Obstetrics, Gynaecology and Reproductive Medicine最新文献_第2页

Optimizing outcomes of pregnancy in chronic liver disease 优化慢性肝病患者妊娠结局

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2026-03-01 Epub Date: 2026-01-07 DOI: 10.1016/j.ogrm.2025.12.004

Charlotte Sewell

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Management of dichorionic diamniotic pregnancies 双绒毛膜双羊膜妊娠的处理

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2026-03-01 Epub Date: 2026-01-05 DOI: 10.1016/j.ogrm.2025.12.003

Miriam Lopian, Asma Khalil

{"title":"Management of dichorionic diamniotic pregnancies","authors":"Miriam Lopian, Asma Khalil","doi":"10.1016/j.ogrm.2025.12.003","DOIUrl":"10.1016/j.ogrm.2025.12.003","url":null,"abstract":"<div><div>Dichorionic diamniotic (DCDA) twin pregnancies, the most common form of twin gestation, are associated with a higher risk of adverse maternal and perinatal outcomes than singleton pregnancies, including fetal growth restriction, hypertensive disorders, and preterm birth. Contemporary management emphasizes individualized and multidisciplinary care, guided by early and accurate determination of chorionicity, amnionicity, and gestational age. Ongoing surveillance should include serial ultrasound assessments from the second trimester to monitor fetal growth and wellbeing, alongside screening for preterm birth and pre-eclampsia. Optimizing maternal health, ensuring appropriate timing of delivery, and providing tailored counselling are central to improving outcomes. For uncomplicated DCDA twin pregnancies, planned birth at 37 weeks of gestation achieves the best balance between the risks of stillbirth and iatrogenic prematurity. The mode of delivery is determined primarily by the presentation of the first twin and prevailing obstetric factors. This review integrates current NICE and international recommendations to inform best practice, strengthen antenatal surveillance strategies, and enhance clinical decision-making for DCDA twin pregnancies.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 3","pages":"Pages 84-90"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415164","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}

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Vaginal birth after caesarean: candidate selection, risk stratification and intrapartum care 剖宫产后顺产：候选人选择、风险分层和产时护理

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2026-03-01 Epub Date: 2026-01-06 DOI: 10.1016/j.ogrm.2025.12.001

Akshitha Meenakshi Veera Rajkumar, Myint Nyan Htein Win, Kate F Walker

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Optimizing outcomes in monochorionic pregnancies: screening, monitoring and management 优化单绒毛膜妊娠的结局：筛查、监测和管理

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2026-03-01 Epub Date: 2026-01-06 DOI: 10.1016/j.ogrm.2025.12.002

Kelsey Lennox, Asma Khalil

{"title":"Optimizing outcomes in monochorionic pregnancies: screening, monitoring and management","authors":"Kelsey Lennox, Asma Khalil","doi":"10.1016/j.ogrm.2025.12.002","DOIUrl":"10.1016/j.ogrm.2025.12.002","url":null,"abstract":"<div><div>Monochorionic pregnancies are high-risk due to the presence of shared placental circulation. They are associated with increased rates of perinatal morbidity and mortality, even in the absence of structural or chromosomal anomalies. Complications such as twin-to-twin transfusion syndrome, selective fetal growth restriction, twin anaemia-polycythaemia sequence, and single twin demise require early recognition and expert management. Fortnightly ultrasound surveillance from 16 weeks is recommended. Screening strategies including nuchal translucency, amniotic fluid volume, Doppler velocimetry and fetal size assessment play a crucial role in risk stratification. Where selective feticide is indicated, procedures must avoid intertwin transfusion and use vascular occlusion methods such as radiofrequency ablation. Monoamnionicity, conjoined twins, and rare conditions such as TRAP sequence require additional expertise. Antenatal corticosteroids are used selectively for anticipated preterm birth. Effective management requires multidisciplinary planning, timely referral, and thoughtful counselling. This review provides an evidence-based summary of the screening, monitoring, and management of monochorionic pregnancies.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 3","pages":"Pages 69-83"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147414611","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 自我评估的问题

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2026-03-01 Epub Date: 2026-01-05 DOI: 10.1016/j.ogrm.2025.12.005

Anna Richmond, Georgina Smart

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From booking to baby: a comprehensive review of the UK Maternity Care Pathway 从预订到婴儿：英国产科护理途径的全面审查

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2026-02-01 Epub Date: 2025-11-26 DOI: 10.1016/j.ogrm.2025.11.002

Rajangam Akshaya, Roy Chandrima

{"title":"From booking to baby: a comprehensive review of the UK Maternity Care Pathway","authors":"Rajangam Akshaya, Roy Chandrima","doi":"10.1016/j.ogrm.2025.11.002","DOIUrl":"10.1016/j.ogrm.2025.11.002","url":null,"abstract":"<div><div>Antenatal care in the UK has evolved since the late 20th century, following a structured, evidence-based pathway, with early booking by 10 weeks' gestation recommended to optimise maternal and fetal outcomes. The initial midwifery-led booking appointment identifies clinical and social risk factors, directing women into either standard or high-risk pathways. Those identified as high risk are referred to consultant-led or multidisciplinary clinics and undergo additional scans and monitoring throughout pregnancy. Universal antenatal care includes basic blood tests with offering of screening tests, first trimester dating and second trimester anomaly scans, with further investigations arranged as indicated. A minimum of 6–8 appointments with a named midwife supports continuity, holistic care and informed decision-making. Women are empowered to create personalised birth plans, supported by counselling on delivery options and associated risks. The pathway has evolved to incorporate targeted support for vulnerable women and late bookers. Postnatal care includes structured follow-up, contraceptive counselling, and transition to primary care. Increasingly, pre-conception and equity-focused models, such as the inverted care pyramid, are being explored to improve long-term outcomes.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"36 2","pages":"Pages 41-48"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146070930","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

Amniotic fluid in fetal life: physiology and pathophysiology 羊水在胎儿生命中的作用：生理学和病理生理学

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-11 DOI: 10.1016/j.ogrm.2025.11.001

Nashwa Anwar, Leo Gurney

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Management of pre-existing diabetes in pregnancy 妊娠期糖尿病的管理

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2026-02-01 Epub Date: 2025-11-20 DOI: 10.1016/j.ogrm.2025.11.003

Anna K Richmond, Amy E Morrison, Claire L Meek

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A placenta accreta spectrum review: focusing on antenatal care and surgical approach 胎盘增生谱回顾：重点产前护理和手术方法

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2026-02-01 Epub Date: 2025-11-20 DOI: 10.1016/j.ogrm.2025.11.004

Lucy Blanks, Nia Wyn Jones

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Self-assessment questions 自我评估的问题

Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-08 DOI: 10.1016/j.ogrm.2025.11.005

Anna Richmond, Georgina Smart

引用次数: 0