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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
Self-assessment questions
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.ogrm.2024.11.005
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2024.11.005","DOIUrl":"10.1016/j.ogrm.2024.11.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 2","pages":"Pages 53-55"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176880","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
The clinical impact and management of premenstrual syndrome
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.ogrm.2024.11.001
Supriya Preman Thazhath Pullayikudi, Akanksha Sood
{"title":"The clinical impact and management of premenstrual syndrome","authors":"Supriya Preman Thazhath Pullayikudi,&nbsp;Akanksha Sood","doi":"10.1016/j.ogrm.2024.11.001","DOIUrl":"10.1016/j.ogrm.2024.11.001","url":null,"abstract":"<div><div>Premenstrual syndrome (PMS) is a condition characterized by psychological, physical and behavioural symptoms occurring in the luteal phase of the normal menstrual cycle but resolves shortly after menstruation. Around 40% of women experience symptoms of PMS and of these 5–8% suffer from severe PMS including premenstrual dysphoric disorder (PMDD), a debilitating condition with severe emotional and physical symptoms and functional impairment. Premenstrual syndrome is effectively related to hormonal changes in the menstrual cycle, supported by the absence of PMS prior to puberty, during pregnancy, and after the menopause. Diagnosis is aided by reviewing symptoms in the Daily Record of Severity of Problems (DRSP) questionnaire. Management is centred around lifestyle modifications, cognitive behavioural therapy and pharmacological treatment. This article is a review of the clinical impact of premenstrual syndrome and its management strategies.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 2","pages":"Pages 27-31"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176881","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
Evidence-based management of women of advanced maternal age
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.ogrm.2024.11.002
Huda MEM Ahmed, Kate F Walker
{"title":"Evidence-based management of women of advanced maternal age","authors":"Huda MEM Ahmed,&nbsp;Kate F Walker","doi":"10.1016/j.ogrm.2024.11.002","DOIUrl":"10.1016/j.ogrm.2024.11.002","url":null,"abstract":"<div><div>The average age of women at childbirth in industrialised nations has been increasing steadily for approximately 30 years. Women aged 35 years or over have an increased risk of gestational hypertensive disease, gestational diabetes, placenta praevia, placental abruption, perinatal death, preterm labour, fetal macrosomia and fetal growth restriction. The risk of trisomy 21, 18 and 13, and other sex chromosome aberrations (e.g. Klinefelter syndrome) increases significantly with maternal age, especially in women aged 35 years and older but there is no age-related association with an increased risk of triploidy or monosomy X. Unsurprisingly, rates of obstetric intervention are higher among older women. Of particular concern is the increased risk of antepartum stillbirth at term in women of advanced maternal age. In all maternal age groups, the risk of stillbirth is higher among nulliparous women than among multiparous women. Women of advanced maternal age (&gt;40 years) should be offered low dose aspirin (in the presence of an additional risk factor for pre-eclampsia) and offered serial ultrasounds for fetal growth and wellbeing; given the increased risk of antepartum stillbirth, induction of labour from 39 weeks’ gestation should be discussed with the woman. In very advanced maternal age (≥45 years of age), women who conceived via <em>in vitro</em> fertilization are significantly at increased risk of preterm delivery and adverse maternal outcomes compared to those who conceive naturally.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 2","pages":"Pages 32-36"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176879","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
The obstetric anal sphincter injury (OASI) clinic: postnatal and subsequent antenatal management of women with a history of obstetric anal sphincter injury
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.ogrm.2024.11.004
Kathy Parsons, Matthew Parsons
{"title":"The obstetric anal sphincter injury (OASI) clinic: postnatal and subsequent antenatal management of women with a history of obstetric anal sphincter injury","authors":"Kathy Parsons,&nbsp;Matthew Parsons","doi":"10.1016/j.ogrm.2024.11.004","DOIUrl":"10.1016/j.ogrm.2024.11.004","url":null,"abstract":"<div><div>Obstetric anal sphincter injuries (OASI) occur in around 6.1% of first vaginal births and around 5–7% of subsequent vaginal births. The multidisciplinary OASI clinic plays a vital role in the postnatal, and subsequent antenatal, management of women with a history of OASI. This review will outline the recommended best practice for the outpatient postnatal management of women who have sustained a recent OASI and also the current guidance on mode of birth recommendations in a subsequent pregnancy after an OASI. It will explore the evidence supporting current practice recommendations to facilitate clinicians leading mode of birth discussions for women with a previous OASI.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 2","pages":"Pages 45-52"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143177137","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
Endometrial cancer: an update on diagnosis, treatment and the role of molecular profiling
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.ogrm.2024.11.003
Cathrine Holland
{"title":"Endometrial cancer: an update on diagnosis, treatment and the role of molecular profiling","authors":"Cathrine Holland","doi":"10.1016/j.ogrm.2024.11.003","DOIUrl":"10.1016/j.ogrm.2024.11.003","url":null,"abstract":"<div><div>The incidence of endometrial cancer in the UK has risen steeply since the 1990s. Survival has improved significantly over several decades but outcomes for 25% of women remain poor. Surgery is the initial treatment approach in most cases. Sentinel node surgery has largely replaced systematic lymphadenectomy for surgical staging in apparent early-stage disease. Radiotherapy and chemotherapy are used to reduce recurrence, and for upfront primary treatment in selected cases. Different endometrial cancer sub-types have different aetiologies, histological and molecular characteristics and prognoses. Molecular classification of tumours is now indicated in all patients treated for endometrial cancer. Molecular characterization has important implications for treatment options, both at initial presentation and any subsequent recurrence, including access to new immunotherapy treatments. In addition, “mainstreaming” of genetic testing in those at risk of Lynch syndrome, will improve identification of at-risk families and help prevent future endometrial, ovarian and bowel cancers.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 2","pages":"Pages 37-44"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176878","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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