Obstetrics, Gynaecology and Reproductive Medicine最新文献

{"title":"Self-assessment questions","authors":"Anna Richmond, Georgina Smart","doi":"10.1016/j.ogrm.2026.07.005","DOIUrl":"10.1016/j.ogrm.2026.07.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 10","pages":"Pages 307-308"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096749","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}

{"title":"Invasive cervical cancer: what every clinician should know","authors":"Keeley Howard,&nbsp;Faiza Gaba","doi":"10.1016/j.ogrm.2026.07.001","DOIUrl":"10.1016/j.ogrm.2026.07.001","url":null,"abstract":"<div><div>The management of cervical cancer is complex and decision making in treatment requires subspecialist management and gynaecological oncology MDT input. Staging of cervical cancer includes diagnostic biopsy, clinical assessment and cross-sectional imaging. Treatment depends on the stage of disease and includes surgery for early-stage disease and chemoradiotherapy for locally advanced and metastatic disease. Cervical cancer incidence peaks in patients of reproductive age so its management also requires fertility preservation consideration.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 10","pages":"Pages 287-291"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096751","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}

{"title":"The impact of obesity on endometrial health","authors":"Holly Baker-Rand,&nbsp;Emma J. Davidson","doi":"10.1016/j.ogrm.2026.07.002","DOIUrl":"10.1016/j.ogrm.2026.07.002","url":null,"abstract":"<div><div>There are 890 million adults worldwide who are living with obesity and the prevalence continues to rise. Obesity is a complex multisystem disease that causes metabolic dysfunction. The endometrium is vulnerable to the effects of obesity at all life stages. Obesity is associated with heavy menstrual bleeding, infertility and miscarriage, polycystic ovary syndrome, endometrial hyperplasia and endometrial cancer. Obesity is the aetiological driver in 50% of endometrial cancers. Hyperestrogenism, hyperinsulinemia and chronic inflammation are considered the underlying mechanisms. Health optimization in people living with obesity relies on clinicians providing quality health education about the effects of obesity on gynaecological health. Progestins can protect the endometrium against obesity-associated proliferation and are recommended for the management of obesity-associated endometrial disorders. Weight reduction and maintaining a healthy weight improves endometrial health and reproductive outcomes. Clinicians can initiate discussions about weight and signpost or refer to weight management services where appropriate.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 10","pages":"Pages 292-297"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096750","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}

{"title":"Epilepsy and having a baby: a multi-disciplinary approach to holistic care","authors":"Zoë Barrett,&nbsp;Motaz Helali,&nbsp;Lucy Murena","doi":"10.1016/j.ogrm.2026.07.003","DOIUrl":"10.1016/j.ogrm.2026.07.003","url":null,"abstract":"<div><div>Epilepsy is among the top 5 leading causes for maternal death in the UK, making the management from preconception, through antenatal, intrapartum and the postnatal periods extremely important to reduce risk and to keep people with epilepsy (PWE) safe when having a baby. There is strong evidence for effective team working between neurology and obstetrics in caring for this high risk group leading to safer, higher quality care. This article discusses the pregnancy journey and the considerations required when caring for an individual with epilepsy (IWE), including pre-conception, the benefits of thorough counselling including risk and safety advice, discussion around anti-seizure medications (ASMs) to include the variance in teratogenicity risk and which ASMs require blood monitoring. Pharmacokinetics and pharmacology are examined including the impact of common pregnancy symptoms and their potential effect. Labour care, delivery planning and wider considerations including risk reductions and suitable analgesics are considered and postnatal planning including parent education around baby safety and the importance of a postnatal review for PWE is also discussed.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 10","pages":"Pages 298-303"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096748","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}

{"title":"Group B Streptococcus screening: universal or risk-based?","authors":"Charlotte Hoy,&nbsp;Joanne Marie Mushi,&nbsp;Elsa Brigitte Phillips,&nbsp;Brielle Jasmine Smidt-Wallis,&nbsp;Amy Udall,&nbsp;Victoria Hodgetts Morton,&nbsp;Jack Le Vance","doi":"10.1016/j.ogrm.2026.07.004","DOIUrl":"10.1016/j.ogrm.2026.07.004","url":null,"abstract":"<div><div>Approximately 20–40% of adults carry group B <em>Streptococcus</em> (GBS). Its vertical bacterial transmission remains the leading cause of neonatal sepsis in the UK. Currently, there is a disparity in GBS screening recommendations, with the Royal College of Obstetricians and Gynaecologists (RCOG) endorsing risk-based screening, whilst the World Health Organization (WHO) recommends universal screening. Evidence to guide screening choice substantially varies, from a rapid systematic review of three studies for RCOG to a more comprehensive review of 72 studies informing the WHO. Given the morbidity associated with neonatal GBS infection, it is prudent to understand the justification of each screening regime and its effectiveness. This spotlight article appraises the effectiveness of each regime, considering the most appropriate pathway for future UK practice.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 10","pages":"Pages 304-306"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096753","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}

{"title":"Induction of labour: methods, indications, decision-making and improving the patient's experience","authors":"Alexandra Emms,&nbsp;Sharon Morad,&nbsp;Samiramis Saba,&nbsp;R Katie Morris","doi":"10.1016/j.ogrm.2026.06.003","DOIUrl":"10.1016/j.ogrm.2026.06.003","url":null,"abstract":"<div><div>Induction of labour (IOL), artificially commencing the labour process, is the most common intervention offered to pregnant women in the UK. Rates are steadily increasing over the last decades, from 21% in 2009–2010 to approximately one third in 2023, based on the National Maternity and Perinatal Audit (NMPA) “Induction of labour snapshot”. The goal of IOL is to expedite birth and thereby reduce the risk of adverse perinatal outcomes or to improve maternal health. There are many different methods of induction of labour, which are explained in this article. The common reasons for IOL, according to the National Institute for Care and Health Excellence, the Royal College of Obstetricians and Gynaecologists and the Saving Babies’ Lives Care Bundle, are briefly explained. This article aims to provide an overview of induction of labour to the level required for the MRCOG part 2 and 3 examinations. It also highlights patient-centred decision-making and ways to improve the patient experience of induction of labour.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 9","pages":"Pages 265-271"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148949777","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}

{"title":"A peri-operative care framework for caesarean delivery in women with raised body mass index","authors":"Mohammed Jaber Hussain,&nbsp;Anoop Surendran,&nbsp;James Castleman,&nbsp;Sarah Poppy Walker","doi":"10.1016/j.ogrm.2026.06.002","DOIUrl":"10.1016/j.ogrm.2026.06.002","url":null,"abstract":"<div><div>Maternal obesity is an increasingly prevalent global health concern and is strongly associated with adverse obstetric outcomes, including higher rates of caesarean delivery and perioperative morbidity. In the UK, over one quarter of women enter pregnancy living with obesity, with a disproportionate burden among women from socioeconomically deprived backgrounds and certain ethnic groups. The rise in maternal obesity parallels increasing caesarean delivery rates, particularly among women with class 3 (body mass index ≥40 kg/m²) and class 4 (body mass index ≥50 kg/m²) obesity, in whom caesarean delivery is associated with substantially increased operative complexity, infectious morbidity, haemorrhage, prolonged hospital stay, and healthcare costs. This review focuses on the unique surgical and anaesthetic challenges encountered during caesarean delivery in women withobesity and outlines evidence-based strategies to optimise perioperative safety and recovery. Key ergonomic and technical issues include airway and positioning difficulties, compromised surgical exposure due to a large abdominal pannus, increased operative depth, and challenges in accessing the lower uterine segment. These factors contribute to longer operative times, greater blood loss, and increased fatigue for the surgical team, occasionally necessitating modification of uterine incision techniques with potential implications for future pregnancies. Infective morbidity remains a major contributor to postoperative complications, with surgical site infections and endometritis occurring at substantially higher rates with increasing body mass index. Standard antibiotic prophylaxis and skin preparation may be insufficient in women with obesity, highlighting the need for weight-adjusted dosing, repeat intraoperative dosing, rigorous preoperative skin decontamination, vaginal preparation, glove change after delivery, and consideration of negative pressure wound therapy. Antenatal optimisation, including dietetic input and multidisciplinary planning, alongside tailored anaesthetic strategies such as combined spinal–epidural techniques and ultrasound-guided access, are integral to reducing perioperative risk. A structured, multidisciplinary perioperative care pathway that integrates antenatal preparation, individualised surgical planning, meticulous intraoperative technique, and enhanced postoperative wound care is essential to improve maternal outcomes and recovery following caesarean delivery in women with obesity.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 9","pages":"Pages 256-264"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148949705","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}

{"title":"A practical guide to the management of headache in pregnancy","authors":"Iain Alexander Maltman,&nbsp;Richard Davenport","doi":"10.1016/j.ogrm.2026.06.004","DOIUrl":"10.1016/j.ogrm.2026.06.004","url":null,"abstract":"<div><div>Headache is a common symptom which disproportionately affects women of reproductive age. Clinicians involved in the care of pregnant women should be confident in their ability to assess and manage headache disorders. In this article, based on recently published guidelines from the Scottish Perinatal Network and the Scottish Intercollegiate Guidelines Network (SIGN), we provide a framework for the assessment of headache in pregnant women. A focus on how to take a comprehensive headache history is included, reflecting its importance in diagnosis and management. We provide an overview of common primary headache disorders, as well as rarer but important, secondary headache disorders, focussing on appropriate investigations and management. We discuss in detail the management of migraine in pregnancy, given that this is the most common headache disorder. Although primarily aimed at Obstetric trainees, this article will be of value to general physicians and all healthcare professionals involved in the care of pregnant women presenting with headache.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 9","pages":"Pages 272-283"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148949701","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}

{"title":"Training the minimally invasive gynaecological surgeon in the UK: principles, challenges and future directions","authors":"Aditi Siddharth,&nbsp;Angus Thomson,&nbsp;Donna Ghosh,&nbsp;Natalia Price","doi":"10.1016/j.ogrm.2026.06.001","DOIUrl":"10.1016/j.ogrm.2026.06.001","url":null,"abstract":"<div><div>Minimally invasive surgery (MIS) is now central to gynaecological practice, but training pathways have become increasingly constrained by reduced operative exposure, fragmented case volume, changing patterns of service delivery and greater subspecialisation. At the same time, the procedural scope of MIS has expanded, with trainees expected to develop competence across laparoscopy, hysteroscopy, natural orifice surgery and robotic platforms. This review examines the principles, challenges and future directions of training the minimally invasive gynaecological surgeon in the UK. Competence in MIS is multidimensional and requires technical skill, anatomical knowledge, sound judgement and non-technical skills, all of which must be developed and assessed together. Traditional apprenticeship models are no longer sufficient in isolation. Simulation, deliberate practice, structured feedback, mentorship and graded autonomy are therefore essential components of training. However, their effectiveness depends on protected time, access to expertise and integration within a coherent training system. Regional training networks, accredited centres, post-CCT fellowships, credentialing frameworks and digital approaches to assessment and supervision offer practical routes to improving equity, consistency and transparency. Ergonomics and surgeon sustainability must also be recognised as part of long-term workforce planning. A future model for MIS training in gynaecology should be planned rather than opportunistic, multimodal rather than theatre-dependent, and system-supported rather than individually negotiated. Such an approach is necessary to develop a technically proficient, adaptable and sustainable workforce capable of delivering safe and high-quality care.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 9","pages":"Pages 247-255"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148949704","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}

{"title":"Self-assessment questions","authors":"Anna Richmond,&nbsp;Georgina Smart","doi":"10.1016/j.ogrm.2026.06.005","DOIUrl":"10.1016/j.ogrm.2026.06.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 9","pages":"Pages 284-286"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148949702","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}