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Best Practice & Research. Clinical Obstetrics & Gynaecology

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https://www.readbyqxmd.com/read/30606689/vacuum-extraction-for-non-rotational-and-rotational-assisted-vaginal-birth
#1
REVIEW
Thomas van den Akker
Vacuum-assisted birth is a safe mode of birth in the presence of a skilled provider. Vacuum extraction can avoid prolonged second stage of labour, birth asphyxia in the presence of foetal distress or maternal pushing where contraindicated. Vacuum-assisted births - particularly those in midpelvic rotational births - have been increasingly traded for caesarean births, although the latter are generally associated with potentially a greater risk to women and (future) children. In this article, (contra)indications and the basics of vacuum technique are elaborated...
December 13, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30600168/the-patient-experience-of-kidney-disease-and-pregnancy
#2
REVIEW
Shilpanjali Jesudason, Allison Tong
Achieving parenthood is often a priority and goal for women with chronic kidney disease (CKD). It can be challenging due to medical and emotional complexities around pregnancy planning and care, increased risk of adverse maternal and fetal outcomes, fears about medications such as immunosuppressants and fetal harm, and concerns regarding the impact of pregnancy on women's kidney health. Navigating the pathways for shared decision-making regarding parenthood requires an understanding of the patient's experiences, values, priorities, and needs...
December 12, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30638905/renal-physiology-and-fluid-and-electrolyte-disorders-in-pregnancy
#3
REVIEW
Maxime Belzile, Audrey Pouliot, Annabelle Cumyn, Anne Marie Côté
The majority of women are healthy entering pregnancy and do not require measurement of renal function or serum electrolytes. Clinicians must remain alert to the possibility of renal as well as fluid and electrolyte disorders in pregnancy, as the presenting complaints are often vague and mistaken for the normal physiology of pregnancy. In this chapter, our objectives are 1) to review the renal physiology from a practical/clinical standpoint; 2) to provide the clinical obstetrician a case-based approach to fluid and electrolyte disorders commonly encountered in pregnancy; 3) to consolidate knowledge on renal physiology and fluid and electrolyte disorders in pregnancy with MCQs that are directly aligned with content; and 4) to highlight key practice points and present a research agenda...
December 4, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30606688/dialysis-in-pregnancy
#4
REVIEW
Kate Wiles, Leandro de Oliveira
Although kidney disease impacts on fertility, increasing numbers of pregnancies are reported in women on dialysis. Despite a trend of increasing live birth rates over recent decades, pregnancies on dialysis remain high risk with increased rates of adverse pregnancy outcomes including pregnancy loss, pre-eclampsia, pre-term delivery, low birth weight and higher levels of neonatal care. This article describes the prevalence of dialysis and pregnancy in women of childbearing age, with relevant information regarding the effects of end-stage renal disease on fertility in women...
November 27, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30580957/controversies-in-urogynaecology
#5
EDITORIAL
Stephen Jeffery, Peter de Jong
No abstract text is available yet for this article.
November 20, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30554856/laparoscopic-surgical-anatomy-for-pelvic-floor-surgery
#6
REVIEW
Dakalo Arnold Muavha, Lamees Ras, Stephen Jeffery
Understanding anatomy is one of the pillars for performing a safe, effective, and efficient surgery, but recently, it is reported that there has been a decline in teaching anatomy during the preclinical years of medical school. There is also evidence that by the time a medical student becomes a clinician, a considerable proportion of the basic anatomy knowledge is lost. Hence, it is crucial for surgeons performing or assisting in pelvic floor surgery to revisit this integral clinical aspect of pelvic anatomy for performing a safe surgery...
November 17, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30553717/surrogacy-and-ethics-in-women-with-cancer
#7
REVIEW
Susan V Carr
Women diagnosed with gynaecological cancer may face unwanted loss of fertility as well as all the other life-changing issues with which cancer and its treatments are associated. The decision to harvest and store gametes has to be made before commencement of treatment, and advances in these techniques have made this successful. Fertility sparing therefore must be discussed and offered at an early stage post diagnosis. Surrogacy is currently an evidence-based method of assisted reproduction, with mainly desirable outcomes for the commissioning mother, surrogate and child, without impacting on the cancer treatment and long-term survival...
November 9, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30503362/surgical-management-of-urinary-stress-incontinence-where-are-we-now
#8
REVIEW
Peter L Dwyer, Debjyoti Karmakar
Mid-urethral sling procedures (MUS) have been the surgical option of choice for most gynaecologists and urologists treating stress urinary incontinence (SUI) in women around the world for almost 20 years, since their introduction in the late 1990s. The evidence suggests that the long-term effectiveness of the MUS is good and similar to the Burch Colposuspension and the fascial pubovaginal slings. The bulking agents are now being put forward as another minimally invasive option for the surgical treatment of SUI...
October 30, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30497942/chronic-renal-disease-and-antenatal-care
#9
REVIEW
Matt Hall
In 2018, it is unusual for women with chronic kidney disease (CKD) to be told that pregnancy is not an option. Maternal and foetal outcomes have steadily improved over the last 50 years and a successful pregnancy, resulting in a healthy infant without detrimental to maternal health, is commonplace. Nevertheless, the incidence of adverse outcomes including pre-eclampsia, preterm birth and small-for-gestational age infants is higher for women with CKD than the general population, requiring enhanced monitoring...
October 30, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30415886/preface-vol-53
#10
EDITORIAL
William Ledger
No abstract text is available yet for this article.
October 29, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30473487/preface
#11
EDITORIAL
Joe Leigh Simpson
No abstract text is available yet for this article.
October 28, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30580956/a-comparison-of-the-use-of-mesh-to-native-tissue-in-the-management-of-vaginal-vault-prolapse
#12
REVIEW
Jens-Erik Walter
Vaginal vault prolapse afflicts millions of women and evokes significant psychosocial and pelvic floor dysfunction. The risk factors and modalities of conservative management are discussed in this study. There remains controversy in the optimal surgical management. This review serves to study the clinical conundrum of the decision-making process to utilize the mesh and the approach. In-depth evaluation of mesh-related postsurgical complications as compared to those associated with the native tissue is explored...
January 2019: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30037532/controversies-in-the-management-of-vesicovaginal-fistula
#13
REVIEW
Michael Breen, Michael Ingber
Achieving 100% closure and continence rate in the management of vesicovaginal fistulas remains a challenge. There is still debate about several aspects of the care including the following.
January 2019: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30518485/unexplained-infertility-is-it-over-diagnosed-and-over-treated
#14
REVIEW
Ben W Mol, Raissa Tjon-Kon-Fat, Esmé Kamphuis, Madelon van Wely
Unexplained infertility is defined as the absence of conception despite 12 months of unprotected intercourse, not explained by anovulation, poor sperm quality, tubal pathology or any known cause of infertility. The two most applied treatments for unexplained infertility are intra-uterine insemination and in vitro fertilisation. As these treatments do not target a specific mechanism but rather increase the probability of conception as compared to natural conception chances, they should be weighed against the prognosis of natural conception...
November 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30482660/is-sperm-dna-fragmentation-a-useful-test-that-identifies-a-treatable-cause-of-male-infertility
#15
REVIEW
Allan Pacey
The present-day laboratory methods of sperm analysis are a poor predictor of reproductive outcome, and for many years it has been clear that newer and better tests are required. Although many such tests have been proposed, only those which determine sperm DNA quality are still being considered. Of these, several tests of sperm DNA fragmentation are available, although there is presently no consensus about the most appropriate test, the best test specimen (fresh or washed sperm) or what level of fragmentation is of clinical concern...
November 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30297314/does-intra-uterine-insemination-have-a-place-in-modern-art-practice
#16
REVIEW
Valarmathy Kandavel, Ying Cheong
Intra-uterine insemination (IUI) is a cheaper, less intensive treatment modality for achieving a pregnancy in couples with specific indications. The use of IUI seems to have declined after NICE guideline 2013 (CG 156) recommended IVF over IUI in couples with unexplained and mild male factor infertility. This review examines the current evidence and the applicability of IUI as a first-line option of treatment in couples with unexplained and mild male factor subfertility. The outcome of the review supports this argument...
November 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30056110/in-vitro-maturation
#17
REVIEW
Melanie L Walls, Roger J Hart
In vitro maturation (IVM) is an in vitro fertilisation (IVF) technique modified to collect immature oocytes from antral follicles, with the final stages of meiosis completed during in vitro culture. The primary benefit of IVM is that it reduces gonadotrophin stimulation in the patient, thereby eliminating the risk of ovarian hyperstimulation syndrome (OHSS) in high-risk patients such as those with polycystic ovaries (PCO) and polycystic ovary syndrome (PCOS). IVM has additional benefits for fertility preservation, particularly in oncofertility patients...
November 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30447884/skills-training-for-operative-vaginal-birth
#18
EDITORIAL
Emily Hotton, Stephen O'Brien, Timothy J Draycott
Skilled, safe operative vaginal birth can substantially improve maternal and neonatal outcomes arising from complications in the second stage of labour and should be available in a diverse range of maternity settings for women across the world. Operative vaginal births are complex, requiring a combination of good technical skills, non-technical skills as well as sensitivity from the accoucher. It is axiomatic that accouchers should be adequately trained and simulation-based training is a promising strategy to improve outcomes and increase the rates of operative vaginal birth...
October 23, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30392949/global-perspectives-on-operative-vaginal-deliveries
#19
REVIEW
V Vannevel, C Swanepoel, R C Pattinson
Operative vaginal delivery (OVD) refers to the use of an instrument (forceps or vacuum device) to assist with the delivery of the fetus from the vagina. This can help improve maternal and fetal outcomes and has to be weighed up against the risks and benefits of performing second-stage cesarean deliveries. OVD forms an integral part of basic emergency obstetric care and a skilled birth attendant's duties. Outlet forceps and vacuum extraction should be used to shorten the second stage of labor and to improve maternal and fetal outcomes associated with delayed second stage...
October 3, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/30314740/cervical-alterations-in-pregnancy
#20
REVIEW
Joy Vink, Kristin Myers
Spontaneous preterm birth (SPTB), defined as delivery before 37 weeks' gestation, remains a significant obstetric dilemma even after decades of research in this field. Although trends from 2007 to 2014 showed the rate of preterm birth slightly decreased, the CDC recently reported the rate of preterm birth has increased for two consecutive years since 2014. Currently, 1 in 10 pregnancies in the US still end prematurely. In this chapter, we focus on the "compartment" of the cervix. The goal is to outline the current knowledge of normal cervical structure and function in pregnancy and the current knowledge of how the cervix malfunctions lead to SPTB...
October 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
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