Best Practice & Research Clinical Obstetrics & Gynaecology最新文献_第9页

Ethical challenges in obstetric emergencies in low- and middle-income countries 中低收入国家产科急诊的伦理挑战

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-17 DOI: 10.1016/j.bpobgyn.2023.102451

Patrick Ifeanyi Okonta MBBCh, FWACS, FMCOG, MPH, MD , Odidika Ugochukwu Joannes Umeora MBBS, FWACS, FMCOG, MPH, MD

{"title":"Ethical challenges in obstetric emergencies in low- and middle-income countries","authors":"Patrick Ifeanyi Okonta MBBCh, FWACS, FMCOG, MPH, MD , Odidika Ugochukwu Joannes Umeora MBBS, FWACS, FMCOG, MPH, MD","doi":"10.1016/j.bpobgyn.2023.102451","DOIUrl":"10.1016/j.bpobgyn.2023.102451","url":null,"abstract":"<div>Obstetric emergencies are challenging, requiring implementation of a rapid sequence of interventions in a very short time to optimize clinical outcome. Managing obstetric emergencies could evoke ethical dilemmas for the obstetrician because of limited time to adequately educate the patient about her condition; impaired consciousness of the patient to give consent; nonexistent prior patient -doctor relationship and the need to consider both the patient and the fetus. In Low- and middle-income countries (LMICs), poor access to appropriate emergency care, structural and financial barriers and a largely uneducated and a deeply cultural population contribute to the ethical challenges.In this article we review key ethical issues in obstetric emergencies in LMICs such as informed consent, refusal of life saving treatment, confidentiality, disclosure of patient medical information and discharge against medical advice. The duties and responsibilities of the state to disadvantaged pregnant women and the ethical imperative of the obstetrician to provide care under these circumstances are discussed.</div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"92 ","pages":"Article 102451"},"PeriodicalIF":5.5,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138692866","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

Contraception after abortion, miscarriage, ectopic and molar pregnancy 堕胎、流产、宫外孕和臼齿妊娠后的避孕措施

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-12 DOI: 10.1016/j.bpobgyn.2023.102428

Michelle Cooper, Sharon Cameron

引用次数: 0

Robotic radical hysterectomy after conization for patients with small volume early-stage cervical cancer 小体积早期宫颈癌患者锥切术后的机器人根治性子宫切除术

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-10 DOI: 10.1016/j.bpobgyn.2023.102434

Pluvio J. Coronado , Myriam Gracia

{"title":"Robotic radical hysterectomy after conization for patients with small volume early-stage cervical cancer","authors":"Pluvio J. Coronado , Myriam Gracia","doi":"10.1016/j.bpobgyn.2023.102434","DOIUrl":"10.1016/j.bpobgyn.2023.102434","url":null,"abstract":"<div>Laparoscopy and robotics are recommended for managing gynecological cancer, as they are associated with lower morbidity and comparable outcomes to open surgery. However, in the case of early cervical cancer, new evidence suggests worse oncological outcomes with these approaches compared to open surgery, though the limited number of robotic cases makes it challenging to draw definitive conclusions for this particular approach. The prior conization has been proposed as a strategy to reduce the risk of tumor spillage and contamination during minimally invasive (MIS) radical hysterectomy (RH). Retrospective studies have indicated that undergoing conization before RH is linked to a reduced risk of recurrences, especially in cervical tumors measuring less than 2 cm. Nevertheless, these studies lack the statistical power needed to definitively establish conization as a recommended step before RH. Furthermore, these studies do not have enough cases utilizing the robotic approach and specific conclusions cannot be drawn from this technique. The question of whether a subset of cases would benefit from preoperative conization and whether conization should be performed to recommend MIS over open surgery remains unanswered. Prospective clinical trials involving women diagnosed with early-stage cervical cancer <2 cm, randomized between undergoing conization before robotic RH or without prior conization are mandatory to assess the role of conization before robotic RH in cervical cancer.</div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"92 ","pages":"Article 102434"},"PeriodicalIF":5.5,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138565885","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

Role of ultrasonography in the diagnosis of endometriosis in infertile women: Ovarian endometrioma, deep endometriosis, and superficial endometriosis 超声波检查在诊断不孕妇女子宫内膜异位症中的作用：卵巢子宫内膜异位症、深部子宫内膜异位症和表层子宫内膜异位症

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-10 DOI: 10.1016/j.bpobgyn.2023.102450

Samantha Tan , Mathew Leonardi , Glen Lo , Emmeline Lee

{"title":"Role of ultrasonography in the diagnosis of endometriosis in infertile women: Ovarian endometrioma, deep endometriosis, and superficial endometriosis","authors":"Samantha Tan , Mathew Leonardi , Glen Lo , Emmeline Lee","doi":"10.1016/j.bpobgyn.2023.102450","DOIUrl":"10.1016/j.bpobgyn.2023.102450","url":null,"abstract":"<div>Endometriosis is a complex chronic inflammatory process characterised by the presence of endometrial-like glandular tissue outside the uterine cavity, typically within the pelvic structures. This condition affects up to 10–15 % of women and those assigned female at birth, and can result in chronic pelvic pain and in/subfertility. Treatment goals include medical, surgical options and alternative therapies.Transvaginal ultrasound (TVUS) is the currently recommended first line investigation for endometriosis with magnetic resonance imaging (MRI) reserved for those with equivocal ultrasound findings.In this paper, we aim to outline the commonly seen sonographic appearances of endometriosis divided into anterior, middle and posterior pelvic compartments. Limitations to ultrasound imaging include high operator dependence and patient factors.New imaging techniques and research into the utility of artificial intelligence (AI) into the detection of endometriosis is currently underway, with possibility of reduced diagnostic delay and better patient outcomes.</div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"92 ","pages":"Article 102450"},"PeriodicalIF":5.5,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138576149","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

Treatment of endometriomas: Surgical approaches and the impact on ovarian reserve, recurrence, and spontaneous pregnancy 子宫内膜异位瘤的治疗:手术入路及其对卵巢储备、复发和自然妊娠的影响

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-05 DOI: 10.1016/j.bpobgyn.2023.102449

Dana Baraki, Elliott G. Richards, Tommaso Falcone

{"title":"Treatment of endometriomas: Surgical approaches and the impact on ovarian reserve, recurrence, and spontaneous pregnancy","authors":"Dana Baraki, Elliott G. Richards, Tommaso Falcone","doi":"10.1016/j.bpobgyn.2023.102449","DOIUrl":"10.1016/j.bpobgyn.2023.102449","url":null,"abstract":"<div>Endometriomas may contribute to infertility and are associated with diminished ovarian reserve. Surgical management can damage the ovarian cortex and further diminish ovarian reserve. Surgical therapy of endometriomas can be achieved via cystectomy, ablation (electrosurgical, laser, or plasma energy), sclerotherapy, or oophorectomy. Each approach has varying effects on ovarian reserve, spontaneous pregnancy rates, and recurrence rates: Cystectomy is associated with a low recurrence rate but higher risk of diminished ovarian reserve; Ablation (with laser or plasma energy) appears to have minimal effect on ovarian reserve while also having low recurrence rates; Sclerotherapy is mixed in terms of effect on ovarian reserve as well as recurrence rates. Fertility preservation counseling is recommended for patients considering surgical management. The surgical approach selected should be tailored to each individual patient with respect to their fertility and therapeutic goals.</div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"92 ","pages":"Article 102449"},"PeriodicalIF":5.5,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138493619","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

Endometriosis and adenomyosis: Similarities and differences 子宫内膜异位症和子宫腺肌症：异同

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-05 DOI: 10.1016/j.bpobgyn.2023.102432

Jacques Donnez , Christina Anna Stratopoulou , Dolmans Marie-Madeleine

{"title":"Endometriosis and adenomyosis: Similarities and differences","authors":"Jacques Donnez , Christina Anna Stratopoulou , Dolmans Marie-Madeleine","doi":"10.1016/j.bpobgyn.2023.102432","DOIUrl":"10.1016/j.bpobgyn.2023.102432","url":null,"abstract":"<div>Deep endometriosis and uterine adenomyosis are two frequently encountered conditions affecting approximately 200 million women worldwide. They are closely related, showing similar histological patterns and multiple common pathogenic features, and share the same symptoms. It is therefore not surprising that they are often thought to have a common developmental origin. Indeed, both deep endometriosis and adenomyosis appear to derive from estrogen-dependent overproliferation of endometrial tissue and its subsequent implantation in ectopic sites.Although the scientific community has shown increasing interest in these diseases over recent years, neither pathogenesis has yet been elucidated, so there are currently no efficient treatment options. Understanding the mechanisms underlying disease development, as well as discerning their relationship, are key to improving clinical management for millions of patients.The aims of this review are to summarize current knowledge on deep endometriosis and adenomyosis pathogeneses and discuss the possibility that these two entities are actually differential phenotypes of the same disease.</div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"92 ","pages":"Article 102432"},"PeriodicalIF":5.5,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138552379","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

Advances in reproductive medicine – Real world evidence assessment of treatment strategies – Multiple choice questions – Questions 生殖医学进展。治疗策略的真实世界证据评估。多项选择题。问题

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-01 DOI: 10.1016/j.bpobgyn.2023.102375

引用次数: 0

ERAS and reducing opioid use in obstetrics and gynecology - Multiple choice questions - Answers ERAS和减少产科和妇科阿片类药物的使用-选择题-答案

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-01 DOI: 10.1016/j.bpobgyn.2023.102374

引用次数: 0

Transgender health – Multiple choice questions – Answers 变性人健康-选择题-答案

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-01 DOI: 10.1016/j.bpobgyn.2023.102378

引用次数: 0

Transgender health – Multiple choice questions – Questions 变性人健康-选择题-问题

IF 5.5 2区医学

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-01 DOI: 10.1016/j.bpobgyn.2023.102377

引用次数: 0