Best Practice & Research Clinical Obstetrics & Gynaecology最新文献_第7页

Conservative surgical treatment for adenomyosis: New options for looking beyond uterus removal 子宫腺肌症的保守手术治疗：除切除子宫外的新选择。

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102507

Tommaso Capezzuoli , Federico Toscano , Marcello Ceccaroni , Giovanni Roviglione , Anna Stepniewska , Massimiliano Fambrini , Silvia Vannuccini , Felice Petraglia

{"title":"Conservative surgical treatment for adenomyosis: New options for looking beyond uterus removal","authors":"Tommaso Capezzuoli , Federico Toscano , Marcello Ceccaroni , Giovanni Roviglione , Anna Stepniewska , Massimiliano Fambrini , Silvia Vannuccini , Felice Petraglia","doi":"10.1016/j.bpobgyn.2024.102507","DOIUrl":"10.1016/j.bpobgyn.2024.102507","url":null,"abstract":"<div><p>Adenomyosis is a common benign uterine disorders and patients may present dysmenorrhea, dyspareunia, abnormal uterine bleeding (AUB) and infertility. The treatment is very complex, including medical, surgical or radiological approaches. Hormonal drugs represent the first line therapy of adenomyosis, highly effective on symptoms and uterine volume reduction. Radiological procedures (UAE and HIFU), RFA and hysteroscopy may be proposed in those cases in which medical therapy is ineffective. Considering surgical treatment, hysterectomy remains the only existing definitive treatment but in the last decades the desire of uterus preservation is becoming more and more diffuse. On the other hand, surgical conservative treatments of adenomyosis are very effective in ameliorating AUB and pelvic pain and in reducing uterine volume, with some post-operative risks and obstetrics complications. Cytoreductive surgery for adenomyosis may be very complex, therefore it should be performed by experienced surgeons in dedicated centers, above all in case of concomitant endometriosis.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102507"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521693424000531/pdfft?md5=24985635e4407632a18b475cfdb919cf&pid=1-s2.0-S1521693424000531-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437909","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

Endometriosis related infertility 与子宫内膜异位症有关的不孕症。

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102504

Simone Ferrero (Prof)

引用次数: 0

Impact of surgery for endometriosis on the outcomes of in vitro fertilization 子宫内膜异位症手术对体外受精结果的影响

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102496

Simone Ferrero , Irene Gazzo , Marco Crosa , Francesco Paolo Rosato , Fabio Barra , Umberto Leone Roberti Maggiore

{"title":"Impact of surgery for endometriosis on the outcomes of in vitro fertilization","authors":"Simone Ferrero , Irene Gazzo , Marco Crosa , Francesco Paolo Rosato , Fabio Barra , Umberto Leone Roberti Maggiore","doi":"10.1016/j.bpobgyn.2024.102496","DOIUrl":"10.1016/j.bpobgyn.2024.102496","url":null,"abstract":"<div><p>This narrative review aims to summarize available evidence on the IVF-associated outcomes after surgery for endometriosis. Only one retrospective study investigated if surgical treatment of superficial/peritoneal endometriosis may modify the outcomes of IVF; therefore, more data are needed to confirm the benefit of surgery for this type of disease for improving ART outcomes, and to be able to support it in routine practice. Solid evidence from several meta-analyses demonstrates that surgical treatment of endometriomas does not enhance the outcomes of IVF. In contrast, surgical treatment of ovarian endometriosis may lead to a reduction in ovarian reserve, especially in cases involving bilateral endometriomas or repeated surgical procedures. Some non-randomized studies have examined if surgical treatment on deep endometriosis may influence IVF outcomes. A systematic review with meta-analysis revealed that patients who underwent surgery before IVF exhibited significantly higher pregnancy rates per patient, pregnancy rates per cycle, and live birth rates per patient compared to those without prior surgery. However, the available data are insufficient to recommend surgical excision of deep endometriosis as the first-line treatment for asymptomatic patients to enhance IVF outcomes.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102496"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521693424000427/pdfft?md5=c125e7d1e9cdcc3fb2f31bf0ab20171d&pid=1-s2.0-S1521693424000427-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140612328","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

Tailoring radicality in diaphragmatic surgery for deep endometriosis: A matter of choice 为深部子宫内膜异位症的膈肌手术量身定制根治方案：选择问题。

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102499

Marcello Ceccaroni , Gianmarco D'Ancona , Giovanni Roviglione , Sarah Choi , Tommaso Capezzuoli , Andrea Puppo , Ashot Drampyan , Fabio Barra

{"title":"Tailoring radicality in diaphragmatic surgery for deep endometriosis: A matter of choice","authors":"Marcello Ceccaroni , Gianmarco D'Ancona , Giovanni Roviglione , Sarah Choi , Tommaso Capezzuoli , Andrea Puppo , Ashot Drampyan , Fabio Barra","doi":"10.1016/j.bpobgyn.2024.102499","DOIUrl":"10.1016/j.bpobgyn.2024.102499","url":null,"abstract":"<div><p>Diaphragmatic endometriosis (DpE) is a rare disease localization which represents an important clinical challenge. The main criticisms toward the proper DpE management consist of poor consensus on both surgical indications and the choice between different surgical techniques available to treat the disease. Furthermore, only weak recommendations are provided by current guidelines and surgical management is mostly based on surgeon's experience. As consequence, the lack of standardization about the surgical treatment led to the risk of under- or over-treatments in patients suffering from this form of endometriosis.</p><p>The latest evidence-based data suggest to adopt a lesion-oriented surgical approach serving as a guide in daily surgical activities, in order to ensure a tailored radicality and reduce the rate of surgery-related complications.</p><p>Diaphragmatic endometriosis surgery should be performed only by expert surgeons with an extensive oncogynecologic expertise since it represents a technically demanding procedure. A multidisciplinary approach is also mandatory in order to adequately select and treat these patients by minimizing the risk of additional morbidity.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102499"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867402","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

Conservative approaches to postpartum haemorrhage 产后出血的保守治疗方法

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102516

Christian Chigozie Makwe , Kehinde Sharafadeen Okunade

引用次数: 0

Challenges of prenatal diagnosis in obese pregnant women 肥胖孕妇产前诊断面临的挑战

IF 3.9 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-07-01 DOI: 10.1016/j.bpobgyn.2024.102470

Farah Siddiqui , Karim Kalache , Badreledeen Ahmed , Justin C. Konje

{"title":"Challenges of prenatal diagnosis in obese pregnant women","authors":"Farah Siddiqui , Karim Kalache , Badreledeen Ahmed , Justin C. Konje","doi":"10.1016/j.bpobgyn.2024.102470","DOIUrl":"10.1016/j.bpobgyn.2024.102470","url":null,"abstract":"<div><p>Obesity rates are increasing world-wide with most of the increase in women of the reproductive age group. While recognised as an important contributor to non-communicable diseases, pregnant women with obesity are particularly at risk of not only maternal and pregnant complications but also have an increased risk of congenital malformations. Furthermore, pregnant obese women are more likely to be older and therefore at a greater risk of aneuploidy. Prenatal diagnosis in these women especially those who are morbidly obese is challenging due not only to their weight but the implications of the increase adiposity on biochemical markers of aneuploidy. In this review we discuss the current challenges in providing prenatal diagnosis for these women including those related to the ergonomics of ultrasound and those inherent in them because of their obesity. Appropriate counselling for these women should include the lower sensitivity of the tests, the difficulties in performing some of the procedures (imaging and invasive testing) as well as the increased risk of structural abnormalities related to their obesity.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"95 ","pages":"Article 102470"},"PeriodicalIF":3.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278776","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

Audit as a tool for improving obstetric care in low- and middle-income countries 将审计作为改善中低收入国家产科护理的工具

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-04-03 DOI: 10.1016/j.bpobgyn.2024.102477

G.S. Gebhardt, L. de Waard

引用次数: 0

“From the tip to the deep of the iceberg”: Parametrial involvement in endometriosis "从冰山一角到冰山深处"：子宫内膜异位症的腮腺受累

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-04-02 DOI: 10.1016/j.bpobgyn.2024.102493

Fabio Barra , Simone Ferrero , Carlotta Zorzi , Giulio Evangelisti , Umberto Perrone , Irene Valente , Tommaso Capezzuoli , Gianmarco D'Ancona , Stefano Bogliolo , Giovanni Roviglione , Marcello Ceccaroni

{"title":"“From the tip to the deep of the iceberg”: Parametrial involvement in endometriosis","authors":"Fabio Barra , Simone Ferrero , Carlotta Zorzi , Giulio Evangelisti , Umberto Perrone , Irene Valente , Tommaso Capezzuoli , Gianmarco D'Ancona , Stefano Bogliolo , Giovanni Roviglione , Marcello Ceccaroni","doi":"10.1016/j.bpobgyn.2024.102493","DOIUrl":"https://doi.org/10.1016/j.bpobgyn.2024.102493","url":null,"abstract":"<div><p>Deep endometriosis (DE) can be localized in the parametrium, a complex bilateral anatomical structure, sometimes necessitating intricate surgical intervention due to the potential involvement of autonomic nerves, uterine artery, and ureter. If endometriotic ovarian cysts have been considered metaphorically representative of “the tip of the iceberg” concerning concealed DE lesions, it is reasonable to assert that parametrial lesions should be construed as the most profound region of this iceberg. Also, based on a subdual clinical presentation, a comprehensive diagnostic parametrial evaluation becomes imperative to strategize optimal management for patients with suspected DE. Recently, the ULTRAPARAMETRENDO studies aimed to evaluate the role of transvaginal ultrasound for parametrial endometriosis, showing distinctive features, such as a mild hypoechoic appearance, starry morphology, irregular margins, and limited vascularization. The impact of medical therapy on parametrial lesions has not been described in the current literature, primarily due to the lack of adequate detection at imaging. The extension of DE into the parametrium poses significant challenges during the surgical approach, thereby increasing the risk of intra- and postoperative complications, mainly if performed by centers with low expertise and following multiple surgical procedures where parametrial involvement has gone unrecognized. Over time, the principles of nerve-sparing surgery have been incorporated into the surgical DE treatment to minimize iatrogenic damage and potentially reduce the risk of functional complications.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"94 ","pages":"Article 102493"},"PeriodicalIF":5.5,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521693424000397/pdfft?md5=1562ba8e015a0a54fff910f068ac6dfd&pid=1-s2.0-S1521693424000397-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140348183","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

Bowel endometriosis: Surgical customization is demanding 肠道子宫内膜异位症：手术定制要求很高

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-03-31 DOI: 10.1016/j.bpobgyn.2024.102495

Adrien Crestani , Benjamin Merlot , Paul-Henri Goualard , Georgios Grigoriadis , Isabelle Chanavaz Lacheray , Thomas Dennis , Horace Roman

引用次数: 0

Barriers to accessing post-pregnancy contraception in Brazil: The impact of COVID-19 巴西孕后避孕的障碍：COVID-19 的影响

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-02-23 DOI: 10.1016/j.bpobgyn.2024.102482

Cássia R.T. Juliato, Montas Laporte, Fernanda Surita, Luis Bahamondes

{"title":"Barriers to accessing post-pregnancy contraception in Brazil: The impact of COVID-19","authors":"Cássia R.T. Juliato, Montas Laporte, Fernanda Surita, Luis Bahamondes","doi":"10.1016/j.bpobgyn.2024.102482","DOIUrl":"10.1016/j.bpobgyn.2024.102482","url":null,"abstract":"<div><p>The aim of our article is to discuss barriers associated with post-pregnancy contraception in Brazil during the SARS-CoV-2 (COVID-19) pandemic. Socioeconomic differences in gaining access to long-acting reversible contraceptive (LARC) methods became greater during the COVID-19 pandemic. The inadequate distribution of existing resources and the reduced capacity for elective care meant that healthcare providers in family planning had to be reallocated to respond to COVID-19 emergencies. In Brazil, 74% of the population depends on the national health service (<em>Sistema Unico de Saúde</em>) including for the provision of free contraception. However, the only LARC method available at the public service is the copper-intrauterine device (IUD); implants and hormonal-IUDs are not available, except at some teaching hospitals. Contraceptive sales remained unmodified during the pandemic, which shows that the majority of the population used less effective or no contraceptive methods during this time. However, sales of implants and the hormonal-IUD increased significantly, indicating the inequity of the low-income portion of the society as only the wealthy can afford these. On the other hand, there was an increase in sales of emergency contraception. The uptake of postpartum IUDs and contraceptive implants at the selected teaching hospitals in which they were available was high during the COVID-19 pandemic as they were the only methods immediately available. In conclusion, the COVID-19 pandemic increased both inequality and social differences in gaining access to contraceptives. Postpartum and immediate post abortion methods were also good strategies during the pandemic and were well accepted by the population. However, they were not offered by most services.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"94 ","pages":"Article 102482"},"PeriodicalIF":5.5,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139957058","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