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Obstetrics, Gynaecology and Reproductive Medicine最新文献

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Self-assessment questions 自我评估问题
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-02-21 DOI: 10.1016/j.ogrm.2024.02.001
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.ogrm.2024.02.001","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 4","pages":"Pages 109-111"},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290650","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 new-onset hypertension in pregnancy 妊娠期新发高血压的管理
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-02-17 DOI: 10.1016/j.ogrm.2024.01.004
Bernadette Jenner, Ian B. Wilkinson
{"title":"Management of new-onset hypertension in pregnancy","authors":"Bernadette Jenner,&nbsp;Ian B. Wilkinson","doi":"10.1016/j.ogrm.2024.01.004","DOIUrl":"10.1016/j.ogrm.2024.01.004","url":null,"abstract":"<div><p>Hypertensive disorders affect approximately 8–10% of all pregnancies and include pre-eclampsia, gestational hypertension and pre-existing chronic hypertension, which may be primary or secondary. New onset hypertension in pregnancy is defined as a sustained systolic blood pressure (sBP) ≥140 mmHg <em>and/or</em> diastolic blood pressure (dBP) ≥90 mmHg, and severe hypertension diagnosed when sBP ≥160 mmHg <em>and/or</em> dBP ≥110 mmHg. Gestational hypertension and pre-eclampsia are most common, affecting 4.2–7.9% and 1.5–7.7% respectively. Chronic hypertension affects 0.6–2.7% of pregnancies but may be under-reported due to early physiological adaptations in pregnancy lowering blood pressure or unknown preconception blood pressure. New onset hypertension developing at any stage of pregnancy requires a full history, examination, and investigations to delineate an underlying cause, assess for target organ damage and the presence of pre-eclampsia to assign risk. Developing a hypertensive disorder in pregnancy is associated with increased life-long cardiometabolic risk and other cardiovascular risk factors should be minimised to improve a woman's long-term health.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 4","pages":"Pages 101-108"},"PeriodicalIF":0.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139966812","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 impact of the COVID-19 pandemic on training in obstetrics and gynaecology in the UK COVID-19 大流行对英国妇产科培训的影响
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-02-13 DOI: 10.1016/j.ogrm.2024.01.002
Sophie Wienand-Barnett, Karen Guerrero, Alec McEwan
{"title":"The impact of the COVID-19 pandemic on training in obstetrics and gynaecology in the UK","authors":"Sophie Wienand-Barnett,&nbsp;Karen Guerrero,&nbsp;Alec McEwan","doi":"10.1016/j.ogrm.2024.01.002","DOIUrl":"10.1016/j.ogrm.2024.01.002","url":null,"abstract":"<div><p>During the COVID-19 pandemic clinical practice in obstetrics and gynaecology (O&amp;G) underwent swift and dramatic changes, some transient, others permanent. Training, continuous professional development, educational supervision, and other non-patient facing roles were initially paused. Trainees and trainers saw unprecedented changes to their working patterns. With these changes it is unsurprising there was a significant effect on training in O&amp;G. For the majority obstetric training was unaffected. However, most trainees reported a reduction to their gynaecological training. Furthermore, three quarters of trainees reported COVID had negatively impacted on both their physical and mental well-being. Training recovery has been proactively managed and the impact on progression for many mitigated. There is no doubt the COVID-19 impacted training in O&amp;G. The pandemic has had a greater impact on gynaecological training than obstetric training. The impact on gynaecological operative training persists. The long-term effects on trainees remain to be seen.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 4","pages":"Pages 88-92"},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139871980","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
Fetal anaemia 胎儿贫血
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-02-12 DOI: 10.1016/j.ogrm.2024.01.003
Borna Poljak, Alec McEwan
{"title":"Fetal anaemia","authors":"Borna Poljak,&nbsp;Alec McEwan","doi":"10.1016/j.ogrm.2024.01.003","DOIUrl":"10.1016/j.ogrm.2024.01.003","url":null,"abstract":"<div><p>Fetal anaemia is a relatively rare occurrence, but it carries a risk of significant fetal morbidity and mortality. The most common causes of fetal anaemia are haemolytic disease of fetus and newborn and parvovirus B19 infection. The only diagnostic test for fetal anaemia is fetal blood sampling, but this is an invasive test with associated risk of miscarriage, preterm membrane rupture or intrauterine fetal death. Therefore it is only performed if there is a strong suspicion of fetal anamia based on the patient's history and ultrasound findings of raised peak systolic velocity in middle cerebral artery and/or fetal hydrops. The treatment for fetal anaemia is symptomatic rather than curative in most of the cases. In severely anaemic fetuses intrauterine blood transfusion is undertaken which corrects the anaemia but does not deal with the underlying cause. The aim of this intervention is to reach the gestation when the delivery is safer.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 4","pages":"Pages 93-100"},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139871907","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
An update on the assessment and management of hirsutism 多毛症评估和管理的最新进展
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-02-12 DOI: 10.1016/j.ogrm.2024.01.001
Ilianna Armata, Alka Prakash
{"title":"An update on the assessment and management of hirsutism","authors":"Ilianna Armata,&nbsp;Alka Prakash","doi":"10.1016/j.ogrm.2024.01.001","DOIUrl":"10.1016/j.ogrm.2024.01.001","url":null,"abstract":"<div><p>Hirsutism is the abnormal excessive growth of coarse terminal hair over androgen-sensitive body areas. It is a very common endocrine pathology, affecting up to 10% of young females and has been linked with multiple conditions. Polycystic ovary syndrome (PCOS) and Idiopathic hirsutism encompass 90% of the cases. Patients presenting with hirsutism may require additional investigations and a plan with options for treatment. Mechanical hair removal is first-line management, along with lifestyle changes. Laser and phototherapy have been gaining popularity. The combined contraceptive pill is the preferred initial medical treatment offered, if not contraindicated, followed by anti-androgen therapy. Other emerging therapeutic options are inositol and vitamin D, especially in patients with PCOS. Treatment options should be discussed with patients, irrespective of the clinical severity, as they could be addressing underlying psychosocial concerns.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 4","pages":"Pages 81-87"},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139816384","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
Caesarean scar pregnancy, a rare but emerging problem: an overview of diagnosis, management and potential preventative strategies 剖腹产瘢痕妊娠，一个罕见但新出现的问题：诊断、管理和潜在预防策略概述
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-02-01 DOI: 10.1016/j.ogrm.2023.11.004
Joana Mousinho, Fiona R. Clarke
{"title":"Caesarean scar pregnancy, a rare but emerging problem: an overview of diagnosis, management and potential preventative strategies","authors":"Joana Mousinho,&nbsp;Fiona R. Clarke","doi":"10.1016/j.ogrm.2023.11.004","DOIUrl":"10.1016/j.ogrm.2023.11.004","url":null,"abstract":"<div><p><span>With the rate of Caesarean sections rising globally, we are seeing an increase in associated complications. One of these complications is a Caesarean scar pregnancy (CSP). These are </span>ectopic pregnancies that implant into the scar of the previous Caesarean section and are associated with severe maternal and fetal morbidity and mortality. An early diagnosis of CSP and prompt intervention can help to mitigate some of the risks. In this review article we go through the diagnosis and management of CSP. We also present two cases of CSP, both managed in the same way but with very different outcomes, illustrating the complexity of this condition. Finally we review the emerging evidence for prevention of scar niche formation.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 2","pages":"Pages 44-49"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139196318","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 : 2024-02-01 DOI: 10.1016/j.ogrm.2023.11.005
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2023.11.005","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.11.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 2","pages":"Pages 50-52"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139654204","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
Navigating and understanding clinical governance and risk management in maternity 引导和了解产科临床治理和风险管理
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-02-01 DOI: 10.1016/j.ogrm.2023.11.003
Lucy Blanks, Gemma Wright
{"title":"Navigating and understanding clinical governance and risk management in maternity","authors":"Lucy Blanks,&nbsp;Gemma Wright","doi":"10.1016/j.ogrm.2023.11.003","DOIUrl":"10.1016/j.ogrm.2023.11.003","url":null,"abstract":"<div><p>An understanding of clinical governance<span><span> and risk management is essential for a career in obstetrics and </span>gynaecology. In a stressed and struggling system, knowing where and how to improve our maternity services is crucial in order to keep our patients safe. This article outlines the principles of clinical governance with a focus on risk management; it provides insight as to how this is managed and implemented within NHS trusts. We will look at how just culture and systems-based learning determine the effectiveness of both, and we will demonstrate how this is used by external governing bodies to judge the safety of maternity units. Only through robust clinical governance structures is the NHS able to ensure that it learns from mistakes and evolves to safeguard future patients and its workforce. Knowledge of the inner workings of these structures is important for examination preparation, any job interview, and for providing responsible and safe care to patients as a clinician.</span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 2","pages":"Pages 39-43"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139187916","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
Effects of cancer treatment on reproductive health 癌症治疗对生殖健康的影响
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-02-01 DOI: 10.1016/j.ogrm.2023.11.002
Karolina Palinska-Rudzka, Cheryl Fitzgerald
{"title":"Effects of cancer treatment on reproductive health","authors":"Karolina Palinska-Rudzka,&nbsp;Cheryl Fitzgerald","doi":"10.1016/j.ogrm.2023.11.002","DOIUrl":"10.1016/j.ogrm.2023.11.002","url":null,"abstract":"<div><p>Cancer treatments, including chemotherapy, surgery, and radiotherapy, present distinct challenges to reproductive health<span><span>. Ovarian function<span> might undergo various degrees of impairment, leading to a significantly diminished ovarian reserve<span>, even without persistent amenorrhea<span>. The return of menses post-chemotherapy might not mirror the full extend of follicular damage. Ovarian reserve testing is indicated in reproductive-aged cancer survivors. The magnitude of follicle depletion can be influenced by factors such as age, initial ovarian reserve, and specific treatment modalities. Radiotherapy, dependent on its target, can introduce risk to both ovarian and uterine health. Moreover, radiotherapy targeting the brain can disrupt the hypothalamic-pituitary-reproductive axis, adding another layer of reproductive complication. As </span></span></span></span>cancer survival rates improve, addressing these multifaceted reproductive concerns has become essential.</span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 2","pages":"Pages 33-38"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139187716","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
Preventing cervical cancer through human papillomavirus vaccination and cervical screening programmes 通过人类乳头瘤病毒疫苗接种和宫颈筛查计划预防宫颈癌
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2024-02-01 DOI: 10.1016/j.ogrm.2023.11.001
Mark McGowan, Peter Otott
{"title":"Preventing cervical cancer through human papillomavirus vaccination and cervical screening programmes","authors":"Mark McGowan,&nbsp;Peter Otott","doi":"10.1016/j.ogrm.2023.11.001","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.11.001","url":null,"abstract":"<div><p><span>Cervical cancer causes more than 300,000 deaths worldwide every year, affecting women from a young age. It has a well-understood natural history, caused by HPV, which is estimated to be responsible for 99.8% of cases. In order to decrease the number of UK cervical cancer cases, a national screening programme was launched in 1988. Women between the ages of 25 and 64 are invited for </span>cervical screening<span>. A primary high-risk HPV testing approach is used, whereby samples are only tested for cytology<span><span> if they are positive for high-risk HPV. The national HPV vaccination programme was introduced in 2008 in the UK. The Gardasil 9 vaccine is offered at year 8 in UK schools (ages 12–13 years old) to boys and girls. These programmes have been a huge success in reducing the number of cervical cancer cases. However, still only 70% of eligible women attend their screening appointments. To further increase the proportion of women reached by the programme, further alternatives are currently tested, including home vaginal swab tests and </span>urinary HPV testing.</span></span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"34 2","pages":"Pages 29-32"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139654205","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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