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Current Opinion in Obstetrics & Gynecology | Page 2

Barbara Lawrenz, Carol Coughlan, Human M Fatemi
PURPOSE OF REVIEW: The aim of this review is to summarize the different aspects of luteal phase deficiency in IVF treatment and the possibilities of individualized luteal phase support. RECENT FINDINGS: After the application of human chorionic gonadotrophin (hCG) for final oocyte maturation, the vaginal route for progesterone administration is sufficient to maintain an adequate luteal phase support. New data point toward the possibility of oral medication; however, those data have yet to be confirmed in larger studies...
June 2019: Current Opinion in Obstetrics & Gynecology
Jessica Traylor, Angela Chaudhari, Susan Tsai, Magdy P Milad
PURPOSE OF REVIEW: Use of patient-reported outcome measures in clinical practice and research is becoming more prevalent and reflects initiatives to center the patient in healthcare delivery and outcomes assessment. The purpose of this review is to provide a summary description of selected, validated tools used to assess outcomes related to several benign gynecologic conditions: abnormal uterine bleeding, fibroids and endometriosis. RECENT FINDINGS: Given the availability of several validated instruments to assess patient outcomes in benign gynecology, there is still significant heterogeneity in tools used in trials...
April 9, 2019: Current Opinion in Obstetrics & Gynecology
Michelle Louie, Janelle K Moulder, Kelly Wright, Matthew Siedhoff
PURPOSE OF REVIEW: We seek to define the Millennial generation and identify strengths that can be employed to improve medical and surgical education and career development. We outline how generational traits can be incorporated into adult learning theory, offer suggestions for modernizing traditional teaching and mentorship models, and discuss why Millennials are ideally positioned to succeed in 21st century medicine. RECENT FINDINGS: Millennials (born ∼1981 to 1996) have several consistently identified traits that should be considered when teaching trainees and mentoring junior faculty...
April 9, 2019: Current Opinion in Obstetrics & Gynecology
Yoshio Yoshida
PURPOSE OF REVIEW: Gynecologic cancer patients of elderly has been increasing rapidly. Useful information on older patients, especially, with recurrent gynecological cancer is extremely limited. RECENT FINDINGS: A unified concept for assessing treatment risk was proposed when providing cancer treatment to older patients. Fit: patients capable of withstanding the same standard treatment as healthy younger patients; Vulnerable: patients incapable of withstanding the same standard treatment as healthy younger patients, but capable of undergoing some sort of treatment; and Frail: patients incapable of withstanding the same standard treatment as healthy younger patients, and also unsuitable to undergo any kind of active treatment...
April 2, 2019: Current Opinion in Obstetrics & Gynecology
Brian J Morris
PURPOSE OF REVIEW: This review updates progress in the human papillomavirus (HPV)-based revolution in cervical screening and vaccination predicted to eventually eliminate cervical cancer. RECENT FINDINGS: HPV PCR, patented by the author in 1987, has recently begun to replace cytology for primary cervical screening. I highlight the findings from large randomized clinical trials that have brought about this change, and progress with implementation. Australia was the first to introduce a national, publicly-funded HPV PCR-based program of primary screening, on 1 December 2017...
April 2, 2019: Current Opinion in Obstetrics & Gynecology
Nidhi Saraiya, Marilou Corpuz
PURPOSE OF REVIEW: Corynebacterium kroppenstedtii is a difficult pathogen associated with granulomatous mastitis and recurrent breast abscesses. Despite over a dozen studies, there is no guidance on surgical interventions, steroid use, or dosing or duration of antibiotic treatment. RECENT FINDINGS: Initially seen in predominantly Maori and Pacific Islander multiparous, postlactating women, C. kroppenstedtii breast infection has since been reported throughout the world, including in nulliparous women...
April 2, 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
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...
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
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...
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
Andres Reig, Emre Seli
PURPOSE OF REVIEW: To examine the existing literature in regards to the relationship between assisted reproductive technologies (ART) and low birth weight (LBW). RECENT FINDINGS: In 2017, Martin et al. reported on the incidence of low birth weight in relation to the number of embryos transferred, and showed that incidence of low birth weight in singletons correlates with number of embryos transferred. Meanwhile, several studies have shown increased weight of singletons born after frozen embryo transfers compared with fresh embryo transfers...
March 18, 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
Polasik Arkadius, Müller Volkmar, Huober Jens, Janni Wolfgang, Fehm Tanja
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...
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
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