JoAnn V Pinkerton
Selective estrogen receptor (ER) modulators have variable tissue specific estrogen agonist and antagonist activities. Tamoxifen is approved for treatment and prevention of breast cancer; acts as an endometrial estrogen agonist. Raloxifene is approved for prevention and treatment of osteoporosis and prevention of breast cancer. The selective ER modulators bazedoxifene paired with conjugated estrogens relieves vasomotor symptoms and prevents bone loss with neutral effects on breast and amenorrhea similar to placebo...
July 23, 2021: Clinical Obstetrics and Gynecology
Melyssa Wilde, Patricia Huguelet, Veronica I Alaniz
The transgender community comprises individuals with diverse identities in both gender and sexual orientation. Unfortunately, many face discrimination and harassment within our society-including within the medical system. There is an overall lack of provider training in transgender specific health which has led to health disparities and inequities within this population. This chapter aims to elucidate the medical needs unique to transgender and gender nonconforming individuals and thus enable medical providers to meet those needs with competency and compassion...
July 21, 2021: Clinical Obstetrics and Gynecology
Cynthia A Stuenkel
Menopause is a universal experience for midlife women. The physiological decline in endogenous estrogen can be associated with vasomotor symptoms or hot flashes, sleep disruption, and mood disorders. Long-term concerns arise with sequelae of estrogen loss such as genitourinary syndrome of menopause and osteoporosis. Although the pendulum has swung widely since the 1942 approval of conjugated equine estrogens, estrogen therapy, now available in an ever-expanding menu of preparations, routes of administration, and dosing, remains the most effective means to collectively address these, and potentially, additional concerns...
July 7, 2021: Clinical Obstetrics and Gynecology
Jenny Summerfield, Lesley Regan
The Sustainable Development Goals (SDGs) were launched in 2016 to expand the 2000 Millennium Development Goals. SDG-5 calls on governments to achieve gender equality and empowerment of all girls, highlighting the importance of sexual and reproductive health (SRH). There are large variations across the globe in maternity safety and there is clear evidence that a significant percentage of maternity mortality is preventable through the provision of reliable contraception and safe abortion services for women. If SDG-5 is to be achieved by 2030, it is essential that women have access to appropriate life-saving healthcare and support services...
July 7, 2021: Clinical Obstetrics and Gynecology
Paul D Blumenthal
No abstract text is available yet for this article.
July 2, 2021: Clinical Obstetrics and Gynecology
Shilpa Babbar
No abstract text is available yet for this article.
June 25, 2021: Clinical Obstetrics and Gynecology
Esteban Oyarzabal, Barbara Seuferling, Shaweta Babbar, Shannon Lawton-O'Boyle, Shilpa Babbar
Maternal stress can perturb physiology and psychiatric health leading to adverse outcomes. This review investigates the effectiveness of several mind-body therapies-namely biofeedback, progressive muscle relaxation, guided imagery, tai chi, and yoga-as interventions in reducing maternal stress and other pregnancy-related conditions. Through randomized trials, these techniques have shown promising benefits for reducing pain, high blood pressure, stress, anxiety, depressive symptoms, labor pain and outcomes, and postpartum mood disturbances...
June 23, 2021: Clinical Obstetrics and Gynecology
Shilpa Babbar, Alejandro J Oyarzabal, Esteban A Oyarzabal
Given their growing popularity, mindfulness practices including meditation are actively being studied in clinical trials to assess their efficacy at improving health outcomes during pregnancy and the postpartum period. We conducted a literature review to compile these studies and assessed their findings. There is sufficient evidence to support the practice of mindfulness practices in pregnancy to reduce anxiety, depression, and stress during pregnancy, which may continue to have beneficial effects through the postpartum period...
June 23, 2021: Clinical Obstetrics and Gynecology
Emma R Allanson, Kathleen M Schmeler
Cervical cancer is one of the commonest cancers afflicting women in low and middle income countries, however, both primary prevention with human papillomavirus vaccination, and secondary prevention with screening programs and treatment of preinvasive disease are possible. A coordinated approach to eliminating cervical cancer, as has been called for by the World Health Organization, requires a complex series of steps at all levels of a health system. This article outlines the current state of cervical cancer prevention in low and middle income countries, the innovations being employed to improve outcomes, and consideration of the next steps needed as we move towards global elimination...
June 14, 2021: Clinical Obstetrics and Gynecology
Mary B Keegan
Spirituality with its impact on health outcomes continues to emerge in the medical literature. This article discusses the role of spirituality in pregnancy, childbirth, and postpartum. It highlights the importance of more fully integrating this concept into births traditionally attended by physicians and midwives in the hospital setting. This discussion covers birthing practices ingrained with culture and spirituality. The article concludes with strategies to elicit and integrate spirituality into routine practice to provide improved health care to patients and to find more fulfillment in the role as birth attendant...
June 3, 2021: Clinical Obstetrics and Gynecology
Sarah L Pachtman Shetty, Sarah Fogarty
Massage is systematic touch and manipulation of the soft tissues of the body that is increasingly being used as an adjunctive therapy for stress relief and to promote relaxation and wellbeing during pregnancy and as an alternative to pharmacologic or invasive forms of analgesia during labor. Literature to support the use of massage in pregnancy and labor is limited; however, evidence to support its use has been increasing over the past 30 years. Massage has been shown to be valuable to pregnant women with anxiety, depression, leg, and back pain, and has shown significant benefit in perception of pain during labor...
September 1, 2021: Clinical Obstetrics and Gynecology
Shilpa Babbar, Alejandro J Oyarzabal
Hypnosis, the induction of a naturally relaxed state of mind and body, is most commonly practiced by pregnant women in preparation for the childbirth experience. A literature review was performed to assess the effects of hypnosis before, during and after pregnancy. The majority of data is extracted from case series and low-quality studies thereby limiting the acceptability of hypnosis for various pregnancy related conditions. A few well-designed studies show that self-hypnosis may be beneficial for mitigating labor pain and fear of childbirth...
September 1, 2021: Clinical Obstetrics and Gynecology
Melissa L Feigel, Anne Kennard, Kia Lannaman
More pregnant and nursing mothers are using herbal remedies than health care providers realize. Lack of familiarity with herbalism in addition to the sparsity of high-quality research for many complementary and alternative medicines are barriers for the western practitioner to engage a patient about herbal therapies. This review provides historical information and available evidence for Traditional Chinese and Western herbal medicines commonly sought by pregnant and nursing mothers. We will review herbs commonly used for: nausea and vomiting, constipation, gestational diabetes, threatened miscarriage, immune system support, parturition preparation, postpartum depression, postpartum bleeding and pain, wound healing, and lactation support...
September 1, 2021: Clinical Obstetrics and Gynecology
Christina Pisani-Conway
Ayurveda is a system of holistic medicine that integrates health with lifestyle to restore balance and remove disease by resolving the imbalance that causes it. Ayurvedic techniques that support digestion, immunity, vitality, and rejuvenation can help assist women with a healthy conception, pregnancy, delivery, and postpartum. Ayurvedic approaches can help common but bothersome pregnancy symptoms as well as potentially prevent more serious pregnancy complications. Specific techniques, including developing a daily routine and the practice of pranayama to support vitality through breathing exercises are described to help guide modern obstetrical practice...
September 1, 2021: Clinical Obstetrics and Gynecology
Kristin L Atkins, Sarah Fogarty, Melissa L Feigel
Acupuncture is the procedure of inserting fine needles into specific points on the body for therapeutic purposes. Acupuncture and its derivatives (acupressure, moxibustion, electroacupuncture, and transcutaneous electric nerve stimulation on acupoints) are a popular treatment choice in the peripartum period (32 wk' gestation to 14 d postdelivery). There is substantial research evidence supporting acupuncture and its derivatives in the peripartum period. Benefits in the use of acupressure to reduce labor pain intensity and a reduction in the duration of labor with acupressure have been found...
September 1, 2021: Clinical Obstetrics and Gynecology
(no author information available yet)
No abstract text is available yet for this article.
September 1, 2021: Clinical Obstetrics and Gynecology
Amy J Voedisch, Rebecca Dunsmoor-Su, Jennifer Kasirsky
Perimenopause and menopause are a time of great transition for women-physically, mentally, and emotionally. Symptoms of the menopause transition and beyond impact women worldwide. Unfortunately, physician knowledge and comfort with addressing menopausal concerns vary greatly, limiting the support physicians provide to women in need. This review aims to increase physician understanding of the epidemiology, physiology, symptomology, and treatment options available for perimenopausal and menopausal women. Our goal is to empower physicians to educate and treat their patients to reduce the negative impact of perimenopausal changes and enhance overall well-being for women...
September 1, 2021: Clinical Obstetrics and Gynecology
Sarrah Shahawy, Nawal M Nour
Female genital cutting (FGC) is a persisting global practice that increases patients' risk for experiencing long-term health sequelae. Existing meta-analysis evidence strongly supports an association between FGC and the development of long-term dyspareunia, urinary tract infections, and sexual dysfunction as well as increased risk obstetrically of prolonged labor, cesarean section, perineal lacerations, and episiotomy. Surgical defibulation is recommended in patients with type III FGC to decrease obstetric and gynecologic morbidity...
September 1, 2021: Clinical Obstetrics and Gynecology
L Lewis Wall, Itengre Ouedraogo, Fekade Ayenachew
We discuss a variety of contemporary issues relating to obstetric fistula. These include definitions of these injuries, the etiologic mechanisms by which fistulas occur, the role of specialist fistula centers in diagnosis and management, the classification of fistulas, and the assessment of surgical outcomes. We also review the growing need for complex reconstructive surgical procedures, follow-up challenges, and the transition to a fistula-free world in which other pathologies (such as pelvic organ prolapse) will be of increasing importance...
September 1, 2021: Clinical Obstetrics and Gynecology
Jennifer Deese, Renee Heffron, Heather Jaspan, Lindi Masson, Jennifer A Smit, Sengeziwe Sibeko
Although rates of human immunodeficiency virus (HIV) have declined globally over the past 10 years, United Nations Programme on HIV/AIDS estimates 1.7 million new infections occurred in 2019, with cisgender women (cis women) and girls accounting for 48%. Acquired immune deficiency syndrome-related illnesses are the leading global cause of mortality in cis women aged 15 to 49, and in many sub-Saharan Africa countries, young women face substantially higher HIV risk than their male counterparts. Drivers of this increased risk include sexual and reproductive health characteristics unique to cis women...
September 1, 2021: Clinical Obstetrics and Gynecology
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