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Current Opinion in Obstetrics & Gynecology最新文献

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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
A review of menopause in transgender and gender diverse individuals.
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.0000000000001013
Carly E Kelley, Danit Ariel
{"title":"A review of menopause in transgender and gender diverse individuals.","authors":"Carly E Kelley, Danit Ariel","doi":"10.1097/GCO.0000000000001013","DOIUrl":"10.1097/GCO.0000000000001013","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to provide a comprehensive overview of the specific challenges, health considerations, and healthcare needs of transgender and gender diverse (TGD) people navigating menopause, highlighting the intersection of gender identity, hormone treatment, and age-related changes.</p><p><strong>Recent findings: </strong>Research on menopause in TGD individuals is lacking, without guidelines to support clinical management. This is the first review of its type to summarize the described impact of the menopausal transition on TGD individuals, the potential long-term risks associated with both gender-affirming hormone therapy and the intersectionality with aging, and how these risks may impact hormone management and overall comprehensive care.</p><p><strong>Summary: </strong>By drawing on the shared principles of cisgender menopausal hormone therapy and gender-affirming hormone therapy, providers are well positioned to apply their expertise to support the TGD population during menopause. We recommend using shared decision-making, culturally competent care, and a strong understanding of the biological, personal, and social experiences of TGD people that do not necessarily conform to stereotypically ciswoman experiences.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"83-96"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460835","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 and mental health.
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.0000000000001014
Karen Horst, Nicole Cirino, Karen E Adams
{"title":"Menopause and mental health.","authors":"Karen Horst, Nicole Cirino, Karen E Adams","doi":"10.1097/GCO.0000000000001014","DOIUrl":"10.1097/GCO.0000000000001014","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review discusses mental health changes commonly experienced by individuals during the menopause transition (MT). The pathophysiology of the MT, the chronology and type of mental health symptoms arising from this pathophysiology, and evidence-based options for treating midlife patients are discussed. This review concludes with treatment options to enable clinicians to more effectively counsel, recognize and treat symptoms during the MT.</p><p><strong>Recent findings: </strong>The MT begins earlier than previously understood with mood and cognitive issues as common initial mental health symptoms significantly impacting quality of life. These symptoms are due to profound changes in the brain's structure, connectivity, energy metabolism, and inflammation linked to perimenopausal hormone shifts. Hormone therapy, psychiatric medication, psychotherapy, and lifestyle adjustments all play a role in the management of mental health symptoms arising during the MT. Lack of both obstetrician and gynecologist and mental health clinician awareness can leave patients undertreated and vulnerable to nonevidence-based approaches.</p><p><strong>Summary: </strong>Patients in the MT are at increased risk for mental health issues, both preexisting and new onset. The OB/GYN clinician plays a key role in recognizing and addressing these conditions to improve health outcomes in midlife women.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"102-110"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460839","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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