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Maternal cardiac disease in pregnancy
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-04-01 DOI: 10.1016/j.ogrm.2025.01.003
Bernadette Jenner, William Jenner, Rahul Chattopadhyay, Catriona J Bhagra
{"title":"Maternal cardiac disease in pregnancy","authors":"Bernadette Jenner,&nbsp;William Jenner,&nbsp;Rahul Chattopadhyay,&nbsp;Catriona J Bhagra","doi":"10.1016/j.ogrm.2025.01.003","DOIUrl":"10.1016/j.ogrm.2025.01.003","url":null,"abstract":"<div><div>The 2024 MBRRACE-UK report showed a rise in overall maternal mortality, with deaths from cardiac disease remaining the main indirect cause, barring deaths from COVID-19. Advancing maternal age and a rise in cardiovascular co-morbidities, along with improvements in congenital heart disease management and assisted reproductive technology have all contributed to an increasingly complex maternity population with higher pregnancy risks. Despite improvements in obstetric and cardiac care, health inequalities for women with multiple comorbidities, socio-economic deprivation and those from Black and Asian ethnic groups persist, with these groups being more likely to have poor cardiovascular and pregnancy outcomes. In this review we consider the importance of pre-conception counselling for women with known heart disease, review the physiological changes of pregnancy and explore maternal risk, from a cardiovascular perspective. Importantly, management of women with moderate to severe heart disease during pregnancy should be delivered by the pregnancy heart team, as coined by the European Society of Cardiology in its 2018 guidelines. Individualized care empowers trust and shared decision making, and early access to multidisciplinary care is vital in optimizing maternal and fetal outcomes.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 4","pages":"Pages 101-110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modern approaches to surgical treatment for female stress urinary incontinence
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-04-01 DOI: 10.1016/j.ogrm.2025.01.001
Natalia Price, Paul Moran
{"title":"Modern approaches to surgical treatment for female stress urinary incontinence","authors":"Natalia Price,&nbsp;Paul Moran","doi":"10.1016/j.ogrm.2025.01.001","DOIUrl":"10.1016/j.ogrm.2025.01.001","url":null,"abstract":"<div><div>Stress urinary incontinence (SUI) is a prevalent condition, affecting a significant proportion of women, with 13.6% requiring surgical intervention during their lifetime. Surgical treatments primarily aim to provide suburethral support or enhance urethral closure mechanisms. Traditionally, colposuspensions and autologous rectus fascial slings have been considered effective first-line surgical options for managing SUI. These procedures have shown reliable outcomes in terms of symptom relief and long-term efficacy. The use of midurethral tapes, once the most popular treatment option in the UK, is currently suspended due to the concerns about the risk of chronic pelvic pain and vaginal mesh exposure. It remains an option for women with deemed ‘exceptional circumstances’ and may be cautiously reintroduced into practice with certain prerequisites. The mesh ‘pause’ has driven a much-improved process of patient counselling, expectation setting, utilizsation of the ‘MDT’, enhanced surgical standards and data collection. It has led to a reassessment of surgical approaches. The current trend is for many women to request intra-urethral bulking (Bladder neck injection) as a first line procedure to treat primary SUI. There is a renewed focus on established methods like colposuspension, open or laparoscopic, and modified autologous fascial ‘sling on a string’. These procedures avoid mesh related risks but are associated with different risks such as new onset vaginal prolapse and post-operative voiding difficulty, respectively.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 4","pages":"Pages 89-97"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Principles of palliative care for advanced gynaecological cancers
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-04-01 DOI: 10.1016/j.ogrm.2025.01.004
Marika Ai Victoria Reinius, Arjun David Napier Kingdon
{"title":"Principles of palliative care for advanced gynaecological cancers","authors":"Marika Ai Victoria Reinius,&nbsp;Arjun David Napier Kingdon","doi":"10.1016/j.ogrm.2025.01.004","DOIUrl":"10.1016/j.ogrm.2025.01.004","url":null,"abstract":"<div><div>Women with gynaecological malignancies often suffer significant physical and psychological symptom burden throughout the course of their disease. Despite advances in treatment, up to 25% of women diagnosed with a gynaecological cancers will die from recurrent disease. A palliative approach – delivered by the Gynaecology team, supported by a Specialist Palliative Care team as needed – can be offered alongside curative or life prolonging treatment as well as at end of life. This article reviews the management of common physical symptoms and complications experienced by patients with advanced gynaecological malignancies, including pain, nausea and vomiting, malignant bowel obstruction, constipation, malignant ascites, fistulating and fungating disease, anaemia and bleeding, and ureteric obstruction.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 4","pages":"Pages 111-118"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Self-assessment questions
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-04-01 DOI: 10.1016/j.ogrm.2025.01.005
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2025.01.005","DOIUrl":"10.1016/j.ogrm.2025.01.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 4","pages":"Pages 119-121"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aetiology and management of postcoital and intermenstrual bleeding: a review of literature
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-04-01 DOI: 10.1016/j.ogrm.2025.01.002
Bidisha Chatterjee, Helen Bolton
{"title":"Aetiology and management of postcoital and intermenstrual bleeding: a review of literature","authors":"Bidisha Chatterjee,&nbsp;Helen Bolton","doi":"10.1016/j.ogrm.2025.01.002","DOIUrl":"10.1016/j.ogrm.2025.01.002","url":null,"abstract":"<div><div>Post coital bleeding (PCB) and intermenstrual bleeding (IMB) are common gynaecological complaints that can result from a wide range of benign, infective, hormonal, structural, psychological and malignant conditions. Though a majority of these cases are benign in nature, persistent and unexplained bleeding warrants detailed assessments to rule out any sinister pathology. It can be a source of great distress in women and a comprehensive evaluation not only facilitates diagnosis and management but also can significantly improve the quality of life of the patients.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 4","pages":"Pages 98-100"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genitourinary syndrome of menopause: overview and management
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.ogrm.2024.12.004
Hebatallah Awad, Sami Shawer
{"title":"Genitourinary syndrome of menopause: overview and management","authors":"Hebatallah Awad,&nbsp;Sami Shawer","doi":"10.1016/j.ogrm.2024.12.004","DOIUrl":"10.1016/j.ogrm.2024.12.004","url":null,"abstract":"<div><div>Menopause is a natural physiological process experienced by women, characterized by a hypoestrogenic state. This hormonal deficiency can arise from various factors such as aging, premature ovarian failure, or surgical oophorectomies. Historically, the focus has been primarily on the vasomotor and psychological manifestations of hypoestrogenism in menopausal women, likely due to the prevalence of these symptoms. However, it is important to recognize that genitourinary syndrome of menopause (GSM) significantly impacts a substantial portion of women during this stage of life. These symptoms are often overlooked or underreported due to feelings of embarrassment.\" This paper provides comprehensive overview of GSM, including its pathophysiology, epidemiology, clinical presentation, and impact on the quality of life. Furthermore, it will discuss current management strategies to provide healthcare professionals with a thorough understanding of GSM to improve patient outcomes through timely diagnosis and appropriate management.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 3","pages":"Pages 82-85"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intrapartum fetal monitoring
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.ogrm.2024.12.003
Anna K Richmond, Louise Dewick, Eamonn J Breslin
{"title":"Intrapartum fetal monitoring","authors":"Anna K Richmond,&nbsp;Louise Dewick,&nbsp;Eamonn J Breslin","doi":"10.1016/j.ogrm.2024.12.003","DOIUrl":"10.1016/j.ogrm.2024.12.003","url":null,"abstract":"<div><div>Fetuses are physiologically adapted to cope with labour. However, some fetuses are at risk of hypoxic injury. Whether fetuses are monitored using intermittent auscultation (IA) or continuous cardiotocography (CTG), knowledge of the fetal physiological responses to labour and the various mechanisms of hypoxia is vital to provision of appropriate interventions. Hypoxia in labour can be caused by umbilical cord compression and/or utero-placental insufficiency, sometimes potentiated through infection and inflammation. Recognition of intrapartum risks such as meconium stained liquor, bleeding or maternal pyrexia aid in determining the individual risk of fetal hypoxia but a holistic view needs to be maintained. Detection is only the first step, then requiring appropriate escalation, communication and timely action which are reinforced by initiatives including the Avoiding Brain injury in Childbirth (ABC) programme and the Each Baby Counts (EBC) project. This paper aims to provide an overview of intrapartum fetal monitoring founded in physiological interpretation and insights into new recommendations by the ABC programme.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 3","pages":"Pages 73-81"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Self-assessment questions
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.ogrm.2024.12.005
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2024.12.005","DOIUrl":"10.1016/j.ogrm.2024.12.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 3","pages":"Pages 86-88"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Non-HIV sexually transmitted infections in pregnancy
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.ogrm.2024.12.001
Beth Bateson, David Brown, Richard Kennedy
{"title":"Non-HIV sexually transmitted infections in pregnancy","authors":"Beth Bateson,&nbsp;David Brown,&nbsp;Richard Kennedy","doi":"10.1016/j.ogrm.2024.12.001","DOIUrl":"10.1016/j.ogrm.2024.12.001","url":null,"abstract":"<div><div>Sexually transmitted infections (STIs) directly impact sexual and reproductive health, with a particular burden in women. They can lead to significant adverse complications and outcomes during pregnancy, and infertility. Antenatal care guidance focuses on a holistic approach, ensuring risk assessments are carried out at every appointment. Except for performing hepatitis B/HIV/syphilis serology at booking appointments, STIs are often overlooked. There are no explicit recommendations on when to perform STI screening tests during pregnancy. Given the current burden (and potential impact) of STIs, it is imperative these are considered during antenatal appointments and screened for appropriately. Early detection and treatment are necessary to secure good outcomes for the pregnant person and fetus. Partner notification is essential to halt transmission and prevent reinfection. Management should be via a multidisciplinary, cross-specialty approach. In this article we review various (non-HIV) STIs in pregnancy - focusing on presentation, diagnosis, management, and possible complications of each.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 3","pages":"Pages 57-62"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A basic understanding of urodynamics
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.ogrm.2024.12.002
Kate McCrossan, Holly Vickers
{"title":"A basic understanding of urodynamics","authors":"Kate McCrossan,&nbsp;Holly Vickers","doi":"10.1016/j.ogrm.2024.12.002","DOIUrl":"10.1016/j.ogrm.2024.12.002","url":null,"abstract":"<div><div>Urodynamic investigations provide a valuable tool to aid diagnosis and management of lower urinary tract symptoms by evaluating bladder function during the filling, storage and voiding phases. As well as covering basic urinary tract anatomy and physiology, this article provides a comprehensive overview of urodynamic principles, from a gynaecological perspective. It discusses an overview of the various different tests including cystometry, uroflowmetry and pressure flow studies including understanding abdominal pressure, bladder pressure and detrusor pressure significance. It provides case studies that include useful tips for interpreting urodynamic studies, including two single best answer questions, in order to aid professionals preparing for the MRCOG exam or those participating in urogynaecology clinics.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 3","pages":"Pages 63-72"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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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