Clinical obstetrics and gynecology最新文献

Over 10 years, the reported incidence of primary and secondary syphilis increased among women at 6 times the rate compared with men (636% vs. 103%). Untreated syphilis can lead to life-altering complications including permanent vision and hearing loss, congenital syphilis, and increased HIV acquisition. Syphilis diagnosis and staging require current and prior laboratory results, physical examination, and history. The preferred treatment for syphilis is long-acting penicillin G benzathine. Partner testing and treatment are critical to prevent re-infection and further community transmission. Innovative strategies are needed to prevent and treat syphilis among women, especially those without regular access to health care.

Interventional Radiology (IR) can be a crucial player in managing placenta accrete spectrum disorder (PAS), offering minimally invasive angiographic techniques that can prevent or control hemorrhage and preserve fertility. These include prophylactic balloon occlusion of the aorta or iliac arteries, preoperative catheter placement in the iliac or uterine arteries for subsequent embolization, or pre-emptive arterial embolization preceding hysterotomy and delivery. This review provides obstetricians with an overview of IR's role in the management of PAS by describing specific endovascular techniques; existing outcomes data; and considerations for protocol development, preoperative planning, and intraoperative dynamics for when IR assists with PAS cases.

More than 1 million curable sexually transmitted infections (STIs) are acquired worldwide each day. There are more than 30 bacterial, viral, and parasite infections that are transmitted through sexual contact, including oral, vaginal, and anal intercourse. In this article, we will discuss less common bacterial and viral STIs that affect women's health and highlight the most recent data associated with each infection, its clinical manifestation and significance, as well as approach to treatment and prevention of STIs.

Placental abruption is a complete or partial separation of the placenta from the uterine decidua. Clinical manifestations include vaginal bleeding, abdominal pain, uterine contractions, and abnormalities in the fetal heart rate tracing. Placental abruption occurs in 0.4% to 1.0% of all pregnancies. However, the pathophysiology remains incompletely understood. We present a review of the pathophysiology, diagnosis, and management of placental abruption, exploring overlapping processes which contribute to premature placental separation. Classic findings and limitations of ultrasound in evaluating placental abruption are explained. Finally, we discuss the management of placental abruption based on gestational age, fetal status, and maternal hemodynamic stability.

Rare ultrasound placenta findings, such as avascular cystic lesions, hyperechogenic and thick placenta, and enlarged placenta, are associated with infarcts, perivillous fibrin deposition, and mesenchymal dysplasia. These lesions can be present in 20% of normal pregnancies but are more frequent in pregnant women with pre-eclampsia (PE) and/or fetal growth restriction, autoimmune diseases, and infections, and can increase the risk of perinatal complications, including fetal death. Evaluation of the placental surface may also identify cases with circumvallate placenta and chorioangiomas. These rare placental findings require close clinical follow-up and serial fetal evaluations to identify those at a higher risk of abnormal perinatal outcomes.

Aim: To describe orgasm disorders in women.

Results: Orgasmic problems are prevalent in women, and many experience distress related to the condition. The problem often co-exist with other sexual disorders and can be caused by many biopsychocial factors. A comprehensive assessment focusing on biopsychosocial factors contributing to the orgasmic problem is necessary. This includes a sexological, medical, and psychological history. Treatment should include cognitive and behavioral interventions, which may include the partner. No pharmacological treatment is approved to treat orgasmic disorders in women.

As the majority of female cancer survivors can now expect to live long lives beyond cancer diagnosis and treatment, there is a growing need to address the significant late effects of treatment. Unfortunately, sexual health remains a primary concern that often goes unaddressed among female cancer survivors. Sexual dysfunction is one of the most common and distressing effects of treatment. Management of issues related to sexual health and sexual function depends upon the type of malignancy, stage and other tumor characteristics, treatment, and the history, concerns, and goals of the individual patient.

The umbilical cord is the connection between mother and fetus through which gases and nutrients are exchanged. It's remarkable structure allows for freedom of movement while providing a cushioned, protected conduit from mother to fetus. Fetal development and survival are dependent upon the umbilical cord. This article reviews abnormalities of the umbilical cord that can be seen with structural and chromosomal abnormalities and altered umbilical cord flow associated with fetal growth restriction and poor pregnancy outcomes.