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Current Opinion in Obstetrics & Gynecology最新文献

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The use of GLP-1: receptor agonist medications for benign gynecology.
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-04 DOI: 10.1097/GCO.0000000000001028
Megan D Howard, Sarah E Allen
{"title":"The use of GLP-1: receptor agonist medications for benign gynecology.","authors":"Megan D Howard, Sarah E Allen","doi":"10.1097/GCO.0000000000001028","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001028","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes research on glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications and their relevance in the treatment of benign gynecologic conditions.</p><p><strong>Recent findings: </strong>GLP-1 RA use is increasing in popularity in the USA, with expanding applications for gynecology. GLP-1 RA may improve weight loss, metabolic dysfunction, and menstrual regularity in patients with polycystic ovarian syndrome (PCOS). Side effects of these medications, including delayed gastric emptying, impact perioperative management, and the efficacy of oral contraception for patients on tirzepatide. Research is ongoing for their use in infertility and endometrial hyperplasia treatment. Recent studies showed a higher spontaneous conception rate and pregnancy rate with combined GLP-1 RA and metformin therapy when taken before IVF. Further studies are needed to establish recommendations for GLP-1 RA medication use in treating gynecologic conditions.</p><p><strong>Summary: </strong>With obesity, diabetes, and cardiovascular disease on the rise in the USA, the use of GLP-1 RA medication is also increasing. GLP-1 RAs are currently indicated for the treatment of diabetes with cardiovascular disease to improve glycemic control, in addition to weight loss management. Gynecologists must consider the implications of GLP-1 RA medication in treating metabolic disorders, such as PCOS, contraceptive management, perioperative care, and potential impacts on infertility and endometrial hyperplasia.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Womb for debate: the complexities of early-age hysterectomies.
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-04 DOI: 10.1097/GCO.0000000000001031
Maria C Alzamora, Lindsey N Valentine, Megan R Billow
{"title":"Womb for debate: the complexities of early-age hysterectomies.","authors":"Maria C Alzamora, Lindsey N Valentine, Megan R Billow","doi":"10.1097/GCO.0000000000001031","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001031","url":null,"abstract":"<p><strong>Purpose of review: </strong>Hysterectomy remains one of the most performed gynecologic procedures, yet its application in young and nulliparous individuals raises complex ethical, medical, and psychosocial considerations. As early detection of gynecologic conditions improves, requests for hysterectomy at younger ages may increase. This review examines the current literature on the morbidity, quality of life, psychological impact, and social implications of hysterectomy in younger patients.</p><p><strong>Recent findings: </strong>Research indicates both benefits and risks associated with early-age hysterectomy. While it provides significant symptom relief for conditions such as chronic pelvic pain, endometriosis, and fibroids, studies also suggest an increased risk of cardiovascular disease, metabolic disorders, and psychological distress. Younger patients may experience residual symptoms and identity disruption, particularly in relation to fertility loss. While regret appears to be low in the short term, long-term data on patient satisfaction remain limited. In addition, hysterectomy plays a critical role in gender-affirming care, highlighting the need for individualized counseling.</p><p><strong>Summary: </strong>Gynecology providers must engage in shared decision-making, providing evidence-based counseling on the benefits, risks, and alternatives to hysterectomy. Future research should focus on long-term outcomes, particularly in younger and nulliparous patients, to guide best practices and optimize patient-centered care.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Access to maternity care: challenges and solutions for improving equity across US communities. 获得孕产妇护理：提高美国各社区公平性的挑战和解决方案。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2024-11-05 DOI: 10.1097/GCO.0000000000001003
Katy B Kozhimannil, Julia D Interrante, Alecia J McGregor
{"title":"Access to maternity care: challenges and solutions for improving equity across US communities.","authors":"Katy B Kozhimannil, Julia D Interrante, Alecia J McGregor","doi":"10.1097/GCO.0000000000001003","DOIUrl":"10.1097/GCO.0000000000001003","url":null,"abstract":"<p><strong>Purpose of review: </strong>Improving maternal health is a clinical and policy priority in the United States. We reviewed recent literature on access to maternity care and impacts on racial and geographic equity.</p><p><strong>Recent findings: </strong>New research indicates a wide range of consequences of obstetric unit closures, as well as health challenges for lower-volume obstetric units and those who travel long distances to care.</p><p><strong>Summary: </strong>As maternal mortality rates rise, maternity care access is declining in the US, especially in rural areas and communities with a higher proportion of Black, Latinx, or Indigenous residents. Lack of resources and financial strain are challenges for low-volume and Black-serving obstetric units, and targeted investments may help improve safety and access.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"43-48"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
GLP-1 receptor agonists for weight loss for perimenopausal and postmenopausal women: current evidence.
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2025-02-25 DOI: 10.1097/GCO.0000000000001015
Hana Mikdachi, Rebecca Dunsmoor-Su
{"title":"GLP-1 receptor agonists for weight loss for perimenopausal and postmenopausal women: current evidence.","authors":"Hana Mikdachi, Rebecca Dunsmoor-Su","doi":"10.1097/GCO.0000000000001015","DOIUrl":"10.1097/GCO.0000000000001015","url":null,"abstract":"<p><strong>Purpose of review: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RA) have emerged as a leading pharmacologic for managing weight gain across most populations, including peri and postmenopausal women who frequently suffer from weight gain. There is a paucity of data about this specific population and how they respond to these medications. This review aims to discuss the data available about the use and effects of GLP-1 RAs in the peri and postmenopausal populations.</p><p><strong>Recent findings: </strong>GLP-1 RAs are consistently the most effective pharmacologic for weight loss and can be a valuable tool for use in peri and postmenopausal women.</p><p><strong>Summary: </strong>Additional research is needed to determine the risks and benefits and ideal use of GLP-1 RAs in peri and postmenopausal women.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"97-101"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Menopause.
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2025-02-25 DOI: 10.1097/GCO.0000000000001016
Amy J Voedisch
{"title":"Menopause.","authors":"Amy J Voedisch","doi":"10.1097/GCO.0000000000001016","DOIUrl":"10.1097/GCO.0000000000001016","url":null,"abstract":"","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":"37 2","pages":"66"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Contemporary uses of "lethal" or "life limiting" terminology in perinatal research. 围产期研究中“致命”或“生命限制”术语的当代使用。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2024-12-30 DOI: 10.1097/GCO.0000000000001010
Luke A Gatta, Allison M McCarthy, Sarah S Osmundson
{"title":"Contemporary uses of \"lethal\" or \"life limiting\" terminology in perinatal research.","authors":"Luke A Gatta, Allison M McCarthy, Sarah S Osmundson","doi":"10.1097/GCO.0000000000001010","DOIUrl":"10.1097/GCO.0000000000001010","url":null,"abstract":"<p><strong>Purpose of review: </strong>A life-limiting fetal diagnosis (LLD) refers to a medical condition identified during pregnancy that is expected to lead to stillbirth, preclude ex utero survival, or significantly reduce neonatal life expectancy. The terms 'lethal' or 'life-limiting' are used to prognosticate early death for various anatomic or physiologic causes, although the expected timeframe is nonspecific. The purpose of this manuscript is to review how the terms 'lethal' or 'life limiting' are used in contemporary perinatal research.</p><p><strong>Recent findings: </strong>Depending on the study design, 'life-limiting' is defined either prior to data analysis (such as prospective cohort studies), or after outcomes are assessed (such as case series). When 'life-limiting' is defined prior to data analysis, study-specific specific definitions may include timeframes from birth to death, probability of neonatal mortality, or a list of diagnoses based off billing codes.</p><p><strong>Summary: </strong>Professional societies have guidelines to standardize the reporting of vital statistics, including early death. While these fall short of defining LLDs comprehensively, they present an opportunity for more specific prognostication following prenatal diagnosis, which may improve research standardization to facilitate a clearer understanding of LLDs in clinical practice.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"49-54"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rho(D) immune globulin shortage and fetal Rh(D) screening with cell-free DNA. Rho(D)免疫球蛋白缺乏和胎儿Rh(D)无细胞DNA筛查。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2024-12-30 DOI: 10.1097/GCO.0000000000001011
Matthew R Grace, Brighton Goodhue, Neeta L Vora
{"title":"Rho(D) immune globulin shortage and fetal Rh(D) screening with cell-free DNA.","authors":"Matthew R Grace, Brighton Goodhue, Neeta L Vora","doi":"10.1097/GCO.0000000000001011","DOIUrl":"10.1097/GCO.0000000000001011","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite the availability of Rh(D) immune globulin (RhIg) to prevent alloimmunization in Rh(D)-negative pregnant patients, anti-Rh(D) alloimmunization remains a prevalent cause of hemolytic disease of the fetus and newborn (HDFN). Recent RhIg shortages have caused clinicians and professional societies to identify methods to prioritize RhIg administration. New cell-free DNA (cfDNA) tests to predict fetal red blood cell antigen genotypes have been proposed as an option to prioritize the administration of RhIg to Rh(D)-negative pregnant people.</p><p><strong>Recent findings: </strong>Commercial laboratories offer fetal Rh(D) genotype testing as part of cfDNA screening for fetal aneuploidy. Studies indicate that these tests have a high sensitivity and specificity for the detection of fetal Rh(D) status. Considering the current RhIg shortage, the American College of Obstetricians & Gynecologists (ACOG) suggests that utilizing cfDNA tests to determine fetal Rh(D) status is a reasonable approach to prioritize RhIg administration when supply is limited.</p><p><strong>Summary: </strong>cfDNA screening for fetal Rh(D) status is a reasonable approach to triage the administration of RhIg in the setting of the current RhIg shortage. Utilization of cfDNA screening for fetal Rh(D) and other red blood cell antigen status is likely to increase in routine care. Research, professional society guidance, and education are necessary to ensure well tolerated and equitable utilization.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"55-59"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
State of the art endocrine treatments for patients diagnosed with endometrial cancer in 2025. 2025年诊断为子宫内膜癌的患者的最先进的内分泌治疗。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2024-12-10 DOI: 10.1097/GCO.0000000000001008
Fernanda B Musa, Kathleen N Moore, Vivek Podder, Brian M Slomovitz
{"title":"State of the art endocrine treatments for patients diagnosed with endometrial cancer in 2025.","authors":"Fernanda B Musa, Kathleen N Moore, Vivek Podder, Brian M Slomovitz","doi":"10.1097/GCO.0000000000001008","DOIUrl":"10.1097/GCO.0000000000001008","url":null,"abstract":"<p><strong>Purpose of review: </strong>Endometrial cancer (EC) is rising in incidence, particularly in younger, premenopausal women, due to increasing rates of obesity and delayed childbearing. This review evaluates current and emerging endocrine therapies, with a focus on fertility-preserving approaches for early-stage EC and treatment options for advanced or recurrent disease.</p><p><strong>Recent findings: </strong>Fertility-sparing endocrine therapies, such as medroxyprogesterone acetate, megestrol acetate, and levonorgestrel-releasing intrauterine devices, achieve high response rates but carry recurrence risks. Biomarkers, including progesterone receptor status and molecular subtyping, are improving patient selection and outcomes. In advanced EC, single-agent and combination endocrine therapies with agents like selective estrogen receptor modulators, selective estrogen receptor down-regulators (SERDs), and aromatase inhibitors show efficacy, especially in hormone receptor-positive disease. Newer agents, including next-generation SERDs and proteolysis-targeting chimeras, hold potential for treating resistant cases.</p><p><strong>Summary: </strong>Endocrine therapy offers a well tolerated alternative to chemotherapy in selected EC patients, particularly those with hormone-sensitive tumors. Advances in molecular profiling and the development of novel endocrine agents are refining treatment strategies, supporting endocrine therapy's continued role in managing EC across various stages.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"111-119"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Updates in nonhormonal therapy for perimenopausal and menopausal symptoms. 围绝经期和更年期症状的非激素治疗的最新进展。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2025-01-13 DOI: 10.1097/GCO.0000000000001009
Amy J Voedisch
{"title":"Updates in nonhormonal therapy for perimenopausal and menopausal symptoms.","authors":"Amy J Voedisch","doi":"10.1097/GCO.0000000000001009","DOIUrl":"10.1097/GCO.0000000000001009","url":null,"abstract":"<p><strong>Purpose of review: </strong>Perimenopausal and menopausal symptoms are common and may significantly impact quality of life. Menopausal hormone therapy is the most effective treatment but may not be appropriate in all cases. Nonhormonal alternatives range from lifestyle changes and dietary supplements to medical interventions and prescription therapies. This review will summarize the newest advancements in nonhormonal therapies for bothersome perimenopausal and menopausal symptoms.</p><p><strong>Recent findings: </strong>The Menopause Society recently updated their recommendations and guidelines for nonhormonal therapies. Previous recommendations, such as clonidine and pregabalin, are no longer recommended. A new class of medication, neurokinin B antagonists, are now available to target vasomotor symptoms and show promise in addressing sleep and mood issues.</p><p><strong>Summary: </strong>Well tolerated, effective nonhormonal therapies are available to address perimenopausal and menopausal symptoms for those patients who are not candidates for or chose not to use menopausal hormone therapy.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"67-74"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial introductions.
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2025-02-25 DOI: 10.1097/GCO.0000000000001018
{"title":"Editorial introductions.","authors":"","doi":"10.1097/GCO.0000000000001018","DOIUrl":"10.1097/GCO.0000000000001018","url":null,"abstract":"","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":"37 2","pages":"v-vi"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","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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