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Genomics and hereditary cancer syndromes in women's health: a focus on gynaecological management 基因组学与妇女健康中的遗传性癌症综合征：关注妇科管理
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-09-14 DOI: 10.1016/j.ogrm.2024.07.002
{"title":"Genomics and hereditary cancer syndromes in women's health: a focus on gynaecological management","authors":"","doi":"10.1016/j.ogrm.2024.07.002","DOIUrl":"10.1016/j.ogrm.2024.07.002","url":null,"abstract":"<div><div>Hereditary or familial cancer syndromes are caused by inherited pathogenic variants in cancer susceptibility genes and are associated with an increased risk of developing malignancies occurring at an earlier age. BRCA-associated Hereditary Breast and Ovarian Cancer and Lynch Syndromes are the most common conditions encountered in gynaecology. Identification presents opportunities to prevent or reduce the risk of cancer, or to detect cancers at earlier stages with improved outcomes. When cancer does occur, there may be options for personalized therapeutic approaches. Cancer prevention invariably requires risk-reducing surgical treatment, which may result in irreversible loss of fertility and premature menopause; issues which must be addressed through a personalized management approach. Regular review with adjustments to plans are required as individuals pass through different reproductive life-stages. Comprehensive management requires a multi-professional approach including specialist genetics input, prevention of cancer by education, modification of risk factors and specific interventions, in addition to psychosocial support.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311623","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 自我评估问题
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-09-11 DOI: 10.1016/j.ogrm.2024.08.005
{"title":"Self-assessment questions","authors":"","doi":"10.1016/j.ogrm.2024.08.005","DOIUrl":"10.1016/j.ogrm.2024.08.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527080","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
Adolescent gynaecology: a review of core conditions 青少年妇科：核心病症回顾
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-09-03 DOI: 10.1016/j.ogrm.2024.08.003
{"title":"Adolescent gynaecology: a review of core conditions","authors":"","doi":"10.1016/j.ogrm.2024.08.003","DOIUrl":"10.1016/j.ogrm.2024.08.003","url":null,"abstract":"<div><div>In adolescent gynaecology clinic, we can encounter conditions that solely occur at this specific time in development and that we otherwise do not come across in other aspects of our working life. Though a patient may present with a ‘menstrual disorder’, this may well be the first manifestation of an endocrine disease or underlying congenital abnormality. When caring for adolescent gynaecology patients, it is essential we are alert to these possibilities, equipped with the specific knowledge pertaining to this patient group and that we investigate diligently so as not to miss a potentially serious condition. This article comprises key learning points for important adolescent gynaecology conditions including genital tract anomalies such as Mayer-Rokitansky-Kuster-Hauser and OHVIRA (obstructed hemivagina, ipsilateral renal anomalies) syndromes, genetic conditions such as Turner's syndrome, endocrine disorders such as androgen insensitivity and congenital adrenal hyperplasia, as well as abnormal uterine bleeding, primary ovarian insufficiency and polycystic ovarian syndrome.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527079","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
Management of antepartum haemorrhage 产前出血的处理
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-09-03 DOI: 10.1016/j.ogrm.2024.08.001
{"title":"Management of antepartum haemorrhage","authors":"","doi":"10.1016/j.ogrm.2024.08.001","DOIUrl":"10.1016/j.ogrm.2024.08.001","url":null,"abstract":"<div><div>Obstetrics haemorrhage is the third direct leading cause for maternal mortality as highlighted in the last Mothers and Babies: Reducing risk through Audits and Confidential Enquires across the UK (MBRRACE-UK) report published in 2023. Antepartum haemorrhage (APH) can occur at any time between the age of viability until delivery. The most significant causes of APH, though not the most common, are associated with maternal and perinatal morbidity and mortality. These are placenta praevia, placental abruption, placenta accreta, vasa praevia, and uterine rupture. This review will outline the basic management principles of APH and provide an overview for most serious APH causes.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527077","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
Surgical approaches to hysterectomy in benign gynaecological conditions 良性妇科疾病的子宫切除手术方法
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-08-29 DOI: 10.1016/j.ogrm.2024.08.002
{"title":"Surgical approaches to hysterectomy in benign gynaecological conditions","authors":"","doi":"10.1016/j.ogrm.2024.08.002","DOIUrl":"10.1016/j.ogrm.2024.08.002","url":null,"abstract":"<div><div>Hysterectomy is among the most frequently performed major gynaecological procedures globally. The primary indications include various benign conditions that have not responded to conservative management, including heavy menstrual bleeding, symptomatic uterine fibroids, chronic pelvic pain and uterine prolapse. Surgeons must be well-versed in surgical anatomy and the various approaches for performing a hysterectomy. The appropriate approach should be tailored for each patient whilst taking into consideration surgical risk factors as well as modern management of complications of hysterectomy.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527078","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
Outpatient management of severe ovarian hyperstimulation syndrome 严重卵巢过度刺激综合征的门诊治疗
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-08-20 DOI: 10.1016/j.ogrm.2024.08.004
{"title":"Outpatient management of severe ovarian hyperstimulation syndrome","authors":"","doi":"10.1016/j.ogrm.2024.08.004","DOIUrl":"10.1016/j.ogrm.2024.08.004","url":null,"abstract":"<div><div>Ovarian hyperstimulation (OHSS) is an iatrogenic complication, which commonly occurs after controlled ovarian stimulation (COS) in in-vitro fertilization (IVF) cycles. Most patients experience mild to moderate OHSS and can be managed safely in an outpatient setting with regular monitoring from their fertility treatment centre. However, severe OHSS has traditionally been managed on an inpatient basis to ensure regular monitoring and bloods can be performed to ensure there is no deterioration in the patient's condition. The mainstay of treatment remains supportive care even in severe cases of OHSS. This spotlight article aims to show that, with correct patient selection, most patients can be managed safely and effectively in an outpatient setting.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527081","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
Management of connective tissue disorders and dermatological disorders in pregnancy 妊娠期结缔组织疾病和皮肤病的管理
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-08-17 DOI: 10.1016/j.ogrm.2024.07.003
{"title":"Management of connective tissue disorders and dermatological disorders in pregnancy","authors":"","doi":"10.1016/j.ogrm.2024.07.003","DOIUrl":"10.1016/j.ogrm.2024.07.003","url":null,"abstract":"<div><div>Connective tissue, rheumatological and dermatological conditions affect a large proportion of the pregnant population and have important implications for women and their babies. Some conditions are chronic but may occur de novo in pregnancy whereas some are seen only during pregnancy. Multidisciplinary care is essential to maximise fetal and maternal outcomes, since many of these women require immunosuppressive treatment and close monitoring of their pregnancies. The development of biological therapies has revolutionised treatment of many connective tissue and arthritic diseases, allowing both more targeted treatments and an increase in treatment options. Their impact on fertility is minimal compared to older treatments and hence more women are able to conceive. With new treatments there will always be concerns about safety in pregnancy but concerns around neonatal immunosuppression have largely been unfounded and the benefits of continuing medication are significant. This article uses four cases to illustrate the challenges of management.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311624","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
Surgical management of pelvic organ prolapse 盆腔器官脱垂的手术治疗
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.ogrm.2024.05.003
{"title":"Surgical management of pelvic organ prolapse","authors":"","doi":"10.1016/j.ogrm.2024.05.003","DOIUrl":"10.1016/j.ogrm.2024.05.003","url":null,"abstract":"<div><p>Pelvic organ prolapse (POP) is a common condition and is thought to affect approximately 40% of women over the age of 50, with prevalence increasing with age. 1 in 10 women will undergo surgery during their lifetime. Symptomatic women can be offered supervized pelvic floor exercises supported by Specialist Pelvic Floor Physiotherapists, vaginal pessary management or surgical management. This article covers comprehensive assessment, preoperative considerations to support shared decision making, and clinical governance surrounding surgical management of prolapse. It also provides a summary of different surgical techniques for both vaginal and abdominal approach for prolapse.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950376","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-management of vaginal pessaries for prolapse: the TOPSY trial key findings 阴道塞药治疗脱垂的自我管理：TOPSY 试验的主要发现
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.ogrm.2024.05.004
{"title":"Self-management of vaginal pessaries for prolapse: the TOPSY trial key findings","authors":"","doi":"10.1016/j.ogrm.2024.05.004","DOIUrl":"10.1016/j.ogrm.2024.05.004","url":null,"abstract":"<div><p><span>Women with symptomatic pelvic organ prolapse are offered a choice of conservative and surgical treatment options. Two thirds of women choose a vaginal </span>pessary<span>, a support device inserted in the vagina. This article reports the finding of a randomized controlled trial<span><span> published in 2023 evaluating the cost-effectiveness of self-management of pessary compared to clinic-based care. Women were recruited in 21 centres across the UK and 340 women were randomized to pessary self-management or clinic-based care. The primary outcome measure was prolapse-specific quality of life and secondary outcomes were generic quality of life, </span>pelvic floor<span> symptoms, sexual function, self-efficacy, pessary complications, pessary use and pessary confidence. Participants’ health care resource use was measured. The trial showed that at 18 month follow-up self-management was not associated with better or worse quality of life than clinic-based care. Women in the self-management group reported fewer pessary complications and lower healthcare resource use.</span></span></span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141408278","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 fetal anomaly screening scan: an international perspective 胎儿异常筛查扫描：国际视角
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.ogrm.2024.05.002
{"title":"The fetal anomaly screening scan: an international perspective","authors":"","doi":"10.1016/j.ogrm.2024.05.002","DOIUrl":"10.1016/j.ogrm.2024.05.002","url":null,"abstract":"<div><p>Fetal structural anomalies, affecting up to 3% of pregnancies, can be a major concern for expectant parents. Ultrasound screening has become an essential part of prenatal care, offering early detection of birth defects and empowering parents with information for reproductive decision making. While first-trimester scans are becoming more informative, the second-trimester scan remains the cornerstone of anomaly detection. Technological advancements, and the use of additional tools like MRI, are further enhancing our ability to ensure a healthy outcome for both mother and baby. Advancements have enabled detection of around half of all major anomalies in the first trimester (11–13+6) weeks. Professional societies recommend the second-trimester anatomy scan (18–22 weeks) as the gold standard for anomaly detection. The fetal anomaly scan boasts a high detection rate for major structural malformations, ranging from 15% to exceeding 90% in some cases. Detection rates vary depending on the organ system being examined. Equipment settings and sonographer experience play a role in accuracy. Whilst not 100% effective, the scan is safe and valuable. It empowers informed decision-making and can improve some pregnancy outcomes by enabling early detection and management. This allows for interventions, planning for delivery at the right time and place, and emotional preparation for parents. However, it is crucial to understand the limitations of the scan and the possibility of false positives or missed anomalies.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950375","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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