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Evaluation of endometrial receptivity and implantation failure
Purpose of review To succinctly review the basic mechanisms of implantation and luteal phase endometrial differentiation, the etiologies of impaired endometrial function and receptivity, and the current methods that exist to evaluate and treat impaired endometrial receptivity. Recent findings Human embryo implantation requires bidirectional communication between blastocyst and a receptive endometrium. Etiologies of impaired endometrial receptivity are varied. Some of these include delayed endometrial maturation, structural abnormalities, inflammation, and progesterone resistance. Current methods to evaluate endo...
Source: Current Opinion in Obstetrics and Gynecology - May 31, 2022 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Prevention of multiple pregnancies in gonadotropin-insemination cycles
Purpose of review Although elective single embryo transfer has significantly reduced, the rate of multiple pregnancy in IVF cycles, this rate is still relatively high in gonadotropin-insemination cycles. Patients who fail to ovulate or to conceive with oral agents and have constraints for IVF are usually candidates for gonadotropin injections. The current review article provides an up-to-date summation of the different strategies that can be adopted to reduce the risk of multiple pregnancies in gonadotropin-stimulated intrauterine insemination cycles. Recent findings Gonadotropin-insemination treatments should b...
Source: Current Opinion in Obstetrics and Gynecology - May 31, 2022 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Editorial introduction
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - May 31, 2022 Category: OBGYN Tags: EDITORIAL INTRODUCTIONS Source Type: research

Prenatal diagnosis of placenta accreta spectrum
Purpose of review Placenta accreta spectrum (PAS) is a major cause of severe maternal morbidity. Perinatal outcomes are significantly improved when PAS is diagnosed prenatally. However, a large proportion of cases of PAS remain undiagnosed until delivery. Recent findings The prenatal diagnosis of PAS requires a high index of suspicion. The first step is identifying maternal risk factors. The most significant risk factor for PAS is the combination of a prior caesarean delivery and a placenta previa. Other major risk factors include a prior history of PAS, caesarean scar pregnancy (CSP), uterine artery embolizatio...
Source: Current Opinion in Obstetrics and Gynecology - March 2, 2022 Category: OBGYN Tags: PRENATAL DIAGNOSIS: Edited by Jane Chueh Source Type: research

Uterine atony
Purpose of review Postpartum hemorrhage (PPH) is the leading preventable cause of maternal morbidity and mortality worldwide. Uterine atony is identified as the underlying etiology in up to 80% of PPH. This serves as a contemporary review of the epidemiology, risk factors, pathophysiology, and treatment of uterine atony. Recent findings Rates of postpartum hemorrhage continue to rise worldwide with the largest fraction attributed to uterine atony. A simple 0–10 numerical rating score for uterine tone was recently validated for use during cesarean delivery and may allow for more standardized assessment in clini...
Source: Current Opinion in Obstetrics and Gynecology - March 2, 2022 Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy and Martha Rode Source Type: research

Activity restriction and preterm birth prevention
Purpose of review Since the 1900s, activity restriction (AR) has been widely prescribed as a strategy for preventing preterm birth (PTB). Over the past decade, the practice has been called into question as numerous studies have demonstrated that AR does not improve obstetrical and perinatal outcomes but does confer significant physical and psychological risks. The purpose of this review is to offer clinicians a summary of the latest data on the risks, benefits, and efficacy of AR for the prevention of PTB. Recent findings Both retrospective and prospective studies have demonstrated that AR does not significantly...
Source: Current Opinion in Obstetrics and Gynecology - March 2, 2022 Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy and Martha Rode Source Type: research

Iron deficiency anemia in pregnancy
Purpose of review Anemia in pregnancy is associated with increased maternal and neonatal morbidity. There is increasing awareness amongst obstetricians about the need to screen for iron deficiency anemia (IDA), as well as growing literature on diagnosis and treatment. This review aims to summarize causes, consequences, treatment, and evaluation of IDA in pregnancy. Recent Findings National guidelines provide varying guidance on diagnosis and treatment of IDA in pregnancy. Serum ferritin is a helpful adjunct for the diagnosis of IDA. Oral iron remains an option for treatment; absorption is improved with every oth...
Source: Current Opinion in Obstetrics and Gynecology - March 2, 2022 Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy and Martha Rode Source Type: research

Perinatal considerations for care of transgender and nonbinary people: a narrative review
This article will review current literature and provide recommendations specific to the hospital birthing environment to help address the lack of knowledge regarding pregnancy-related care of TGNB individuals. This care is further divided into three main times: (1) preconception, antepartum care, and triage, (2) intrapartum, and (3) postpartum. We also discuss considerations for the general medical care of TGNB individuals. Summary Understanding facilitators and barriers to gender affirming pregnancy-related care of TGNB individuals are first steps toward providing a respectful, affirming, and evidence-based environ...
Source: Current Opinion in Obstetrics and Gynecology - March 2, 2022 Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy and Martha Rode Source Type: research

Cellular aging and telomere dynamics in pregnancy
Purpose of review Telomere biology is an emerging area of scientific interest. Telomeres are deoxynucleic acid caps at the ends of chromosomes that naturally shorten over one's lifespan; because of this, short telomeres have been studied as a marker of cellular aging. Given the association between short telomeres and genetic and environmental factors, their role in pregnancy has become an intriguing area of research. Recent findings This review describes recent data on telomeres in pregnancy. Specifically, we discuss the association between short maternal leukocyte telomeres and poor nutritional status, between ...
Source: Current Opinion in Obstetrics and Gynecology - March 2, 2022 Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy and Martha Rode Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - March 2, 2022 Category: OBGYN Tags: EDITORIAL INTRODUCTIONS Source Type: research

Triple negative breast cancer: any closer to cracking the code?
Purpose of review Triple negative breast cancer is the most aggressive subtype of breast cancer and has traditionally lacked targeted therapies leading to worse prognosis in most patients. Recent findings We will review new targeted therapies for triple negative breast cancer including immunotherapy, antibody-drug conjugates, and poly (adenosine diphosphate–ribose) polymerase (PARP) inhibitors. Summary Immunotherapy is now a backbone of PD-L1 positive metastatic triple negative breast cancer in the front-line setting as well as part of neoadjuvant therapy for high risk localized triple negative breast c...
Source: Current Opinion in Obstetrics and Gynecology - January 4, 2022 Category: OBGYN Tags: BREAST CANCER: Edited by Gottfried E. Konecny Source Type: research

Updates on treating ductal carcinoma in situ: what's to know in 2021
Purpose of review Ductal carcinoma in situ (DCIS) is a noninvasive stage of disease but understood to be a nonobligate precursor to invasive breast cancer. As such, women with DCIS are routinely recommended for standard breast cancer treatment to prevent progression to invasive disease. DCIS, however, represents a heterogeneous group of lesions that differs in its biologic behavior and risk of progression. Thus, optimal treatment is unclear. This review presents the clinical trials evaluating the de-escalation of therapy, attempts at risk stratification, and future directions in the management of this disease. Recen...
Source: Current Opinion in Obstetrics and Gynecology - January 4, 2022 Category: OBGYN Tags: BREAST CANCER: Edited by Gottfried E. Konecny Source Type: research

Updates on targeting human epidermal growth factor receptor 2-positive breast cancer: what's to know in 2021
Purpose of review To highlight recent practice changing clinical trials, focusing on those leading to new drug approvals, in human epidermal growth factor receptor 2-positive (HER2+) breast cancer. Recent findings The improved disease-free survival of adjuvant trastuzumab emtansine (T-DM1) over trastuzumab in patients with residual disease has made neoadjuvant sequencing of therapy standard for most patients with early stage disease. In patients with metastatic HER2+ breast cancer, trastuzumab deruxtecan has recently shown dramatically improved efficacy over T-DM1. Tucatinib is an oral tyrosine kinase inhibitor ...
Source: Current Opinion in Obstetrics and Gynecology - January 4, 2022 Category: OBGYN Tags: BREAST CANCER: Edited by Gottfried E. Konecny Source Type: research

Should all patients undergoing genetic testing for hereditary breast cancer syndromes be offered a multigene panel?
Purpose of review We aim to demonstrate why multigene panel testing (MGPT) is the superior testing option for individuals undergoing hereditary cancer genetic testing. We will outline the clinical benefits and possible limitations of MGPT for individuals at risk for a hereditary cancer syndrome. Recent findings The use of MGPT increases the identification of individuals with hereditary cancer syndromes. Recent studies continue to prove that MGPT is a superior option to single gene/or syndrome testing. MGPT is a cost-effective testing approach for those meeting criteria for genetic testing. Individuals interested...
Source: Current Opinion in Obstetrics and Gynecology - January 4, 2022 Category: OBGYN Tags: BREAST CANCER: Edited by Gottfried E. Konecny Source Type: research

Changing treatments paradigms and role of immunotherapy in recurrent endometrial cancer
Purpose of review Over the past decade, the treatment of patients diagnosed with endometrial cancer (EC) shifted away from the use of chemotherapy to more novel targeted therapy and immunotherapy approaches. Recent findings The Cancer Genome Atlas data demonstrated different subgroups within ECs, more specifically, it facilitated the identification of predictive biomarkers. In particular, immunotherapies (immuno-oncology (IO)) are active either as monotherapy or in combination with other agents, depending on the biomarker profile of the tumor. Summary In May 2017, pembrolizumab was approved for patients w...
Source: Current Opinion in Obstetrics and Gynecology - January 4, 2022 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research