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The role of point-of-care ultrasound (POCUS) in maternal medicine 点护理超声（POCUS）在产妇医学中的作用
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-20 DOI: 10.1016/j.bpobgyn.2025.102599
J.A. van der Zande , K. Rijs , A.A. Shamshirsaz , H. Soliman , A. Franx , R.M. Kauling , J.W. Roos-Hesselink , C.D. van der Marel , K. Verdonk , J.M.J. Cornette
{"title":"The role of point-of-care ultrasound (POCUS) in maternal medicine","authors":"J.A. van der Zande ,&nbsp;K. Rijs ,&nbsp;A.A. Shamshirsaz ,&nbsp;H. Soliman ,&nbsp;A. Franx ,&nbsp;R.M. Kauling ,&nbsp;J.W. Roos-Hesselink ,&nbsp;C.D. van der Marel ,&nbsp;K. Verdonk ,&nbsp;J.M.J. Cornette","doi":"10.1016/j.bpobgyn.2025.102599","DOIUrl":"10.1016/j.bpobgyn.2025.102599","url":null,"abstract":"<div><div>Point-of-care ultrasound (POCUS) is an increasingly valuable tool in maternal medicine, offering rapid, bedside evaluation of critically ill pregnant patients. This study explores the expanding role of POCUS in obstetric care, particularly its application in assessing different organ systems. POCUS enables timely, accurate diagnoses and interventions, crucial for preventing maternal morbidity and mortality. While POCUS is widely used in emergency and intensive care, its potential in obstetric settings remains underexplored. Maternal and Fetal Medicine specialists, who already possess substantial ultrasound expertise, can easily integrate POCUS in daily practice.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"100 ","pages":"Article 102599"},"PeriodicalIF":3.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682824","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
Second trimester echocardiography 妊娠中期超声心动图
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-19 DOI: 10.1016/j.bpobgyn.2025.102592
Enery Gómez-Montes, Ignacio Herraiz, Cecilia Villalain, Alberto Galindo
{"title":"Second trimester echocardiography","authors":"Enery Gómez-Montes,&nbsp;Ignacio Herraiz,&nbsp;Cecilia Villalain,&nbsp;Alberto Galindo","doi":"10.1016/j.bpobgyn.2025.102592","DOIUrl":"10.1016/j.bpobgyn.2025.102592","url":null,"abstract":"<div><div>Fetal echocardiography involves a comprehensive cardiac assessment aiming to make a complete structural examination of the heart as well as to detect signs of cardiovascular adaptation to different insults. For the former, this assessment entails expert's evaluation of the anatomy of the heart including additional views beyond the five axial views used in cardiac screening examinations and always complemented with colour and pulsed Doppler. Echocardiography may accurately diagnose most congenital heart defects in fetal life, which enables adjusting the perinatal management. For the latter, echocardiography encompasses cardiac morphometric assessment to identify signs of cardiac remodeling indicative of cardiac adaptation in structure, shape, and size in response to underlying diseases, and cardiac functional assessment to detect signs of systolic and/or diastolic dysfunction. The most used parameters to study the systolic function (stroke volume, cardiac output, ejection fraction, fractional shortening, and mitral and tricuspid annular plane systolic excursion), diastolic function (characteristics of flow in the precordial veins and through the atrioventricular valves) and global myocardial function (myocardial performance index) will be discussed in this review.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"100 ","pages":"Article 102592"},"PeriodicalIF":3.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682823","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
3rd trimester ultrasound assessment 妊娠晚期超声检查
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-19 DOI: 10.1016/j.bpobgyn.2025.102593
Cecilia Villalain, Alberto Galindo, Enery Gómez-Montes, Ignacio Herraiz
{"title":"3rd trimester ultrasound assessment","authors":"Cecilia Villalain,&nbsp;Alberto Galindo,&nbsp;Enery Gómez-Montes,&nbsp;Ignacio Herraiz","doi":"10.1016/j.bpobgyn.2025.102593","DOIUrl":"10.1016/j.bpobgyn.2025.102593","url":null,"abstract":"<div><div>The third-trimester scan allows not only the assessment of foetal growth but also its presentation and anatomy, and placental, amniotic fluid, and umbilical cord anomalies. Although there is a great disparity when considering its recommendation, most recent studies raise the question for its usefulness considering its impact in a potential reduction of perinatal morbidity and mortality. For this to be a reality in a population-wide setting, a systematic approach should be made considering performing it between 35 + 0 and 36 + 6 weeks’, including the assessment of estimated foetal weight, foetal Doppler (umbilical and middle cerebral artery), placenta, amniotic fluid, foetal anatomy, and presentation. In high-risk cases, additional evaluation of the placenta, umbilical cord, or advanced foetal anatomy assessment can be warranted. Furthermore, pre-defined and evidence-based protocols should be followed after anomalies are detected in order to improve maternal and perinatal outcomes.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"100 ","pages":"Article 102593"},"PeriodicalIF":3.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697225","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
Carrier screening and pregnancy 携带者筛查与妊娠
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-15 DOI: 10.1016/j.bpobgyn.2025.102601
Borut Peterlin , Ana Peterlin
{"title":"Carrier screening and pregnancy","authors":"Borut Peterlin ,&nbsp;Ana Peterlin","doi":"10.1016/j.bpobgyn.2025.102601","DOIUrl":"10.1016/j.bpobgyn.2025.102601","url":null,"abstract":"<div><div>Recessive genetic conditions impose a significant burden, often leading to severe childhood disorders, many of which remain untreatable. It is estimated that 1–2 % of couples are at risk of having an affected child in the general population, with the risk being significantly higher in consanguineous couples. Understanding the increased risk of having a child with a recessive disorder empowers prospective parents to make informed reproductive choices. With technological advancements, genetic screening has evolved beyond identifying only a few common conditions. Expanded carrier screening (ESC) now offers a single test that covers a comprehensive list of recessive disorders, addressing those that contribute most significantly to the burden of these conditions within specific populations.</div><div>ESC is recommended for all couples planning a pregnancy, with particular emphasis on consanguineous couples or those who are subfertile. To ensure responsible use of ESC, clinical service delivery should adopt a multidisciplinary approach, providing couples with the information they need to make voluntary, informed decisions. This includes access to high-quality genetic testing, genetic counseling, and psychosocial support.</div><div>National professional societies and governments play a crucial role in shaping guidelines, policies, oversight, and funding to guarantee equitable access to high-quality ESC services.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"100 ","pages":"Article 102601"},"PeriodicalIF":3.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682822","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
Fetal Doppler assessment in pregnancy 妊娠期胎儿多普勒评估
IF 3.9 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-03-14 DOI: 10.1016/j.bpobgyn.2025.102594
Jose H. Ochoa , Daniel Cafici
{"title":"Fetal Doppler assessment in pregnancy","authors":"Jose H. Ochoa ,&nbsp;Daniel Cafici","doi":"10.1016/j.bpobgyn.2025.102594","DOIUrl":"10.1016/j.bpobgyn.2025.102594","url":null,"abstract":"<div><div>Fetal Doppler assessment plays a crucial role in monitoring the fetal well-being during pregnancy. This non-invasive technique assesses blood flow dynamics in key fetal vessels, namely the umbilical artery, middle cerebral artery, and ductus venosus.</div><div>The umbilical artery Doppler provides valuable insights into placental function aiding in the early detection of fetal growth restriction and fetal distress.</div><div>Assessment of the middle cerebral artery Doppler provides information on the adequacy of cerebral perfusion. It is highly sensitive to changes in fetal oxygenation and contributes to the management of advanced stages of early fetal growth restriction. It is also a valuable and sometimes standalone marker for late-term fetal hypoxic compromise and fetal anemia.</div><div>Doppler evaluation of ductus venosus offers additional data for identifying cardiac compromise and predicting adverse perinatal outcomes.</div><div>Incorporating these Doppler assessments into routine prenatal care enhances the ability to detect and manage fetal compromise, ultimately improving pregnancy outcomes.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"100 ","pages":"Article 102594"},"PeriodicalIF":3.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767599","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
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
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