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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
Lewis Nancarrow, Andrew Drakeley
{"title":"Outpatient management of severe ovarian hyperstimulation syndrome","authors":"Lewis Nancarrow,&nbsp;Andrew Drakeley","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":"34 11","pages":"Pages 312-315"},"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
Frances Hills
{"title":"Management of connective tissue disorders and dermatological disorders in pregnancy","authors":"Frances Hills","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":"34 10","pages":"Pages 278-285"},"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
Navjeet Chohan, Veenu Tyagi
{"title":"Surgical management of pelvic organ prolapse","authors":"Navjeet Chohan,&nbsp;Veenu Tyagi","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":"34 8","pages":"Pages 218-228"},"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
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
Hessa Hazeem Al Suwaidi, Reham Mahmoud Abas Abdelhalem, Andrea Kaelin Agten
{"title":"The fetal anomaly screening scan: an international perspective","authors":"Hessa Hazeem Al Suwaidi,&nbsp;Reham Mahmoud Abas Abdelhalem,&nbsp;Andrea Kaelin Agten","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":"34 8","pages":"Pages 213-217"},"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
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":"34 8","pages":"Pages 229-231"},"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
Self-assessment questions 自我评估问题
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.ogrm.2024.05.005
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2024.05.005","DOIUrl":"10.1016/j.ogrm.2024.05.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 8","pages":"Pages 232-233"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950377","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
Fertility care for persons considering gender transition 为考虑性别转换者提供生育护理
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.ogrm.2024.07.004
Ephia Yasmin
{"title":"Fertility care for persons considering gender transition","authors":"Ephia Yasmin","doi":"10.1016/j.ogrm.2024.07.004","DOIUrl":"10.1016/j.ogrm.2024.07.004","url":null,"abstract":"<div><div>Referrals to the gender identity development service and gender identity clinics are increasing. Gender-affirming medical interventions can adversely impact on the fertility potential of the individual. The possible fertility impact of various treatments such as gonadotropin hormone releasing hormone agonists and cross over hormones, and surgery of genitalia and reproductive organs, should be discussed. An opportunity should be provided to discuss options for fertility preservation and patients should be assisted in decision making. It should be appreciated that transgender individuals have an increased incidence of mental health problems, and that there are currently many barriers to optimal care. Oocyte and spermatozoa cryopreservation provide options for biological parenthood.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 10","pages":"Pages 286-288"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311625","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
Antenatal screening in the UK 英国的产前筛查
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.ogrm.2024.05.001
Judith Moore, Rawia Fatouta, Danielle Christian
{"title":"Antenatal screening in the UK","authors":"Judith Moore,&nbsp;Rawia Fatouta,&nbsp;Danielle Christian","doi":"10.1016/j.ogrm.2024.05.001","DOIUrl":"10.1016/j.ogrm.2024.05.001","url":null,"abstract":"<div><p><span><span>The process of screening aims to reduce the burden of disease. In pregnancy this is relevant to both the mother and her baby. There are national screening programmes for infectious disease, haemoglobinopathy and </span>fetal anomalies, all of which have the potential to reduce the life-long burden of disease in the </span>newborn. But screening extends beyond these programmes and when risk factors are identified, interventions might be instigated to reduce the impact of disease on pregnancy outcomes. This article reviews screening in its broadest sense. It describes the various screening opportunities and considers the actions that can be taken to optimize the health of the mother and her baby. The process of screening continues throughout pregnancy, in the same way that risks evolve as pregnancy progresses.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 8","pages":"Pages 203-212"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950374","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 pelvic floor dysfunction in pregnancy 孕期盆底功能障碍的治疗
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-07-31 DOI: 10.1016/j.ogrm.2024.07.001
Rayan Mohamed-Ahmed, Angie Rantell, George Araklitis
{"title":"The management of pelvic floor dysfunction in pregnancy","authors":"Rayan Mohamed-Ahmed,&nbsp;Angie Rantell,&nbsp;George Araklitis","doi":"10.1016/j.ogrm.2024.07.001","DOIUrl":"10.1016/j.ogrm.2024.07.001","url":null,"abstract":"<div><div>Physiological changes in pregnancy can trigger or worsen a variety of pelvic floor symptoms, including stress incontinence, overactive bladder, stress incontinence and prolapse. In order to minimize both physical and psychological morbidity in the short and long term, it is important for clinicians to appropriately stratify individual risk scores and identify and manage pelvic floor disorders during pregnancy. There has been an introduction of perinatal pelvic health services as part of a government review of pelvic health in pregnancy, which aim to prevent pelvic floor dysfunction following pregnancy but identifying women at risk and referring them onwards for support from physiotherapists or specialist nurses and midwives.</div><div>This review article aims to discuss the assessment tools, government initiatives and management options for common pelvic floor disorders during pregnancy.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 10","pages":"Pages 267-270"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311622","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 : 2024-07-31 DOI: 10.1016/j.ogrm.2024.07.005
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2024.07.005","DOIUrl":"10.1016/j.ogrm.2024.07.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 10","pages":"Pages 289-291"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311626","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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