Preface: Volume 57
Publication date: Available online 8 April 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Kate Bramham, Laura A. Magee (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - April 18, 2019 Category: OBGYN Source Type: research

Index
Publication date: April 2019Source: Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 56Author(s): (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - April 14, 2019 Category: OBGYN Source Type: research

Editorial Board
Publication date: April 2019Source: Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 56Author(s): (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - April 14, 2019 Category: OBGYN Source Type: research

Preface
Publication date: Available online 8 April 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Kate Bramham, Laura A. Magee (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - April 9, 2019 Category: OBGYN Source Type: research

Drugs in Renal Disease and Pregnancy
Publication date: Available online 3 April 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Asif SarwarAbstractThis review aims to summarise historic and the latest evidence about commonly used drugs in pregnant mothers with chronic kidney disease (CKD). Data regarding safety in breast-feeding are also described. Practical recommendations are made about use in women with CKD including newer agents with more limited experience of use in pregnancy. Pharmaokinetic and dynamic issues are outlined and general principles for prescribing in pregnant women with CKD are listed. Resources to i...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - April 3, 2019 Category: OBGYN Source Type: research

Maturation of the immune system in the fetus and the implications for congenital CMV
Publication date: Available online 16 March 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Erez Rechavi, Raz SomechAbstractCongenital cytomegalovirus (CMV) infection is the most prevalent and consequential congenital infection, among others, that affects approximately 0.6% of all live births worldwide. Timing of maternal infection and maternal immune status largely determine the likelihood of a symptomatic infection. However, recent studies suggest that the fetal immune system, long perceived as naïve and immature, may also play a role in deciding the outcome of congenital CMV...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 29, 2019 Category: OBGYN Source Type: research

Autoimmunity in obstetrics and autoimmune diseases in pregnancy
Publication date: Available online 18 March 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Sara De Carolis, Sascia Moresi, Francesca Rizzo, Giuseppina Monteleone, Sara Tabacco, Silvia Salvi, Cristina Garufi, Antonio LanzoneAbstractAutoimmune diseases (AIDs) are associated with strong female preponderance and often present before or during the reproductive years; consequently, pregnancy and breastfeeding are topics of major interest for these patients. AIDs show different responses to pregnancy: some ameliorate, while others remain unchanged, and several AIDs aggravate. The response...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 29, 2019 Category: OBGYN Source Type: research

Immunotherapy of Gynecological Cancers
Publication date: Available online 21 March 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Emad Matanes, Walter H. GotliebAbstractOncology treatments have evolved from intuitive, via empiric, to the present precision medicine, with the integration of molecular targeted therapies in our treatment arsenal. Using the patients' powerful immune system has long been contemplated, and recently led to the integration of immunotherapy to overturn the well documented inhibitory effects of the tumor on the immune system and restore it to a state of activity against the cancer. Recent favorabl...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 22, 2019 Category: OBGYN Source Type: research

“Strategies to increase the accuracy and safety of OVD” (Clinical assessment skills and role of ultrasound, simulation training and new technologies to enhance instrument application)
Publication date: Available online 15 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): M. RamphulAbstractOperative vaginal delivery (OVD) is commonly performed in the UK and Ireland. With skillful practice, the risks to mothers and babies are low. Caesarean section at full dilatation, particularly after failed OVD, can be more hazardous for mothers and babies. It is important to maintain and develop skills in OVD in order to provide it as a safe delivery option when the benefits outweigh the risks. As ultrasound machines have become more readily available on the labour ward,...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 20, 2019 Category: OBGYN Source Type: research

Open Fetal Surgery for Neural Tube Defects
This article will provide background to the scope of MMC, review the MOMS trial data and highlight the current clinical status of open fMMC closure. (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 19, 2019 Category: OBGYN Source Type: research

Autoimmunity in obstetrics, and Autoimmune Diseases in Pregnancy
Publication date: Available online 18 March 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): De Carolis Sara, Moresi Sascia, Rizzo Francesca, Monteleone Giuseppina, Tabacco Sara, Salvi Silvia, Garufi Cristina, Lanzone AntonioAbstractAutoimmune diseases (AIDs) are associated with strong female preponderance and often present before or during the reproductive years, consequently pregnancy and breastfeeding are topics of major interest for these patients. AIDs show different response to pregnancy: some ameliorate, other remain unchanged and several AIDs aggravate. The response of the AI...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 19, 2019 Category: OBGYN Source Type: research

Maturation of the Immune System in the Fetus, and the Implications for Congenital CMV
Publication date: Available online 16 March 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Erez Rechavi, Raz SomechAbstractCongenital Cytomegalovirus (CMV) infection is the most prevalent and most consequential of all congenital infections, affecting roughly 0.6% of all live births worldwide. Timing of maternal infection and maternal immune status largely determine the likelihood of a symptomatic infection. However, recent studies suggest that the fetal immune system, long perceived as naïve and immature, may also play a role in deciding the outcome of congenital CMV infection...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 16, 2019 Category: OBGYN Source Type: research

Autoimmune diseases: Role of steroid hormones
Publication date: Available online 16 March 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Marisa Benagiano, Paola Bianchi, Mario Milco D’Elios, Ivo Brosens, Giuseppe BenagianoAbstractAutoimmune disorders (AIDs) are a heterogeneous group of diseases in terms of clinical manifestations, pathogenesis, and prevalence and there is yet no agreement to date on a common classification.Adaptive immune responses are responsible for the existence of AIDs, although innate immunity is also involved in misguiding the immune response against self-antigens.Hormones in general, and specifica...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 16, 2019 Category: OBGYN Source Type: research

Renal disease in pregnancy: Fetal, neonatal, and long-term outcomes
Publication date: Available online 15 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Emily Haesler, Nabil Melhem, Manish D. SinhaAbstractRenal disease in women of childbearing age is estimated to be approximately 3%; consequently, renal disease is not an uncommon comorbidity in pregnancy. There has been considerable evidence published over the last 20 years to suggest that renal disease in pregnancy is associated with higher maternal, fetal, and offspring morbidity. Studies published are largely heterogeneous; include unmatched cohort studies; and focus on early neonatal o...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 7, 2019 Category: OBGYN Source Type: research

Surgical management of congenital uterine anomalies (including indications and surgical techniques)
Publication date: Available online 15 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Theodoros D. Theodoridis, Panagiotis Pappas, Grigoris F. GrimbizisAbstractThe prevalence of congenital uterine anomalies (CUA) is reported to be 4.3–6.7% in the general population, 3.4%–8% in the infertile population, and 12.6–18.2% of those with recurrent miscarriages. They are the result of abnormal formation, differentiation, and fusion of the Müllerian or paramesonephric ducts during fetal life.To date, various classification systems have been proposed for the ca...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 6, 2019 Category: OBGYN Source Type: research

Fetal stem cell transplantation and gene therapy
Publication date: Available online 5 March 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Rachel Sagar, Cecilia Götherström, Anna L. David, Magnus WestgrenAbstractThen present chapter summarize our current knowledge on fetal stem cell and gene therapy. It focus on these therapeutic alternatives in regard to past experience and ongoing and planned studies in humans. Several methodological challenges are discussed that may have wide implications on how these methods could be introduced in clinical practice. Although, still promising the methods are afflicted with very speci...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 6, 2019 Category: OBGYN Source Type: research

Operative vaginal delivery
Publication date: Available online 12 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Deirdre J. Murphy (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 25, 2019 Category: OBGYN Source Type: research

Uterine scar rupture - Prediction, prevention, diagnosis, and management
Publication date: Available online 10 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Vasilios Tanos, Zara Abigail ToneyAbstractThe increasing rate of elective and indicated caesarean sections worldwide has led to new pathologies and management challenges. The number of patients undergoing trial of labor after caesarean section (TOLAC) is also increasing. Three professional societies provide detailed guidelines based on scientific evidence for the management of patients attempting vaginal birth after caesarean section (VBAC). However, they do not provide any recommendations...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 23, 2019 Category: OBGYN Source Type: research

Index
Publication date: February 2019Source: Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 55Author(s): (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 17, 2019 Category: OBGYN Source Type: research

Conservative management of reproductive cancers – Multiple choice questions Vol. 55
Publication date: February 2019Source: Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 55Author(s): (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 17, 2019 Category: OBGYN Source Type: research

Editorial Board
Publication date: February 2019Source: Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 55Author(s): (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 17, 2019 Category: OBGYN Source Type: research

Foetal and neonatal alloimmune thrombocytopenia
Publication date: Available online 6 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Dian Winkelhorst, Dick OepkesAbstractFoetal or neonatal thrombocytopenia results from alloimmunisation during pregnancy. Maternal alloantibodies can be formed following exposure to paternally derived human platelet antigens (HPAs) on foetal platelets, in case of incompatible HPA type. These alloantibodies are of the immunoglobulin G subclass and can therefore enter the foetal circulation through active placental transport mediated by the neonatal Fc-receptor. After entering the foetal circu...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 16, 2019 Category: OBGYN Source Type: research

Renal disease in pregnancy: fetal, neonatal and long-term outcomes
Publication date: Available online 15 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Emily Haesler, Nabil Melhem, Manish D. SinhaAbstractRenal disease in women of childbearing age is estimated to be around 3%, consequently renal disease is not an uncommon co-morbidity in pregnancy. There has been considerable evidence published over the last 20 years to suggest that renal disease in pregnancy is associated with higher maternal, fetal and offspring morbidity. Studies published are largely heterogeneous, include unmatched cohort studies and focus on early neonatal outcomes s...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 16, 2019 Category: OBGYN Source Type: research

Surgical management of congenital uterine anomalies (Include indications and surgical techniques)
Publication date: Available online 15 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Theodoros D. Theodoridis, Panagiotis Pappas, Grigoris F. GrimbizisAbstractThe prevalence of congenital uterine anomalies (CUA) is reported to be 4,3-6,7% in the general population, 3,4-8% in the infertile population and 12,6-18,2% among those with recurrent miscarriages. They are the result of abnormal formation, differentiation and fusion of the Mu¨llerian or paramesonephric ducts during fetal life.Until now, various classification systems have been proposed for the categorization of ...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 16, 2019 Category: OBGYN Source Type: research

“Strategies to increase the accuracy and safety of OVD”(Clinical assessment skills and role of ultrasound, simulation training and new technologies to enhance instrument application)
Publication date: Available online 15 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): M. RamphulAbstractOperative vaginal delivery (OVD) is commonly performed in the UK and Ireland. With skillful practice, the risks to mothers and babies are low. Caesarean section at full dilatation, particularly after failed OVD, can be more hazardous for mothers and babies. It is important to maintain and develop skills in OVD in order to provide it as a safe delivery option when the benefits outweigh the risks. As ultrasound machines have become more readily available on the labour ward,...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 15, 2019 Category: OBGYN Source Type: research

Conservative management of reproductive cancers - Multiple choice answers Vol. 55
Publication date: Available online 14 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 14, 2019 Category: OBGYN Source Type: research

Nontechnical skills and decision making in operative vaginal delivery
Publication date: Available online 11 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Lisa Kirk, Rachna BahlAbstractNontechnical skills are defined as social, cognitive and personal resource skills that are necessary to conduct any technical skill safely. Whilst the skills are categorised into three domains: social, cognitive and personal resources, these are dependent on each other and the development and effectiveness of one relies on the other two. Effective nontechnical skills are essential in the safe care of patients in any setting, and their importance can be clearly...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 12, 2019 Category: OBGYN Source Type: research

Forceps delivery for non-rotational and rotational Operative Vaginal Delivery
Publication date: Available online 11 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Mairead Black, Deirdre J. MurphyAbstractForceps are a commonly used instrument for assisting vaginal birth. Accepted indications include prolonged labour, suspected fetal distress, and maternal medical conditions that benefit from a shortened second stage of labour. Maternal and offspring outcomes of forceps-assisted birth have been extensively reported in observational studies, but randomized trial evidence is limited. Forceps assisted delivery has a lower failure rate than vacuum-assiste...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 12, 2019 Category: OBGYN Source Type: research

Operative Vaginal Delivery - Preface
Publication date: Available online 12 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Deirdre J. Murphy (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 12, 2019 Category: OBGYN Source Type: research

Uterine scar rupture - prediction, prevention, diagnosis and management
Publication date: Available online 10 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Vasilios Tanos, Zara Abigail ToneyAbstractThe increasing rate of elective and indicated caesarean sections worldwide has led to new pathologies and management challenges. The number of patients undergoing trial of labour after caesarean section (TOLAC) is also increasing. Three professional societies provide detailed guidelines based on scientific evidence for the management of patients attempting vaginal birth after caesarean section (VBAC). However, they do not provide any recommendation...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 10, 2019 Category: OBGYN Source Type: research

Medico-legal considerations and Operative Vaginal Delivery
Publication date: Available online 10 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Deirdre J. MurphyAbstractOperative vaginal delivery (OVD) provides women with an alternative to caesarean section when complications arise in the second stage of labour. The perinatal mortality associated with OVD is very low and most of the perinatal morbidity is minor. However, when serious adverse events occur, such as traumatic birth injury, shoulder dystocia, cerebral palsy and perinatal death, there are medico-legal implications. There is also the potential for litigation in relation...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 10, 2019 Category: OBGYN Source Type: research

Operative Vaginal Delivery and Pelvic Floor Complications
Publication date: Available online 10 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Richard P. DeaneAbstractOperative vaginal delivery (OVD) is associated with injury to the pelvic floor and compromise to the urinary, genital and gastrointestinal systems. There has been significant evolution in recent years in the practice of OVD (from the use of forceps to vacuum delivery), the conduct of delivery (from routine to selective episiotomy) and the recognition and management of obstetric anal sphincter injury (OASIS). This review article considers a number of key questions fr...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 10, 2019 Category: OBGYN Source Type: research

Role of general gynaecologists in the prevention of infertility
Publication date: Available online 6 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Ertan SaridoganAbstractGynaecologists are frequently involved in the management of conditions which may result in reduced fertility or treatments they administer can lead to infertility. Sexually transmitted infections and pelvic inflammatory disease are the most common cause of tubal damage, gynaecologists can play an important role in the identification and early treatment. Pelvic surgery for conditions such as leiomyoma, ovarian cysts and endometriosis can lead to pelvic adhesions and ia...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 7, 2019 Category: OBGYN Source Type: research

Training and qualification in gynecological minimal access surgery: a systematic review
We present the results of a systematic analysis to identify how simulation is used during training and qualification in minimal access surgery to improve Gynecologist´s surgical skills. We found that, despite the availability of simulation tools along with methods for training and testing specific endoscopic psychomotor and technical skills, there is no clear evidence of the superiority of one tool or method over the others in skill acquisition. However, prospective studies show that well-guided training courses combined with different trainers and methods improve significantly surgeon’s laparoscopic skills and...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 7, 2019 Category: OBGYN Source Type: research

Fetal and neonatal alloimmune thrombocytopenia
Publication date: Available online 6 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Dian Winkelhorst, Dick OepkesAbstractFetal or neonatal thrombocytopenia results from alloimmunisation during pregnancy. Maternal alloantibodies can be formed following exposure to paternally derived human platelet antigens (HPA) on fetal platelets, in case of incompatible HPA type. These alloantibodies are of the immunoglobulin G subclass and can therefore enter the fetal circulation via active placental transport mediated by the neonatal Fc-receptor. After entering the fetal circulation, t...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 7, 2019 Category: OBGYN Source Type: research

In utero intervention for severe congenital heart disease
Publication date: Available online 17 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Helena M. GardinerAbstractThe aim of foetal cardiac therapy is to treat an abnormality at the developmental stage so that the process of cardiac growth, which is complex and relies on the volume and direction of circulating blood as well as genetic determinants, can continue. In reality, most cardiac interventions are palliative; hence, major abnormalities are still present at birth. Nevertheless, tangible benefits following successful foetal intervention include improved haemodynamics and ...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - February 6, 2019 Category: OBGYN Source Type: research

Choosing the right technique for deep endometriosis
Publication date: Available online 29 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Michelle Nisolle, Géraldine Brichant, Linda TebacheAbstractThe surgical management of bowel endometriosis is a real challenge. Besides that only symptomatic patients should undergo surgery, no consensus has been approved in the literature.Among the surgical techniques, the surgeon has to choose between rectal shaving, disc excision or segmental colorectal resection. All those procedures are associated with complications but the risk of rectovaginal fistula is higher if a disc excisio...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 30, 2019 Category: OBGYN Source Type: research

Hydrosalpinx – salpingostomy, salpingectomy or tubal occlusion
Publication date: Available online 29 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Ka Ying Bonnie Ng, Ying CheongAbstractTubal factors account for around 25% of cases of infertility and the most severe manifestation of tubal disease is hydrosalpinx, accounting for 10-30% of tubal diseases. Hydrosalpinx is a distension or dilatation of the Fallopian tube in the presence of a distal tubal occlusion, and the most common cause is pelvic inflammatory disease. Women with hydrosalpinges have lower implantation and pregnancy rates in assisted reproductive technology (ART), due to...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 30, 2019 Category: OBGYN Source Type: research

Fetal anemia: Diagnosis and management
Publication date: Available online 9 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Federico Prefumo, Anna Fichera, Nicola Fratelli, Enrico SartoriAbstractFetal anemia has been known for many years as a dangerous complication of pregnancy. Its most common causes are maternal alloimmunization and parvovirus B19 infection, although it can be associated with many different pathological conditions including fetal aneuploidies, vascular tumors, and arteriovenous malformations of the fetus or placenta and inherited conditions such as alpha-thalassemia or genetic metabolic disorde...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 26, 2019 Category: OBGYN Source Type: research

The Conservative Management of Reproductive Tract Cancers
Publication date: Available online 24 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Michael Quinn, John McBain (Source: Best Practice and Research Clinical Obstetrics and Gynaecology)
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 25, 2019 Category: OBGYN Source Type: research

In-utero intervention for severe congenital heart disease
Publication date: Available online 17 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Helena M. GardinerAbstractThe aim of fetal cardiac therapy is to treat an abnormality at the developmental stage so that the complex process of cardiac growth, which relies on volume and direction of circulating blood as well as genetic determinants, can continue. In reality, most cardiac interventions are palliative, so that important abnormality is still present at birth, nevertheless tangible benefits following successful fetal intervention include improved haemodynamics and reduction in...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 18, 2019 Category: OBGYN Source Type: research

Management of fetal tumors
Publication date: Available online 14 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Sophie Masmejan, David Baud, Greg Ryan, Tim Van MieghemAbstractIn this review article, we discuss the most common fetal tumors, their prenatal management and outcomes. Overall, the most important outcome predictors are tumor histology, size, vascularity and location. Very large lesions, lesions causing cardiac failure and hydrops and lesions obstructing the fetal airway have the poorest outcome as they may cause fetal death or complications at the time of delivery. Fetal therapy has been de...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 15, 2019 Category: OBGYN Source Type: research

Fetal Primary Pleural Effusions: Prenatal Diagnosis And Management
Publication date: Available online 12 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Nimrah Abbasi, Greg RyanAbstractFetal pleural effusions can be associated with significant perinatal morbidity and mortality. When diagnosed antenatally, referral to a tertiary fetal medicine center is recommended for a detailed ultrasound evaluation for additional structural abnormalities or features suggestive of congenital infections or fetal anemia. The effusions should be characterized as unilateral or bilateral, and hydrops and/or mediastinal shift should be documented. Additional tes...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 12, 2019 Category: OBGYN Source Type: research

Embryo transfer techniques
Publication date: Available online 11 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Sotirios H. Saravelos, Tin-Chiu LiAbstractEmbryo transfer is the final and rate limiting step of the ART process. Few advances have occurred in the last few decades with regards to this procedure. Studies so far have focused on factors and interventions taking place prior to, during and after this procedure. These factors are highly varied and range from methods to improve the psychological state of the patients, to methods aimed at reducing uterine contractility and methods aimed at optimi...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 11, 2019 Category: OBGYN Source Type: research

Congenital urinary tract obstruction
Publication date: Available online 11 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Ka Wang Cheung, Rachel Katie Morris, Mark David KilbyAbstractCongenital bladder neck obstruction (or lower urinary tract obstruction [LUTO]) describes a heterogeneous group of congenital anomalies presenting with similar prenatal ultrasonographic findings of dilated posterior urethra, megacystis, hydronephrosis, oligohydramnios and often with associated renal dysplasia. Untreated LUTO has high rate of perinatal morbidity and mortality from associated pulmonary hypoplasia and early-onset ren...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 11, 2019 Category: OBGYN Source Type: research

Fetal anaemia: diagnosis and management
Publication date: Available online 9 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Federico Prefumo, Anna Fichera, Nicola Fratelli, Enrico SartoriAbstractFetal anaemia has been known for many years as a dangerous complication of pregnancy. Its most common causes are maternal alloimmunization and parvovirus B19 infection, although it can be associated many different pathological conditions including fetal aneuploidies, vascular tumors and arteriovenous malformations of the fetus or placenta, and inherited conditions such as alpha-thalassemia or genetic metabolic disorders. ...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 10, 2019 Category: OBGYN Source Type: research

Fetal dysrhythmias
Publication date: Available online 9 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Julene S. CarvalhoAbstractFetal dysrhythmias are common, usually manifesting as irregular rhythms. Whilst most irregularities are benign and caused by isolated atrial ectopics, in a few cases, rhythm irregularity may indicate partial atrioventricular block, which has different aetiological and prognostic implications. We provide a flowchart for initial management of irregular rhythm, to help select cases requiring urgent specialist referral. Tachycardias and bradycardias are less frequent, c...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 10, 2019 Category: OBGYN Source Type: research

Fallopian subtle pathology
Publication date: Available online 7 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Jing Guan, Antoine WatrelotAbstractThe aim of the present review is to give a comprehensive overview of fallopian subtle lesions and suggest the impacts of these abnormalities on fertility. Tubal subtle variations including tubal diverticulae, Morgagni hydatids, accessory fallopian tube, accessory ostium of fallopian tube, tubal phimosis, agglutination and sacculation have been described and cited as making significant contributions to infertility. This review summarizes characteristics of t...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 8, 2019 Category: OBGYN Source Type: research

Update on twin-to-twin transfusion syndrome
Publication date: Available online 5 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Christian Bamberg, Kurt HecherAbstractTwin-to-twin transfusion syndrome (TTTS) is a serious complication that affects 10-15% of monochorionic multiple pregnancies. Communicating placental vessels on the chorionic plate between the donor and recipient twin are responsible for the imbalance of blood flow. There is evidence for the superiority of fetoscopic laser ablation over serial amnioreductions regarding survival and neurological outcome for stages II-IV TTTS. However, the optimal manageme...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 5, 2019 Category: OBGYN Source Type: research

Modern approaches to surgical management of endometrioma
Publication date: Available online 5 January 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): S. Gordts, R. CampoAbstractFormation of the ovarian endometrioma consists of implantation, invagination of the ovarian cortex and adhesion formation. Progression is characterized by repeated injury and repair (ReTIAR) with degenerative changes. Already with a partially deprived ovarian reserve, as a consequence of the disease, surgical treatment carries a potential risk of further follicular deprivation. Surgery should therefor be performed with microsurgical precision by experienced hands.E...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - January 5, 2019 Category: OBGYN Source Type: research