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Current Opinion in Obstetrics & Gynecology

Karl Oliver Kagan, Jiri Sonek, Klaus Hamprecht
PURPOSE OF REVIEW: Cytomegalovirus (CMV) infection is by far the most common fetal viral infection. It carries a risk of long-term sequelae for the neonate; though the severity depends on the gestational age at the time of infection. Improvement in primary prevention of a CMV infection during pregnancy can be achieved by providing information regarding hygiene to the mother. Once a maternal infection occurs, treatment options include prevention of maternal-fetal transmission and, once transmission occurs, attempts to reduce the severity of its effect on the fetus...
August 29, 2018: Current Opinion in Obstetrics & Gynecology
Maki Kawasaki, Naoko Arata, Yoshihiro Ogawa
PURPOSE OF REVIEW: Type 2 diabetes and obesity during childhood, puberty, and adulthood have become more common. This trend presents a global problem in terms of public health and health economics. Associations between intrauterine exposure to hyperglycemia, obesity, and abnormal glucose tolerance (AGT) in offspring have been reported in populations at high risk of diabetes such as Pima Indians, but these associations have not been established in other groups. In this review, we summarize the evidence on obesity and AGT in the offspring of mothers with diabetes...
August 9, 2018: Current Opinion in Obstetrics & Gynecology
Yaakov Melcer, Ron Maymon, Eric Jauniaux
PURPOSE OF REVIEW: Vasa previa is a rare disorder of placentation associated with a high rate of perinatal morbidity and mortality when undetected before delivery. We have evaluated the recent evidence for prenatal diagnosis and management of vasa previa. RECENT FINDINGS: Around 85% of cases of vasa previa have one or more identifiable risk factors including in-vitro fertilization, multiple gestations, bilobed, succenturiate or low-lying placentas, and velamentous cord insertion...
August 9, 2018: Current Opinion in Obstetrics & Gynecology
Sung Bin Park
PURPOSE OF REVIEW: Acute pelvic pain in pregnant and postpartum patients presents diagnostic and therapeutic challenges. Ultrasound remains the primary imaging modality of choice for assessing pregnant and postpartum women. The purpose of this review is to help practitioners ensure a correct diagnosis of acute pelvic pain in pregnancy and the postpartum period. RECENT FINDINGS: This review describes the various causes and highlights the sonographic features and characteristics of acute pelvic pain in pregnancy and the postpartum period...
August 7, 2018: Current Opinion in Obstetrics & Gynecology
Saifuddin T Mama
PURPOSE OF REVIEW: The present article provides an overview of the molecular mechanisms underlying adolescent endometriosis and advances in both medical and surgical management. RECENT FINDINGS: Molecular and cellular features of endometriotic lesions differ from eutopic endometrium. There is altered estrogen-mediated cell signaling, proinflammatory pathways develop in the local microenvironment, along with impaired cellular immunity and growth factors, cytokines, and angiogenic factors play a critical role...
October 2018: Current Opinion in Obstetrics & Gynecology
Lynae M Brayboy, Katryna McCoy, Sneha Thamotharan, Emily Zhu, Gabriela Gil, Christopher Houck
PURPOSE OF REVIEW: The purpose of this review is to examine current sexual health education technologies for adolescents and identify gaps in knowledge. Disparities in sexual health education are prominent and mainly affect young women of color. As a result, the use of technology to reach these marginalized populations could potentially invoke change. Thus, it is crucial to determine the viability of technology as a mechanism to bridge the knowledge gap regarding sexual health for adolescents that are most at risk of sexually transmitted infections and unwanted pregnancies...
October 2018: Current Opinion in Obstetrics & Gynecology
Judith E Hersh
PURPOSE OF REVIEW: Vulvodynia in adults is a significant source of genital and sexual pain with far reaching negative repercussions. Well designed studies with sufficient power in adults are limited and there are even fewer in adolescents. This review will help the clinician understand, diagnose and treat vulvodynia in adolescents based on current knowledge. RECENT FINDINGS: Although research on vulvodynia in adolescents is lacking, studies suggest that it not only exists but also may negatively impact an adolescent's medical and sexual health...
October 2018: Current Opinion in Obstetrics & Gynecology
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October 2018: Current Opinion in Obstetrics & Gynecology
Maria C Monge
PURPOSE OF REVIEW: The purpose is to provide a brief overview of factors that impact adolescent bone health and review special populations that deserve extra consideration of their bone health status. RECENT FINDINGS: Optimization of modifiable factors is critical for adolescents to reach peak bone mass. Binge drinking, tobacco use, and certain medications all have accumulating evidence showing detrimental impacts on adolescent bone health and certain populations are more at risk for poorer bone health outcomes because of the nature of their conditions...
October 2018: Current Opinion in Obstetrics & Gynecology
Nancy Sokkary, Jennie Yoost
PURPOSE OF REVIEW: This review aims to emphasize the importance of including adolescents in research, outline current standards and evaluate barriers that prevent adolescent research. We also hope to provide some guidance and call for much needed additional direction in the field. RECENT FINDINGS: The absolute necessity for including adolescents in research has been an area of focus within the community of adolescent providers and care takers. Recent policy and support from major organizations has emphasized the importance of including this population in research but also pointed out many of the complexities...
October 2018: Current Opinion in Obstetrics & Gynecology
Kathryn Stambough, Krista J Childress
PURPOSE OF REVIEW: The purpose of this review is to outline ovarian conservation and fertility sparing surgery (FSS) in the management of the most common pediatric gynecology malignancies. RECENT FINDINGS: Management of gynecologic malignancies has evolved to have a greater appreciation for adverse late effects from radical surgery, chemotherapy, and radiation. A growing body of literature has led to a paradigm shift toward ovarian conservation and FSS in the management of pediatric ovarian malignancies and genitourinary rhabdomyosarcoma (RMS)...
October 2018: Current Opinion in Obstetrics & Gynecology
Nisse V Clark, Kristen J Pepin, Jon I Einarsson
PURPOSE OF REVIEW: The purpose of this review is to outline surgical skills assessment tools for the purpose of training and competency evaluation, with a focus on recent literature in gynecology. RECENT FINDINGS: Objective standardized surgical skills assessment tools are increasingly being explored in multiple surgical disciplines including gynecology. Several small studies in gynecology have validated procedure-specific checklists, global rating scales, and other surgical proficiency examinations in their ability to differentiate trainee skill level or correlate with other standardized tests...
October 2018: Current Opinion in Obstetrics & Gynecology
Traci Ito, Patricia J Mattingly, Ambareen G Jan, Shan M Biscette, Jin Hee J Kim
PURPOSE OF REVIEW: This article provides a clinical review of the alternatives to traditional excisional surgical therapies for uterine leiomyomas, such as myomectomy or hysterectomy. RECENT FINDINGS: In this review, currently available hormonal medications will be briefly discussed. Then, nonhormonal medical therapy will be addressed with respect to mechanism of action, safety, and efficacy. Finally, the risk-benefit profile of nonexcisional procedures for management of leiomyomas will be addressed...
August 2018: Current Opinion in Obstetrics & Gynecology
Jaclyn A Friedman, Jacqueline M K Wong, Angela Chaudhari, Susan Tsai, Magdy P Milad
PURPOSE OF REVIEW: Submucosal uterine leiomyomas are a common benign pelvic tumor that can cause abnormal uterine bleeding and may contribute to infertility and miscarriage. Hysteroscopic myomectomy is the treatment of choice to alleviate bleeding from these myomas and to normalize the uterine cavity. This review discusses the techniques and recent evidence for hysteroscopic myomectomy and examines the two primary surgical tools employed today: the bipolar resectoscope and hysteroscopic mechanical morcellator...
August 2018: Current Opinion in Obstetrics & Gynecology
Cynthia Arvizo, Sumit T Mehta, Amanda Yunker
PURPOSE OF REVIEW: Laparoscopy is routinely performed for the treatment and management of gynaecologic disorders. During gynaecologic laparoscopy, the patient is placed in the Trendelenburg position to optimize visualization and access to the pelvis. The Trendelenburg position may result in complications in many organ systems. RECENT FINDINGS: Trendelenburg positioning may cause rare, potentially life-threatening complications of the respiratory and cardiovascular systems...
August 2018: Current Opinion in Obstetrics & Gynecology
Michael P Dougherty, Shelley Dolitsky, Rhea Chattopadhyay, Mark V Sauer
PURPOSE OF REVIEW: The present study briefly reviews the history of mitochondrial replacement therapy (MRT); however, the focus is on recent advancements and future directions of the field. Specifically addressing societal and legal concerns and advances in MRT. RECENT FINDINGS: There continue to be new ethical debates surrounding MRT. In addition, there have been advancements in MRT techniques which could improve potential outcomes. Furthermore, advances in genetics continue to provide alternative approaches to treatment of many diseases, including alternatives to MRT...
August 2018: Current Opinion in Obstetrics & Gynecology
José Bellver, Carlos Simón
PURPOSE OF REVIEW: To review recent findings related to possible causes of recurrent implantation failure of endometrial origin in normal uterus. RECENT FINDINGS: Recent evidences suggest that in apparently normal endometria, RIF may associate with molecular and functional changes in the uterus such as abnormal endometrial microbiota, including the presence of chronic endometritis, poor synchronization between the blastocyst and endometrium, and/or excessive uterine peristalsis...
August 2018: Current Opinion in Obstetrics & Gynecology
Jessica Shields, Andrew Lupo, Teresa Walsh, Kimberly Kho
PURPOSE OF REVIEW: Preoperative testing is a routine component of surgical planning, however, the majority of literature agree that laboratory and diagnostic studies are over utilized. We aim to summarize the available literature and provide gynecologists performing elective surgery for benign indications guidance to determine when, in whom, and in what time frame preoperative studies should be collected. RECENT FINDINGS: Current literature supports previous publications indicating routine laboratory and diagnostic testing for elective surgery is unnecessary and continues to be excessive...
August 2018: Current Opinion in Obstetrics & Gynecology
Arthur M Dizon, Erin T Carey
PURPOSE OF REVIEW: Nonobstetric surgery is performed in 1 : 200 to 1 : 500 of pregnant women in the United States annually. Previously, many argued that laparoscopy was contraindicated during pregnancy because of concerns for uterine injury and fetal malperfusion. Because surgeons have gained more experience with laparoscopy, it has become the preferred treatment modality for many surgical diseases in the gravid patient. RECENT FINDINGS: Specific preoperative considerations, intraoperative techniques, and postoperative management per trimester will be reviewed to optimize patient and surgical outcomes...
August 2018: Current Opinion in Obstetrics & Gynecology
Ann Peters, Suketu M Mansuria
PURPOSE OF REVIEW: The risk-benefit ratio of concurrent appendectomy at the time of gynecologic surgery has long been debated and remains controversial. However, emerging data on the appendix's role in chronic pain syndromes point to a previously unrecognized link between gynecologic disorders and appendicular pathology. In this article, we review the indications for appendectomy at the time of laparoscopic gynecologic surgery for the treatment of endometriosis and chronic pelvic pain...
August 2018: Current Opinion in Obstetrics & Gynecology
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