journal
https://read.qxmd.com/read/38032824/the-arrive-trial
#21
REVIEW
William A Grobman
Timing of delivery such that maternal and perinatal outcomes are optimized is among the most important and commonplace decisions in obstetric care. Given the importance of this determination, it is somewhat surprising that there has been, until relatively recently, little in the way of high-quality evidence to guide obstetric clinicians in this decision. This chapter describes the evolution of studies examining the effects of labor induction and the importance of the ARRIVE trial in that context.
June 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281176/integrated-care-for-persons-with-persistent-gynecologic-conditions
#22
REVIEW
Kathryn A Witzeman, Alison Lieberman, Elizabeth Joy Beckman, Kaitlin V Ross, Helen L Coons
Persons with persistent gynecologic conditions frequently cope with complex biopsychosocial challenges and benefit from integrated behavioral health evaluation and treatment within gynecologic practices. Integrated care refers to the provision of behavioral health services within a health care setting which contributes to improved patient, provider, and practice outcomes, however, has not been commonly provided in traditional gynecologic practices. Several models of integrated behavioral health are reviewed...
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281175/perinatal-psychopharmacology-innovative-approaches-to-care-delivery
#23
JOURNAL ARTICLE
Sarah Nagle-Yang, Emily S Miller, Lindsay G Lebin, Gabriella Blissett, Emily C Dossett
Perinatal mental health conditions are the most common complications of childbirth and have well-established enduring negative effects. Obstetric (Ob) clinicians care for patients with perinatal mental health conditions across a spectrum of acuity, severity, and complexity. Ob and psychiatric clinicians can collaborate to create a cohesive continuum of psychopharmacologic care for perinatal patients. This chapter provides an overall framework for Ob-psychiatric clinician collaboration with examples of innovation in care delivery...
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281174/behavioral-health-integration-on-inpatient-obstetric-units-program-development-strategies-for-implementation-and-lessons-learned
#24
JOURNAL ARTICLE
Melissa A Kwitowski, Lindsay G Lebin, Jessalyn Kelleher, Meggan Zsemlye, Sarah Nagle-Yang
Perinatal mood and anxiety disorders and substance use disorders are the primary causes of maternal mortality in the postpartum period and represent major public health concerns. Despite this, these conditions remain undertreated. Behavioral health integration in outpatient obstetric settings is necessary but insufficient to meet the needs of all patients. Inpatient behavioral health integration represents a promising avenue for addressing gaps in care. Results from recent program development indicate that needs assessment, stakeholder backing, collaboration with existing programs, and adaptability are key factors in successful implementation...
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281173/screening-assessment-and-treatment-of-perinatal-mental-health-in-obstetrical-settings
#25
JOURNAL ARTICLE
Lauren A Gimbel, Martha Zimmermann, Nancy Byatt, Tiffany A Moore Simas, M Camille Hoffman
Perinatal mood and anxiety disorders (PMADs) are common, yet obstetricians receive little training prior to independent practice on screening, assessing, diagnosing, and treating patients with depression and anxiety. Untreated PMADs lead to adverse pregnancy and fetal outcomes. Obstetricians are in a unique position to address PMADs. The following serves as a resource for addressing PMADs in obstetric practice.
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281172/the-pressing-need-to-integrate-mental-health-into-obstetric-care
#26
REVIEW
Martha Zimmermann, Tiffany A Moore Simas, Margaret Howard, Nancy Byatt
Mental health and substance use conditions are prevalent among perinatal individuals. These conditions have a negative impact on the health of perinatal individuals, their infants, and families, yet are underdiagnosed and undertreated. Populations that have been marginalized disproportionately face barriers to accessing care. Integrating mental health into obstetric care could address the perinatal mental health crisis. We review perinatal mental health conditions and substance use, outline the impact associated with these conditions, and describe the promise and potential of integrating mental health into obstetric settings to improve outcomes for patients receiving obstetric and gynecologic care...
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281171/foreword-integrating-mental-health-care-in-obstetrical-and-gynecology-practice
#27
JOURNAL ARTICLE
Michael R Caudle, Helen L Coons
No abstract text is available yet for this article.
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281170/contributors-integrating-mental-health-care-in-obstetrical-and-gynecology-practice
#28
JOURNAL ARTICLE
(no author information available yet)
No abstract text is available yet for this article.
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281169/sexual-dysfunction-and-dyspareunia-in-the-setting-of-the-genitourinary-syndrome-of-menopause
#29
JOURNAL ARTICLE
Neha G Gaddam, Sheryl A Kingsberg, Cheryl B Iglesia
Sexual dysfunction is a common consequence of the genitourinary syndrome of menopause (GSM). In this book chapter, we discuss the pathophysiology, prevalence, evaluation, and evidence-based management of sexual dysfunction in patients affected by GSM. Additionally, we present an algorithm to guide clinicians in the management and treatment of sexual dysfunction in this setting based on available evidence and best practices.
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281168/genitourinary-syndrome-of-menopause-pathophysiology-clinical-presentation-and-differential-diagnosis
#30
JOURNAL ARTICLE
Amanda L Clark, Martha F Goetsch
Scientific information is incomplete regarding the genitourinary syndrome of menopause. Both the lower genital and urinary tracts are rich in receptors for reproductive hormones and are highly susceptible to waning ovarian hormones at menopause. Symptoms of dryness and pain emerge in late perimenopause, but they can also result earlier from cancer therapies or bilateral oophorectomy. Lower urinary tract symptoms rise in prevalence at midlife and increase further with advancing age. Because ovarian senescence is typically followed by years of aging, some postmenopausal complaints may be attributable to increasing longevity...
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281167/foreword-genitourinary-syndrome-of-menopause
#31
JOURNAL ARTICLE
Susan D Reed
No abstract text is available yet for this article.
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38281166/contributors-genitourinary-syndrome-of-menopause
#32
JOURNAL ARTICLE
(no author information available yet)
No abstract text is available yet for this article.
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38146084/integrated-behavioral-health-care-in-reproductive-medicine-how-and-why-to-include-mental-health-professionals-in-infertility-care-teams
#33
JOURNAL ARTICLE
Julia T Woodward, Nicole H Cirino, Susannah Copland, Teni Davoudian
Despite fertility patients' reports of significant distress, few have access to integrated mental health care services. We elucidate the benefits and challenges of mental health integration in infertility practices from the perspective of both patients and providers. We outline specific models of integration, financial viability, and the first steps fertility clinics could take to improve their patients' access to these critical supports.
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38126460/clinical-practice-guidelines-for-managing-genitourinary-symptoms-associated-with-menopause
#34
JOURNAL ARTICLE
Monica Christmas, Annabelle Huguenin, Shilpa Iyer
Genitourinary syndrome of menopause encompasses the group of urogenital signs and symptoms resultant from hypoestrogenism, including genital dryness, burning or irritation, sexual discomfort, pain or dysfunction, and urinary urgency, dysuria, and recurrent urinary tract infections. Genitourinary syndrome of menopause can have a profound impact on well-being, functioning, and quality of life in postmenopausal women. Treatment includes vaginal moisturizers and lubricants geared towards providing symptomatic relief; hormonal treatments which promote epithelial thickening and production of vaginal secretions; and pelvic floor physical therapy along with behavioral therapies that address pelvic floor hypertonicity and psychosocial factors...
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38126336/genitourinary-syndrome-of-menopause-prevalence-and-predictors
#35
REVIEW
Nancy F Woods, Joan F Shaver, Judith A Berg
The genitourinary syndrome of menopause (GSM) has been proposed as a diagnosis by a consensus of clinicians and investigators. Our purpose for this paper is to review extant evidence about: 1) the breadth of symptoms and symptom clusters as related to the syndrome; 2) the prevalence of GSM (includes vulvar and vaginal atrophy); 3) factors that are associated with, predict, or explain the syndrome; and 4) what should be pursued for expanding meaningful evidence. Within recent literature, we found a wide range of prevalence estimates, likely a function of the differing populations studied, study design, and methods of data collection...
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38032828/the-postmenopausal-vaginal-microbiome-and-genitourinary-syndrome-of-menopause
#36
REVIEW
Elizabeth Micks, Susan D Reed, Caroline Mitchell
This review summarizes our current understanding of associations of the postmenopausal vaginal microbiome with genitourinary syndrome of menopause. We review the normal postmenopausal microbiota, examine the association of the microbiome with vulvovaginal symptoms, describe microbial communities associated with physical and laboratory findings, and report the impact of different treatments for genitourinary syndrome of menopause on microbiota and symptom improvement. Postmenopausal vaginal symptoms have an underlying pathophysiology that has not been fully elucidated...
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38032827/hormonal-medications-for-genitourinary-syndrome-of-menopause
#37
JOURNAL ARTICLE
JoAnn V Pinkerton, Monique H Vaughan, Andrew M Kaunitz
Genitourinary syndrome of menopause is a common, under-reported, and undertreated chronic progressive condition requiring long-term treatment. Hypoestrogenism in the urogenital tissues is associated with bothersome dyspareunia, vulvovaginal symptoms, overactive bladder, and frequent urinary tract infections. Vaginal hormone therapies, including vaginal estrogen and intravaginal dehydroepiandrostenedione, are safe and effective and improve symptoms and clinical findings. Systemic hormone therapy treats vulvovaginal atrophy less effectively than vaginal hormone therapies with increased stress and urge urinary incontinence...
March 1, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38343037/when-change-chooses-you-my-journey-with-paralysis
#38
JOURNAL ARTICLE
Dale B Hull
Life sometimes provides unannounced challenges that threaten the structure of our existence. This personal account of an ob-gyn's encounter with paralysis will illustrate the impact of one such experience.
February 12, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38251758/the-road-well-traveled-making-choices-ensuring-progress-while-heeding-the-clarion-call
#39
JOURNAL ARTICLE
E Albert Reece
The career path of everyone is quite unique based on the goals and the choices we make, and success can take time to unfold. My career choices have been greatly influenced by remarkable mentors and opportunities. Reciprocally I have had the pleasure, as a faculty member, department chair, and medical school dean to mentor promising young physicians and scientists to launch successful careers. We need to continue to attract physicians and scientists to academic medicine to ensure that our field continues to innovate and improve the lives of our patients...
January 22, 2024: Clinical Obstetrics and Gynecology
https://read.qxmd.com/read/38234166/teeter-totter-or-tapestry-a-life-in-academic-medicine
#40
JOURNAL ARTICLE
Kirtly Parker Jones
Constructing a career in academic medicine involves more than a focus on work-life balance. That image of a teeter-totter suggests that life is what happens when you are not working. The nature of the scope of interests (clinical, research, teaching) and values (service, leadership, curiosity, transparency, and honesty) creates a larger framework through which home life and work life become one interwoven tapestry. The author reflects on these perspectives as she looks back on a career in academic medicine.
January 18, 2024: Clinical Obstetrics and Gynecology
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