Current opinion in gynecology and obstetrics最新文献_第2页

The Utilization of Viscoelastic Testing to Guide Blood Component Therapy and Adjunctive Hemostatic Therapy for Postpartum Hemorrhage: A Narrative Review 应用粘弹性试验指导产后出血血液成分治疗和辅助止血治疗的综述

Current opinion in gynecology and obstetrics Pub Date : 2019-08-09 DOI: 10.18314/COGO.V2I1.1837

Baumgartner S, Shariff F, Vande Lune Sa, Zackariya N, Grisoli A, McCauley R, Zackariya S, Patel S, Sualeh A, Hake D, Thomas Av, Walsh M

{"title":"The Utilization of Viscoelastic Testing to Guide Blood Component Therapy and Adjunctive Hemostatic Therapy for Postpartum Hemorrhage: A Narrative Review","authors":"Baumgartner S, Shariff F, Vande Lune Sa, Zackariya N, Grisoli A, McCauley R, Zackariya S, Patel S, Sualeh A, Hake D, Thomas Av, Walsh M","doi":"10.18314/COGO.V2I1.1837","DOIUrl":"https://doi.org/10.18314/COGO.V2I1.1837","url":null,"abstract":"This narrative review discusses the history of the pathophysiologic principles and utilization of point-of-care (POC) viscoelastic tests (VETs) in the definition and treatment of postpartum hemorrhage (PPH). This paper addresses the epidemiology of PPH, describes the hemostatic changes that occur in pregnancy and in PPH, and demonstrates the utilization of viscoelastic testing in the identification and treatment of patients with PPH. Additionally, a description of rotational thromboelastometry (ROTEM) and thromboelastography (TEG), the two most commonly used VETs, is detailed in this paper. VETs have only recently been used to guide blood component therapy (BCT) in trauma in the last decade. The recent increased utilization of VETs to guide BCT in PPH is following a similar trend with a delay of ten years. In a similar fashion to the trauma literature, which expanded greatly within this last decade, the literature concerning the use of VETs in PPH has also increased in the last few years. However, because of differing pathophysiologies associated with the coagulopathy of PPH verses traumatic-induced coagulopathy (TIC), utilization of VETs has been more refined and focused on the VETs’ capacity to determine low fibrinogen and to guide the utilization of blood components and prohemostatic agents. The identification and treatment of PPH depends on clinical parameters, conventional coagulation tests (CCTs) including Clauss fibrinogen, and VETs. Successful treatment of PPH will no doubt include utilization of all three strategies with an increasing utilization of VETs in the future.","PeriodicalId":92345,"journal":{"name":"Current opinion in gynecology and obstetrics","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79065650","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: 1

The Effect of Perinatal Fish Oil Supplement on Perinatal Depression: A Systemic Review and Meta- Analysis of Randomized Clinical Trials 围产期补充鱼油对围产期抑郁症的影响:随机临床试验的系统评价和荟萃分析

Current opinion in gynecology and obstetrics Pub Date : 2019-08-02 DOI: 10.18314/COGO.V2I1.1834

Helman S, Baker Rb, Hassan M, Nafee T, Yang J, Vuddanda V

{"title":"The Effect of Perinatal Fish Oil Supplement on Perinatal Depression: A Systemic Review and Meta- Analysis of Randomized Clinical Trials","authors":"Helman S, Baker Rb, Hassan M, Nafee T, Yang J, Vuddanda V","doi":"10.18314/COGO.V2I1.1834","DOIUrl":"https://doi.org/10.18314/COGO.V2I1.1834","url":null,"abstract":"Background: Perinatal depression is a common complication of pregnancy and can have severe and long-termadverse effects on both mother and infant. Randomized controlled trials (RCT) assessing the effect of fish oilsupplements on perinatal depression have shown mixed results.Objectives: We performed a systematic review and meta-analysis to assess the effects of fish oil supplementation during pregnancy on perinatal depression.Methods: A comprehensive search of MEDLINE (PubMed), EMBASE, and Cochrane Central Registry were conducted in adherence with the PRISMA guideline. Only RCTs published in English from January 2000 to date were included. The participants were pregnant women receiving fish oil supplementation or placebo. Summary effect measure of each study was converted to a common effect measure (log odds ratio) and its variance was calculated to estimate the pooled odds ratio and its 95% confidence Interval using random Effects model. Heterogeneity was assessed used restricted maximum likelihood method.Results: Nine trials were included in our analysis (2,979 women). Prevention Cohort (n = 5): Fish oil supplementation during pregnancy was associated with reduced risk of developing perinatal depression (OR: 0.87; CI: 0.076 to 0.99; p = 0.03). Treatment Cohort (n = 4) Fish oil supplementation during pregnancy was associated with reduced risk of persistent perinatal depression during postpartum period but did not reach statistical significance.Conclusion: In conclusion, a meta-analysis of included RCTs data shows a significant reduction in incidences of perinatal depression in women who received fish oil supplements during pregnancy. However, there was no evidence for a similar effect among women diagnosed with perinatal depression or women with major depressive disorder.","PeriodicalId":92345,"journal":{"name":"Current opinion in gynecology and obstetrics","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74343161","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

Para-Aortic Lymphadenectomy by Minimally Invasive Surgery 微创主动脉旁淋巴结切除术

Current opinion in gynecology and obstetrics Pub Date : 2019-07-22 DOI: 10.18314/COGO.V2I1.1736

Puerta Sanabria Jm, Rios Lorenzo M, Gilabert-Estelles J

引用次数: 0

Clinicopathological Risk Factors Affecting Sexual Function after Radiotherapy for Cervical Cancer Patients 影响宫颈癌患者放疗后性功能的临床病理危险因素

Current opinion in gynecology and obstetrics Pub Date : 2019-06-14 DOI: 10.18314/COGO.V2I1.1738

Y. Harding, T. Ooyama, Shinichiro Ueda

{"title":"Clinicopathological Risk Factors Affecting Sexual Function after Radiotherapy for Cervical Cancer Patients","authors":"Y. Harding, T. Ooyama, Shinichiro Ueda","doi":"10.18314/COGO.V2I1.1738","DOIUrl":"https://doi.org/10.18314/COGO.V2I1.1738","url":null,"abstract":"Aim: To specify the clinicopathological risk factors that influence sexual function after radiotherapy for cervical cancer.Methods: This observational and cross-sectional study includes a population of 60 adult women diagnosed with stage I to III cervical cancer who underwent radiotherapy. Sexual function was assessed using a self-reported standardized questionnaire, the Female Sexual Function Index (FSFI). Age, clinical stage, tumor diameter, type of radiotherapy, use of hormone replacement therapy, and period of time elapsed since the completion of radiotherapy at the time of data collection were documented using participants’ medical records. Multivariate logistic regression was used to identify independent risk factors for decreased sexual function.Results: The median age of participants was 53 years (Interquartile range, IQR, 45-60 years). Using the FSFI total score compared by variable, sexual dysfunction was significantly more prevalent among women in FIGO stage III than those in stage I /II (P = 0.038), and at ≥ 12 months after the completion of radiotherapy than at < 12 months after completion (P = 0.008). Multivariate analysis revealed that sexual morbidity was significantly more likely in stage III women (OR 4.60, 95% CI, 1.07, 24.39, P = 0.040), or where radiotherapy had occurred more than 12 months before (OR 4.78, 95% CI, 1.17, 25.20, P = 0.028).Conclusion: FIGO stage III and a period of ≥ 12 months after radiotherapy are associated with reduced sexual function. In medical consultations with women in these categories, adequate treatment should be provided where appropriate.","PeriodicalId":92345,"journal":{"name":"Current opinion in gynecology and obstetrics","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77673422","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

Struma Ovarii. Can we face this Challenge? A Case Report 甲状腺肿Ovarii。我们能面对这一挑战吗?病例报告

Current opinion in gynecology and obstetrics Pub Date : 2019-06-07 DOI: 10.18314/cogo.v2i1.1789

S. C., C. J., Peiro-Valganon V, R. K

引用次数: 0

Ureteral Obstruction Secondary to Vaginal Implant 阴道植入物继发输尿管梗阻

Current opinion in gynecology and obstetrics Pub Date : 2019-05-15 DOI: 10.18314/COGO.V2I1.1713

G. Levy, A. Beck, O. Raz, M. Pansky

引用次数: 0

Massive Ovarian Oedema: A Misleading Tumour 卵巢大量水肿:一种误导性肿瘤

Current opinion in gynecology and obstetrics Pub Date : 2019-05-15 DOI: 10.18314/COGO.V2I1.1626

C. Escayola, G. Ripoll, A. Cardesa, Torrent Jj

引用次数: 0

Angiographic Embolization followed by Excision of Large Cellular Angiofibroma of the Vulva 血管造影栓塞后外阴大细胞血管纤维瘤切除术

Current opinion in gynecology and obstetrics Pub Date : 2019-05-13 DOI: 10.18314/COGO.V2I1.1624

Torres Sb, M. DiezBrito, M. S. Peremateu, A. Wernicke, C. SaezPerrotta, C. Marchitelli

{"title":"Angiographic Embolization followed by Excision of Large Cellular Angiofibroma of the Vulva","authors":"Torres Sb, M. DiezBrito, M. S. Peremateu, A. Wernicke, C. SaezPerrotta, C. Marchitelli","doi":"10.18314/COGO.V2I1.1624","DOIUrl":"https://doi.org/10.18314/COGO.V2I1.1624","url":null,"abstract":"Introduction: Cellular angiofibroma is a rare benign mesenchymal tumor, occurring almost exclusively in the superficial soft tissues of the genital region. Some of these lesions presents as large, hypervascularized masses. There are no reports in the literature to date on the challenges of resection of hypervascularized vulvar masses, or of hypervascularized cellular angiofibroma.Materials and methods: We describe a case of a cellular angiofibroma of the vulva and the surgical approach with tumoral vessel embolization and posterior resection.Case: A 47-year-old women was referred to vulvar pathology section of Italian Hospital of Buenos Aires for evaluation of left vulvar mass. A pelvic angiography was performed 5 days prior to surgery. It showed a hypervascularized formation at the level of the left vulva at the expense mainly of branches of the left internal pudendal artery. A complete resection was performed afterwards at our institution. The histopathological diagnosis was compatible with cellular angiofibroma.Conclusion: We consider that surgical planning is essential and has to be performed with a multidisciplinary approach. Angiographic embolization should be taken into account as a valid resource when planning a surgery with a high risk of blood loss in order to decrease morbidity.","PeriodicalId":92345,"journal":{"name":"Current opinion in gynecology and obstetrics","volume":"127 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90279595","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

Case of Cardiorespiratory Arrest following Removal of Cervical Cerclage 颈环摘除术后心肺骤停1例

Current opinion in gynecology and obstetrics Pub Date : 2019-05-12 DOI: 10.18314/COGO.V2I1.1673

Raheem M, Orefice R

引用次数: 0

The Neglected Luteal Phase after Natural Conception: Rescue by Early Progesterone Supplementation 自然受孕后被忽视的黄体期:早期补充黄体酮抢救

Current opinion in gynecology and obstetrics Pub Date : 2019-05-02 DOI: 10.18314/COGO.V2I1.1722

J. Tesarik, N. Mendoza, Raquel Mendoza‐Tesarik

{"title":"The Neglected Luteal Phase after Natural Conception: Rescue by Early Progesterone Supplementation","authors":"J. Tesarik, N. Mendoza, Raquel Mendoza‐Tesarik","doi":"10.18314/COGO.V2I1.1722","DOIUrl":"https://doi.org/10.18314/COGO.V2I1.1722","url":null,"abstract":"Background: Luteal phase deficiency (LPD) was recognized as a potential cause of infertility well before the first attempts at ovarian stimulation and in vitro fertilization (IVF). However, in the subsequent IVF era, the fact that LPD is particularly frequent in the context of ovarian stimulation has driven the attention to LPD almost exclusively to stimulated cycles. Here we re-assess the role of LPD as the primary cause of infertility and suggest a possible solution.Patients and methods: This study involves 12 young couples with unexplained infertility who attended our clinic for an assisted reproduction attempt. All of the female partners had low serum progesterone concentrations on day 21 of their menstrual cycle, in spite of the presence on an apparently functional corpus luteum. The female patients underwent repeated ultrasound scans during three subsequent cycles to determine the day of spontaneous ovulation. They were counselled to have frequent sexual intercourse when the dominant follicle reached the size of >17 mm, and progesterone was administered daily, by vaginal route, in all of them beginning with the day on which ovulation had been confirmed.Results: Out of the 12 women included in this study, six became pregnant naturally during one of the three progesterone-supplemented cycles. Progesterone supplementation was discontinued progressively, based on repeated serum progesterone determinations during the early pregnancy. All of the pregnancies were singleton. One of them ended in a miscarriage, while the others went to term, resulting in the birth of five normal children.Conclusions: Our data suggest that LPD during natural ovulatory cycles may be more frequent than believed. In the present study, no other apparent causes of infertility were detected. In such cases, assisted reproduction techniques can be avoided and replaced by individualized progesterone supplementation during the early luteal phase.","PeriodicalId":92345,"journal":{"name":"Current opinion in gynecology and obstetrics","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84428564","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: 6