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Current Opinion in Obstetrics & Gynecology | Page 2

Pedro Montoya-Botero, Jorge Rodriguez-Purata, Nikolaos P Polyzos
PURPOSE OF REVIEW: The purpose of this review is to provide an overview of androgen supplementation in ART with the most updated evidence, from animal studies to its clinical applications in poor ovarian responders (POR) and the future studies to be published. RECENT FINDINGS: Animal studies, has shown that testosterone supplementation, can be an option to increase the recruitable follicular pool in POR. However, the potential mechanism of action, dose, and duration of treatment is still under investigation...
June 2019: Current Opinion in Obstetrics & Gynecology
Sarah S Osmundson, Jea Young Min, Carlos G Grijalva
PURPOSE OF REVIEW: Overprescribing opioids contributes to the epidemic of drug overdoses and deaths in the United States. Opioids are commonly prescribed after childbirth especially after caesarean, the most common major surgery. This review summarizes recent literature on patterns of opioid overprescribing and consumption after childbirth, the relationship between opioid prescribing and chronic opioid use, and interventions that can help reduce overprescribing. RECENT FINDINGS: It is estimated that more than 80% of women fill opioid prescriptions after caesarean birth and about 54% of women after vaginal birth, although these figures vary greatly by geographical location and setting...
April 2019: Current Opinion in Obstetrics & Gynecology
Megan E Foeller, Ronald S Gibbs
PURPOSE OF REVIEW: Sepsis is a leading cause of severe maternal morbidity and maternal death. As pregnancy-related sepsis can be difficult to recognize, clinicians should maintain a low threshold for early evaluation and treatment. RECENT FINDINGS: Definitions and treatment guidelines for maternal sepsis were recently revised in 2016 and 2017 by the Surviving Sepsis Campaign and WHO. Multiple clinical decision tools have been created to aid clinicians in early recognition and risk prediction for sepsis in obstetric populations, but currently, an optimal screening tool does not exist...
April 2019: Current Opinion in Obstetrics & Gynecology
Marika Toscano, Loralei L Thornburg
PURPOSE OF REVIEW: To summarize recent research findings and current concepts related to care of neurologic diseases in pregnancy and the risks of pregnancy to the mother-infant dyad. Recent publications related to best practices for neurologic care, risks of pregnancy, rate of relapse during and after pregnancy, as well as medication safety in pregnancy and lactation for more commonly used neurologic medications are reviewed. RECENT FINDINGS: Data continues to grow that women with neurologic conditions can experience pregnancy with minimal risks...
April 2019: Current Opinion in Obstetrics & Gynecology
Samantha C Do, Maurice L Druzin
PURPOSE OF REVIEW: The aim of this study was to describe risks of systemic lupus erythematosus (SLE) in pregnancy and the importance of preconception counselling, medication optimization and close surveillance. RECENT FINDINGS: Advances in care for pregnant patients with SLE have led to improved obstetric outcomes, but maternal and foetal risks continue to be elevated. Conception during periods of disease quiescence and continuation of most medications decrease adverse pregnancy outcomes...
April 2019: Current Opinion in Obstetrics & Gynecology
Fengchang Qiao, Ping Hu, Zhengfeng Xu
PURPOSE OF REVIEW: Congenital heart defects (CHDs) are the most common type of birth defects, and are thought to result from genetic-environmental interactions. Currently, karyotype and chromosomal microarray analyses are the primary methods used to detect chromosomal abnormalities and copy number variations in fetuses with CHD. Recently, with the introduction of next-generation sequencing (NGS) in prenatal diagnosis, gene mutations have been identified in cases of CHD. The purpose of this review is to summarize current studies about the genetic cause of fetal CHD, paying particular attention to the application of NGS for fetuses with CHD...
April 2019: Current Opinion in Obstetrics & Gynecology
Molly B Moravek
PURPOSE OF REVIEW: To provide an overview of the current state of knowledge of fertility risks of gender-affirming therapy, review fertility preservation options for transgender individuals and ways to minimize gender dysphoria during fertility treatment, and identify gaps in knowledge. RECENT FINDINGS: Recent studies have corroborated older data that gender-affirming hormone therapy creates histopathological changes in the gonads; however, the newer data suggests that some function of the gametes may be preserved...
February 18, 2019: Current Opinion in Obstetrics & Gynecology
Baris Ata, Ayse Seyhan, Emre Seli
PURPOSE OF REVIEW: Diminished ovarian reserve, in general, implies a quantitative decline in the oocyte pool. However, whether this quantitative decline is necessarily accompanied by a qualitative decline, remains to be determined. RECENT FINDINGS: Studies of natural conception suggest that fecundity of women with a quantitative decline in ovarian reserve is similar to age-matched women with normal ovarian reserve. Data on rates of pregnancy loss and fetal chromosomal abnormality do not consistently suggest a decline in oocyte quality in women who has a lower ovarian reserve...
February 18, 2019: Current Opinion in Obstetrics & Gynecology
Kathleen F Brookfield, Abigail Vinson
PURPOSE OF REVIEW: The aim of this review is to describe the proposed mechanisms of action of magnesium sulfate for fetal neuroprotection, different dosing regimens of the drug that have shown benefit, and to review recent pharmacokinetic studies of the drug to better inform clinicians regarding expected benefits and remaining research questions. RECENT FINDINGS: Retrospective secondary analysis of the beneficial effects of antenatal magnesium sulfate trial database and prospective pharmacokinetic/pharmacodynamic modeling indicate magnesium sulfate administration for duration longer than 18 h, given within 12 h of delivery, and maintaining a maternal serum level of 4...
February 8, 2019: Current Opinion in Obstetrics & Gynecology
Matthew Cowan, Jonathan B Strauss, Emma L Barber, Daniela Matei
PURPOSE OF REVIEW: This article will provide an opinion on adjuvant treatment of stage I-III endometrial cancer based on existing and evolving evidence. RECENT FINDINGS: For early-stage (I and II) intermediate risk endometrial cancer, vaginal brachytherapy reduces the risk of locoregional relapse. Recent studies have investigated the use of chemotherapy in early stage, high-risk patient population, but did not demonstrate a survival benefit. As such, chemotherapy is only recommended for selected patients at high risk for distant recurrence...
February 2019: Current Opinion in Obstetrics & Gynecology
Gottfried E Konecny, Peter A Fasching
No abstract text is available yet for this article.
February 2019: Current Opinion in Obstetrics & Gynecology
(no author information available yet)
No abstract text is available yet for this article.
February 2019: Current Opinion in Obstetrics & Gynecology
Bruce Schaar, Venkatesh Krishnan, Supreeti Tallapragada, Anita Chanana, Oliver Dorigo
PURPOSE OF REVIEW: To provide an update on cell-based immunotherapies in solid tumors particularly in gynecological cancers. RECENT FINDINGS: Improvements have been made in engineering T cells to overcome the immunosuppressive environment in ovarian cancer. Significant efforts are underway to create 'off the shelf' cell therapies which leverage natural killer (NK) cells and would not rely on engineering a patient's T cells. SUMMARY: Efforts to target solid tumors using cell-based therapies are expanding into cell types other than T cells (NK cells and macrophages) which may have a lower risk of significant side effects and higher efficacy in solid tumors than chimeric antigen receptor T cells...
February 2019: Current Opinion in Obstetrics & Gynecology
Puja S Venkat, Neil Parikh, Phillip Beron
PURPOSE OF REVIEW: Radiation has long been a primary treatment modality in locally advanced gynecologic carcinomas and a tool for palliation of metastatic disease. Here we review advances in imaging and radiation technologies and the corresponding clinical evolution of the role for radiation oncology in the treatment of gynecologic malignancies. RECENT FINDINGS: Advances in MRI are impacting diagnosis, radiation target delineation, planning, treatment delivery, and response assessment...
February 2019: Current Opinion in Obstetrics & Gynecology
Boris Winterhoff, Shobhana Talukdar, Zenas Chang, Jinhua Wang, Timothy K Starr
PURPOSE OF REVIEW: This article discusses the advances, applications and challenges of using single-cell RNA sequencing data in guiding treatment decisions for ovarian cancer. RECENT FINDINGS: Genetic heterogeneity is a hallmark of ovarian cancer biology and underlies treatment resistance. Defining the different cell types present within a single ovarian cancer is difficult, but could ultimately lead to improvements in diagnosis and treatment. Next-generation sequencing technologies have rapidly increased our understanding of the molecular landscape of epithelial ovarian cancers, but the majority of these studies are conducted on bulk samples, resulting in data that represents an 'average' of all cells present...
February 2019: Current Opinion in Obstetrics & Gynecology
Amanda Yeaton-Massey, Tiffany Herrero
PURPOSE OF REVIEW: Maternal mental health disorders, including anxiety and depression, are one of the most common obstetric complications, presenting in pregnancy and postpartum. RECENT FINDINGS: Maternal mental health disorders are associated with adverse maternal and neonatal outcomes. Screening women in pregnancy and postpartum for mental health disorders is key to early identification and treatment of anxiety and depression in the perinatal population. Although universal screening is now recommended by numerous professional organizations, rates of screening are low and often not performed with a validated screening instrument...
January 28, 2019: Current Opinion in Obstetrics & Gynecology
Yiu-Man Chan, Tin-Chiu Li, Liona C Y Poon
PURPOSE OF REVIEW: To provide updated information on preimplantation genetic testing for aneuploidy (PGT-A), focusing on its implications on prenatal diagnostic approaches after transferal of mosaic aneuploid embryos. RECENT FINDINGS: PGT-A is a technology to screen for chromosome aneuploidy or major chromosome structural rearrangement in embryos before implantation using different cytogenetic analyses. PGT-A has been shown to reduce the negative effect of increasing maternal age on in-vitro fertilization (IVF) outcomes...
January 7, 2019: Current Opinion in Obstetrics & Gynecology
Arkadius Polasik, Marie Tzschaschel, Fabienne Schochter, Thomas W P Friedl, Brigitte Rack, Andreas Hartkopf, Peter A Fasching, Andreas Schneeweiss, Volkmar Müller, Jens Huober, Wolfgang Janni, Tanja Fehm
PURPOSE OF REVIEW: The possibility of tumor dissemination through the blood system has been known for years. Circulating tumor cells (CTCs) are detectable in the peripheral blood of patients with early as well as metastatic breast cancer. The prognostic relevance of this biomarker has already been described. By the use of repeated blood sampling along the course of disease, CTCs can be monitored in terms of a regular 'liquid biopsy'. This review aims to summarize recent research findings and actual ongoing clinical studies to demonstrate the actual and future relevance of CTCs in daily clinical routine...
December 11, 2018: Current Opinion in Obstetrics & Gynecology
Kelly E McCann
PURPOSE OF REVIEW: Poly-ADP-ribosyl-polymerase (PARP) inhibitors are an increasingly-utilized therapy in women with high-grade serous ovarian carcinoma, but tumor resistance to PARP inhibitor monotherapy is inevitable. RECENT FINDINGS: PARP inhibitors have been most studied in patients with breast and ovarian cancers associated with deleterious germline BRCA1 or BRCA2 mutations, though their role has expanded to include use as maintenance therapy in women with platinum-sensitive high-grade serous ovarian cancer due to the high propensity of such cancers to have defects in DNA repair by homologous recombination...
December 11, 2018: Current Opinion in Obstetrics & Gynecology
Daphne Stewart, Mihaela Cristea
PURPOSE OF REVIEW: Antibody drug conjugates (ADC) are a novel class of cancer therapeutics, delivering cytotoxic therapy directly to cancer cells, and show promise in the management of platinum-resistant ovarian cancer. Herein we summarize the ADC landscape currently in clinical study. RECENT FINDINGS: Mirvetuximab Soravtansine, IMGN853, is an ADC targeting the folate receptor alpha (FRα) and has demonstrated promising single agent activity and a favorable toxicity profile in FRα-positive, platinum-resistant, epithelial ovarian cancer (EOC)...
December 10, 2018: Current Opinion in Obstetrics & Gynecology
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