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Medico-legal issues in gynaecology 妇科医疗法律问题
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.ogrm.2023.07.003
Roberta Bugeja, Swati Jha
{"title":"Medico-legal issues in gynaecology","authors":"Roberta Bugeja,&nbsp;Swati Jha","doi":"10.1016/j.ogrm.2023.07.003","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.07.003","url":null,"abstract":"<div><p><span>Medicolegal issues in </span>gynaecology<span> pose unique challenges to the healthcare system. This article explores the complex landscape of legal considerations in gynaecological practice, including informed consent<span>, medical negligence, patient autonomy, and ethical dilemmas. Gynaecological procedures such as reproductive interventions and pelvic surgeries<span> often involve sensitive and intimate matters, making the medicolegal framework critical for protecting patient rights and ensuring good-quality care. Through a comprehensive review of relevant literature and case studies, this article highlights the need for interdisciplinary collaboration among healthcare providers, legal professionals, and policymakers to navigate these complex issues. It also highlights the importance of clear guidelines, education and training to promote ethical decision-making, accountability and avoidance of litigation. By addressing medicolegal challenges in gynaecology, the healthcare system will be able to uphold patient welfare, safeguard the rights of patients and maintain the highest standards of care.</span></span></span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 10","pages":"Pages 286-290"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50183477","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 management of fibroids 纤维瘤的现代治疗
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.ogrm.2023.07.004
Miriam N. Baumgarten, Lukasz T. Polanski
{"title":"Modern management of fibroids","authors":"Miriam N. Baumgarten,&nbsp;Lukasz T. Polanski","doi":"10.1016/j.ogrm.2023.07.004","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.07.004","url":null,"abstract":"<div><p>Fibroids are uterine smooth muscle tumours<span><span> which are commonly found. They can vary in their number, location and size. Depending on the location and the size, fibroids can be symptomatic. Symptoms include menstrual dysfunction, pressure or </span>subfertility<span><span>. The treatment<span> strategies will depend on the patient's characteristics<span>, of which the most important is the wish to preserve the uterus. In this review all treatment modalities will be discussed with their risks. Clinicians need to be aware of the very rare risk of these benign tumours developing into </span></span></span>malignancy.</span></span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 10","pages":"Pages 291-296"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50183507","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
Obstetric anaesthesia: more than just pain relief 产科麻醉：不仅仅是止痛
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.ogrm.2023.07.001
Samuel Besant, Elizabeth Maronge
{"title":"Obstetric anaesthesia: more than just pain relief","authors":"Samuel Besant,&nbsp;Elizabeth Maronge","doi":"10.1016/j.ogrm.2023.07.001","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.07.001","url":null,"abstract":"<div><p>Obstetric<span> anaesthetists are becoming more frequently involved in many women's maternity care. During the antenatal period<span>, many women will visit the antenatal anaesthetic clinic to discuss risk factors for anaesthetic intervention and how these may affect the woman's individual birth plan. Prior planning and the involvement of multidisciplinary teams allows for risk mitigation, and a personalised plan to be created for each woman with her involvement. An increasing number of women are also requiring surgical intervention as part of their maternity care. An understanding of the factors which affect the anaesthetic used for each woman, and the risks but also benefits of each one allows better appreciation of the decision-making principles involved. In a period that requires quick decisions to ensure the best outcomes possible, clear communication within the team allows for interventions to be fully optimised.</span></span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 10","pages":"Pages 275-280"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50183479","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 : 2023-10-01 DOI: 10.1016/j.ogrm.2023.07.005
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2023.07.005","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.07.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 10","pages":"Pages 297-298"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50183508","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
Review of invasive cervical cancer 癌症侵袭性研究进展
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.ogrm.2023.07.002
Alison Montgomery, Andrew Durden, Srividya Sundararajan, Hoda Al-Booz, Claire Newton
{"title":"Review of invasive cervical cancer","authors":"Alison Montgomery,&nbsp;Andrew Durden,&nbsp;Srividya Sundararajan,&nbsp;Hoda Al-Booz,&nbsp;Claire Newton","doi":"10.1016/j.ogrm.2023.07.002","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.07.002","url":null,"abstract":"<div><p><span>This review of invasive cervical cancer explores the aetiology with HPV infection and prevention through vaccination. Diagnosis, imaging studies and the most recent </span>FIGO<span> staging are discussed. Management of stages 1A1-1B2 with surgery and stages 1B3-IV with chemoradiation<span><span> are outlined. Fertility-sparing approaches along with exenteration and </span>palliative treatments are also summarised.</span></span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 10","pages":"Pages 281-285"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50183478","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 : 2023-09-01 DOI: 10.1016/j.ogrm.2023.06.005
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2023.06.005","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.06.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 9","pages":"Pages 271-273"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50191905","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 challenges in primary and secondary postpartum haemorrhage 原发性和继发性产后出血的管理挑战
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-09-01 DOI: 10.1016/j.ogrm.2023.06.001
Naomi Taylor, Nicholas Brazel
{"title":"Management challenges in primary and secondary postpartum haemorrhage","authors":"Naomi Taylor,&nbsp;Nicholas Brazel","doi":"10.1016/j.ogrm.2023.06.001","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.06.001","url":null,"abstract":"<div><p>In this review article we will cover the management of both primary and secondary postpartum haemorrhage<span><span>. Detailed national guidance on the management of primary PPH has been in place since 1998. Despite this, multiple MBRRACE-UK reports have consistently found significant scope for improvement in the care delivered to women. The recurrent nature of the themes highlighted in the reports is equally sobering, which suggests a failure to learn from these tragic cases. The first part of this paper will provide practical steps that can be taken to embed the learning from successive MBRRACE-UK reports into our day-to-day clinical practice. The second part of this paper will provide an overview of the literature on secondary postpartum haemorrhage. Secondary PPH is associated with significant maternal morbidity. Despite this, there is a lack of </span>randomised controlled trials to inform the management of these women, and the long-term sequalae associated with both the condition and its management is unknown.</span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 9","pages":"Pages 243-254"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50191900","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
Organoid cultures as model systems to study disorders of the human endometrium and placenta 类器官培养作为研究人类子宫内膜和胎盘疾病的模型系统
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-09-01 DOI: 10.1016/j.ogrm.2023.06.004
Ashley Moffett
{"title":"Organoid cultures as model systems to study disorders of the human endometrium and placenta","authors":"Ashley Moffett","doi":"10.1016/j.ogrm.2023.06.004","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.06.004","url":null,"abstract":"<div><p><span>Studying the underlying pathogenesis of disorders of the endometrium<span><span> and of human pregnancy is challenging due to the lack of good in vivo and animal models. The development of organoid cultures has provided new opportunities to perform experiments in humans that recapitulate the in vivo situation. Endometrial organoids can be derived from tissues or menstrual fluid and respond robustly to ovarian hormones. Placental trophoblast organoids can only be generated from </span>placentas<span> under 9 weeks gestation. These assemble to form the structure of a placental villus. Modification of the culture conditions drives them to differentiate to the invading trophoblast that functions to transform the uterine </span></span></span>spiral arteries<span>. This process is critical for pregnancy success. These model systems will be transformative in understanding the biology of the female reproductive tract in health and disease.</span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 9","pages":"Pages 268-270"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50191904","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 management of acquired bleeding disorders in pregnancy 妊娠期获得性出血性疾病的处理
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-09-01 DOI: 10.1016/j.ogrm.2023.06.003
Jahnavi Daru, Bethan Myers
{"title":"The management of acquired bleeding disorders in pregnancy","authors":"Jahnavi Daru,&nbsp;Bethan Myers","doi":"10.1016/j.ogrm.2023.06.003","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.06.003","url":null,"abstract":"<div><p>This article will highlight how to identify, diagnose and manage acquired bleeding disorders in pregnancy. Postpartum haemorrhage<span> is the leading acquired bleeding disorder, but is extensively covered in multiple guidelines and within the MRCOG curriculum, so we will instead focus on platelet disorders<span>. This is an important area to understand the investigation of and how platelet disorders can range from pre-existing conditions to those acquired only in pregnancy and related to placental dysfunction.</span></span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 9","pages":"Pages 255-259"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50191903","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
Assisted vaginal birth: what is best practice? 辅助阴道分娩：什么是最佳实践？
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-09-01 DOI: 10.1016/j.ogrm.2023.06.002
Katherine Lattey, Andrew Demetri, Timothy Draycott, Emily Hotton
{"title":"Assisted vaginal birth: what is best practice?","authors":"Katherine Lattey,&nbsp;Andrew Demetri,&nbsp;Timothy Draycott,&nbsp;Emily Hotton","doi":"10.1016/j.ogrm.2023.06.002","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.06.002","url":null,"abstract":"<div><p><span><span>Assisted vaginal birth<span> (AVB) is the vaginal birth of a baby performed with the help of a medical device<span>. In the United Kingdom, 10–15% of birthing people will have an AVB for maternal and/or fetal indications. Devices for AVB most commonly include forceps and vacuum, with differing risks and benefits. However, complications can include maternal and fetal morbidity. The decision-making in AVB is complex and multi-factorial to ensure a safe AVB is achieved. Technical and non-technical skills including: communication, situational awareness and human factors, are crucial for </span></span></span>holistic care<span>. Safety considerations comprised of a thorough assessment, intrapartum care and postnatal aspects of management. Training needs to cover all aspects of a competent AVB, including understanding the different devices and evaluating which to use in varied clinical settings. With rising rates of second-stage caesarean AVB continues to be an essential skill in </span></span>obstetric care.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 9","pages":"Pages 260-267"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50191906","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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