Best Practice & Research Clinical Obstetrics & Gynaecology最新文献

{"title":"Effects of hormonal contraception on mood and sexuality","authors":"Prof em Johannes Bitzer","doi":"10.1016/j.bpobgyn.2024.102560","DOIUrl":"10.1016/j.bpobgyn.2024.102560","url":null,"abstract":"<div><div>The impact of hormonal contraception on mental and sexual health has long been either ignored or considered to be much less important than the cardiovascular, metabolic and cancer risks. In recent years the interest in these side effects, having an impact on the quality of life of users, has grown due to several reasons.<ul><li><span>•</span><span><div>The increased risk in mental health issues like depression and suicide among users became a matter of concern, especially from a public health perspective, in which these risks became as important as the physical health risks described.</div></span></li><li><span>•</span><span><div>The negative impact of mental and sexual health problems on wellbeing became the predominant reason for either not using hormonal contraceptives or the discontinuation of use.</div></span></li></ul></div><div><ul><li><span>•</span><span><div>The increased risk in mental health issues like depression and suicide among users became a matter of concern, especially from a public health perspective, in which these risks became as important as the physical health risks described.</div></span></li><li><span>•</span><span><div>The negative impact of mental and sexual health problems on wellbeing became the predominant reason for either not using hormonal contraceptives or the discontinuation of use.</div></span></li></ul></div><div>In the last decades different scientific approaches to gain empirical evidence about the type and extent of negative effects of hormonal contraceptives on mood and sex did not result in clear evidence-based statements due to the complexity of the interaction between contraceptive methods and mental and sexual health (inconsistent measurement of patient reported outcomes, multiplicity of intervening variables etc).</div><div>Based on an understanding of the biological, psychological and sociocultural factors contributing to the mental and sexual health of the individual user, and the individual impact of hormonal contraception, which can have negative, positive or neutral effects on mood and sexuality, an individualized approach is proposed to integrate mental and sexual health into the practice of contraceptive counselling and care.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"97 ","pages":"Article 102560"},"PeriodicalIF":3.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482863","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}

{"title":"The road to hormonal male contraception: End in sight?","authors":"R.A. Anderson,&nbsp;J.J. Reynolds-Wright","doi":"10.1016/j.bpobgyn.2024.102559","DOIUrl":"10.1016/j.bpobgyn.2024.102559","url":null,"abstract":"<div><div>The concept of a hormonal approach that sufficiently and reversibly suppresses spermatogenesis to the level required for effective contraception has been developed and tested over several decades. The reality of achieving this has been confirmed using both testosterone alone and combination methods using a progestogen with a physiological dose of testosterone, necessary to replace the lack of endogenous testosterone production by the suppressed testes. A range of both long-acting and self-administered combination methods are effective, including injection, implant and gel methods of administration, with up to 95% of men achieving sufficient spermatogenic suppression. New steroids are also being trialled. Surveys show the widespread willingness of men and their female partners to use novel male methods, suggesting the potential of this approach to contribute to global family planning and sustainable development goals. This approach to contraception can clearly be effective, and needs to move from relatively small scale testing to large scale pre-marketing trials: only then can information about long-term safety and real-world acceptability be obtained.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"97 ","pages":"Article 102559"},"PeriodicalIF":3.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334263","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}

{"title":"Genome sequencing in the prenatal diagnosis of structural malformations in the fetus","authors":"Matthew Hoi Kin Chau ,&nbsp;Mahesh Choolani ,&nbsp;Zirui Dong ,&nbsp;Ye Cao ,&nbsp;Kwong Wai Choy","doi":"10.1016/j.bpobgyn.2024.102539","DOIUrl":"10.1016/j.bpobgyn.2024.102539","url":null,"abstract":"<div><div>Prenatal genetic diagnosis has undergone two pivotal paradigm shifts, initially with the introduction of chromosomal microarray and subsequently with the advent of next-generation sequencing technologies (NGS). NGS technology has given rise to a multitude of applications, with gene panels, exome sequencing (ES), and genome sequencing (GS) emerging as highly promising tests for prenatal genetic investigations. These advanced approaches have demonstrated superior diagnostic rates when compared to conventional testing methods, showcasing the evolution and enhancement of prenatal genetic screening and diagnostic capabilities. With these ground-breaking innovations, NGS technologies have the potential to replace current standard practice in prenatal diagnosis. With the increasing use of prenatal sequencing, the need for better education and guidance on their applications grows. This chapter aims to illustrate the detection scope and feasibility of various NGS-based methods that are currently used in prenatal diagnosis.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"97 ","pages":"Article 102539"},"PeriodicalIF":3.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334262","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}

{"title":"The roles of blood picture, haemoglobinopathy traits, and blood groups determined in routine antenatal tests in the screening for complications in pregnancy","authors":"Terence T. Lao","doi":"10.1016/j.bpobgyn.2024.102537","DOIUrl":"10.1016/j.bpobgyn.2024.102537","url":null,"abstract":"<div><div>Routine antenatal tests include haemoglobin measurement, usually with red blood cell indices, white cell and platelet counts, and ABO and Rhesus blood groups, are aimed to screen for iron deficiency anaemia, carriage of haemoglobinopathy traits, and other forms of anaemia or other underlying but undiagnosed conditions. Iron deficiency anaemia has been associated with most of the common pregnancy complications including pre-eclampsia, preterm birth, antepartum and postpartum haemorrhage, low birthweight and small-for-gestational age infants, and impacts long-term neurocognitive and developmental outcomes in the offspring. Increased adverse pregnancy and perinatal outcomes are also found with high haemoglobin, thalassaemia and sickle cell traits, and the non-O blood groups especially group AB. Total white cell, neutrophil, and platelet counts and platelet indices can help to predict gestational diabetes mellitus. Results from these tests can be useful by themselves or used in combination with demographics and biomarkers to enhance the screening for high-risk pregnancies.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"97 ","pages":"Article 102537"},"PeriodicalIF":3.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482864","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}

{"title":"Reframing antepartum and intrapartum surveillance","authors":"Lawrence D. Devoe ,&nbsp;David W. Britt ,&nbsp;Mark I. Evans","doi":"10.1016/j.bpobgyn.2024.102538","DOIUrl":"10.1016/j.bpobgyn.2024.102538","url":null,"abstract":"<div><div>The original goal of electronic fetal monitoring was to reduce stillbirths. It worked. Then the mission expanded to reducing neurologic impairment including cerebral palsy. Despite 50 years’ experience, the data have been contradictory, and even the key opinion leaders of EFM admit it an only detect about half the problems. Concomitantly, the cesarean delivery rate which has greater complications and costs has increased about 6-fold. Here we review multiple generations of antenatal testing schemes having increasing sophistication but still not too much improvement in outcomes and our re-engineered approach to intrapartum fetal monitoring for which we morph from the subjective Category system which has poor statistical performance metrics to a new approach we call the “Fetal Reserve Index.” The FRI breaks down the tracing into 4 quantifiable components (fetal heart rate, variability, accelerations, and decelerations) and then formally adds to the analysis the presence of increased uterine activity, and maternal, fetal, and obstetrical risk factors. In version 1.0, all parameters are weighted equally. We have shown improved and earlier identification of fetal risk earlier in the pathophysiology allowing less abrupt and dramatic interventions. We have further shown the early postpartum period to be one of commonly unrecognized risks, and we envision a continuum of assessment from antepartum through intrapartum and postpartum for optimal results.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"97 ","pages":"Article 102538"},"PeriodicalIF":3.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585109","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}

{"title":"Surgical treatment of endometriosis – Controversies: Preface","authors":"Marcello Ceccaroni,&nbsp;Fabio Barra","doi":"10.1016/j.bpobgyn.2024.102561","DOIUrl":"10.1016/j.bpobgyn.2024.102561","url":null,"abstract":"","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"97 ","pages":"Article 102561"},"PeriodicalIF":3.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634313","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}

{"title":"Post pregnancy family planning in Latin America and the Caribbean analysis and strengths in training on immediate contraception post obstetric event by CLAP/PAHO","authors":"Rodolfo Gómez Ponce de León ,&nbsp;Cristian Fabrizio Lombardo ,&nbsp;Franco Dilascio ,&nbsp;Gabriela Perrotta ,&nbsp;Carlos A. León ,&nbsp;Suzanne Jacob Serruya","doi":"10.1016/j.bpobgyn.2024.102551","DOIUrl":"10.1016/j.bpobgyn.2024.102551","url":null,"abstract":"<div><div>Virtual courses developed by the Pan American Health Organization (PAHO) on family planning and immediate contraception post obstetric event (ICPOE) were launched in 2021 as training actions on ICPOE in the region. A total of 89,899 people enrolled in these courses; 36,494 (40.7%) of them enrolled in the course on ICPOE, and almost 60% of participants from Latin America passed the course. Moreover, 37% of participants were nurses, and 36% were physicians; most participants were from 20 to 39 years old. Eighty per cent completed the course in a week, and 89% had finished it by the 15th day. Students who passed the course expressed high overall satisfaction (95%), with ease of taking the course at home (63%) and at the workplace (33%) identified most frequently. Furthermore, practice training sessions (including simulation models) were conducted with 165 candidates to be trainers, physicians, and obstetricians. Approved trainers came from the Dominican Republic, Honduras, Bolivia, and Paraguay.</div></div><div><h3>Conclusion</h3><div>There was evidence of the need for ICPOE training, and the innovative virtual courses developed by PAHO.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"97 ","pages":"Article 102551"},"PeriodicalIF":3.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303285","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}

{"title":"Fetal therapies – (Stem cell transplantation; enzyme replacement therapy; in utero genetic therapies)","authors":"Rachel Sagar ,&nbsp;Anna L. David","doi":"10.1016/j.bpobgyn.2024.102542","DOIUrl":"10.1016/j.bpobgyn.2024.102542","url":null,"abstract":"<div><p>Advances in ultrasound and prenatal diagnosis are leading an expansion in the options for parents whose fetus is identified with a congenital disease. Obstetric diseases such as pre-eclampsia and fetal growth restriction may also be amenable to intervention to improve maternal and neonatal outcomes. Advanced Medicinal Therapeutic Products such as stem cell, gene, enzyme and protein therapies are most commonly being investigated as the trajectory of treatment for severe genetic diseases moves toward earlier intervention. Theoretical benefits include prevention of in utero damage, smaller treatment doses compared to postnatal intervention, use of fetal circulatory shunts and induction of immune tolerance. New systematic terminology can capture adverse maternal and fetal adverse events to improve safe trial conduct. First-in-human clinical trials are now beginning to generate results with a focus on safety first and efficacy second. If successful, these trials will transform the care of fetuses with severe early-onset congenital disease.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"97 ","pages":"Article 102542"},"PeriodicalIF":3.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521693424000968/pdfft?md5=3be5e279e0cb3b6beea5aec7f43a200e&pid=1-s2.0-S1521693424000968-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142242168","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}

{"title":"Prenatal detection of copy number variants","authors":"Mohamed Wafik ,&nbsp;Alice Pendlebury-Watt ,&nbsp;Kelly Price ,&nbsp;Charlotte Tomlinson ,&nbsp;Emma Fowler ,&nbsp;Natalie Chandler ,&nbsp;Muriel Holder-Espinasse","doi":"10.1016/j.bpobgyn.2024.102547","DOIUrl":"10.1016/j.bpobgyn.2024.102547","url":null,"abstract":"<div><p>Prenatal detection of copy number variants (CNVs) plays an important role in the diagnosis of fetal genetic abnormalities. Understanding the methods used for prenatal CNV detection and their clinical significance contributes to the implementation of advanced genetic screening techniques in prenatal care; facilitating early identification and management of genetic disorders in fetuses. Some CNVs impose significant genetic counselling challenges; especially those which are associated with uncertain clinical significance, in the context of variable penetrance and/or expressivity or when identified incidentally.</p><p>This chapter focuses on the different techniques used for detecting CNVs, including Single Nucleotide Polymorphism (SNP) arrays, comparative genomic hybridization (CGH) arrays, Non-Invasive Prenatal Testing (NIPT), Whole Exome Sequencing (WES) and Whole Genome Sequencing (WGS) as well as their advantages and limitations. The tools needed for the classification of CNVs and their clinical relevance are also explored, emphasising the importance of accurate interpretation for appropriate clinical management and genetic counselling.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"97 ","pages":"Article 102547"},"PeriodicalIF":3.9,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229093","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}

{"title":"Ethical considerations in prenatal genomic testing","authors":"Ruth Horn ,&nbsp;Alison Hall ,&nbsp;Anneke Lucassen","doi":"10.1016/j.bpobgyn.2024.102548","DOIUrl":"10.1016/j.bpobgyn.2024.102548","url":null,"abstract":"<div><p>This paper discusses ethical issues arising in the context of prenatal genomic testing. While genomic information in the prenatal context might increase reproductive choice, e.g. to better understand a phenotype detected during screening, the availability of ever broader screens, even in the absence of a suspicion of abnormality, will generate increasingly complex and uncertain information. This raises questions of how much and what information should be provided prior to testing and what information should be returned (and to whom) once testing has been performed. As prenatal genomic testing becomes broader and more routine, the information generated will have more often implications not only for the fetus, but also for the parents, siblings and the wider family, raising questions about professionals' responsibilities. Further challenges discussed in this paper include access to genomic testing and justice, as well as ongoing management and post-pregnancy follow-up. The paper highlights the importance of taking into account the particular difficulties that arise in the context of prenatal genomic testing: the uncertainty of the information while choices are binary (to continue with or to terminate pregnancy); the time pressure due to the statutory limits on the availability of termination; and the impact the testing of the fetus has on the woman's body and life.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"97 ","pages":"Article 102548"},"PeriodicalIF":3.9,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521693424001020/pdfft?md5=77e5a5a199abfed5d2135a6a46ddca3b&pid=1-s2.0-S1521693424001020-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142171832","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}