E. Picardo, E. M. Canuto, L. Marozio, C. Benedetto
Multiple sclerosis (MS) is a chronic autoimmune disease of the CNS, which usually affects women during their childbearing years. Several studies have reported that pregnant MS patients have a low risk of disease progression and an even lower risk of exacerbation, especially in the third trimester, with a rise in relapse rate during the first 3 postpartum months. Although it has been demonstrated that pregnancy has no effect either on the lifetime course of the disease or long-term disability, it is not yet known exactly how well informed patients are as to the interactions between pregnancy and MS or how patients perceive the course of the disease during and after pregnancy. The heterogeneity of symptoms and their multifactorial impact on various sectors such as physical, psychological, familial, social and business necessitate the involvement of an interdisciplinary team with various professionals who work both with one another as well as with the MS patient. This article aims at providing the gynecologi...
{"title":"Multiple sclerosis and pregnancy","authors":"E. Picardo, E. M. Canuto, L. Marozio, C. Benedetto","doi":"10.1586/EOG.13.4","DOIUrl":"https://doi.org/10.1586/EOG.13.4","url":null,"abstract":"Multiple sclerosis (MS) is a chronic autoimmune disease of the CNS, which usually affects women during their childbearing years. Several studies have reported that pregnant MS patients have a low risk of disease progression and an even lower risk of exacerbation, especially in the third trimester, with a rise in relapse rate during the first 3 postpartum months. Although it has been demonstrated that pregnancy has no effect either on the lifetime course of the disease or long-term disability, it is not yet known exactly how well informed patients are as to the interactions between pregnancy and MS or how patients perceive the course of the disease during and after pregnancy. The heterogeneity of symptoms and their multifactorial impact on various sectors such as physical, psychological, familial, social and business necessitate the involvement of an interdisciplinary team with various professionals who work both with one another as well as with the MS patient. This article aims at providing the gynecologi...","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"31 1","pages":"223-234"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84513320","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}
A. Perrin, M. Nguyen, N. Douet-Guilbert, F. Morel, M. Braekeleer
Twelve years ago, the introduction of motile sperm organelle morphology examination led to the development of a modified intracytoplasmic sperm injection procedure called intracytoplasmic morphologically selected sperm injection (IMSI) in which a spermatozoon selected under high magnification instead of 400× magnification is injected into an oocyte. Several studies found no correlation between IMSI and early embryo development in terms of fertilization while others found an increase in the fertilization rate. Conflicting results regarding the rates of implantation, pregnancy and abortion were also reported. A significant increase in the rate of top-quality embryos on days 3 and 5 was reported by the majority of the studies, and few failed to demonstrate a relationship between IMSI and embryo quality. Because of the extent of the population sizes and the diverse approaches and motile sperm organelle morphology examination classifications used by the studies reported thus far, definite conclusions on the co...
{"title":"Intracytoplasmic morphologically selected sperm injection or intracytoplasmic sperm injection: where are we 12 years later?","authors":"A. Perrin, M. Nguyen, N. Douet-Guilbert, F. Morel, M. Braekeleer","doi":"10.1586/EOG.13.12","DOIUrl":"https://doi.org/10.1586/EOG.13.12","url":null,"abstract":"Twelve years ago, the introduction of motile sperm organelle morphology examination led to the development of a modified intracytoplasmic sperm injection procedure called intracytoplasmic morphologically selected sperm injection (IMSI) in which a spermatozoon selected under high magnification instead of 400× magnification is injected into an oocyte. Several studies found no correlation between IMSI and early embryo development in terms of fertilization while others found an increase in the fertilization rate. Conflicting results regarding the rates of implantation, pregnancy and abortion were also reported. A significant increase in the rate of top-quality embryos on days 3 and 5 was reported by the majority of the studies, and few failed to demonstrate a relationship between IMSI and embryo quality. Because of the extent of the population sizes and the diverse approaches and motile sperm organelle morphology examination classifications used by the studies reported thus far, definite conclusions on the co...","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"69 1","pages":"261-270"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85738122","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}
Pub Date : 2013-04-08DOI: 10.1586/17474108.2013.811934
N. Burke, K. Flood, S. Muellers, A. Murray, M. Dempsey, M. Geary, D. Kenny, F. Malone
The pregnant state must achieve a fine balance between hemorrhage and thrombosis. Platelets play a critical role in this balance yet there is a lack of clear knowledge and consensus about platelet function in pregnancy. This review will outline the mechanisms involved in platelet clot and thrombus formation, delineate the different techniques available for the assessment of platelet function and highlight the current understanding of platelet function in pregnancy. With respect to normal pregnancy, there appears to be an increase in platelet aggregation when compared with the nonpregnant state. In pregnancies complicated by pre-eclampsia and intrauterine growth restriction, platelets are further activated when compared with normal pregnancy. Platelet function testing in those with recurrent miscarriage suggests a tendency toward thrombosis. However, further studies are needed to clarify platelet function status in normal and complicated pregnancy.
{"title":"An overview of platelet function in normal and complicated pregnancies","authors":"N. Burke, K. Flood, S. Muellers, A. Murray, M. Dempsey, M. Geary, D. Kenny, F. Malone","doi":"10.1586/17474108.2013.811934","DOIUrl":"https://doi.org/10.1586/17474108.2013.811934","url":null,"abstract":"The pregnant state must achieve a fine balance between hemorrhage and thrombosis. Platelets play a critical role in this balance yet there is a lack of clear knowledge and consensus about platelet function in pregnancy. This review will outline the mechanisms involved in platelet clot and thrombus formation, delineate the different techniques available for the assessment of platelet function and highlight the current understanding of platelet function in pregnancy. With respect to normal pregnancy, there appears to be an increase in platelet aggregation when compared with the nonpregnant state. In pregnancies complicated by pre-eclampsia and intrauterine growth restriction, platelets are further activated when compared with normal pregnancy. Platelet function testing in those with recurrent miscarriage suggests a tendency toward thrombosis. However, further studies are needed to clarify platelet function status in normal and complicated pregnancy.","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"135 1","pages":"379-386"},"PeriodicalIF":0.0,"publicationDate":"2013-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81743643","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}
An estimated 17% of all new cancers in women worldwide are due to cancers of the cervix, the ovary and the uterus. Together, these cancers account for 14.6% of all female cancer deaths. This is a significant societal and economic burden, which can be limited through cancer screening. In the developed world, marked reductions of 50–90% in disease rates have been observed as a result of cervical cancer screening. By contrast, in developing countries, where more than 85% of all new cases and deaths from this cancer are reported, significant challenges need to be overcome. Although cytology remains a key component of cervical screening, the newer molecular tests offer a more targeted, risk-attuned approach. The situation for the other two gynecological cancers is different. The case for ovarian cancer screening has yet to be made with the results of key screening trials in high- and low-risk populations still pending. Screening for endometrial cancer is traditionally not advocated as women become symptomatic ...
{"title":"Screening for gynecological cancers","authors":"Jatinderpal K Kalsi, R. Manchanda, U. Menon","doi":"10.1586/EOG.13.5","DOIUrl":"https://doi.org/10.1586/EOG.13.5","url":null,"abstract":"An estimated 17% of all new cancers in women worldwide are due to cancers of the cervix, the ovary and the uterus. Together, these cancers account for 14.6% of all female cancer deaths. This is a significant societal and economic burden, which can be limited through cancer screening. In the developed world, marked reductions of 50–90% in disease rates have been observed as a result of cervical cancer screening. By contrast, in developing countries, where more than 85% of all new cases and deaths from this cancer are reported, significant challenges need to be overcome. Although cytology remains a key component of cervical screening, the newer molecular tests offer a more targeted, risk-attuned approach. The situation for the other two gynecological cancers is different. The case for ovarian cancer screening has yet to be made with the results of key screening trials in high- and low-risk populations still pending. Screening for endometrial cancer is traditionally not advocated as women become symptomatic ...","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"76 1","pages":"143-160"},"PeriodicalIF":0.0,"publicationDate":"2013-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90828673","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}
A case of severe scalp laceration due to a scalp electrode in our hospital prompted us to review the available literature on this matter. Roughly three categories of adverse effects due to scalp electrodes can be distinguished: common minor skin lesions (41% of cases of electrode application), scalp abscesses (0.1–4.5%) and rarer, sometimes major, complications only described in case reports. We present a complete overview of published case reports. A recently published Cochrane review on the effectiveness of continuous fetal heart rate monitoring sheds doubt on the benefits of continuous monitoring over intermittent auscultation. Reported complications, considering this controversy regarding the benefits, should prompt clinicians to reconsider at what threshold the benefits of scalp electrode placement outweigh its risks.
{"title":"Complications of fetal scalp electrode placement: a case report, literature review and summary of case reports","authors":"P. D. Groot, B. Mol, W. Onland","doi":"10.1586/EOG.13.9","DOIUrl":"https://doi.org/10.1586/EOG.13.9","url":null,"abstract":"A case of severe scalp laceration due to a scalp electrode in our hospital prompted us to review the available literature on this matter. Roughly three categories of adverse effects due to scalp electrodes can be distinguished: common minor skin lesions (41% of cases of electrode application), scalp abscesses (0.1–4.5%) and rarer, sometimes major, complications only described in case reports. We present a complete overview of published case reports. A recently published Cochrane review on the effectiveness of continuous fetal heart rate monitoring sheds doubt on the benefits of continuous monitoring over intermittent auscultation. Reported complications, considering this controversy regarding the benefits, should prompt clinicians to reconsider at what threshold the benefits of scalp electrode placement outweigh its risks.","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"37 1","pages":"113-120"},"PeriodicalIF":0.0,"publicationDate":"2013-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90494952","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}
M. Keltz, May-Tal Sauerbrun-Cutler, A. Breborowicz
Managing poor responders in IVF is a significant challenge for fertility specialists. Several ovarian reserve tests have been developed to predict poor response. These include serum basal follicle-stimulating hormone and estradiol levels, as well as, more recently, anti-Mullerian hormone. Sonographic assessment of ovarian reserve has also been employed including ovarian volume and antral follicle count. However, the most accurate predictor of a poor response cycle is a history of poor response to gonadotropins. This review defines and details the various regimens applied to poor responders over the past several decades of assisted reproduction. In the ‘Expert commentary’, the authors review the published literature on each protocol and offer our opinion. In the ‘Five-year view’, the authors suggest the direction that the management of poor responders is heading for autologous, as well as oocyte donation. The authors hope this will be a valuable resource to our colleagues for managing infertile patients wi...
{"title":"Managing poor responders in IVF","authors":"M. Keltz, May-Tal Sauerbrun-Cutler, A. Breborowicz","doi":"10.1586/EOG.13.1","DOIUrl":"https://doi.org/10.1586/EOG.13.1","url":null,"abstract":"Managing poor responders in IVF is a significant challenge for fertility specialists. Several ovarian reserve tests have been developed to predict poor response. These include serum basal follicle-stimulating hormone and estradiol levels, as well as, more recently, anti-Mullerian hormone. Sonographic assessment of ovarian reserve has also been employed including ovarian volume and antral follicle count. However, the most accurate predictor of a poor response cycle is a history of poor response to gonadotropins. This review defines and details the various regimens applied to poor responders over the past several decades of assisted reproduction. In the ‘Expert commentary’, the authors review the published literature on each protocol and offer our opinion. In the ‘Five-year view’, the authors suggest the direction that the management of poor responders is heading for autologous, as well as oocyte donation. The authors hope this will be a valuable resource to our colleagues for managing infertile patients wi...","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"1 1","pages":"121-134"},"PeriodicalIF":0.0,"publicationDate":"2013-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79010676","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}
Recent publications have indicated that the risk of fetal loss following amniocentesis or chorionic villus sampling is lower than the figure widely quoted in pretest counseling. This review examine...
{"title":"Procedure-related pregnancy loss following invasive prenatal sampling: time for a new approach to risk assessment and counseling","authors":"C. Ogilvie, R. Akolekar","doi":"10.1586/EOG.12.81","DOIUrl":"https://doi.org/10.1586/EOG.12.81","url":null,"abstract":"Recent publications have indicated that the risk of fetal loss following amniocentesis or chorionic villus sampling is lower than the figure widely quoted in pretest counseling. This review examine...","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"14 1","pages":"135-142"},"PeriodicalIF":0.0,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75434093","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}
The treatment of recurrent ovarian cancer continues to evolve with improved surgical, chemotherapeutic and targeted approaches resulting in improvements in survival. Effective salvage regimens mean that more patients who develop recurrent disease may go on to receive multiple lines of treatments over a longer period of time. New classes of targeted agents in the early and late stages of development bring hope for more gains to be made over the next few years. The paradigm of maintenance treatment is being slowly advanced with antiangiogenic therapies, although the longer term impact on overall survival at this juncture is still unclear. There are variations in practice across the world; for example, bevacizumab in platinum-sensitive ovarian cancer is approved in Europe but not in the USA. Subgroups of patients with chemotherapy-refractory or -resistant disease, clear cell and mucinous cancer still respond poorly to treatment and represent an area of urgent need. The molecular characterization of these tum...
{"title":"Systemic treatment for recurrent epithelial ovarian cancer","authors":"W. Chia, A. George, Susana Banerjee","doi":"10.1586/EOG.13.2","DOIUrl":"https://doi.org/10.1586/EOG.13.2","url":null,"abstract":"The treatment of recurrent ovarian cancer continues to evolve with improved surgical, chemotherapeutic and targeted approaches resulting in improvements in survival. Effective salvage regimens mean that more patients who develop recurrent disease may go on to receive multiple lines of treatments over a longer period of time. New classes of targeted agents in the early and late stages of development bring hope for more gains to be made over the next few years. The paradigm of maintenance treatment is being slowly advanced with antiangiogenic therapies, although the longer term impact on overall survival at this juncture is still unclear. There are variations in practice across the world; for example, bevacizumab in platinum-sensitive ovarian cancer is approved in Europe but not in the USA. Subgroups of patients with chemotherapy-refractory or -resistant disease, clear cell and mucinous cancer still respond poorly to treatment and represent an area of urgent need. The molecular characterization of these tum...","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"37 1","pages":"161-168"},"PeriodicalIF":0.0,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82995264","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}
E. Diaz, R. Burky, Charles S. Hummel, R. Farias-Eisner
Ovarian cancer is usually diagnosed after reaching an advanced stage, in part because of the nonspecific nature of the presenting symptoms. A method of early detection is urgently needed because of the stark difference in long-term survival between early- and late-stage disease. A useful screening test must be easy to perform, low cost, safe and have high positive-predictive value in order to reduce the number of unnecessary invasive procedures performed. A variety of modalities – from pelvic examination to transvaginal ultrasound to cancer antigen 125 to serum biomarker panels and proteomic and other novel approaches – have been explored as possible tests to detect early disease. To date, an effective screening approach has yet to be introduced to clinical practice. Here, the authors evaluate the approaches and highlight promising areas of new research aimed at improving early detection of ovarian cancer.
{"title":"Early detection of ovarian cancer","authors":"E. Diaz, R. Burky, Charles S. Hummel, R. Farias-Eisner","doi":"10.1586/EOG.13.3","DOIUrl":"https://doi.org/10.1586/EOG.13.3","url":null,"abstract":"Ovarian cancer is usually diagnosed after reaching an advanced stage, in part because of the nonspecific nature of the presenting symptoms. A method of early detection is urgently needed because of the stark difference in long-term survival between early- and late-stage disease. A useful screening test must be easy to perform, low cost, safe and have high positive-predictive value in order to reduce the number of unnecessary invasive procedures performed. A variety of modalities – from pelvic examination to transvaginal ultrasound to cancer antigen 125 to serum biomarker panels and proteomic and other novel approaches – have been explored as possible tests to detect early disease. To date, an effective screening approach has yet to be introduced to clinical practice. Here, the authors evaluate the approaches and highlight promising areas of new research aimed at improving early detection of ovarian cancer.","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"39 1","pages":"169-179"},"PeriodicalIF":0.0,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81112072","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}
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