Current Obstetrics and Gynecology Reports最新文献

{"title":"Pharmacologic Treatment of Obesity in Reproductive Aged Women.","authors":"Akua Nuako, Lucy Tu, Karen J Campoverde Reyes, Shradha M Chhabria, Fatima Cody Stanford","doi":"10.1007/s13669-023-00350-1","DOIUrl":"10.1007/s13669-023-00350-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>This report will review existing literature on weight loss outcomes for various anti-obesity medications (AOMs) as well as their effects on human fertility, pregnancy, or breastfeeding.</p><p><strong>Recent findings: </strong>There is a paucity of research on the effects of AOMs on human pregnancy and fertility. The majority of AOMs are not recommended during pregnancy and breastfeeding due to known or unclear risks of harm to offspring.</p><p><strong>Summary: </strong>As the prevalence of obesity rises, AOMs have proven to be effective tools for weight loss in the general adult population. When prescribing AOMs to reproductive-aged women, providers should consider both the cardiometabolic benefits of these medications and potential effects that AOMs might have on hormonal contraception, pregnancy, or breastfeeding. Animal studies in rats, rabbits, and monkeys have suggested teratogenic effects of several medications discussed in this report. However, a lack of data on the use of many AOMs during human pregnancy or lactation makes it difficult to comment on the safety of their use in these time periods. Some AOMs show promise in promoting fertility while others might decrease the efficacy of oral contraceptives, highlighting some of the special considerations that must be taken when prescribing AOMs to reproductive-aged women. More research into the risks and benefits of AOMs in the context of reproductive-aged women's unique healthcare needs is an important step in improving this population's access to effective treatments for obesity.</p>","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"12 2","pages":"138-146"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328448/pdf/nihms-1884086.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9815188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updates on Anti-seizure Medication Use in Pregnancy","authors":"Alexa King, Elizabeth E. Gerard","doi":"10.1007/s13669-023-00359-6","DOIUrl":"https://doi.org/10.1007/s13669-023-00359-6","url":null,"abstract":"","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"12 1","pages":"37 - 44"},"PeriodicalIF":0.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43806728","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}

{"title":"Preventing Adverse Cardiovascular Outcomes in Pregnancy Complicated by Obesity.","authors":"Aarti Purohit, Chigolum Pamela Oyeka, Sadiya S Khan, Marika Toscano, Shriddha Nayak, Shari M Lawson, Roger S Blumenthal, Garima Sharma","doi":"10.1007/s13669-023-00356-9","DOIUrl":"10.1007/s13669-023-00356-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obesity is a chronic disease that is becoming increasingly prevalent, and more individuals of reproductive age have obesity prior to becoming pregnant. Obesity in pregnancy is associated with short- and long-term adverse consequences for both the birthing person and their offspring which have been associated with increased long-term cardiovascular morbidity and mortality. The goal of this review is to discuss what is currently understood about the relationship between maternal obesity and adverse pregnancy outcomes (APOs), the association between APOs and future cardiovascular disease (CVD) risk, and what evidence-based interventions can be implemented to prevent adverse outcomes in this population.</p><p><strong>Recent findings: </strong>Maternal obesity has been associated with an increased risk of APOs such as gestational diabetes, hypertensive disorders of pregnancy, and preterm birth as well as an increased risk of future CVD, such as metabolic syndrome, chronic hypertension, coronary heart disease, and stroke. The impact of maternal obesity also extends beyond the pregnant individual to the offspring, increasing the risk of fetal, neonatal, and infant mortality, as well as of congenital malformations, prematurity, and long-term health problems such as insulin resistance and childhood obesity. Prevention guidelines are incorporating the increased risk of adverse outcomes from maternal obesity into formalized risk assessments to guide both prenatal and postpartum care. It is becoming evident that a multidisciplinary cardio-obstetrics team is an important part of providing comprehensive care for pregnant individuals with obesity and other cardiovascular risk factors, including preexisting CVD and a history of prior APOs. There remains a need for further studies to better understand the mechanisms underlying the relationship between maternal obesity and APOs, as well as the racial and ethnic disparities that have been noted in the prevalence of APOs and associated CVD risk and mortality.</p><p><strong>Summary: </strong>There is increasing awareness that obesity in pregnancy is associated with various short- and long-term adverse maternal and offspring outcomes. There are multiple screening and prevention strategies that may be implemented before, during, and after pregnancy to prevent these adverse outcomes.</p>","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"12 2","pages":"129-137"},"PeriodicalIF":0.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10575259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Update on Contraception for Transgender, Non-binary, and Gender-expansive Individuals","authors":"Kelsey Mumford, A. Light","doi":"10.1007/s13669-023-00362-x","DOIUrl":"https://doi.org/10.1007/s13669-023-00362-x","url":null,"abstract":"","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"12 1","pages":"76 - 82"},"PeriodicalIF":0.5,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46262284","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}

{"title":"Intrapartum Oxygen for Fetal Resuscitation: State of the Science.","authors":"Julia Burd, Nandini Raghuraman","doi":"10.1007/s13669-023-00363-w","DOIUrl":"10.1007/s13669-023-00363-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to summarize the current evidence regarding maternal oxygen supplementation for Category II fetal heart tracings (FHT) in labor. We aim to evaluate the theoretical rationale for oxygen administration, the clinical efficacy of supplemental oxygen, and the potential risks.</p><p><strong>Recent findings: </strong>Maternal oxygen supplementation is an intrauterine resuscitation technique rooted in the theoretic rationale that hyperoxygenating the mother results in increased oxygen transfer to the fetus. However, recent data suggest otherwise. Randomized controlled trials on the efficacy of oxygen supplementation in labor suggest no improvement in umbilical cord gases or other adverse maternal and neonatal outcomes compared to room air. Two meta-analyses demonstrated that oxygen supplementation is not associated with an improvement in umbilical artery pH or reduction in cesarean delivery. Although we lack data on definitive clinical neonatal outcomes with this practice, there is some suggestion of adverse neonatal outcomes with excess in utero oxygen exposure, including lower umbilical artery pH.</p><p><strong>Summary: </strong>Despite historic data suggesting the benefit of maternal oxygen supplementation in increasing fetal oxygenation, recent randomized trials and meta-analyses have demonstrated a lack of efficacy of this practice and some suggestion of harm. This has led to conflicting national guidelines<i>.</i> Further research is needed on short- and long-term neonatal clinical outcomes following prolonged intrauterine oxygen exposure.</p>","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":" ","pages":"1-5"},"PeriodicalIF":0.7,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second Trimester Medication Abortion Regimens and the Mifepristone-Misoprostol Dosing Interval","authors":"Emma M. Smith, Katherine D. Pocius, J. Atrio","doi":"10.1007/s13669-023-00358-7","DOIUrl":"https://doi.org/10.1007/s13669-023-00358-7","url":null,"abstract":"","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"12 1","pages":"83 - 87"},"PeriodicalIF":0.5,"publicationDate":"2023-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44533979","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}

{"title":"Intrauterine Device Complications and Their Management","authors":"Melissa G. Myo, B. Nguyen","doi":"10.1007/s13669-023-00357-8","DOIUrl":"https://doi.org/10.1007/s13669-023-00357-8","url":null,"abstract":"","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"12 1","pages":"88 - 95"},"PeriodicalIF":0.5,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46300165","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}

{"title":"Management of Labor and Delivery to Reduce Risk for Cesarean Birth in Women with Obesity","authors":"C. Jevitt","doi":"10.1007/s13669-023-00361-y","DOIUrl":"https://doi.org/10.1007/s13669-023-00361-y","url":null,"abstract":"","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"12 1","pages":"103 - 116"},"PeriodicalIF":0.5,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44061344","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}

{"title":"Infertility Treatment in Women with Obesity","authors":"Miriam A. Andrusier, R. Reddy, E. Ginsburg","doi":"10.1007/s13669-023-00360-z","DOIUrl":"https://doi.org/10.1007/s13669-023-00360-z","url":null,"abstract":"","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"12 1","pages":"122 - 128"},"PeriodicalIF":0.5,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47345336","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}

{"title":"Congenital Anomalies in Women with Obesity","authors":"K. Pressman, Sarah Obican","doi":"10.1007/s13669-023-00352-z","DOIUrl":"https://doi.org/10.1007/s13669-023-00352-z","url":null,"abstract":"","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"12 1","pages":"117 - 121"},"PeriodicalIF":0.5,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44821155","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}