Index
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Index Source Type: research

How Telehealth Can be Used to Improve Maternal and Child Health Outcomes: A Population Approach
Mobile applications and telehealth services are being used to unprecedented degrees in maternal and child care, with uncertain impact on population health outcomes. In this article, we will review the role of the COVID-19 pandemic in accelerating large scale implementation of telehealth services, known and anticipated impacts on maternal and child health and related inequities, and potential strategies to optimize outcomes at the population level. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Smart Technology in Obstetrical Care Source Type: research

Use of Telemedicine and Smart Technology in Obstetrics: Barriers and Privacy Issues
While telemedicine had been utilized in varying ways over the last several years, it has dramatically accelerated in the era of the COVID-19 pandemic. In this article we describe the privacy issues, in relation to the barriers to care for health care providers and barriers to the obstetric patient, licensing and payments for telehealth services, technological issues and language barriers. While there may be barriers to the use of telehealth services this type of care is feasible and the barriers are surmountable. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Smart Technology in Obstetrical Care Source Type: research

Mobile Health Approaches to Breastfeeding
Breastfeeding is available to nearly all women and has well-established short-term and long-term health benefits for mothers and infants. However, rates of breastfeeding initiation and continuation vary significantly according to sociodemographic factors, particularly in the United States. Mobile health (mHealth) interventions such as web-based/online education or smartphone applications have showed promise in increasing breastfeeding initiation and supporting breastfeeding continuation, and the importance of such mHealth-based breastfeeding support has increased significantly during the ongoing COVID-19 pandemic. This exp...
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Smart Technology in Obstetrical Care Source Type: research

Reducing Disparities Using Telehealth Approaches for Postdelivery Preeclampsia Care
The management of hypertensive disease of pregnancy presents an ongoing challenge after patients are discharged from delivery hospitalizations. Preeclampsia and other forms of postpartum hypertension increase the risk for severe maternal morbidity and mortality in the postpartum period, and both hypertension and its associated adverse events disproportionately affect black women. With its ability to transcend barriers to health care access, telemedicine can facilitate high-quality postpartum care delivery for preeclampsia management and thereby reduce racial disparities in obstetric care and outcomes. Here we discuss racia...
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Smart Technology in Obstetrical Care Source Type: research

Text Messaging as a Means to Engage Patients in the Postpartum Period
We describe key areas of telemedicine utilization including lactation services, blood pressure monitoring, diabetes screening, mental health services, weight loss programs, and access to contraception in the postpartum period. Future research and clinical work should aim to further examine the use of telehealth among postpartum individuals. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Smart Technology in Obstetrical Care Source Type: research

Telehealth Approaches to Improve Opioid Use Care in Pregnancy
This article presents a case study of using telemedicine to provide pharmacotherapy in pregnancy, examines the barriers to providing pharmacotherapy via telemedicine, and proposes solutions to overcome these barriers. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Smart Technology in Obstetrical Care Source Type: research

Prenatal Education in the Digital Age
The millennial pregnant patient expects an innovative approach to prenatal care. Patients are reaching to peer support online communities or engaging in direct-to-consumer mobile applications during their pregnancy. Currently developed solutions show promise, however, the clinical impact and generalizability of these solutions remains unclear. Technology has the potential to decrease health care disparities, improve patient and provider satisfaction as well as clinical outcomes. In this article we discuss traditional models of prenatal education as well and suggest how obstetricians should consider utilizing technology as ...
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Smart Technology in Obstetrical Care Source Type: research

Using Telehealth Approaches to Address Social Determinants of Health and Improve Pregnancy and Postpartum Outcomes
Telehealth has expanded its reach significantly since its inception due to the advances in technology over the last few decades. Social determinants of health (SDOH) negatively impact the health of pregnant and postpartum women and need to be considered when deploying telehealth strategies. In this article, we describe telehealth modalities and their application to improve the SDOH that impact pregnancy and postpartum outcomes. Physicians and patients alike report satisfaction with telehealth as it improves access to education, disease monitoring, specialty care, prenatal and postpartum care. Ten years ago, we developed a ...
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Smart Technology in Obstetrical Care Source Type: research

Foreword: Smart Technology in Obstetrical Care
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Smart Technology in Obstetrical Care Source Type: research

Contributors: Smart Technology in Obstetrical Care
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Contributors: Smart Technology in Obstetrical Care Source Type: research

Obstetric and Gynecologic Genitourinary Fistulas
Urinary incontinence shortly after childbirth or gynecologic surgery can be the result of obstetric or iatrogenic fistula formation. This can be a confusing and challenging diagnosis for medical providers. While the number of iatrogenic fistula cases is rising worldwide, obstetric fistulas are an issue uniquely particular to resource poor settings. Appropriate treatment of genitourinary fistulas spans beyond surgical intervention of leakage, and includes re-integration into the community, widespread education and counseling, and battling social stigma and cultural biases. Current and future research must focus on rigorous,...
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: An Evidenced Based Approach to Urinary Incontinence in Women: What's New? Source Type: research

Urinary Incontinence and Pelvic Organ Prolapse
The multifactorial pathophysiology of pelvic floor disorder accounts for the coexistence of several pelvic floor disorders in many women. Up to 54% of women with pelvic organ prolapse (POP) report concurrent stress urinary incontinence (SUI). While POP is a risk factor for coexistent SUI, apical and anterior prolapse can also conceal SUI symptoms that are unmasked by POP repair, resulting in de novo SUI postoperatively. It is important for pelvic reconstructive surgeons to consider the relationship between POP and urinary incontinence in presurgical planning and to discuss with patients the risks and advantages of concurre...
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: An Evidenced Based Approach to Urinary Incontinence in Women: What's New? Source Type: research

Management of Urgency and Mixed Urinary Incontinence
This article reviews management of urgency and mixed UI by breaking the management algorithm down into observation, lifestyle and behavioral changes, pharmacologic therapy, and procedural management. Stress UI is best managed with mid-urethral slings and is covered in other chapters. Behavioral and pharmacologic management are equally efficacious for urgency UI, but procedural therapy is superior. Mixed UI is conventionally treated by first managing whichever UI subtype is most bothersome. The management of overflow UI is directed at its underlying etiology: detrusor underactivity or bladder outlet obstruction. (Source: Cl...
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: An Evidenced Based Approach to Urinary Incontinence in Women: What's New? Source Type: research

Surgical Management of Stress Incontinence
The aim was to describe contemporary surgical procedures for the treatment of stress urinary incontinence (SUI) in women. The 4 most commonly performed surgical procedures for the treatment of SUI were reviewed using standardized terminology. We addressed the history and evolution of the procedures as well as the mechanisms of action by which they work. Efficacy and safety data were also presented. Midurethral Sling, Pubovaginal Sling, Retropubic Colposuspension, and Urethral Bulking are safe and effective procedures. Midurethral Sling, Pubovaginal Sling, Retropubic Colposuspension, and Urethral Bulking are contemporary pr...
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: An Evidenced Based Approach to Urinary Incontinence in Women: What's New? Source Type: research

An Evidenced-based Approach to Stress Urinary Incontinence in Women: What's New?
Stress urinary incontinence is a common condition in women potentially affecting women of any age including young women who have not yet completed childbearing. It is important to consider the impact on quality of life and offer treatment to those experiencing bother. There are several effective nonsurgical treatments for women before considering more invasive or definitive intervention. There is good data on lifestyle and behavioral changes which are often first-line recommendations. Data is also strong for pelvic muscle training and strengthening. Pessary supportive devices also play a role. Additional options also exist...
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: An Evidenced Based Approach to Urinary Incontinence in Women: What's New? Source Type: research

Basic Evaluation of Urinary Incontinence
Urinary incontinence is a significant, quality of life health condition affecting millions of women. Incontinence is increasingly common as the population ages, and women present with varying degrees of bother. With basic in-office evaluation, most subtypes of urinary incontinence can be defined, evaluated, and treated. Basic in-office evaluation involves a detailed history with a review of current medical problems and medications, a physical examination, and selective in-office testing. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: An Evidenced Based Approach to Urinary Incontinence in Women: What's New? Source Type: research

Applying a Health Equity Lens to Urinary Incontinence
This article will review what we currently know about urinary incontinence disparities and provide a framework for evaluation as well as a framework for advancing health equity in the care of diverse patient populations with urinary incontinence. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: An Evidenced Based Approach to Urinary Incontinence in Women: What's New? Source Type: research

Background, Etiology, and Subtypes of Urinary Incontinence
Urinary incontinence (UI) is the involuntary loss of urine. UI is a prevalent condition that affects people of all ages, becoming more common with older age, and which negatively affects the lives of millions of people. Although the pathophysiology behind UI is still being researched, we review here the basic neuromuscular system regulating urinary control and several other potential factors influencing the lower urinary tract dysfunction that contributes to UI including the urobiome and genetic variants. The specific subtypes, risk factors and findings associated with UI are reviewed. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: An Evidenced Based Approach to Urinary Incontinence in Women: What's New? Source Type: research

Foreword: An Evidenced Based Approach to Urinary Incontinence in Women: What's New?
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: An Evidenced Based Approach to Urinary Incontinence in Women: What's New? Source Type: research

Contributors: An Evidenced Based Approach to Urinary Incontinence in Women: What's New?
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - April 30, 2021 Category: OBGYN Tags: Contributors: An Evidenced Based Approach to Urinary Incontinence in Women: What's New? Source Type: research

Index
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Index Source Type: research

Educating Trainees to Manage Pregnant Women With Obesity: A Primer
This review is intended to outline essential resources for trainees in order to optimize education on the care of pregnant patients with obesity. Addressing provider biases, exploring ethical considerations of care and streamlining screening and counseling of patients with obesity will provide an excellent framework for our trainees to care for women with obesity from preconception to postpartum care and beyond. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Risk Factors for Progression From Gestational Diabetes to Postpartum Type 2 Diabetes: A Review
Gestational diabetes mellitus (GDM) complicates 6% to 8% of pregnancies and up to 50% of women with GDM progress to type 2 diabetes mellitus (DM) within 5 years postpartum. Clinicians have little guidance on which women are most at risk for DM progression or when evidence-based prevention strategies should be implemented in a woman’s lifecycle. To help address this gap, the authors review identifiable determinants of progression from GDM to DM across the perinatal period, considering prepregnancy, pregnancy, and postpartum periods. The authors categorize evidence by pathways of risk including genetic, metabolic, and ...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Optimizing Care Preconception for Women With Diabetes and Obesity
The prevalence of diabetes in reproductive age women has been reported to be as high as 6.8%, with pregestational diabetes affecting 2% of all pregnancies. As cases of diabetes in children and adolescents rise, more patients will be entering reproductive age and pregnancy with diagnoses of obesity, prediabetes, type 2 diabetes. Early interventions of diet modification and exercise to maintain healthy weights can delay or even prevent these complications. It is critical for health care providers to emphasize the importance of preconception counseling in this high-risk patient population to reduce the morbidities associated ...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Medications for Pregnant Women With Obesity: Special Considerations
Pregnant women with obesity are at increased risk of a multitude of complications of pregnancy and adverse perinatal outcomes. The risk of some of these complications, such as neural tube defects or preeclampsia, may be mitigated by some medications. Other complications, such as diabetes, venous thromboembolism, and infections, require treatment with medications. Given the changes in pharmacokinetics and pharmacodynamics during pregnancy, which is further enhanced by obesity, the optimal medication and its dose is often researched. This chapter further explores the different complications and common medications that women ...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Diabesity and Perinatal Mental Health: Evidence-based Recommendations for Screening and Intervention
Perinatal mental illness, obesity, and diabetes mellitus are common complications of the perinatal period that are becoming ever more prevalent and frequently co-occur. This review seeks to examine the prevalence of comorbid obesity/diabetes (termed “diabesity”) and mental illness in the perinatal period and current understandings of the psychosocial and pathophysiological relationships between these diseases. We will present current guidelines for screening and make recommendations for adaptations of mental health treatment in patients with this comorbidity. Finally, we present future directions for research a...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Sleep Duration, Sleep Timing, and Sleep Disordered Breathing—Associations With Obesity and Gestational Diabetes in Pregnancy
This article will review the epidemiology of sleep duration, sleep timing, and sleep disordered breathing in pregnancy with a focus on how the prevalence of these sleep conditions relate to body mass index. In addition, it will summarize the literature suggesting a link between these sleep disturbances and an increased risk for gestational diabetes. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Diabesity and Pregnancy: How Do We Get Our Patients Moving?
Obesity and diabetes are 2 commonly encountered complications in pregnancy that adversely affect pregnancy outcomes, maternal health, and the health of the offspring, both short-term and long-term. It is well established that physical activity provides numerous health benefits, both during and outside of pregnancy. By participating in physical activity, many of the negative consequences of both obesity and diabetes may be mitigated. Physical activity guidelines recommend that all adults, including pregnant women, perform at least 150 minutes of moderate-intensity exercise weekly in order to obtain health benefits. More phy...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Group Prenatal Care as a Strategy to Address Diabesity
Group prenatal care is a health care delivery model that utilizes shared medical appointments to place greater focus on patient education, mutual support, and increased time with the clinician to promote a healthy pregnancy. Several studies suggest that medically low-risk women participating in group prenatal care have improved pregnancy outcomes, but the same tenants can likely be used to help women with diabetes and obesity achieve healthy outcomes during pregnancy and throughout their life course. This chapter will review the background, care model, and evidence regarding group medical visits for pregnant women with dia...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

A Pragmatic Approach to the Treatment of Women With Type 2 Diabetes in Pregnancy
Type 2 diabetes mellitus (DM) is a growing problem among reproductive-aged women. Contemporary trends in obesity and delayed child-bearing are expected to result in an increasing number of pregnancies affected by type 2 DM. Women with known type 2 DM can greatly benefit from preconception care as improved periconception glycemic control and weight loss can decrease the neonatal and maternal risks associated with type 2 DM and pregnancy. Antenatal mainstays of management include frequent blood glucose monitoring, insulin therapy, optimization of coexisting medical conditions, and fetal surveillance. Careful attention to pos...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Ultrasound for the Pregnant Person With Diabesity
Diabetes and obesity increase the risk of congenital anomalies, but the putative mechanisms of this increased risk are not fully elucidated. In this chapter, we delve into sonographic characteristics associated with diabetes and obesity, including fetal structural anomalies, functional cardiac alterations, and growth abnormalities. We will also discuss the technical challenges of imaging in the patient with diabesity and propose methodologies for optimizing imaging. Lastly, we will address the prevention of workplace-associated musculoskeletal disorders injury for sonographers. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Screening for Aneuploidy in the Patient With Diabesity: Pearls and Pitfalls
The American College of Obstetrics & Gynecology (ACOG) recommends offering aneuploidy screening to all pregnant women. Obesity and diabetes are not associated with an increased risk of aneuploidy; however, they can complicate and compromise testing options. As the prevalence of obesity and diabetes, or “diabesity” increases, counseling women regarding potential limitations in testing performance of aneuploidy screening is of paramount importance. This chapter reviews options for aneuploidy screening for women with diabesity including sonography/nuchal translucency, serum analyte screening, and cell-free DNA...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Foreword: Diabesity: Type 2 Diabetes and Obesity
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Clinical Obstetrics and Gynecology Source Type: research

Contributors: Diabesity: Type 2 Diabetes and Obesity
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Contributors: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Animal Models in Polycystic Ovarian Syndrome
The pathogenesis of polycystic ovarian syndrome (PCOS) in women is poorly understood. With its varied endocrine and metabolic effects, it is unlikely a single genetic mutation or biological insult is the cause of the disease. Animals have been the proposed model for further studying the pathogenesis of PCOS and many modalities can be used to induce PCOS-like phenotypes in animals, most often with rodents. While there is not yet an animal model that perfectly recapitulates the classic PCOS phenotype in human women, many models allow for a better understanding of the complex disease process as well as possible treatments. (S...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Menstrual Dysfunction in PCOS
Menstrual irregularities due to anovulation or severe oligoovulation are a key feature of polycystic ovary syndrome for many women. First-line intervention should entail dietary and lifestyle modifications for overweight or obese polycystic ovary syndrome women. For women not seeking fertility, combination low-dose hormonal contraception are the most effective and first-line choice for regulating menstrual cycles. This option, as well as progestin-only options, have the important added benefit of reducing risks of endometrial hyperplasia and cancer. Metformin is an appropriate medical option to improve ovulation rates for ...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Polycystic Ovary Syndrome and Medical Conditions
Polycystic ovary syndrome is a common endocrinopathy that has been associated with many medical conditions across nearly every specialty. This chapter reviews the current understanding of polycystic ovary syndrome and associated medical conditions. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Polycystic Ovary Syndrome: Menopause and Malignancy
Polycystic ovary syndrome (PCOS) has been extensively studied in reproductive-aged women. However, accumulating research shows that PCOS can have lifelong effects on multiple aspects of women’s health. PCOS can affect the onset and course of menopause and cardiovascular health in perimenopausal and postmenopausal patients. Moreover, PCOS may increase a woman’s risk for both gynecologic and nongynecologic malignancies. When treating older PCOS patients, physicians should be cognizant of the syndrome’s long-term effects and consider the unique needs of these women. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Cosmetic Endocrinology
Cosmetic endocrinology treats endocrine pathophysiologies to improve cosmetically bothersome physical exam findings for the patient. Here we review the general cosmetic changes in PCOS with an emphasis on targeted cosmetic medical therapies. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Polycystic Ovary Disease and Obesity: Leptin, Weight-loss Medication, and Bariatric Surgery
For many patients, weight loss is a first-line measure recommended to reduce comorbidities associated with polycystic ovary disease. When lifestyle modifications such as diet and exercise are insufficient at achieving this goal, the addition of weight loss medications has proven effective for many patients. In patients with severe obesity, bariatric surgery is often used when other methods have been unsuccessful and has shown promising results for improving health and fertility in patients with polycystic ovary disease. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Lifestyle Modifications in PCOS
Lifestyle modification is widely considered to be the cornerstone of polycystic ovary syndrome (PCOS) treatment. However, 45% of women with PCOS have reported that they have never been provided information about lifestyle management. This highlights a significant gap in knowledge and is reflective of the lack of evidence-based guidance for lifestyle modification. While more detailed and comprehensive studies are being performed, it is necessary for health professionals to develop effective action plans utilizing the available evidence. This chapter aims to provide a comprehensive review of the current data regarding the im...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Clinical Obstetrics & Gynecology: Polycystic Ovary Disease Ethnicity, Diversity, and Psychosocial Ramifications
Polycystic ovary disease is a heterogenous disorder that presents differently in each individual. Some of this variation is due to racial and ethnic differences, which has been shown to affect hirsutism scores, metabolic comorbidities, cardiovascular risk factors, and long-term health outcomes. Psychosocial factors, including mental health diagnoses, body image distress measures, and disordered eating behaviors have also been shown to affect women with polycystic ovarian syndrome at a higher rate than the general population, and contribute to a decreased quality of life among many patients with this chronic condition. (Sou...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Polycystic Ovarian Syndrome and Fertility
Polycystic ovary syndrome (PCOS) is a common endocrinopathy that has been associated with impaired fertility. This chapter reviews the underlying pathophysiology of PCOS and the associated fertility barriers of the condition. Psychologic concerns, hypothalamic-pituitary, ovarian, and mitochondria dysfunction, obesity, and the role of vitamin D in PCOS are considered with respect to fertility. Lastly, pregnancy risk factors associated with PCOS are also reviewed. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Pharmacologic Treatments for PCOS Patients
Polycystic ovarian syndrome is the most common endocrinopathy in reproductive-aged women and has a vast array of clinical manifestations. Common clinical presentations of the disorder include anovulatory infertility, menstrual disorders, cutaneous symptoms secondary to androgen excess, metabolic abnormalities and mental health issues. If the condition is left unaddressed or inadequately treated, long-term sequelae such as endometrial hyperplasia, diabetes mellitus and dyslipidemia may ensue, therefore it is imperative for clinicians to address each component of the syndrome. When initial lifestyle changes and dietary modif...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Long-term Health of Offspring of Women With Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) presents as a constellation of clinical manifestations that can be varied among patients; however, the hormonal derangement associated with PCOS is uniformly characterized by excess androgens and abnormal insulin activity. The alteration in the normal hormonal milieu in these patients and subsequently during their pregnancies is theorized to alter the normal development of the fetus. This in utero exposure and its relationship with behavioral development, metabolic disease, and reproductive outcomes in male and female offspring of mothers with PCOS are under investigation and remains cont...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

In Vitro Fertilization for Polycystic Ovarian Syndrome
In vitro fertilization is indicated for infertile women with polycystic ovarian syndrome (PCOS) after unsuccessful treatment with ovulation induction agents or in women deemed high-risk of multiple gestations who are ideal candidates for single embryo transfers. PCOS patients are at increased risk of ovarian hyperstimulation syndrome; therefore, attention should be made in the choice of in vitro fertilization treatment protocol, dose of gonadotropin utilized, and regimen to achieve final oocyte maturation. Adopting these strategies in addition to close monitoring may significantly reduce the ovarian hyperstimulation syndro...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Environmental Influences and Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) is a complex endocrine-metabolic disorder whose pathogenesis is not well-understood. While genetic insults have been hypothesized as possible causes, there are a large number of environmental chemicals known to have detrimental effects on the endocrine system and may be irreversible, especially when exposure occurs early in development. Many of these chemicals have been investigated as causes of PCOS by measuring serum and urinary levels of common endocrine disruptors in women and adolescents with PCOS as well as using animal models for PCOS induction with chemical exposures. (Source: Cli...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Polycystic Ovarian Syndrome: Impact on Adult and Fetal Health
Women with the polycystic ovarian syndrome (PCOS) may have an increased risk for complications in pregnancy including miscarriage, gestational diabetes mellitus, hypertensive disorders of pregnancy, higher rates of cesarean delivery, and abnormalities in fetal growth. In addition, PCOS has been associated with the development of type II diabetes mellitus, hypertension, cardiovascular disease, obstructive sleep apnea, endometrial cancer, depression and anxiety, and nonalcoholic fatty liver disease. In understanding that PCOS is a disease impacting more than just a woman’s fertility, prevention and early identification...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Polycystic Ovarian Syndrome Genetics and Epigenetics
Polycystic ovarian syndrome and its associated endocrine abnormalities comprise one of the most common metabolic spectrum disorders within the human race. Because of the variance in phenotypic expression among individuals and within family lineages, attention has been turned to genetic and epigenetic changes in which the root cause of the disorder may lie. Further understanding of DNA/histone methylation and microRNA patterns may help to improve the accuracy of diagnosis and lead to future treatment options. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research