Surgical Options for Patients Seeking Gender-Affirming Surgery
AbstractPurpose of ReviewTo describe the surgical treatments available to transgender women and men desiring gender-affirming surgery (GAS).Recent FindingsTransgender patients who undergo GAS have high satisfaction and improved quality of life. Masculinizing procedures include chest reconstruction, facial masculinization surgeries, hysterectomy with bilateral salpingo-oophorectomy, metoidioplasty, and phalloplasty. Feminizing procedures include facial feminization surgeries, chondroplasty and voice surgeries, breast augmentation, orchiectomy, and genital surgeries, such as vaginoplasty and vulvoplasty. Vaginoplasty can be ...
Source: Current Obstetrics and Gynecology Reports - September 8, 2020 Category: OBGYN Source Type: research

Management of Impending Periviable Delivery
AbstractPurpose of ReviewTo review the role of obstetric interventions, the evidence behind these interventions, and the importance of offering these interventions to women and their families as they make decisions on whether to provide active neonatal management.Recent FindingsOutcomes for infants born at periviability are improving with advancing neonatal care and management. Obstetric interventions play a role in helping to improve these outcomes. Administration of antenatal corticosteroids and magnesium sulfate should be considered if delivery is suspected. Cesarean delivery should be offered in cases of malpresentatio...
Source: Current Obstetrics and Gynecology Reports - August 8, 2020 Category: OBGYN Source Type: research

Gonadotropin-Releasing Hormone Agonists Are Effective in Long-term Treatment of Women with Abnormal Uterine Bleeding and Anticoagulant Therapy: Report of 3 Cases and Review of the Literature
AbstractPurpose of ReviewTo evaluate the efficacy of gonadotropin-releasing hormone agonist (GnRHa) in women with abnormal uterine bleeding (AUB) on anticoagulant therapy.Recent FindingsProspective observational case series (Canadian Task Force Classification II-3) at University-affiliated teaching hospital. From January 2002 through December 2019, three premenopausal women on warfarin therapy were identified from our clinical practice. After clinical assessment, including Papanicolaou smear, endometrial biopsy, and pelvic sonography, a GnRHa was used to treat their AUB. Two women were receiving warfarin therapy (5 –...
Source: Current Obstetrics and Gynecology Reports - July 10, 2020 Category: OBGYN Source Type: research

Effects of Hormonal Contraception on Mood
AbstractPurpose of ReviewThis review will clarify the complex relationship of hormonal contraception and mood in women both with and without mood disorders, in adolescents, and in postpartum women.Recent FindingsThough the overall effect of hormonal contraception on mood does not appear to have a significant clinical impact, several recent population-based studies suggest adolescents are potentially more vulnerable than adults.SummaryStrategic initiation of hormonal contraception may mitigate mood symptoms, with continuous regimens of hormonal therapy demonstrating some benefit over cyclic regimens. Additional rigorous stu...
Source: Current Obstetrics and Gynecology Reports - July 6, 2020 Category: OBGYN Source Type: research

Prepregnancy Counseling for People of All Genders: Enhancing Safe and Accessible Family Building for Transgender, Gender Diverse, and Non-binary Individuals
AbstractPurpose of ReviewThe purpose of this narrative review is to expand routine prepregnancy counseling and anticipatory guidance to include people of all genders.Recent FindingsTransgender, gender diverse, and non-binary (TGNB) individuals who were assigned female at birth may wish to parent, conceive, and carry a pregnancy, but are not included in guidelines for routine prepregnancy counseling. In addition to the topics covered in routine prepregnancy counseling, there are several unique considerations for prepregnancy care for TGNB individuals including perinatal testosterone use, gender dysphoria and distress, chest...
Source: Current Obstetrics and Gynecology Reports - June 30, 2020 Category: OBGYN Source Type: research

Global Abortion Policies Database: a Descriptive Analysis of Financial Coverage for Abortion Care
AbstractPurpose of the ReviewThe purpose of this review is to report on data available in the Global Abortion Policies Database (GAPD) as of February 2020. The GAPD is a repository of publicly available sources related to abortion for all countries.Recent FindingsResearch indicates that where individuals must pay for abortion procedures, costs can often be unaffordable and catastrophic for households. Faced with financial barriers, individuals may be deterred from seeking healthcare or may resort to clandestine practices.SummaryThere are limited countries with publicly available sources related to financial protection for ...
Source: Current Obstetrics and Gynecology Reports - June 25, 2020 Category: OBGYN Source Type: research

Cancer Screening for Transgender and Gender Diverse Patients
AbstractPurpose of ReviewThe purpose of this review is to summarize the current knowledge base for sex-trait related cancer risks and screening guidelines as applied in transgender and gender diverse (TGD) populations with an emphasis on the potential impact of gender-affirming hormonal and surgical therapies. Additionally, this review will address access to screening services and patient-friendly adaptations to screening approaches for this population.Recent FindingsWhile breast cancer incidence is higher among transfeminine persons relative to genotypic males, it still remains significantly lower than that of genotypic f...
Source: Current Obstetrics and Gynecology Reports - June 25, 2020 Category: OBGYN Source Type: research

Fertility Preservation for the Transgender Individual
AbstractPurpose of ReviewThis review aims to update readers on recent evidence in order to counsel and guide clinical management of individuals with gender dysphoria seeking fertility preservation (FP).Recent FindingsRelevant topics include a discussion of the consistent desire for children in transgender people despite a low utilization rate of FP services, animal models, and human histology depicting the effect of gender-affirming treatment (GAT) on the gonads, varied time for resumption of menses, and start of ovarian stimulation upon discontinuing testosterone (T) in transmen, feasible clinical and experimental options...
Source: Current Obstetrics and Gynecology Reports - June 25, 2020 Category: OBGYN Source Type: research

Medical Transition for Gender Diverse Patients
AbstractPurpose of ReviewThe purpose of this review is to provide an up-to-date overview of gender-affirming hormone therapy, including the various hormone regimens available, the efficacy and potential risks of these treatments, and considerations for surveillance and long-term care.Recent FindingsRecent studies reaffirm that hormone therapy has positive physical and psychological effects for many transgender individuals. The overall risks of treatment are low. Transgender women may have an increased risk of venous thromboembolism and breast cancer based on recent cohort studies, but these findings have yet to be confirme...
Source: Current Obstetrics and Gynecology Reports - June 25, 2020 Category: OBGYN Source Type: research

Ectopic Pregnancy Risk with Assisted Reproductive Technology
AbstractPurpose of ReviewTo investigate the optimal methods for the reduction of ectopic pregnancy incidence due to assisted reproductive technology (ART).Recent FindingsDay five or six blastocyst transfer may decrease ectopic pregnancy rates when compared with day three transfer, similarly, frozen-thawed embryo transfer may lessen the risk of ectopic pregnancy relative to fresh embryo transfer. Single embryo transfers decrease ectopic pregnancy risk and have similar clinical pregnancy outcomes as double embryo transfers.SummaryEctopic pregnancy remains a major cause of maternal morbidity and mortality in the first trimest...
Source: Current Obstetrics and Gynecology Reports - June 23, 2020 Category: OBGYN Source Type: research

Pelvic Pain in the Transgender Man
AbstractPurpose of ReviewThe purpose of this review is to update readers on the multifactorial nature of pelvic pain with specific considerations for the female to male (FtM) transgender patient.Recent FindingsSecondary effects of testosterone therapy include both genital and musculoskeletal changes that may contribute to the development of pelvic pain. Hysterectomy is therapeutic for gender affirmation and underlying pain conditions. Postsurgical pain from further pelvic reconstruction may be the result of the reconstruction itself, surgical scarring, or prostheses.SummaryPelvic pain is a common condition with many contri...
Source: Current Obstetrics and Gynecology Reports - June 13, 2020 Category: OBGYN Source Type: research

Care of the Post-vaginoplasty Patient: Management of Complications and Common Gynecologic Issues
AbstractPurpose of ReviewThe purpose of this review is to provide an overview of the surgical complications associated with penile-inversion vaginoplasty surgery as well as the management required to address these complications. We also review common gynecologic problems after penile-inversion vaginoplasty.Recent FindingsThe incidence of reoperation is not low after penile-inversion vaginoplasty with the literature revealing incidence rates as high as 50% in certain cohorts. However, the majority of these reoperations are for cosmesis. Despite these reported complications, most patients “[feel] positive about their g...
Source: Current Obstetrics and Gynecology Reports - June 1, 2020 Category: OBGYN Source Type: research

Interactions Between Hormonal Contraception and Anti-Retroviral Therapy: an Updated Review
This article aims to provide an updated review of the most recent data around hormonal contraceptives and anti-retroviral therapy.Recent FindingsPrior data have suggested possible pharmacologic interactions between certain hormonal contraceptives and anti-retroviral therapy. The most significant interactions implicated include those between progestin-based contraceptive implants and efavirenz as well as between combined hormonal contraceptives and protease inhibitors. Most past studies, however, feature small sample sizes with few clinical outcomes reported.SummaryRecent data since 2017 have largely affirmed prior studies ...
Source: Current Obstetrics and Gynecology Reports - May 31, 2020 Category: OBGYN Source Type: research

A Proposed Platform for Phenotyping Endometriosis-Associated Pain: Unifying Peripheral and Central Pain Mechanisms
AbstractPurpose of the ReviewEndometriosis is defined by a finding of ectopic endometrial glands/stroma, and is characterized by a wide variability in pain symptoms. The goal of this review is to identify peripheral to central factors that can modulate pain output in a given patient with endometriosis. Based on this constellation of factors, we propose a pain classification for endometriosis.Recent FindingsThe development and persistence of endometriosis-associated pain is influenced by a complex interplay between local factors that then interact with central variables. Starting peripherally, endometriosis anatomic charact...
Source: Current Obstetrics and Gynecology Reports - May 30, 2020 Category: OBGYN Source Type: research

Long-Term Health Consequences of Endometriosis —Pathways and Mediation by Treatment
AbstractPurpose of ReviewThe purpose of this review is to discuss the most up to date research on endometriosis and chronic disease risk, highlighting the role treatments for endometriosis may play in these associations.Recent FindingsPrevious studies have shown a consistent association between endometriosis and risk for epithelial ovarian cancer but the association with other cancers is less clear. Current research indicates that endometriosis may in be associated with risk of systemic lupus erythematosus, and potentially other autoimmune diseases. Limited evidence is also present for the association between endometriosis...
Source: Current Obstetrics and Gynecology Reports - May 29, 2020 Category: OBGYN Source Type: research

Treatment of Midlife Women with Chronic Low Back Pain —Opioids Are a Last-Resort Option
AbstractPurpose of ReviewThe purpose of this narrative review is to inform readers of the particular impact opioids have had on midlife women and to provide perspective on non-opioid treatment options for women with chronic low back pain.Recent FindingsResearch has shown that midlife women experience more chronic low back pain than men and other age groups of women. As a result, opioids have been particularly deleterious in this demographic group. In addition, there are no data to recommend them for long-term use, while there is a breadth of data on the negative consequences of long-term opioid use. Treatment guidelines no...
Source: Current Obstetrics and Gynecology Reports - May 29, 2020 Category: OBGYN Source Type: research

Pharmacokinetics of Hormonal Contraception in Individuals with Obesity: a Review
AbstractPurpose of ReviewObesity continues to affect many women globally. In the USA, almost 40% of all women are obese and many of these women use hormonal contraception for pregnancy prevention. How well hormonal contraceptive works for these individuals has been an area of ongoing research. Pharmacokinetics (PK), the study of drug passage through the body, can shed light on how differences in physiology between obese and non-obese populations can impact drug disposition and subsequent efficacy. This review aims to reflect on these types of studies and empower clinicians with information to help tackle the challenges of ...
Source: Current Obstetrics and Gynecology Reports - May 4, 2020 Category: OBGYN Source Type: research

Single-Port Laparoscopic Surgery for Endometrial Cancer: a Systematic Review
AbstractPurpose of ReviewThis review aimed to provide an overview of single-port laparoscopic surgery and related literature. Based on previous reviews on endometrial cancer, we focused on the benefit of single-port laparoscopic surgery in endometrium cancer.Recent FindingsEndometrial cancer is the most common gynecological cancer and can be treated with laparoscopic surgery without negatively affecting the oncological outcome. Single-port laparoscopic surgery is a recently emerging endoscopic technique, and it was shown that endometrial cancer could be staged using this method.SummaryResearch shows that endometrial stagin...
Source: Current Obstetrics and Gynecology Reports - May 2, 2020 Category: OBGYN Source Type: research

Recent Advances in the Medical Management of Early Pregnancy Loss
AbstractPurpose of ReviewTo provide an update on advances in medical management of early pregnancy loss, including the addition of mifepristone pretreatment to existing regimens.Recent FindingsThe utilization of misoprostol for medical management of early pregnancy loss has been studied extensively and is established as a safe and effective treatment. Two recent randomized controlled trials have demonstrated that the addition of mifepristone pretreatment significantly increases the effectiveness of misoprostol and a large body of data demonstrate the excellent safety profile of mifepristone. However, the Food and Drug Admi...
Source: Current Obstetrics and Gynecology Reports - April 6, 2020 Category: OBGYN Source Type: research

Telemedicine for Medication Abortion: The Time Is Now
AbstractPurpose of ReviewThis review will provide an overview of the current restrictions to medication abortion in the USA, strategies for incorporating telemedicine into medical abortion care, and new evidence on the efficacy and safety of telemedicine as a means to provide medication abortions.Recent FindingsNewly published data from the TelAbortion study, the first direct-to-patient medication abortion service in the USA, shows that it is as safe, successful, and acceptable to patients as previous international data on similar care delivery systems. Other groups have continued to build upon the existing body of literat...
Source: Current Obstetrics and Gynecology Reports - April 6, 2020 Category: OBGYN Source Type: research

Endometrial Stem/Progenitor Cells
AbstractPurpose of ReviewTo summarize endometrial stem/progenitor cell biology and endometrial cancer stem cells.Recent FindingsThe subject is relatively new that only about 15  years ago, colony-forming units, as putative endometrial stem/progenitor cells, have been demonstrated in an endometrial sample. Earlier and some recent studies have justifiably focused on endometriosis as the serious gynecologic problem of women. However, on the side of endometrial stem cells res earch, many current studies are still working on in vitro methods, and the majority of the rest are on animal models. Reported cells as endometrial ...
Source: Current Obstetrics and Gynecology Reports - February 29, 2020 Category: OBGYN Source Type: research

Tumor Markers in Endometrial Cancer
This study showed that higher preoperative laboratory results of human epididymis protein 4 and CA-125 are independent risk factors for pelvic lymph node metastasis in endometrial cancer patients. Based on this research, lymphadenectomy is not recommended if none of independent risk factors is present. Prevention of unnecessary lymph node resection and complications associated with lymphadenectomy for low-risk patients is made possible. The authors suggested more effective predictors of lymph node metastasis should be investigated to provide theoretical support for deciding lymphadenectomy and guide the individualized endo...
Source: Current Obstetrics and Gynecology Reports - January 31, 2020 Category: OBGYN Source Type: research

Adverse Pregnancy Outcomes in Endometriosis – Myths and Realities
AbstractPurpose of ReviewThere is increasing interest in the long-term health and comorbid conditions associated with endometriosis for both women and neonates. The purpose of this review was to synthesize and discuss the current state of the literature investigating endometriosis and risk of adverse pregnancy outcomes.Recent FindingsMethodologic considerations for studying endometriosis and adverse pregnancy outcomes include complexities regarding the comparison population, endometriosis definition, sample size, residual confounding, and interactions. The current research on endometriosis and adverse pregnancy outcomes sh...
Source: Current Obstetrics and Gynecology Reports - January 30, 2020 Category: OBGYN Source Type: research

A Novel Approach for Treatment of Uterine Fibroids: Stereotactic Radiosurgery as a Proposed Treatment Modality
AbstractPurpose of ReviewMinimally invasive therapeutic interventions and the field of stereotactic radiosurgery have advanced enormously in recent years. We briefly review the field of stereotactic radiosurgery and propose its use as a novel treatment modality for benign gynecologic conditions such as uterine fibroids.Recent FindingsComputerized searches of Medline and PubMed were conducted using the key words “stereotactic radiosurgery,” “CyberKnife®,” “uterine fibroids,” and “radiation therapy.” References from identified sources were manually searched to allow for a t...
Source: Current Obstetrics and Gynecology Reports - January 23, 2020 Category: OBGYN Source Type: research

Fertility-Sparing Treatment Options in Young Patients with Early-Stage Endometrial Cancer
AbstractPurpose of ReviewTo summarize fertility-sparing treatment options in young patients with early-stage endometrial cancer.Recent FindingsA levonorgestrel-releasing intrauterine device combined with oral progestins seems more effective for patients with endometrial cancer and desiring fertility. Assisted reproductive techniques seem more effective in achieving pregnancy in these young cancer patients than natural conception.SummaryEndometrial cancer is the most common gynecologic cancer in developed countries. For younger patients who wish to have children, fertility preservation methods are available, but not always ...
Source: Current Obstetrics and Gynecology Reports - January 14, 2020 Category: OBGYN Source Type: research

Conservative vs. Radical Management of Placenta Accreta Spectrum (PAS)
AbstractPurpose of ReviewWe review the advantages, disadvantages, and possible risks of current therapeutic alternatives for placenta accreta spectrum (PAS). Details and proper indications may change from one case to another, especially depending on the available resources, practitioner skill, and patient preference. Many treatments are routinely performed without appropriate analysis, which could result in a high rate morbidity. In contrast, undesirable outcomes are typically not reported in the literature, which may lead obstetricians to follow dangerous procedures without accurate information on possible consequences.Re...
Source: Current Obstetrics and Gynecology Reports - January 6, 2020 Category: OBGYN Source Type: research

Promoting Cardiovascular Health in Midlife Women
AbstractPurpose of ReviewCardiovascular disease (CVD) remains the number one cause of death in the USA. In women, coronary heart disease (CHD) accounts for 22% of deaths with an additional 6.2% of deaths secondary to stroke. The prevalence of CVD increases as women age; after the age of 75, the incidence will exceed that reported for men. The risk for CVD in women is systematically underestimated. Both healthcare providers and women need a better understanding of the mechanism and role of traditional CVD risk factors (CVDRF) in women, and the newer identified non-traditional CVDRF which are unique to women and the resultin...
Source: Current Obstetrics and Gynecology Reports - November 21, 2019 Category: OBGYN Source Type: research

Postpartum Hemorrhage: What ’s New?
AbstractPurpose of ReviewPostpartum hemorrhage (PPH) remains an important cause of maternal morbidity and mortality in the USA and in particular worldwide. Recent epidemiological studies have enhanced our ability to identify risk factors for PPH. Novel diagnostic, surgical, and pharmaceutical techniques present opportunities for improving our care of patients with PPH.Recent FindingsThis review aims to highlight recent primary research in the field of PPH. Large studies have refuted some assumed risk factors for PPH, including high body mass index and scheduled repeat cesarean delivery. Non-white race is an increasingly im...
Source: Current Obstetrics and Gynecology Reports - November 5, 2019 Category: OBGYN Source Type: research

Endometrial Cancer General Perspectives, Epidemiology
AbstractPurpose of ReviewThis paper focuses on the epidemiologic factors that are effective on the pathology of the endometrial malignancy. Based on previous reviews and recent articles on endometrial cancer, we sought to define risk factors and related diseases to endometrial malignancies.Recent FindingsPrevious studies have shown that phosphoinositide 3-kinase (PI3K) activity is stimulated by diverse oncogenes and growth factor receptors, and elevated PI3K signaling is considered a hallmark of cancer. A major antagonist of PI3K activity is phosphatase and tensin homolog (PTEN), a tumor suppressor which is often mutated o...
Source: Current Obstetrics and Gynecology Reports - October 14, 2019 Category: OBGYN Source Type: research

Robotic Surgery in Endometrial Cancer
AbstractPurpose of ReviewThe number of minimal invasive gynecological oncological operations performed especially for endometrial cancer is increasing rapidly parallel with the increase in robotic systems in hospitals. This paper focuses on evaluating the studies comparing robotic surgery with laparoscopic and open surgery in patients with endometrial cancer in light of current literature.Recent FindingsWhen the current literature is examined, it is seen that the results of robotic surgery have similar results to laparoscopy such as length of hospital stay, postoperative pain, recovery in a short time, and less blood vesse...
Source: Current Obstetrics and Gynecology Reports - September 3, 2019 Category: OBGYN Source Type: research

The Role of Interventional Radiology in the Management of Placenta Accreta Spectrum Disorders
AbstractPurpose of ReviewPlacenta accreta spectrum disorders encompass a heterogeneous group of conditions classified according to the degree of invasion of the trophoblastic tissue trough the myometrium and uterine serosa with a detrimental effect on maternal outcomes, including life-threatening hemorrhage, need for blood transfusion, damage to adjacent organs, and eventually death, and this highlights the need of additional procedures to improve surgery. The present review aims to provide an up to date on the role of interventional radiology procedures in affecting the outcome of women undergoing surgery for PAS disorder...
Source: Current Obstetrics and Gynecology Reports - August 28, 2019 Category: OBGYN Source Type: research

Contemporary Challenges and Developments: Antenatal Corticosteroid Therapy
AbstractPurpose of ReviewThe purpose of this review is to (i) provide an update to the current challenges surrounding the use of antenatal corticosteroids (ACS) and (ii) to provide a brief synthesis of recent findings relating to work to optimize the efficacy and safety and of ACS therapy to better understand its short- and long-term impacts on the developing foetus.Recent FindingsThere are numerous human and experimental animal studies describing the impact of ACS exposure on foetal growth and programming, in particular, changes to the cardiovascular, endocrine and central nervous systems. Moreover, recent studies have re...
Source: Current Obstetrics and Gynecology Reports - August 21, 2019 Category: OBGYN Source Type: research

Correction to: Updates in Minimally Invasive Approaches to Apical Pelvic Organ Prolapse Repair
The original version of this article unfortunately contained mistake at Conflict of Interest. This section should be corrected and presented as follows: (Source: Current Obstetrics and Gynecology Reports)
Source: Current Obstetrics and Gynecology Reports - August 9, 2019 Category: OBGYN Source Type: research

Prenatal Ultrasound Imaging for Placenta Accreta Spectrum (PAS): a Practical Guide
AbstractPurpose of ReviewPlacenta accreta spectrum (PAS) is a rare pregnancy complication with an increasing incidence worldwide. PAS can cause serious maternal morbidity and even mortality at delivery. Ultrasound (US) is an excellent imaging modality for the diagnosis of PAS, but it must be used correctly and there is little standardised training in placental imaging available. The aim of this paper is to discuss US screening for PAS and provide practical advice on its use for antenatal diagnosis.Recent FindingsScreening for PAS in a high-risk population (history of previous caesarean delivery (CD) and an anterior low-lyi...
Source: Current Obstetrics and Gynecology Reports - July 16, 2019 Category: OBGYN Source Type: research

Multidisciplinary Teams in the Management of Placenta Accreta Spectrum Disorders
AbstractPurpose of ReviewThe three-fold purpose of this review is to summarize recent evidence supporting the use of a multidisciplinary team (MDT) approach in patients with placenta accreta spectrum (PAS), to describe essential members and processes of the PAS MDT, and to highlight necessary resources for both planned and unexpected cases of PAS.Recent FindingsMaternal outcomes in women with PAS are improved when an antenatal diagnosis occurs and referral is made to centers with MDT specialization and experience in treating PAS. New guidelines unequivocally recommend referral to higher-volume, experienced PAS centers of e...
Source: Current Obstetrics and Gynecology Reports - July 11, 2019 Category: OBGYN Source Type: research

Managing Placenta Accreta Spectrum Disorders (PAS) in Middle/Low-Resource Settings
AbstractPurpose of ReviewThe purpose of this review is to describe the technical issues associated with managing the placenta accreta spectrum (PAS) disorders in a low-resource setting and to provide insight on how to improve the outcome under these conditions.Recent FindingsThe available literature recommends managing PAS in a specialized center with a multidisciplinary team (MDT), but there are no standardized management strategies that would help reduce maternal and neonatal morbidity and mortality in a low-resource setting. The increase in the incidence of PAS has been mainly in middle/low-income countries due to high ...
Source: Current Obstetrics and Gynecology Reports - June 27, 2019 Category: OBGYN Source Type: research

Paternal Environmental Toxicant Exposure and Risk of Adverse Pregnancy Outcomes
AbstractPurpose of ReviewCurrent clinical efforts to predict and prevent preterm birth are primarily focused on the mother and have made minimal progress in improving outcomes. However, recent data indicate that paternal factors can also influence timing of birth. Herein, we will review recent human and murine data examining the contribution of the father to pregnancy outcomes with an emphasis on environmental exposures that can negatively impact fertility and the timing of birth.Recent FindingsHuman epidemiology studies now clearly indicate that a variety of paternal factors (age, race, weight, smoking status) can influen...
Source: Current Obstetrics and Gynecology Reports - June 22, 2019 Category: OBGYN Source Type: research

Is There a Role for MRI in the Management of Placenta Accreta Spectrum?
AbstractPurpose of ReviewThe diagnosis of placenta accreta spectrum (PAS) is based on evaluation of risk factors and imaging findings. Ultrasound (US) is widely available and relatively cheap; magnetic resonance imaging (MRI) is expensive and not universally available. We review performance, interpretation, accuracy, and pitfalls of MRI, and whether it has a role in the management of PAS.Recent FindingsRecent meta-analyses showed excellent diagnostic accuracy in depth of placental invasion. Specific MRI features (intraplacental T2 dark bands, myometrial disruption, uterine bulge, and uteroplacental or parametrial hypervasc...
Source: Current Obstetrics and Gynecology Reports - June 22, 2019 Category: OBGYN Source Type: research

Broad Band Ligament Hernia Revisited (85 Cases of Allen-Master ’s Syndrome; History and Perspectives)
AbstractPurpose of ReviewThe purpose of this review is to update readers on the characteristics and pathogenesis of internal hernia secondary to a defect of broad ligament of the uterus.Recent FindingsThe etiopathogenesis of the disease is controversial. There are two main hypotheses to explain the generation of the defect in the ligament. The first of them would explain this entity as a result of obstetric trauma, an inflammatory pelvic disease, or gynecological surgery. However, in the absence of them, the second hypothesis would speak of congenital defects due to rupture of cysts of the ligament itself. In either case, ...
Source: Current Obstetrics and Gynecology Reports - June 4, 2019 Category: OBGYN Source Type: research

Management of Induced Menopause in Gynaecological Cancers and Their Challenges
AbstractPurpose of ReviewThe consequence of treatment for gynaecological cancers can cause sudden onset of intense menopausal symptoms, such as vasomotor symptoms, sexual dysfunction and emotional instability. Hormone replacement therapy (HRT) is often effective and can overcome these unpleasant and severe symptoms. However, data regarding its safety remains controversial. The big question therefore is whether HRT in gynaecological cancer survivors is possible. This is due to the fear of disease relapse. So, the purpose of this study was to review the evidence regarding cancer recurrence or death following use of HRT in su...
Source: Current Obstetrics and Gynecology Reports - May 25, 2019 Category: OBGYN Source Type: research

From Etiopathology to Management of Accreta Placentation
AbstractPurpose of ReviewTo review the etiopathology of the different grades of accreta placentation and evaluate its impact on management strategies and outcomes.Recent FindingsAccreta placentation is essentially the consequence of prior uterine surgery, mainly multiple cesarean deliveries which often result in large scar defects with absence of re-epithelialization by the endometrium. Invasive placentation is associated with high maternal morbidity and if undiagnosed before delivery can lead to massive obstetric hemorrhage leading to maternal death. The clinical symptoms of an adherent placenta accreta are very similar t...
Source: Current Obstetrics and Gynecology Reports - May 20, 2019 Category: OBGYN Source Type: research

Broad Band Ligament Hernias: A Case Report
AbstractPurpose of reviewInternal hernias account for 1% of all mechanical obstructions. However, internal hernias by defect of the broad ligament of the uterus are uncommon. This review aims to update our knowledge regarding this unusual pathology in order to understand its etiology and symptoms, and to aid in early diagnosis and management.Recent findingsSince the end of the nineteenth century, fewer than 100 cases of internal hernias secondary to a defect of the broad ligament have been described. It is known that this defect in the broad uterine ligament can be congenital or acquired, leading to symptoms such as chroni...
Source: Current Obstetrics and Gynecology Reports - April 3, 2019 Category: OBGYN Source Type: research

Vaginal Birth and Pelvic Floor Trauma
AbstractPurpose of ReviewOver the last two to three decades, a growing body of research has shown that vaginal childbirth is more traumatic to mothers than generally assumed. Apart from obstetric anal sphincter tears which have been extensively studied, trauma to the levator ani muscle is a form of maternal injury that is less well recognised and often undiagnosed. In the context of an increasing push towards vaginal birth, this article will review the recent literature to better inform health care providers regarding the significance of pelvic floor trauma.Recent FindingsImaging studies have shown that levator avulsion, w...
Source: Current Obstetrics and Gynecology Reports - March 18, 2019 Category: OBGYN Source Type: research

Updates in Minimally Invasive Approaches to Apical Pelvic Organ Prolapse Repair
AbstractPurpose of ReviewThe purpose of this article is to review and comment on the recent medical evidence regarding minimally invasive procedures for apical pelvic organ prolapse repair.Recent FindingsSacrocolpopexy remains the “gold standard” repair for apical prolapse for those who desire to maintain sexual function, and minimally invasive approaches offer equal efficacy with lower risk than open sacrocolpopexy. Similar to the impact on hysterectomy rates, the introduction of robotic technology has converted a large number of open abdominal sacrocolpopexy procedures to a minimally invasive approach in the ...
Source: Current Obstetrics and Gynecology Reports - March 16, 2019 Category: OBGYN Source Type: research

Endocrine Disruptors and Pregnancy Loss
AbstractPurpose of ReviewIn modern society, we are exposed to a wide variety of manufactured chemical compounds, called “endocrine-disrupting chemicals” (EDCs). EDCs interact with hormone receptors and have a detrimental effect on reproduction, a complex and hormonally regulated process. Two widely prevalent groups of EDCs are bisphenols and phthalates. This review aims to evaluate and summarize current research on EDCs and their proposed relationship with increased rates of pregnancy loss.Recent FindingsMost research focuses on one of many bisphenols, bisphenol A or BPA. Studies of BPA in animals have shown a ...
Source: Current Obstetrics and Gynecology Reports - March 11, 2019 Category: OBGYN Source Type: research

Caring for Pregnant Women with Opioid Use Disorder
AbstractPurpose of ReviewThe US opioid epidemic continues historic trends of disproportionately affecting women. However, attention to the rise in neonatal opioid withdrawal syndrome (NOWS) and other types of neonatal care often overshadow the urgent need for improved and more wide-ranging maternal treatment in the peripartum period.Recent FindingsThis review aims to highlight the trends in maternal morbidity and mortality related to substance use disorder (SUD), to discuss the under-funding of woman-focused interventions, and to discuss medication-assisted treatment (MAT) options for women with SUD. We found that the rate...
Source: Current Obstetrics and Gynecology Reports - March 6, 2019 Category: OBGYN Source Type: research

Noninvasive Prenatal Diagnostics: Recent Developments Using Circulating Fetal Nucleated Cells
AbstractPurpose of ReviewThe purpose of this review is to highlight recent research advances in noninvasive prenatal diagnostic methods.Recent FindingsRecent studies developing noninvasive prenatal diagnostic (NIPD) methods have been focused on either fetal nucleated red blood cells (fNRBCs) or circulating trophoblasts (cTBs). Enriched cTBs were successfully utilized for whole genome profiling and short tandem repeat (STR) identification to confirm feto-maternal relationship. However, further analysis of isolated fNRBCs remains confined to examining fetal cytogenetics.SummaryInvasive prenatal diagnostic procedures, amnioce...
Source: Current Obstetrics and Gynecology Reports - January 21, 2019 Category: OBGYN Source Type: research

Update on Permanent Contraception for Women
AbstractPurpose of ReviewWe completed this review to update readers on the current literature and controversies surrounding different approaches to permanent female contraception.Recent FindingsPermanent contraception continues to be a popular method of pregnancy prevention. The withdrawal of the Essure ® hysteroscopic approach to permanent contraception from the US market and the increased use of salpingectomy to decrease risk of ovarian cancer have changed options available to women. Current studies support allowing adult women who desire no future pregnancies to access permanent contraception r egardless of age, par...
Source: Current Obstetrics and Gynecology Reports - November 3, 2018 Category: OBGYN Source Type: research

Factors Associated with Adolescents ’ Choice to Use Long Acting Reversible Contraceptives: a Systematic Review
AbstractPurpose of ReviewThis review aims to update the published literature to summarize our understanding about the associated factors with adolescents ’ willingness to use long-acting reversible contraceptives.Recent FindingsLong acting reversible contraception (LARCs), specifically intrauterine devices and implants, have been successful in preventing unintended pregnancy and repeat pregnancy among adolescents. Unfortunately, many misconceptions about eligibility, fears of the insertion procedure, and health effects prevent adolescents from choosing them.SummaryA total of 1316 articles were identified and only nin...
Source: Current Obstetrics and Gynecology Reports - October 29, 2018 Category: OBGYN Source Type: research

A Comprehensive Update on Stillbirth Prevention: from Preconception to Postpartum, Individuals to Public Health Administrations
AbstractPurpose of ReviewStillbirth is a devastating event for the pregnant woman, families, and care providers alike. No preventable stillbirths should be tolerated, no matter how low the incidence is. The rate of reducing stillbirth rate is less than satisfactory and warrants continued efforts. Indeed, massive researches from all specialties bloomed in recent years. Some interventions are with good evidence and feasible to be practiced, while others are preliminary but exciting to be investigated further. The purpose of this review is a comprehensive overview of the recent studies on stillbirth prevention. An emphasis is...
Source: Current Obstetrics and Gynecology Reports - October 23, 2018 Category: OBGYN Source Type: research