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BJOG: An International Journal of Obstetrics and Gynaecology

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https://www.readbyqxmd.com/read/28548227/changing-the-risk-threshold-for-surgical-prevention-of-ovarian-cancer
#1
Ranjit Manchanda, Rosa Legood, Antonis C Antoniou, Leigh Pearce, Usha Menon
Ovarian cancer (OC) remains a lethal disease and a major cause of deaths from gynaecological cancer particularly in western countries. Despite advances in treatment, there have been only marginal improvements in survival rates over the last 30years. Additionally, the number of OC cases in the UK is estimated to increase by 27-45%, which translates to a 15% rise in the incidence rate by 2035.(1) A national OC screening programme is unavailable as this has not yet shown a conclusive mortality benefit.(2) Hence, primary prevention continues to be the cornerstone in reducing the burden of OC and improving health outcomes...
May 26, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28544572/inositol-treatment-of-anovulation-in-women-with-polycystic-ovary-syndrome-a-meta-analysis-of-randomised-trials
#2
Jyotsna Pundir, Dimitrios Psaroudakis, Prakash Savnur, Priya Bhide, Luca Sabatini, Helena Teede, Arri Coomarasamy, Shakila Thangaratinam
BACKGROUND: Polycystic ovary syndrome is a common cause of anovulation and infertility, and a risk factor for development of metabolic syndrome and endometrial cancer. OBJECTIVES: Systematic review and meta-analysis of randomised controlled trials that evaluated the effects of inositol as an ovulation-induction agent. SEARCH STRATEGY: We searched MEDLINE, EMBASE, Cochrane and ISI conference proceedings, Register and Meta-register for RCTs and WHO trials' search portal...
May 24, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28544220/gdm-shades-of-gray
#3
Robert M Silver
In this issue of BJOG, Kapur and colleagues call for all European women to undergo screening for gestational diabetes (GDM) as recommended by FIGO (Kapur et al., BJOG 2017 XX). They rightly note the adverse fetal, neonatal, and maternal effects of GDM as well as possible downstream implications for the mother and child. Their recommendations echo those of several leading organizations including FIGO. However, despite these recommendations, some European countries, communities, hospitals and clinicians do not screen all women for GDM...
May 24, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28544260/hysteroscopic-excision-of-symptomatic-myometrial-adenomyosis-feasibility-and-effectiveness
#4
Wei Xia, Duo Zhang, Qian Zhu, Huiyu Zhang, Siqin Yang, Jue Ma, Hongjie Pan, Tong Tong, Jing Sun, Jian Zhang
The aim of this study was to explore the feasibility and efficacy of hysteroscopic excision of myometrial adenomyotic lesions. We conducted a case-series study of 51 women with myometrial adenomyosis undergoing hysteroscopic excision of leisons and followed up the women for 24 months. The degree of symptoms, uterine volume, and serum CA125 concentrations were recorded. The degrees of menorrhagia and dysmenorrhea were evaluated. The mean MVJ and VAS score significantly decreased from the baseline. The uterine volume and the serum CA125 significantly reduced...
May 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28516500/healthcare-utilisation-induced-labour-and-caesarean-section-in-the-pregnancy-after-stillbirth-a-prospective-study
#5
Ida Kathrine Gravensteen, Eva-Marie Jacobsen, Per Morten Sandset, Linda Björk Helgadottir, Ingela Rådestad, Leiv Sandvik, Øivind Ekeberg
OBJECTIVE: To investigate healthcare utilisation, induced labour and caesarean section (CS) in the pregnancy after stillbirth and assess anxiety and dread of childbirth as mediators for these outcomes. DESIGN: Population-based pregnancy cohort study. SETTING: The Norwegian Mother and Child Cohort Study. SAMPLE: 901 pregnant women; 174 pregnant after stillbirth, 362 pregnant after live birth and 365 previously nulliparous...
May 18, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28504857/hysteroscopic-resection-of-a-uterine-caesarean-scar-defect-niche-in-women-with-postmenstrual-spotting-a-randomised-controlled-trial
#6
A J M W Vervoort, L F Van der Voet, W J K Hehenkamp, A L Thurkow, P J M van Kesteren, H Quartero, W Kuchenbecker, M Bongers, P Geomini, L H M de Vleeschouwer, M H A van Hooff, H van Vliet, S Veersema, W B Renes, K Oude Rengerink, S E Zwolsman, H A M Brölmann, B W J Mol, J A F Huirne
OBJECTIVE: To compare in women with postmenstrual spotting and a uterine caesarean scar defect the effectiveness of a hysteroscopic niche resection versus no treatment. DESIGN: Multicentre randomised controlled trial. SETTING: 11 hospitals collaborating in a consortium for women's health research in the Netherlands. POPULATION: Women reporting postmenstrual spotting after a caesarean section who had a niche with a residual myometrium of ≥3mm measured during sonohysterography...
May 15, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28502106/misoprostol-for-cervical-priming-prior-to-office-hysteroscopy-works-in-premenopausal-nulliparous-but-not-in-postmenopausal-women
#7
Shagaf Bakour
This randomized controlled trial (RCT) by Tasma et al. reports on pain at hysteroscopy. This is an important subject since hysteroscopy is the single most common procedure in gynaecology. There has been limited or conflicting evidence regarding misoprostol for cervical priming prior to hysteroscopy. Although there have been three meta-analyses and 25 RCTs published to date, the heterogeneity among regimens, doses, and route of administration plus clinical diversity, make analysis of the data difficult. This article is protected by copyright...
May 14, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28498567/uterine-fibroids-from-observational-epidemiology-to-clinical-management
#8
Paolo Vercellini, Maria Pina Frattaruolo
According to this systematic review of epidemiological studies, fibroid prevalence varied widely, with no consistent association across studies between observed estimates and country, methodology, and population. Fibroid incidence was higher in black than in white women independently of other risk factors, suggesting a racial predisposition. A genetic influence was confirmed also by the association with a positive family history. The association with age and menopausal status maybe interpreted in terms of varying degrees of oestrogen exposure, which could explain also the association with food additives and soybean consumption...
May 12, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28485898/a-call-to-action-for-data-definition-standardization-and-core-outcome-sets
#9
Gary A Dildy
Systematic reviews, which form the pinnacle of the "levels of evidence pyramid", synthesize knowledge and serve to evolve evidence-based medical practice. In this issue of the BJOG, Duffy and colleagues present a systematic review of maternal and offspring outcome reporting across 79 randomized controlled trials (RCT) evaluating 55 various therapeutic interventions for pre-eclampsia. These RCTs reported 119 different outcomes (72 maternal and 47 offspring outcomes) for 31,615 maternal and 28,172 offspring participants...
May 9, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28485895/with-smart-strategies-immediate-postpartum-larc-is-possible
#10
Abigail R A Aiken
The need to provide immediate postpartum access to intrauterine contraceptives and contraceptive implants for those who desire them is now widely acknowledged among leading healthcare organizations. The most recently updated versions of the UK, US, and World Health Organization (WHO) Medical Eligibility Criteria for Contraceptive Use (MEC) all support placement of the progestin implant, Copper IUD, and levonorgestrel IUS following delivery of the placenta and before hospital discharge. Postpartum placement has been recognized as safe, effective, and acceptable by the Royal College of Obstetricians and Gynaecologists (RCOG) and the American College of Obstetricians and Gynecologists (ACOG)...
May 9, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28485851/fibroid-vascularisation-as-a-predictor-for-uterine-fibroid-growth
#11
Margit Dueholm
There is a large variation in fibroid growth such that fibroids may grow at vastly different rates and conversely may spontaneously regress. The ability to predict the growth of fibroids could help clinicians decide, with their patients, the need for treatment. For example, asymptomatic women with fibroids detected incidentally may require follow up if these fibroids are predicted to have a high growth rate. In women of reproductive age, fast-growing fibroids located in a submucous or intramural position may subsequently impair fertility and so early surgical removal should be considered...
May 9, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28481445/optimising-fertility-outcomes-for-women-with-early-stage-cervical-cancer-when-less-is-more
#12
Efterpi Tingi, Emma J Crosbie, Gemma Owens
Radical hysterectomy and pelvic lymphadenectomy is standard management for early-stage cervical cancer. Radical trachelectomy achieves equivalent oncological outcomes to hysterectomy thus providing an alternative for women who wish to preserve their fertility (Xu et al. Acta Obstet Gynecol Scand 2011; 90: 1200-09). Trachelectomy offers the potential for pregnancy but poor obstetric sequelae, including second trimester miscarriage, preterm premature rupture of membranes (PPROM) and preterm delivery are common, likely due to reduced mechanical support from a shortened cervix and ascending infection...
May 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28481444/when-east-meets-west
#13
Qide Han
In the current issue of BJOG, a report titled "Evaluation of HIFU Ablation for Uterine Fibroids: an IDEAL Prospective Exploration Study", was led by Professor Jinghe Lang, a member of Chinese Academy of Technology. While Chinese researchers have been leading the R&D of High-intensity focused ultrasound surgery technology and its clinical applications for more than 20 years, worldwide clinical dissemination has been hindered by the lack of systematic and high quality clinical evaluation. The study by Lang et al...
May 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28481433/can-we-prevent-preterm-birth-after-radical-trachelectomy
#14
Maria Kyrgiou, Phillip Bennett
Despite screening, cervical cancer remains the fourth commonest cancer in women with over 30000 new cases annually in Europe. HPV vaccination will reduce its incidence, but the full impact will require decades. The peak age of CIN matches the mean age of first pregnancy in the Western World. Most cervical cancers are diagnosed at an early stage through screening allowing fertility-sparing procedures such as radical trachelectomy, performed vaginally or abdominally or even simple conisation. This article is protected by copyright...
May 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28477363/physical-activity-and-preterm-birth-risk-factor-or-benefit
#15
B Anthony Armson
Although risk factors and determinants of spontaneous preterm birth have been identified, effective primary and secondary prevention strategies to reduce the global incidence and neonatal consequences of prematurity remain elusive. Physically demanding work (prolonged standing, heavy lifting, physical exertion, occupational fatigue, demanding posture) during pregnancy has been associated with an increased risk of preterm birth (van Beukering MDM, et al. Int Arch Occup Environ Health 2014; 87:809-34). This article is protected by copyright...
May 6, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28467691/quality-of-life-amongst-women-in-bangladesh-following-ileal-conduit-urinary-diversion-operations-for-irreparable-vesicovaginal-fistula-and-bladder-exstrophy-observational-study
#16
Sarah H Walker, Beatrice Ambauen-Berger, Stacy L Saha, Sayeba Akhter
OBJECTIVE: To determine the quality of life (QOL) amongst fistula patients in Bangladesh, who have undergone Ileal Conduit (IC) urinary diversion operations, and to assess whether the risks and ethical challenges involved outweigh the reality of leaving a woman with urinary incontinence for the rest of her life. DESIGN: Observational study. SETTING: LAMB Hospital, Bangladesh. POPULATION: 17 women who had undergone IC between February 2012 and March 2016...
May 3, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28467683/clomiphene-citrate-a-reassuringly-safe-drug
#17
Masoud Afnan
In this edition of the BJOG, Weller and colleagues present a population based study in a single centre over 12 years in which 1,872 of 114,961 women took clomiphene, and showed no increase in the rate of overall or specific major malformations. It provides the best available evidence to date that clomiphene (clomifene) citrate is safe. This article is protected by copyright. All rights reserved.
May 3, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28467660/transvaginal-contained-tissue-extraction-after-laparoscopic-myomectomy-a-cohort-study
#18
Fabio Ghezzi, Jvan Casarin, Giuseppe De Francesco, Paolo Puggina, Stefano Uccella, Maurizio Serati, Antonella Cromi
OBJECTIVE: To describe the technique and report perioperative outcomes of transvaginal contained extraction of surgical specimens at laparoscopic myomectomy. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Two Italian referral centres for gynaecological minimally invasive surgery. POPULATION: Consecutive patients who underwent laparoscopic myomectomy. METHODS: Tissue extraction was accomplished following laparoscopic myomectomy in a specimen retrieval bag via a posterior colpotomy incision...
May 3, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28464415/safety-and-effectiveness-of-female-tubal-sterilisation-by-hysteroscopy-laparoscopy-or-laparotomy-a-register-based-study
#19
Ewa Jokinen, Anna Heino, Tuula Karipohja, Mika Gissler, Ritva Hurskainen
OBJECTIVE: To determine safety and effectiveness of female sterilisation in Finnish population. DESIGN: A national register based study using record linkage. SETTING: National data from Finland. POPULATION OR SAMPLE: 16 272 female sterilisations performed in 2009-2014. METHODS: The Register of Sterilisations was linked with the Hospital Discharge Register, termination of pregnancy register and the Medical Birth Register in order to investigate the occurrence of re-sterilisations, other surgical operations and unwanted pregnancies after sterilisation per method...
May 2, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28447403/management-of-inherited-bleeding-disorders-in-pregnancy-green-top-guideline-no-71-joint-with-ukhcdo
#20
(no author information available yet)
No abstract text is available yet for this article.
April 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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