Neuromodulation
This article reviews recent advancements in SNM therapy including updates in best practices for implant technique, technological innovations, and the new clinical literature relevant to contem porary practice. (Source: Obstetrics and Gynecology Clinics)
Source: Obstetrics and Gynecology Clinics - August 18, 2021 Category: OBGYN Authors: Karen Noblett, Carly Crowder Source Type: research
Advances in Female Pelvic Medicine and Reconstructive Surgery
OBSTETRICS AND GYNECOLOGY CLINICS OF NORTH AMERICA (Source: Obstetrics and Gynecology Clinics)
Source: Obstetrics and Gynecology Clinics - August 18, 2021 Category: OBGYN Authors: Heidi Wendell Brown, Rebecca Glenn Rogers Source Type: research
Copyright
Elsevier (Source: Obstetrics and Gynecology Clinics)
Source: Obstetrics and Gynecology Clinics - August 18, 2021 Category: OBGYN Source Type: research
Contributors
WILLIAM F. RAYBURN, MD, MBA (Source: Obstetrics and Gynecology Clinics)
Source: Obstetrics and Gynecology Clinics - August 18, 2021 Category: OBGYN Source Type: research
Contents
William F. Rayburn (Source: Obstetrics and Gynecology Clinics)
Source: Obstetrics and Gynecology Clinics - August 18, 2021 Category: OBGYN Source Type: research
Forthcoming Issues
A Vision of the Future of Obstetrics and Gynecology (Source: Obstetrics and Gynecology Clinics)
Source: Obstetrics and Gynecology Clinics - August 18, 2021 Category: OBGYN Source Type: research
Postscript
As the world clamored to respond to the rapidly evolving coronavirus 2019 (COVID-19) pandemic, health care systems reacted swiftly to provide uninterrupted care for patients. Within obstetrics and gynecology, nearly every facet of care was influenced. Rescheduling of office visits, safety of labor and delivery and in the operating room, and implementation of telemedicine are examples. Social distancing has impacted academic centers in the education of trainees. COVID-19 vaccine trials have increased awareness of including pregnant and lactating women. Last, the pandemic has reminded us of issues related to ethics, diversit...
Source: Obstetrics and Gynecology Clinics - July 13, 2021 Category: OBGYN Authors: Denisse S. Holcomb, William F. Rayburn Source Type: research
Postscript: Women ’s Health and the Era after COVID-19
As the world clamored to respond to the rapidly evolving coronavirus 2019 (COVID-19) pandemic, healthcare systems reacted swiftly to provide uninterrupted care for patients. Within obstetrics and gynecology, nearly every facet of care has been influenced. Rescheduling of obstetrics and gynecology visits, safety on labor and delivery and the operating room, and implementation of telemedicine are examples. Social distancing has particularly impacted academic centers in the education of trainees. COVID-19 vaccine trials have increased awareness of including pregnant and lactating women in clinical trials. Lastly, the pandemic...
Source: Obstetrics and Gynecology Clinics - July 13, 2021 Category: OBGYN Authors: Denisse S. Holcomb, William F. Rayburn Source Type: research
Placental Function and the Development of Fetal Overgrowth and Fetal Growth Restriction
Placental regulation of fetal growth involves the integration of multiple signaling pathways that modulate an array of placental functions, including nutrient transport. As a result, the flux of oxygen and nutrients to the fetus is altered, leading to changes in placental and fetal growth. Placental insulin/insulinlike growth factor-1 and mechanistic target of rapamycin signaling and amino acid transport capacity are inhibited in fetal growth restriction and activated in fetal overgrowth, implicating these placental functions in driving fetal growth. With novel approaches to specifically target the placenta, clinical inter...
Source: Obstetrics and Gynecology Clinics - May 8, 2021 Category: OBGYN Authors: Jerad H. Dumolt, Theresa L. Powell, Thomas Jansson Source Type: research
Abnormal Fetal Growth
Abnormal fetal growth (growth restriction and overgrowth) is associated with perinatal morbidity, mortality, and lifelong risks to health. To describe abnormal growth, “small for gestational age” and “large for gestational age” are commonly used terms. However, both are statistical definitions of fetal size below or above a certain threshold related to a reference population, rather than referring to an abnormal condition. Fetuses can be constitutionally s mall or large and thus healthy, whereas fetuses with seemingly normal size can be growth restricted or overgrown. Although golden standards to detect abnormal gr...
Source: Obstetrics and Gynecology Clinics - May 8, 2021 Category: OBGYN Authors: Stefanie E. Damhuis, Wessel Ganzevoort, Sanne J. Gordijn Source Type: research
Fetal Growth Curves
Three modern cohort studies have an advantage over historical fetal growth references because they included diverse populations. Despite similar inclusion criteria, estimated fetal weight percentiles for gestational age varied among studies, which result in different proportions of fetuses as being classified below or above a cutoff point. A universal reference would make comparison of fetal growth simpler for clinical use and for comparison across populations but may misclassify small-for-gestational-age or large-for-gestational-age fetuses. It is important to know how a growth reference performs in a local population in ...
Source: Obstetrics and Gynecology Clinics - May 8, 2021 Category: OBGYN Authors: Katherine L. Grantz Source Type: research
Short- and Long-Term Implications of Small for Gestational Age
This article specifically details the neurologic and cardiometabolic sequalae associated with fetal growth restriction, as well as the purported mechanisms that underlie their pathogenesis. We end with a brief discussion about further work that is needed to gain a more complete understanding of fet al growth restriction. (Source: Obstetrics and Gynecology Clinics)
Source: Obstetrics and Gynecology Clinics - May 8, 2021 Category: OBGYN Authors: Camille Fung, Erin Zinkhan Source Type: research
Short- and Long-Term Outcomes Associated with Large for Gestational Age Birth Weight
Large for gestational age birth weight is associated with adverse short- and long-term outcomes. Infants born with large for gestational age birth weight are at increased risk for neonatal intensive care unit admission, respiratory distress, neonatal metabolic abnormalities including hypoglycemia, birth trauma, and even stillbirth or neonatal death. The risk for many of these complications increases with higher birth weights. Individuals with large for gestational age birth weight also appear to be at subsequent increased risk for overweight/obesity, diabetes, cardiovascular disease, and even some childhood cancers. These ...
Source: Obstetrics and Gynecology Clinics - May 8, 2021 Category: OBGYN Authors: Christina M. Scifres Source Type: research
Routine Third Trimester Sonogram
Several risk factors for adverse pregnancy outcomes can be identified by a routine third trimester ultrasound scan. However, there is also potential for harm, anxiety, and additional health care costs through unnecessary intervention due to false positive results. The evidence base informing the balance of risks and benefits of universal screening is inadequate to fully inform decision making. However, data on the diagnostic effectiveness of universal ultrasound suggest that better methods are required to result in net benefit, with the exception of screening for presentation near term, where a clinical and economic case c...
Source: Obstetrics and Gynecology Clinics - May 8, 2021 Category: OBGYN Authors: Katie Stephens, Alexandros Moraitis, Gordon C.S. Smith Source Type: research
Evaluation and Management of Suspected Fetal Growth Restriction
Impaired fetal growth owing to placental insufficiency is a major contributor to adverse perinatal outcomes. No intervention is available that improves outcomes by changing the pathophysiologic process. Monitoring in early-onset fetal growth restriction (FGR) focuses on optimizing the timing of iatrogenic preterm delivery using cardiotocography and Doppler ultrasound. In late-onset FGR, identifying the fetus at risk for immediate hypoxia and who benefits from expedited delivery is challenging. It is likely that studies in the next decade will provide evidence how to best integrate different monitoring variables and other p...
Source: Obstetrics and Gynecology Clinics - May 8, 2021 Category: OBGYN Authors: Claartje Bruin, Stefanie Damhuis, Sanne Gordijn, Wessel Ganzevoort Source Type: research
