Endometrial cancer is the most common gynecologic cancer in women. Most patients are in the early stages at diagnosis and have a favorable prognosis. Minimally invasive hysterectomy is the cornerstone of management. The optimal approach to surgical assessment of lymph nodes is controversial. A minority of early-stage patients have tumors with high-risk features that warrant further treatment, usually vaginal brachytherapy. Patients with advanced disease generally require multimodality treatment to achieve the best outcomes. Selected patients desiring future childbearing can be treated with fertility-sparing options. Routine immunohistochemistry on tumor specimens looking for expression of mismatch repair proteins is an effective method to screen for Lynch syndrome. This review contains 4 figures, 3 tables and 30 references Key Words: adenocarcinoma, chemotherapy, endometrial cancer, lymphadenectomy, Lynch, Progestin, radiation, sentinel, uterus
{"title":"Cancer of the Endometrium","authors":"K. B. Young","doi":"10.2310/obg.19165","DOIUrl":"https://doi.org/10.2310/obg.19165","url":null,"abstract":"Endometrial cancer is the most common gynecologic cancer in women. Most patients are in the early stages at diagnosis and have a favorable prognosis. Minimally invasive hysterectomy is the cornerstone of management. The optimal approach to surgical assessment of lymph nodes is controversial. A minority of early-stage patients have tumors with high-risk features that warrant further treatment, usually vaginal brachytherapy. Patients with advanced disease generally require multimodality treatment to achieve the best outcomes. Selected patients desiring future childbearing can be treated with fertility-sparing options. Routine immunohistochemistry on tumor specimens looking for expression of mismatch repair proteins is an effective method to screen for Lynch syndrome.\u0000 \u0000This review contains 4 figures, 3 tables and 30 references\u0000Key Words: adenocarcinoma, chemotherapy, endometrial cancer, lymphadenectomy, Lynch, Progestin, radiation, sentinel, uterus","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130930042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vaginal deliveries vary widely in the trauma they may introduce to the pelvic floor as does the management of such trauma. Labor, operative deliveries, lacerations, and episiotomies all present unique risk factors for both acute and long-term pelvic floor complications. Of these risk factors, perineal lacerations are the most commonly encountered event that women experience during vaginal childbirth. This review attempts to analyze obstetric perineal lacerations, their management, and potential prevention strategies to enhance pelvic floor health. With standardized management based on evidence based strategies and care during both delivery and postpartum, clinicians can decrease higher order lacerations and their possible sequela. This review contains 12 figures, 1 table and 36 references Key Words: episiotomy, laceration, laceration repair, obstetric, operative delivery, perineal massage, prevention, pudendal block
{"title":"Prevention and Management of Obstetric Perineal Lacerations","authors":"H. Hesham, L. Berkowitz","doi":"10.2310/obg.19027","DOIUrl":"https://doi.org/10.2310/obg.19027","url":null,"abstract":"Vaginal deliveries vary widely in the trauma they may introduce to the pelvic floor as does the management of such trauma. Labor, operative deliveries, lacerations, and episiotomies all present unique risk factors for both acute and long-term pelvic floor complications. Of these risk factors, perineal lacerations are the most commonly encountered event that women experience during vaginal childbirth. This review attempts to analyze obstetric perineal lacerations, their management, and potential prevention strategies to enhance pelvic floor health. With standardized management based on evidence based strategies and care during both delivery and postpartum, clinicians can decrease higher order lacerations and their possible sequela.\u0000\u0000This review contains 12 figures, 1 table and 36 references\u0000Key Words: episiotomy, laceration, laceration repair, obstetric, operative delivery, perineal massage, prevention, pudendal block","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124899291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Providers encounter increasingly diverse patient populations, as migration of people continues to increase worldwide. Health of migrant women is influenced by factors before migration as well as those affecting the migratory process and resettlement. Cultural factors influence patient beliefs and attitudes toward all facets of reproductive health including contraception. Providers may also encounter sequelae of traditional practices such as female genital cutting. Migrant women may be at a higher risk of violence both due to intimate partner violence and risks encountered during migration. They are also at risk for psychological sequelae resulting from stressors before and after displacement. Posttraumatic stress disorder prevalence is higher compared to local populations. Whereas migrants still carry a high burden of infectious disease, chronic health conditions are becoming increasingly common in many groups. Healthcare providers with an awareness of health issues faced by migrants can contribute to improving overall health of migrants and ease the process of resettlement for these people. This review contains 53 references, 1 figure, and 10 tables. Key Words: female genital cutting, immigrant, intestinal parasites, intimate partner violence, migration, nutrition, posttraumatic stress disorder, refugee, reproductive health, tuberculosis
{"title":"Health of Immigrant and Refugee Women","authors":"A. Annamalai","doi":"10.2310/OBG.1601","DOIUrl":"https://doi.org/10.2310/OBG.1601","url":null,"abstract":"Providers encounter increasingly diverse patient populations, as migration of people continues to increase worldwide. Health of migrant women is influenced by factors before migration as well as those affecting the migratory process and resettlement. Cultural factors influence patient beliefs and attitudes toward all facets of reproductive health including contraception. Providers may also encounter sequelae of traditional practices such as female genital cutting. Migrant women may be at a higher risk of violence both due to intimate partner violence and risks encountered during migration. They are also at risk for psychological sequelae resulting from stressors before and after displacement. Posttraumatic stress disorder prevalence is higher compared to local populations. Whereas migrants still carry a high burden of infectious disease, chronic health conditions are becoming increasingly common in many groups. Healthcare providers with an awareness of health issues faced by migrants can contribute to improving overall health of migrants and ease the process of resettlement for these people. \u0000This review contains 53 references, 1 figure, and 10 tables.\u0000Key Words: female genital cutting, immigrant, intestinal parasites, intimate partner violence, migration, nutrition, posttraumatic stress disorder, refugee, reproductive health, tuberculosis","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122498752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：