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Best Practice & Research Clinical Obstetrics & Gynaecology最新文献

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Optimizing advice and approaches for elective fertility preservation 选择性生育保留的优化建议和方法
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-01 DOI: 10.1016/j.bpobgyn.2025.102591
Nalini Kaul Mahajan
{"title":"Optimizing advice and approaches for elective fertility preservation","authors":"Nalini Kaul Mahajan","doi":"10.1016/j.bpobgyn.2025.102591","DOIUrl":"10.1016/j.bpobgyn.2025.102591","url":null,"abstract":"<div><div>Elective fertility preservation enables women to extend their reproductive window, potentially reducing the need for ineffective fertility treatments later in life. Oocyte cryopreservation (OC), an established fertility preservation technique, is often seen as a means of reproductive autonomy, though its impact remains debated. To avoid detrimental effects of aging it is suggested that OC should be done by 37 years. Freezing ≥20 mature oocytes before 38 years gives a 60–70°% possibility of pregnancy. Success of ovarian tissue cryopreservation and transplantation (OTCT) in cancer survivors has encouraged its use in reproductive aging. OTCT provides a longer reproductive window, allows for spontaneous conception and restores ovarian endocrine function but is highly invasive. Ethical concerns raised for elective fertility preservation include medicalization of reproduction, idealization of the right time for pregnancy, psychological effects of advanced age parenthood and promotion of social inequity. With an increasing demand for elective oocyte freezing there is an urgent need to create awareness about the pros and cons of the techniques, the risks of pregnancy complications at an advanced maternal age and long term health of children born. Gamete preservation cannot guarantee a child. Profertility counselling should be a part of the discussion as there is no substitute for spontaneous conception at a younger age.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"99 ","pages":"Article 102591"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Cervical assessment 颈评估
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-01 DOI: 10.1016/j.bpobgyn.2025.102590
Eduardo B. da Fonseca , Thais Bezerra Vasconcelos de Castro , Thereza Dias , Lara Araujo , Daniela Aires
{"title":"Cervical assessment","authors":"Eduardo B. da Fonseca ,&nbsp;Thais Bezerra Vasconcelos de Castro ,&nbsp;Thereza Dias ,&nbsp;Lara Araujo ,&nbsp;Daniela Aires","doi":"10.1016/j.bpobgyn.2025.102590","DOIUrl":"10.1016/j.bpobgyn.2025.102590","url":null,"abstract":"<div><div>Transvaginal scan (TVS) of cervical length (CxL) at mid-trimester anomaly scan in asymptomatic pregnancy is useful for predicting the risk of preterm birth. In symptomatic women, measurement of CxL at presentation can help to distinguish between true and false preterm labor (PTL), and who might not deliver within 48 h and seven days. In both groups, the individualization of risk would lead to improvement of antenatal care, including frequency of visits, patient education to identify earlier symptoms, avoid excessive hospitalization, and unnecessary steroids. It is also possible that vaginal progesterone and/or cerclage reduce the PTB risk on those asymptomatic women with short cervix. The aim is to review the evidence that supports the use of TVS of CxL in both asymptomatic and symptomatic pregnant women for the prediction and management of PTL.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"99 ","pages":"Article 102590"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Controversies related to the cardiac origin of preeclampsia – Does a mother's heart know? 子痫前期心脏起源的争议——母亲的心脏知道吗？
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-01 DOI: 10.1016/j.bpobgyn.2025.102600
Eric J. Stöhr
{"title":"Controversies related to the cardiac origin of preeclampsia – Does a mother's heart know?","authors":"Eric J. Stöhr","doi":"10.1016/j.bpobgyn.2025.102600","DOIUrl":"10.1016/j.bpobgyn.2025.102600","url":null,"abstract":"<div><div>A potential role of cardiac output has been proposed in the development of preeclampsia. Given that cardiac output may contribute to hypertensive states in the general population, a contribution from cardiac output to preeclampsia is plausible. However, the interplay between the heart and the periphery is complex, and some responses in cardiac output during pregnancy are surprising even when pregnancy progresses without complications. Therefore, this review focuses on recent evidence that has provided new insight into cardiac output in healthy humans including pregnancy, and offers some suggestions about future studies in preeclamptic patients.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"99 ","pages":"Article 102600"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Egg freezing for young women: A new dawn for reproductive autonomy? 年轻女性冷冻卵子：生殖自主的新曙光？
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-01 DOI: 10.1016/j.bpobgyn.2025.102589
Michiel De Proost , Molly Johnston , Heidi Mertes
{"title":"Egg freezing for young women: A new dawn for reproductive autonomy?","authors":"Michiel De Proost ,&nbsp;Molly Johnston ,&nbsp;Heidi Mertes","doi":"10.1016/j.bpobgyn.2025.102589","DOIUrl":"10.1016/j.bpobgyn.2025.102589","url":null,"abstract":"<div><div>Egg freezing has become increasingly popular in the past fifteen years. Some experts have hailed it as revolutionary and present it as an answer to young women's problem of aligning their reproductive lifespan with other goals and events in life, likening it to the contraceptive pill. Others, however, are more sceptical, seeing it more as a case of exploitation of a vulnerable group of women and medicalization of societal problems. This review critically examines the portrayed benefits of egg freezing through two lines of enquiry: whether egg freezing is a viable reproductive option (the individual level), and whether it effectively increases gender equality (the collective level), hereby also focussing on the critique that it is the wrong kind of answer, namely a medical answer to a social problem. We conclude that although egg freezing can benefit reproductive autonomy, is not the liberating reproductive revolution it is sometimes made out to be.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"99 ","pages":"Article 102589"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Can we really protect the ovary from chemotherapy damage? 我们真的能保护卵巢免受化疗的伤害吗？
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-01 DOI: 10.1016/j.bpobgyn.2025.102603
Thuy Truong An Nguyen , Margherita Condorelli , Isabelle Demeestere
{"title":"Can we really protect the ovary from chemotherapy damage?","authors":"Thuy Truong An Nguyen ,&nbsp;Margherita Condorelli ,&nbsp;Isabelle Demeestere","doi":"10.1016/j.bpobgyn.2025.102603","DOIUrl":"10.1016/j.bpobgyn.2025.102603","url":null,"abstract":"<div><div>Future alternatives to current fertility preservation methods such as pharmacological strategies to prevent chemotherapy-induced ovarian damage in female cancer patients are of growing interest. Chemotherapeutic agents, especially alkylating agents, cause DNA damage and apoptosis in ovarian follicles, significantly reducing ovarian reserve. To mitigate this gonadotoxicity, various emerging strategies are being explored, including kinase inhibitors, PI3K/Akt/mTOR pathway inhibitors, antioxidants, miRNAs and GnRH agonists. These treatments work by preventing follicular apoptosis or excessive activation of primordial follicles. Although promising results have been observed in vitro and in vivo in rodent models, further investigations to bypass their limitations are needed to confirm their efficacy and safety. These challenges include the non-interference with anti-tumoral effect of chemotherapy and the specificity of fertoprotective agents to ovaries.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"99 ","pages":"Article 102603"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Maternal hemodynamics assessment: Key to unlocking ignored functionalities of the female circulation 母体血液动力学评估：解开女性循环被忽视功能的关键
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-01 DOI: 10.1016/j.bpobgyn.2025.102595
Wilfried Gyselaers , Pauline Dreesen
{"title":"Maternal hemodynamics assessment: Key to unlocking ignored functionalities of the female circulation","authors":"Wilfried Gyselaers ,&nbsp;Pauline Dreesen","doi":"10.1016/j.bpobgyn.2025.102595","DOIUrl":"10.1016/j.bpobgyn.2025.102595","url":null,"abstract":"<div><div>This chapter focuses on currently underappreciated aspects of the maternal circulation: blood pressure phenotypes, venous hemodynamics, intra-abdominal pressure, and body water homeostasis. Based on the hemodynamic balance between cardiac output and total peripheral resistance, flow-dominant and resistance-dominant phenotypes of normotension and hypertension exist, with different impacts on gestational outcome. Cardiac diastolic function and venous hemodynamics play a prominent role in gestational changes in cardiac output. An increase in intra-abdominal pressure during pregnancy interferes with body water volume homeostasis, similar to syndromes of multi-organ dysfunctions in non-pregnant individuals. Today, non-invasive maternal hemodynamics assessment allows for obtaining important information on these ignored circulatory functions in addition to conventional sphygmomanometric blood pressure measurement. This offers perspectives to improve current strategies for screening, diagnosis, and management of gestational hypertension disorders, a path, however, to be paved first by intensified multifaceted and multidisciplinary research.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"99 ","pages":"Article 102595"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Early medical abortion 早期药物流产
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-02-21 DOI: 10.1016/j.bpobgyn.2025.102588
Sharon T. Cameron
{"title":"Early medical abortion","authors":"Sharon T. Cameron","doi":"10.1016/j.bpobgyn.2025.102588","DOIUrl":"10.1016/j.bpobgyn.2025.102588","url":null,"abstract":"<div><div>Early medical abortion (EMA) with mifepristone and misoprostol is expanding access to safe abortion across the world. The drug regimen has changed and the steps involved in EMA have been significantly simplified since EMA was first introduced over 35 years ago. Evidence shows that women can safely self-administer both mifepristone and misoprostol themselves at home and self-manage the procedure including confirming the success of the procedure with a self-performed pregnancy test. Telemedicine has expanded access to EMA and evidence shows that it is associated with similar outcomes to traditional models of delivery and is acceptable to both women and clinicians. Further research is required to optimise the analgesic regimen for EMA. Greater efforts are required to expand availability of medical abortion at home at both very early gestations (less than 6 weeks) and up to the end of the first trimester. More evidence is needed to develop guidelines to support provision in remote settings.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"99 ","pages":"Article 102588"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arterial stiffness in gestational diabetes: Latest insights 妊娠期糖尿病的动脉僵硬：最新见解
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-02-03 DOI: 10.1016/j.bpobgyn.2025.102587
Abigail R. Anness Dr. , Asma Khalil , Hatem A. Mousa
{"title":"Arterial stiffness in gestational diabetes: Latest insights","authors":"Abigail R. Anness Dr. ,&nbsp;Asma Khalil ,&nbsp;Hatem A. Mousa","doi":"10.1016/j.bpobgyn.2025.102587","DOIUrl":"10.1016/j.bpobgyn.2025.102587","url":null,"abstract":"<div><div>Increased arterial stiffness is a known cardiovascular risk factor, associated with hypertension and acute coronary events. Gestational diabetes (GDM) is associated with the development of placental-mediated disorders and future cardiovascular morbidity, raising the possibility of an association with increased arterial stiffness (AS). Several studies have now investigated this association through the assessment of pulse wave velocity and augmentation index. In the current review, we present the latest evidence regarding the changes in arterial stiffness in pregnancies complicated by GDM, before the onset of clinical disease, during its course, and after its resolution. We also review the evidence that AS could influence the need for different treatments for GDM, and the impact that the treatments, and in particular, metformin, could have on arterial stiffness.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"99 ","pages":"Article 102587"},"PeriodicalIF":3.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Best Practice & Research clinical obstetrics & gynaecology 临床妇产科最佳实践与研究。
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-02-01 DOI: 10.1016/j.bpobgyn.2024.102574
Kate Swanson , Mary E. Norton
{"title":"Best Practice & Research clinical obstetrics & gynaecology","authors":"Kate Swanson ,&nbsp;Mary E. Norton","doi":"10.1016/j.bpobgyn.2024.102574","DOIUrl":"10.1016/j.bpobgyn.2024.102574","url":null,"abstract":"<div><div>Screening for fetal genetic disorders is a focus of prenatal care. Cell free DNA (cfDNA) screening for aneuploidies became available in 2011. Initially available only to high-risk individuals, this test is now standard of care in many settings. cfDNA screening has expanded to include sex chromosomal aneuploidies, copy number variants, and rare autosomal trisomies. However, the positive predictive value for rarer conditions is significantly lower, the number of conditions tested for is small, and abnormal results may occur due to maternal genetic findings. The field is changing quickly, and national recommendations for the use of cfDNA in screening for fetal and maternal diseases varies internationally. Research on the performance of screening for many different genetic disorders using cfDNA is ongoing, and suggests that this methodology may allow for testing of a much greater number of genetic conditions. Additionally, improved understanding of the cfDNA molecules themselves may provide additional insights: both high and low fetal fractions may suggest adverse pregnancy outcomes, and characteristics of the fragments themselves may help distinguish tissue of origin.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"98 ","pages":"Article 102574"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Considerations for hormonal contraception and people with larger bodies 激素避孕和体型较大人群的注意事项
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-02-01 DOI: 10.1016/j.bpobgyn.2025.102577
Julia Tasset, Alison Edelman
{"title":"Considerations for hormonal contraception and people with larger bodies","authors":"Julia Tasset,&nbsp;Alison Edelman","doi":"10.1016/j.bpobgyn.2025.102577","DOIUrl":"10.1016/j.bpobgyn.2025.102577","url":null,"abstract":"<div><div>People with larger bodies face discrimination in accessing health care, including equitable contraceptive care. Conscientious provision of person-centered contraception counseling is consistent with principles of the Health at Every Size and the Reproductive Justice movements. One facet of this care includes integration of evidence around unique considerations for steroid hormone efficacy and safety for patients with bigger bodies. Ultimately, this information should be used to empower and support reproductive decision making amongst patients of larger body sizes.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"99 ","pages":"Article 102577"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143296228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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