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Management of malposition and malpresentation in labour 劳动中姿势不当和表现不当的管理
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-11-01 DOI: 10.1016/j.ogrm.2023.08.004
Anna K. Richmond, Janet R. Ashworth
{"title":"Management of malposition and malpresentation in labour","authors":"Anna K. Richmond,&nbsp;Janet R. Ashworth","doi":"10.1016/j.ogrm.2023.08.004","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.08.004","url":null,"abstract":"<div><p>A <span><em>malpresentation</em></span><span> is diagnosed when any part of the baby is presenting to the maternal pelvis other than the vertex of the fetal head. A </span><em>malposition</em><span> is diagnosed when the fetal head is in any position other than occipito-anterior (OA) flexed vertex. Both malpresentation and malposition are associated with prolonged or obstructed labour, fetal and maternal morbidity<span>, and potential mortality, if not managed in labour effectively. Malpresentations can be further classified by the lie of the fetus, be it normal or abnormal. The most common fetal malpresentation in longitudinal lie is breech presentation which itself can be further subdivided into subtypes. Other malpresentations in longitudinal lie include face, brow and compound. The fetus in non-longitudinal lie may be oblique or transverse, with shoulder, arm or cord presentations. Malpositions, such as occipito-posterior (OP) and occipito-transverse (OT), can be further described by the degree of deflexion and asynclitism. This practical review considers the potential fetal abnormal presentations and positions, their risk factors, and how these should be managed during labour.</span></span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 11","pages":"Pages 325-333"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71766220","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 : 2023-11-01 DOI: 10.1016/j.ogrm.2023.08.005
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2023.08.005","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.08.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 11","pages":"Pages 334-336"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71766259","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
Primary dysmenorrhoea: a review of the current evidence 原发性痛经:当前证据综述
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-11-01 DOI: 10.1016/j.ogrm.2023.08.003
Sophie L. Walter, Yadava Jeve
{"title":"Primary dysmenorrhoea: a review of the current evidence","authors":"Sophie L. Walter,&nbsp;Yadava Jeve","doi":"10.1016/j.ogrm.2023.08.003","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.08.003","url":null,"abstract":"<div><p><span>Primary dysmenorrhoea, described as period pain in the absence of identifiable pelvic pathology, is the most common gynaecological condition worldwide. It has a significant impact on </span>quality of life<span> and contributes to difficulties in educational attainment, work productivity and gender inequality. Symptoms can be normalised and self-medication or self-help techniques are commonplace. The mainstay of management currently is non-steroidal anti-inflammatory medication and combined hormonal contraceptive pills. However, this may prove inadequate for up to a quarter of women and there is a growing body of evidence to support an individualised multifaceted approach including lifestyle modifications, non-pharmacological and pharmacological agents. Surgery may have a role in severe refractory cases.</span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 11","pages":"Pages 318-324"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71766221","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
Imaging benign gynaecological conditions 妇科良性疾病的影像学检查
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-11-01 DOI: 10.1016/j.ogrm.2023.08.002
Ishwariya Rajendran, Janette Smith, Helen Addley, Susan Freeman
{"title":"Imaging benign gynaecological conditions","authors":"Ishwariya Rajendran,&nbsp;Janette Smith,&nbsp;Helen Addley,&nbsp;Susan Freeman","doi":"10.1016/j.ogrm.2023.08.002","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.08.002","url":null,"abstract":"<div><p>Radiology<span> plays an essential role in the management of benign gynaecological conditions and includes: ultrasound; computed tomography<span> and magnetic resonance imaging. Each modality has a different role in diagnosis, treatment selection and follow-up. This review discusses the different imaging modalities, their recommended roles in the imaging and imaging findings of common female pelvic pathology.</span></span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 11","pages":"Pages 309-317"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71766260","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
Imaging malignant gynaecological conditions 妇科恶性疾病的影像学检查
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-11-01 DOI: 10.1016/j.ogrm.2023.08.001
Ishwariya Rajendran, Janette Smith, Helen Addley, Susan Freeman
{"title":"Imaging malignant gynaecological conditions","authors":"Ishwariya Rajendran,&nbsp;Janette Smith,&nbsp;Helen Addley,&nbsp;Susan Freeman","doi":"10.1016/j.ogrm.2023.08.001","DOIUrl":"https://doi.org/10.1016/j.ogrm.2023.08.001","url":null,"abstract":"<div><p><span><span>Radiology plays an essential role in the management of malignant gynaecological conditions. Multiple imaging modalities are utilised to investigate suspected gynaecological </span>malignancy<span> including: ultrasound, computed tomography, magnetic resonance imaging and positron emission tomography/computed tomography. Each modality has a different role in diagnosis, staging, treatment selection and follow-up. This review discusses the different imaging modalities and their recommended roles in the imaging of malignant </span></span>gynaecological disease. The imaging findings of common female pelvic pathology are discussed and illustrated.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 11","pages":"Pages 299-308"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71766219","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 : 2023-10-13 DOI: 10.1016/j.ogrm.2023.09.005
Anna Richmond
{"title":"Self-assessment questions","authors":"Anna Richmond","doi":"10.1016/j.ogrm.2023.09.005","DOIUrl":"10.1016/j.ogrm.2023.09.005","url":null,"abstract":"","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 12","pages":"Pages 358-360"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135707831","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
Pre-existing hypertension in pregnancy 妊娠期已有高血压
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-10-11 DOI: 10.1016/j.ogrm.2023.09.002
Charleen Lia
{"title":"Pre-existing hypertension in pregnancy","authors":"Charleen Lia","doi":"10.1016/j.ogrm.2023.09.002","DOIUrl":"10.1016/j.ogrm.2023.09.002","url":null,"abstract":"<div><p><span>Hypertension is common during pregnancy, complicating ∼10–15% of all pregnancies in the UK. The number of women who enter pregnancy affected by chronic hypertension is less clear, but has been estimated at ∼3%. Risk factors for chronic hypertension include maternal race and ethnicity, age, and body mass index<span> (BMI). The changing demographics of today's antenatal population mean that pre-existing hypertension in pregnancy is an increasing clinical problem. Chronic hypertension in pregnancy can be defined as hypertension known to be present prior to conception or first recognised before 20 weeks of gestation. Patients with chronic hypertension are at risk of a variety of adverse maternal and fetal outcomes, and hence should have a comprehensive plan of care. Optimal care includes pre-conceptual counselling, frequent antenatal visits during pregnancy, timely delivery, appropriate </span></span>intrapartum monitoring, and postpartum follow up. The relative risk of superimposed pre-eclampsia in women with chronic hypertension is nearly eightfold higher than in the general population, and all adverse neonatal outcomes are at least twice as likely to occur compared to the general population.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 12","pages":"Pages 341-345"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135663018","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 reproductive therapies and antenatal care 辅助生殖治疗和产前护理
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-10-09 DOI: 10.1016/j.ogrm.2023.09.004
Katherine Lattey, Katherine Barton, Timothy Draycott
{"title":"Assisted reproductive therapies and antenatal care","authors":"Katherine Lattey,&nbsp;Katherine Barton,&nbsp;Timothy Draycott","doi":"10.1016/j.ogrm.2023.09.004","DOIUrl":"10.1016/j.ogrm.2023.09.004","url":null,"abstract":"<div><p><span>Assisted reproductive therapy<span> (ART) is not currently included in UK national guidelines as an indication for specific antenatal, intrapartum or postpartum care even though ART pregnancies have a higher risk of complications compared to spontaneous conception singleton pregnancies. Risks include venous thromboembolism, hypertensive disorders, psychological </span></span>sequelae<span><span><span> and preterm birth. ART alone is not an indication for early induction of labour or continuous </span>electronic fetal monitoring in labour or closer postpartum surveillance. Albeit ART pregnancies may have </span>pregnancy complications that require obstetric-led care. Holistic and personalised care is a priority for all pregnancies and this should include pregnancies after ART with their increased risks related to the therapy itself and/or the underlying cause of infertility. This article outlines the considerations clinicians caring for a pregnancy following ART may need to contemplate.</span></p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 12","pages":"Pages 354-357"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135606989","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
Understanding sexual violence and the implications for practice 理解性暴力及其对实践的影响
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-10-08 DOI: 10.1016/j.ogrm.2023.09.001
Lesley McMillan
{"title":"Understanding sexual violence and the implications for practice","authors":"Lesley McMillan","doi":"10.1016/j.ogrm.2023.09.001","DOIUrl":"10.1016/j.ogrm.2023.09.001","url":null,"abstract":"<div><p>Sexual violence is a significant social problem and rates of victimisation are high. Women face a disproportionate risk of sexual violence, and the impacts and consequences are considerable. These consequences can be physical, psychological, emotional, social and interpersonal. Sexual violence is not commonly disclosed and many women presenting in gynaecologic, obstetric and reproductive medicine practice will have had experiences of sexual violence in their lifetime. These experiences can impact upon experiences of engagement with heath care. Clinicians should be aware of the forms, prevalence and impact of sexual violence in the lives of women and its potential consequences for health care. Sensitive and trauma-informed practices, particularly around intimate examinations, are vital.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 12","pages":"Pages 337-340"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136198363","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
Thromboprophylaxis in pregnancy: a practical guide for the obstetrician 妊娠期血栓预防:产科医生的实用指南
Obstetrics, Gynaecology and Reproductive Medicine Pub Date : 2023-10-05 DOI: 10.1016/j.ogrm.2023.09.003
Paul Timmons, Francoise H. Harlow, Hamish Lyall
{"title":"Thromboprophylaxis in pregnancy: a practical guide for the obstetrician","authors":"Paul Timmons,&nbsp;Francoise H. Harlow,&nbsp;Hamish Lyall","doi":"10.1016/j.ogrm.2023.09.003","DOIUrl":"10.1016/j.ogrm.2023.09.003","url":null,"abstract":"<div><p><span><span>Venous thromboembolism (VTE) in pregnancy remains a leading cause of </span>maternal morbidity and mortality. As rates of pregnancy in women with additional risk factors and underlying diagnoses continue to rise, it is crucial that all obstetricians understand how to approach </span>thromboprophylaxis at all stages of pregnancy. In this review we seek to provide a roadmap to understanding the physiology, pathology and pharmacology of VTE in pregnancy for the obstetrician in order to facilitate a greater understanding of how to best support all women at risk of VTE throughout their pregnancy journey from pre-conception to post-natally. Recent developments and emerging evidence to support changes in practice are explored as well as consideration of some more complex scenarios and discussion of ethical considerations in the hope of providing a comprehensive overview of the subject.</p></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"33 12","pages":"Pages 346-353"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134976785","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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