The Epidemiology of COVID-19 in Pregnancy
As of November, 2021 there have been more than 250 million coronavirus disease-2019 (COVID-19) cases worldwide and more than 5 million deaths. Obstetric patients have been a population of interest given that they may be at risk of more severe infection and adverse pregnancy outcomes. The purpose of this review is to assess current epidemiology and outcomes research related to COVID-19 for the obstetric population. This review covers the epidemiology of COVID-19, symptomatology, transmission, and current knowledge gaps related to outcomes for the obstetric population. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: COVID-19 in Obstetrics Source Type: research
Foreword: COVID-19 in Obstetrics
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: COVID-19 in Obstetrics Source Type: research
Contributors: COVID-19 in Obstetrics
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Contributors: COVID-19 in Obstetrics Source Type: research
The Future of Uterus Transplantation: Cost, Regulations, and Outcomes
Uterus transplantation (UTx) has evolved rapidly since technical success was first demonstrated, and is now practiced worldwide, using both living and deceased donors. As UTx transitions from an experimental to widely available standard clinical procedure, new challenges and questions are becoming more urgent. These include issues of cost and coverage, the establishment of guidelines and registries to ensure quality of care and monitor outcomes, regulatory oversight (including for the allocation organs from deceased donors), and the extent to which indications for UTx should be expanded. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
Uterus Transplantation: A 50-Year Journey
This paper provides an analysis of the last 50 years of uterus transplantation (UTx). Animal research on UTx began in the 1960s, aiming to solve tubal factor infertility. The success of in vitro fertilization shifted the focus onto uterine factor infertility. Early research in small and large animals improved following the advent of immunosuppression and established the uterus’ ability to tolerate cold ischemia and to function following vessel reanastamosis. Upon the achievement of the first live birth following UTx in 2014, human research has started to focus on reducing donor morbidity, optimal immunosuppression regime...
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
Antepartum Care of the Uterus Transplant Patient: The Experience of 3 Successful US Centers
We offer consensus recommendations for the antepartum management of the uterus transplant pregnancy based on our experience at 3 US centers. Patient access to accurate information is important to manage expectations and make informed decisions. Unique aspects of medical management include monitoring tacrolimus levels and performing cervical biopsies for rejection. Low-dose aspirin for preeclampsia is routinely used. Vigilant screening for gestational diabetes and preeclampsia allows for the prompt diagnosis and treatment of these common complications. We aim to deliver patients at 37 to 38 weeks by cesarean section. Shared...
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
Genetic Screening and Teratogenic Exposures: Considerations in Caring for the Uterus Transplant Patient
Counseling the uterus transplant patient requires an enhanced knowledge of unique genetic challenges that include an understanding of the spectrum of Mayer-Rokitansky-Küster-Hauser syndrome. Patients should understand their options for genetic screening and testing including preimplantation genetic testing for aneuploidy, genetic screening, and diagnostic testing. This patient population is potentially at risk for fetal anomalies due to the increased susceptibility to infections, such as cytomegalovirus. There are management strategies to minimize this risk. The risk of teratogenicity from mycophenolate is eliminated by a...
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
Reproductive Technology Considerations in Uterus Transplant
Uterus transplantation (UTx) provides a new pathway to parenthood for patients with absolute uterine factor infertility. The application of reproductive technologies, such as in vitro fertilization, embryo cryopreservation, and frozen embryo transfers, for this unique population, is particularly nuanced and continually evolving. There are important pretransplant and posttransplant reproductive considerations for physicians and patients anticipating UTx. As with any rapidly evolving medical innovation, efforts to consolidate experiences and knowledge by centers offering UTx is paramount. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
Robotic Donor Hysterectomy Results in Technical Success and Live Births After Uterus Transplantation: Subanalysis Within the Dallas Uterus Transplant Study (DUETS) Clinical Trial
This report demonstrates the feasibility and reproducible success of using uterus grafts from living donors who underwent robotic-assisted donor hysterectomy. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
Uterus Transplantation: Lessons Learned From a Psychological Perspective
Uterus transplantation has gained increasing acceptance as a medically viable treatment to achieve pregnancy in women with absolute uterine infertility or loss of uterus. Over 20 live births have occurred worldwide since the first successful live birth in Sweden in 2014. However, the psychological and emotional impact on women who seek uterus transplant, their partners, and the women who donate their uterus is a critical area to explore. This paper will discuss issues related to recipient and donor selection, parenting posttransplant, and consideration of unanticipated outcomes including uterus transplant failure and inabi...
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
Technological Advancements in Uterus Transplantation
Uterus transplantation is barely a decade old and in a young, evolving field it is hard to identify “technological advances” since it is, in of itself, a technological advance. Nonetheless, one can still identify advances in diagnostic imaging that have improved donor screening to avoid graft losses, highlight the adoption of robotic surgery to make the living donor uterus procurement more minimally invasive, and look to a future of biotechnology like perfusion pumps and bioengineering such as synthetic uterus to increase donor supply. Additional technologies are on the horizon and promise to shape the field further. (...
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
Immunologic and Infectious Concerns in Uterus Transplantation
Pharmacologic immunosuppression is required for the success of uterus transplantation but can provoke several complications for the transplant recipient. In this review, we discuss the immunologic complications that can occur in the uterus transplant recipient. First, we provide the latest update on immunosuppression regimens used by programs throughout the world. Next, we discuss the prevalence, mechanisms, treatment, and outcome of rejection in uterus transplant recipients. Finally, we discuss infectious complications of varying severity alongside their treatment and impact. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
The Ethical Evolution of Uterus Transplantation From Concept to Clinical Procedure
Uterus transplantation (UTx) offers women with absolute uterine factor infertility a path to motherhood that enables them to carry their own pregnancy. Debates about the ethics of UTx have evolved in tandem with its clinical evolution: clinical trials have provided evidence regarding risks and benefits to donors and recipients that were initially uncertain; technical advances have altered the balance between risks and benefits; and the experiences of donors and recipients has revealed questions that were not anticipated. As UTx transitions to a clinical procedure, questions remain about long-term risks and benefits, applic...
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
Uterine Transplantation: Recipient Patient Populations
Uterine transplantation is an emerging treatment for patients with uterine factor infertility (UFI). In order to determine patient candidacy for transplant, it is imperative to understand how to identify, counsel and treat uterine transplant recipients. In this article, we focus on patient populations with UFI, whether congenital or acquired, including Mayer-Rokitansky-Kuster-Hauser, complete androgen insensitivity syndrome, hysterectomy, and other causes of nonabsolute UFI. Complete preoperative screening of recipients should be required to assess the candidacy of each individual prior to undergoing this extensive treatme...
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
Uterine Transplantation in 2021: Recent Developments and the Future
Uterine transplantation has evolved rapidly over the last decade. As the number of cases performed increases exponentially worldwide, emerging evidence continues to improve collective knowledge and understanding of the procedure, with the aim of improving both surgical and reproductive outcomes. Although currently restricted to women with absolute uterine factor infertility, increasing awareness as a method of fertility restoration has resulted in a demand for the procedure to be undertaken in transgender women. This manuscript summarizes the recent advances in uterine transplantation, and elaborates further upon the key n...
Source: Clinical Obstetrics and Gynecology - January 29, 2022 Category: OBGYN Tags: Uterine Transplantation in Pregnancy Source Type: research
