Clinical obstetrics and gynecology最新文献

This chapter provides an in-depth overview of gonorrhea and chlamydia, 2 common sexually transmitted infections (STIs) caused by the bacteria Neisseria gonorrhoeae and Chlamydia trachomatis , respectively. It covers their epidemiology, transmission, and risk factors, highlighting the global burden of these infections. It also describes the clinical manifestations of each disease, which range from asymptomatic to pelvic inflammatory disease and infertility. Diagnostic techniques are discussed alongside recommended treatment regimens and antibiotic resistance concerns. In addition, it explores prevention strategies and the importance of sexual health education and screening programs.

Management of the placenta accreta spectrum (PAS) in resource-limited settings poses significant challenges. Traditional approaches, which often involve hysterectomy and extensive technology in all the patients are being replaced by individualized treatment plans considering each patient's specific clinical situation, available resources, and team expertise. Using ultrasonographic and surgical staging based on PAS topographic classification can help design tailored surgical plans and optimize resource use. This article explores the need for personalized PAS management, safe surgical option selection, and how medical teams can adapt to provide more versatile treatment options in resource-constrained environments.

Viral hepatitis poses a significant public health challenge. Five types (A, B, C, D, E) have distinct transmission, prognosis, and management. Hepatitis A (HAV), spread through fecal-oral contamination, is typically self-limiting with supportive therapy. Hepatitis B (HBV) is sexually transmitted but may also be spread perinatally. HBV can progress into cirrhosis or hepatocellular carcinoma. Hepatitis C (HCV), a bloodborne virus, can also cause chronic infection and severe liver disease. Vaccination can prevent HAV and HBV; HCV is curable with antiviral therapy but lacks a vaccine. Pregnant patients and those with HIV require special management considerations. Here, we review the pathogenesis, diagnosis, treatment, and prevention of viral hepatitis.

Genital herpes is a relatively common chronic lower genital tract sexually transmitted infection caused by herpes simplex virus types 1 and 2 (HSV-1 and HSV-2). It is characterized by recurrent, self-limited genital ulcers, and it is the leading cause of genital ulcer disease worldwide (1). The impact of genital herpes on sexual and reproductive health, including the risk of perinatal infection, necessitates a profound understanding of its clinical presentation, diagnosis, treatment, and prevention. This chapter aims to review the critical clinical aspects of HSV in women, emphasizing relevant evidence-based data.

Placenta accreta spectrum survivors face unique physical, psychological, and social challenges extending beyond traditional postpartum care. These patients experience prolonged physical recovery and difficult psychological recovery. Many struggle with grief over fertility loss following hysterectomy. Comprehensive care requires an expanded multidisciplinary team with coordinated transitions between specialists. Recovery often extends months to years, necessitating individualized care pathways that address the full spectrum of needs to optimize the long-term well-being for these patients and their families.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, with up to 90% of females infected at some point in their lifetime. While most HPV infections will be cleared by the immune system within 2 years, persistent HPV infection may result in anogenital warts, dysplasia of the cervix, vagina, vulva, and squamous cell carcinoma. This chapter will review the epidemiology, microbiology, progression, and treatment of HPV-related genital disease in women.

This paper examines the challenges and advancements related to human immunodeficiency virus (HIV) in women, focusing on incidence, disparities, and reproductive health. HIV disproportionately affects Black women, with socioeconomic and health care access factors worsening outcomes. Pre-exposure prophylaxis (PrEP) is promising but underutilized due to awareness and accessibility issues. Contraception access and abortion care remain limited for women living with HIV, while menopause poses additional health risks. Future directions in research and policy call for expanded prevention, improved health care services, and greater support for reproductive and menopausal care, aiming to enhance health care equity and quality of life for women affected by HIV.