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Robotic-assisted fertility sparing surgery in gynecological oncology 妇科肿瘤中的机器人辅助保胎手术
IF 5.5 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-02-15 DOI: 10.1016/j.bpobgyn.2024.102485
Christos Iavazzo, Kalliopi Kokkali, Emmanouil Kaouras, Alexandros Fotiou
{"title":"Robotic-assisted fertility sparing surgery in gynecological oncology","authors":"Christos Iavazzo,&nbsp;Kalliopi Kokkali,&nbsp;Emmanouil Kaouras,&nbsp;Alexandros Fotiou","doi":"10.1016/j.bpobgyn.2024.102485","DOIUrl":"10.1016/j.bpobgyn.2024.102485","url":null,"abstract":"<div><p>While gynecological malignancies are more commonly diagnosed in elderly women, a substantial proportion of women will still be diagnosed with some type of gynecologic cancer during their reproductive age. Over 10% of newly diagnosed ovarian cancers and over one third of newly diagnosed cervical cancers involve women who are under the age of 45. This, coupled with the rising trend of women having their first child after the age of 35, has led to a concerning prevalence of complex fertility issues among women who have been diagnosed with cancer. Since the advent of robotic-assisted surgeries in gynecology, there has been a rise in the occurrence of these procedures. Fertility preserving gynecological surgeries require precise management in order to avoid fertility disorders. Therefore, we conducted a narrative review of robotic assisted fertility sparing surgery in gynecologic malignancies in order to highlight the role of this approach in preserving fertility.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"93 ","pages":"Article 102485"},"PeriodicalIF":5.5,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139894209","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
Post-pregnancy family planning in Southeast Asia with a focus on novel training techniques 东南亚的孕后计划生育，重点是新型培训技术
IF 5.5 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-02-14 DOI: 10.1016/j.bpobgyn.2024.102479
Kusum Thapa , Sapana Amatya , Anil Thapa , Meghan Greeley
{"title":"Post-pregnancy family planning in Southeast Asia with a focus on novel training techniques","authors":"Kusum Thapa ,&nbsp;Sapana Amatya ,&nbsp;Anil Thapa ,&nbsp;Meghan Greeley","doi":"10.1016/j.bpobgyn.2024.102479","DOIUrl":"10.1016/j.bpobgyn.2024.102479","url":null,"abstract":"<div><p>Postpartum Family Planning is a critical strategy in the first 12 months post-childbirth. It aims to prevent unintended, closely spaced pregnancies and thereby help reducing maternal, neonatal as well as child morbidity and mortality. Despite its significance, many women remain without contraception despite a desire to avoid pregnancy. The World Health Organization suggests a 24-month inter-pregnancy interval after delivery, emphasizing the importance of contraceptive counselling from the antenatal to the immediate postpartum period. In South Asia, utilization of PPFP is minimal, even though the inclination towards birth spacing is high. Addressing these needs requires strengthening the capacity of service providers and promoting evidence-based practices. Novel training approaches in South Asia are Competency-Based On-the-Job Training, Group Based Training, Simulation Training, E-Learning, Mentorship Programs, and Continuing Professional Development. Among these, On-the-Job Training and Group Based Training were notably implemented. Emphasizing PPFP and ensuring proper training in this domain is essential for women's health and well-being post-delivery.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"94 ","pages":"Article 102479"},"PeriodicalIF":5.5,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139897490","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
An overview of diabetes mellitus in pregnant women with obesity 肥胖孕妇糖尿病概述
IF 5.5 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-02-10 DOI: 10.1016/j.bpobgyn.2024.102469
Mohammed Bashir , Yassin Fagier , Badreldeen Ahmed , Justin C Konje
{"title":"An overview of diabetes mellitus in pregnant women with obesity","authors":"Mohammed Bashir ,&nbsp;Yassin Fagier ,&nbsp;Badreldeen Ahmed ,&nbsp;Justin C Konje","doi":"10.1016/j.bpobgyn.2024.102469","DOIUrl":"https://doi.org/10.1016/j.bpobgyn.2024.102469","url":null,"abstract":"<div><p>Rates of obesity are increasing world-wide with an estimated 1billion people projected to be obese by 2030 if current trends remain unchanged. Obesity currently considered one of the most significant associated factors of non-communicable diseases poses the greatest threat to health. Diabetes mellitus is an important metabolic disorder closely associated with obesity. It is therefore expected that with the increasing rates of obesity, the rates of diabetes in pregnancy will also be rising. This disorder may pre-date pregnancy (diagnosed or undiagnosed and diagnosed for the first time in pregnancy) or may be of onset in pregnancy. Irrespective of the timing of onset, diabetes in pregnancy is associated with both fetal and maternal complications. Outcomes are much better if control is maximised. Early diagnosis, multidisciplinary care and tailored management with optimum glycaemic control is associated with a significant reduction in not only pregnancy complications but long-term consequences on both the mother and offspring. This review brings together the current understanding of the pathogenesis of the endocrine derangements that are associated with diabetes in pregnancy how screening should be offered and management including pre-pregnancy care and the role of newer agents in management.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"93 ","pages":"Article 102469"},"PeriodicalIF":5.5,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521693424000154/pdfft?md5=e56efa6888c53a0945910188a18284a0&pid=1-s2.0-S1521693424000154-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139738814","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
Chapter 11. Endometriosis-related complications in women undergoing in-vitro fertilization 第11章体外受精妇女的子宫内膜异位症相关并发症
IF 5.5 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-01-12 DOI: 10.1016/j.bpobgyn.2024.102456
Laura Melado , Baris Ata
{"title":"Chapter 11. Endometriosis-related complications in women undergoing in-vitro fertilization","authors":"Laura Melado ,&nbsp;Baris Ata","doi":"10.1016/j.bpobgyn.2024.102456","DOIUrl":"10.1016/j.bpobgyn.2024.102456","url":null,"abstract":"<div><p><span><span>As a chronic inflammatory disease, </span>endometriosis<span> generates fibrosis and anatomic distortion, which add extra-challenges to assisted reproductive technology cycles and requires a personalized approach. Patients with </span></span>endometriomas<span><span><span><span> have significantly decreased ovarian reserve<span> and the ultrasound examination tends to be challenging, possibly underestimating follicle counts. It is crucial to assess the feasibility of oocyte retrieval procedure during the initial examination of the patient, as the distortion of the pelvic </span></span>anatomy, the presence of </span>hydrosalpinges and endometriomas might render the procedure difficult and increase the risk of complications. Possible injury to adjacent organs and risk of infection must be considered. Assisted reproductive technology seems to have limited or no impact on endometriosis recurrence, </span>pain symptom progression or the size of endometrioma.</span></p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"93 ","pages":"Article 102456"},"PeriodicalIF":5.5,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139459015","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
Epidemiology of infertility in women with endometriosis 子宫内膜异位症妇女不孕症的流行病学研究
IF 5.5 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-01-03 DOI: 10.1016/j.bpobgyn.2023.102454
Umberto Leone Roberti Maggiore , Valentina Chiappa , Marcello Ceccaroni , Giovanni Roviglione , Luca Savelli , Simone Ferrero , Francesco Raspagliesi , Ludovica Spanò Bascio
{"title":"Epidemiology of infertility in women with endometriosis","authors":"Umberto Leone Roberti Maggiore ,&nbsp;Valentina Chiappa ,&nbsp;Marcello Ceccaroni ,&nbsp;Giovanni Roviglione ,&nbsp;Luca Savelli ,&nbsp;Simone Ferrero ,&nbsp;Francesco Raspagliesi ,&nbsp;Ludovica Spanò Bascio","doi":"10.1016/j.bpobgyn.2023.102454","DOIUrl":"10.1016/j.bpobgyn.2023.102454","url":null,"abstract":"<div><p><span>Endometriosis<span> is a benign, chronic, inflammatory condition affecting up to 10 % of women and characterised by the presence of glands and stroma tissue outside the uterus. Epidemiological and clinical studies demonstrate a consistent association between </span></span>endometriosis and infertility. However, this relationship is far to be clearly understood and several mechanisms are involved. Available data show that patients with endometriosis have an increased estimated risk of infertility between two and four times compared with the general population. On the other hand, the probability of patients with infertility to have endometriosis is reported up to about 50 % of the cases. Future studies should aim to better elucidate the mechanisms behind endometriosis-associated infertility in order to offer the more appropriate and tailored management for the patients.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"92 ","pages":"Article 102454"},"PeriodicalIF":5.5,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139082111","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
Surgical treatment of deep endometriosis: Impact on spontaneous conception 深部子宫内膜异位症的手术治疗：对自然受孕的影响
IF 5.5 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-01-03 DOI: 10.1016/j.bpobgyn.2024.102455
Georgios Grigoriadis , Angelos Daniilidis , Benjamin Merlot , Konstantinos Stratakis , Thomas Dennis , Adrien Crestani , Isabella Chanavaz-Lacheray , Horace Roman
{"title":"Surgical treatment of deep endometriosis: Impact on spontaneous conception","authors":"Georgios Grigoriadis ,&nbsp;Angelos Daniilidis ,&nbsp;Benjamin Merlot ,&nbsp;Konstantinos Stratakis ,&nbsp;Thomas Dennis ,&nbsp;Adrien Crestani ,&nbsp;Isabella Chanavaz-Lacheray ,&nbsp;Horace Roman","doi":"10.1016/j.bpobgyn.2024.102455","DOIUrl":"10.1016/j.bpobgyn.2024.102455","url":null,"abstract":"<div><p><span>Deep endometriosis (DE) is the most severe form of endometriosis and is commonly associated with infertility. Surgical treatment of DE appears to increase chances of spontaneous conception in appropriately selected patients wishing to conceive. Identifying, however, the exact impact of DE, and its surgical removal, on natural conception is highly challenging. The surgical approach should be favoured in symptomatic patients with pregnancy intention. Limited data from infertile patients suggest that outcomes may not differ from patients without known infertility. Complex DE surgery carries a risk of serious complications, therefore, it should be performed in centers of expertise. Such complications may, however, not have a significant negative impact on fertility outcomes, according to limited available data. Data on </span>obstetric<span> outcomes of spontaneous conceptions after DE surgery are too scarce. In asymptomatic, infertile patients the debate between primary surgery or Artifial Reproductive Technology is ongoing, until randomized studies report their results.</span></p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"93 ","pages":"Article 102455"},"PeriodicalIF":5.5,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139082124","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
Tips and tricks in gynaecological robotic surgery 妇科机器人手术的技巧和窍门
IF 5.5 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-31 DOI: 10.1016/j.bpobgyn.2023.102453
Kamana Subba , Esther Lambert , Alaa El-Ghobashy
{"title":"Tips and tricks in gynaecological robotic surgery","authors":"Kamana Subba ,&nbsp;Esther Lambert ,&nbsp;Alaa El-Ghobashy","doi":"10.1016/j.bpobgyn.2023.102453","DOIUrl":"10.1016/j.bpobgyn.2023.102453","url":null,"abstract":"<div><p><span>It was the dawn of a new era for robotic surgery when the Food and Drug Administration (FDA) approved </span><em>da Vinci</em> robotic surgical system for general laparoscopic procedures in 2000. The surgical practice saw a transformative breakthrough towards minimally invasive approach with the ever-increasing uptake of advanced robots proven to benefit patients and surgeons in various ways. However, these innovative machines only complement and enhance a surgeon's operating skills, and with such privilege come responsibilities and new challenges. Heavy reliance on such advanced devices while operating on humans necessitates thorough training and supervision to ensure safe and efficient applications. It is the surgeon's responsibility to direct the procedure constantly and lead other team members who assist during the surgery. In this chapter, we provide miscellaneous tips and tricks that can help beginners navigate through robotic surgery with more confidence and enthusiasm.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"93 ","pages":"Article 102453"},"PeriodicalIF":5.5,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139063628","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
Robot-assisted laparoscopic myomectomy: Technique & brief literature review 机器人辅助腹腔镜子宫肌瘤切除术：技术与文献综述
IF 5.5 2区 医学
Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-12-24 DOI: 10.1016/j.bpobgyn.2023.102452
Arnold P. Advincula
{"title":"Robot-assisted laparoscopic myomectomy: Technique & brief literature review","authors":"Arnold P. Advincula","doi":"10.1016/j.bpobgyn.2023.102452","DOIUrl":"10.1016/j.bpobgyn.2023.102452","url":null,"abstract":"<div><p>The worldwide growth of robot-assisted laparoscopic surgery has been exponential since its FDA approval for use in gynecologic surgery in the spring of 2005. This growth has spanned the entire gamut of gynecologic procedures and pathology. One area that has leveraged the unique aspects of robotics has been its application to the conservative surgical management of uterine fibroids. This manuscript will review the surgical technique and highlight the current situation regarding the scientific literature with an evidence-based focus on the role of robot-assisted laparoscopic myomectomy (RALM) with the daVinci Surgical System (Intuitive Surgical, Sunnyvale, CA).</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"93 ","pages":"Article 102452"},"PeriodicalIF":5.5,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139035544","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
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 ,&nbsp;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><p>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.</p><p>In this article we review key ethical issues in obstetric emergencies in LMICs such as informed consent<span>, 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.</span></p></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
{"title":"Contraception after abortion, miscarriage, ectopic and molar pregnancy","authors":"Michelle Cooper,&nbsp;Sharon Cameron","doi":"10.1016/j.bpobgyn.2023.102428","DOIUrl":"10.1016/j.bpobgyn.2023.102428","url":null,"abstract":"<div><p><span><span>Regardless of whether a pregnancy ends in abortion, miscarriage or ectopic pregnancy, fertility and sexual activity can resume quickly. For those who do not plan to become pregnant again immediately, effective contraception is therefore required. Although a contraceptive discussion and the offer to provide contraception is considered an integral part of abortion care, health care providers may not always offer this same standard of care to those whose pregnancy ends in miscarriage or ectopic due to sensitivities or assumptions around this and future fertility intentions. Yet, evidence-based recommendations support the safety of initiating contraception at these times. Provision of a chosen method of contraception may be convenient for women and valued by them. As part of </span>holistic care, healthcare professionals who care for women around these reproductive events should therefore offer quality information on contraception and help them access their chosen method to better meet their ongoing </span>reproductive health needs.</p></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"92 ","pages":"Article 102428"},"PeriodicalIF":5.5,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138575742","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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