patients, particularly those with diseases that lead to significant loss of quality of life and function. While this chapter focuses more on oncological palliative care, the tenets of palliative care and the research about symptom management can extend to the care of women with chronic conditions such as chronic pelvic pain, severe endometriosis, interstitial cystitis, untreatable pelvic prolapse, and other conditions. Palliative care, then, can be a focus for fatal and non-fatal diseases, and can and should be provided to address diminished quality-of-life issues as a part of ongoing treatment of a disease process, not just at the end of life.","PeriodicalId":325232,"journal":{"name":"Oxford Textbook of Obstetrics and Gynaecology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121903094","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}

引用次数: 0

Obstetric analgesia and anaesthesia 产科镇痛与麻醉

Oxford Textbook of Obstetrics and Gynaecology Pub Date : 2020-01-01 DOI: 10.1093/med/9780198766360.003.0028

S. Bampoe, A. Addei

引用次数: 0

Obstetric procedures 产科手术

Oxford Textbook of Obstetrics and Gynaecology Pub Date : 2020-01-01 DOI: 10.1093/med/9780198766360.003.0033

Y. Cheng, T. Leung

引用次数: 2