Pub Date : 2016-01-31DOI: 10.1097/01.PGO.0000479468.64386.d6
Caitlin MacGregor, Beth Cronin
Committee on Practice Bulletins—Gynecology in collaboration with Ramez Eskander, MD; Michael Berman, MD; and Lisa Keder, MD, MPH. The information is designed to aid practitioners in making decisions about appropriate obstetric and gynecologic care. These guidelines should not be construed as dictating an exclusive course of treatment or procedure. Variations in practice may be warranted based on the needs of the individual patient, resources, and limitations unique to the institution or type of practice. Background Differential Diagnosis A pelvic mass can have gynecologic or nongynecologic origins (Box 1). Consideration of the location of a pelvic mass in conjunction with patient age and reproductive status can help narrow the differential diagnosis. Adnexal masses of gynecologic origin may be benign or malignant ovarian lesions; tubal or paratubal processes such as hydrosalpinges or ectopic pregnancy; and uterine abnormalities such as leiomyomas or müllerian abnormalities. Nongynecologic causes of pelvic masses are less common and may be related to a variety of other organ systems, including gastrointestinal and urologic sources. Cases of metastatic cancer, especially those from the breast, colon, or stomach, may first present as adnexal masses.
{"title":"Evaluation and Management of Adnexal Masses","authors":"Caitlin MacGregor, Beth Cronin","doi":"10.1097/01.PGO.0000479468.64386.d6","DOIUrl":"https://doi.org/10.1097/01.PGO.0000479468.64386.d6","url":null,"abstract":"Committee on Practice Bulletins—Gynecology in collaboration with Ramez Eskander, MD; Michael Berman, MD; and Lisa Keder, MD, MPH. The information is designed to aid practitioners in making decisions about appropriate obstetric and gynecologic care. These guidelines should not be construed as dictating an exclusive course of treatment or procedure. Variations in practice may be warranted based on the needs of the individual patient, resources, and limitations unique to the institution or type of practice. Background Differential Diagnosis A pelvic mass can have gynecologic or nongynecologic origins (Box 1). Consideration of the location of a pelvic mass in conjunction with patient age and reproductive status can help narrow the differential diagnosis. Adnexal masses of gynecologic origin may be benign or malignant ovarian lesions; tubal or paratubal processes such as hydrosalpinges or ectopic pregnancy; and uterine abnormalities such as leiomyomas or müllerian abnormalities. Nongynecologic causes of pelvic masses are less common and may be related to a variety of other organ systems, including gastrointestinal and urologic sources. Cases of metastatic cancer, especially those from the breast, colon, or stomach, may first present as adnexal masses.","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117109058","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 : 2016-01-15DOI: 10.1097/01.PGO.0000479431.24367.d8
M. Sharma, V. Berghella
{"title":"Management of Difficult Cesarean Deliveries","authors":"M. Sharma, V. Berghella","doi":"10.1097/01.PGO.0000479431.24367.d8","DOIUrl":"https://doi.org/10.1097/01.PGO.0000479431.24367.d8","url":null,"abstract":"","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129393885","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 : 1900-01-01DOI: 10.1097/01.PGO.0000538960.86563.fd
Yiran Xu, Gabriela Ross, C. Glowacki
Female genital mutilation is the partial or total excision of the external female genitalia for nontherapeutic reasons. Type 1 involves excision of the prepuce with or without excision of part or all of the clitoris. Type 2 is excision of the prepuce and clitoris as well as partial or total excision of the labia minora. Type 3 is excision of part or all of the external genitalia and narrowing of the vaginal opening through a process called infibulation. Type 4 includes many procedures such as pricking, piercing, or incision of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterization of the clitoris; scraping of the vaginal orifice or cutting of the vagina; or introduction of corrosive substances into the vagina. Most of these procedures are irreversible and have lifelong adverse effects. Types 1 and 2 account for up to 80% of the procedures, but type 3 is the most common form in some areas. An estimated 100-132 million women have been mutilated in this fashion, and 2 million girls are at risk each year.
{"title":"Female Genital Mutilation","authors":"Yiran Xu, Gabriela Ross, C. Glowacki","doi":"10.1097/01.PGO.0000538960.86563.fd","DOIUrl":"https://doi.org/10.1097/01.PGO.0000538960.86563.fd","url":null,"abstract":"\u0000 Female genital mutilation is the partial or total excision of the external female genitalia for nontherapeutic reasons. Type 1 involves excision of the prepuce with or without excision of part or all of the clitoris. Type 2 is excision of the prepuce and clitoris as well as partial or total excision of the labia minora. Type 3 is excision of part or all of the external genitalia and narrowing of the vaginal opening through a process called infibulation. Type 4 includes many procedures such as pricking, piercing, or incision of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterization of the clitoris; scraping of the vaginal orifice or cutting of the vagina; or introduction of corrosive substances into the vagina. Most of these procedures are irreversible and have lifelong adverse effects. Types 1 and 2 account for up to 80% of the procedures, but type 3 is the most common form in some areas. An estimated 100-132 million women have been mutilated in this fashion, and 2 million girls are at risk each year.\u0000","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134392377","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 : 1900-01-01DOI: 10.1097/01.PGO.0000527689.76423.37
E. C. Holden, S. Ravikumar, S. Morelli
{"title":"Postmenopausal Osteoporosis: Diagnosis and Management","authors":"E. C. Holden, S. Ravikumar, S. Morelli","doi":"10.1097/01.PGO.0000527689.76423.37","DOIUrl":"https://doi.org/10.1097/01.PGO.0000527689.76423.37","url":null,"abstract":"","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133713825","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 : 1900-01-01DOI: 10.1097/01.PGO.0000511145.63274.e8
L. Dugoff
: Noninvasive prenatal screening that uses cell-free DNA from the plasma of pregnant women offers tremendous potential as a screening method for fetal aneuploidy. A number of laboratories have validated different techniques for the use of cell-free DNA as a screening test for fetal aneuploidy. All tests have a high sensitivity and specificity for trisomy 18 and trisomy 21, regardless of which molecular technique is used. Women whose results are not reported, indeterminate, or uninterpretable (a “no call” test result) from cell-free DNA screening should receive further genetic counseling and be offered comprehensive ultrasound evaluation and diagnostic testing because of an increased risk of aneuploidy. Patients should be counseled that cell-free DNA screening does not replace the precision obtained with diagnostic tests, such as chorionic villus sampling or amniocentesis and, therefore, is limited in its ability to identify all chromosome abnormalities. Cell-free DNA screening does not assess risk of fetal anomalies such as neural tube defects or ventral wall defects. Patients who are undergoing cell-free DNA screening should be offered maternal serum alpha-fetoprotein screening or ultrasound evaluation for risk assessment. The cell-free DNA screening test should not be considered in isolation from other clinical findings and test results. Management decisions, including termination of the pregnancy, should not be based on the results of the cell-free DNA screening alone. Patients should be counseled that a negative cell-free DNA test result does not ensure an unaffected pregnancy. Given the performance of conventional screening methods, the limitations of cell-free DNA screening performance, and the limited data on cost-effectiveness in the low-risk obstetric population, conventional screening methods remain the most appropriate choice for first-line screening for most women in the general obstetric population.
{"title":"Cell-Free DNA Screening for Fetal Aneuploidy","authors":"L. Dugoff","doi":"10.1097/01.PGO.0000511145.63274.e8","DOIUrl":"https://doi.org/10.1097/01.PGO.0000511145.63274.e8","url":null,"abstract":": Noninvasive prenatal screening that uses cell-free DNA from the plasma of pregnant women offers tremendous potential as a screening method for fetal aneuploidy. A number of laboratories have validated different techniques for the use of cell-free DNA as a screening test for fetal aneuploidy. All tests have a high sensitivity and specificity for trisomy 18 and trisomy 21, regardless of which molecular technique is used. Women whose results are not reported, indeterminate, or uninterpretable (a “no call” test result) from cell-free DNA screening should receive further genetic counseling and be offered comprehensive ultrasound evaluation and diagnostic testing because of an increased risk of aneuploidy. Patients should be counseled that cell-free DNA screening does not replace the precision obtained with diagnostic tests, such as chorionic villus sampling or amniocentesis and, therefore, is limited in its ability to identify all chromosome abnormalities. Cell-free DNA screening does not assess risk of fetal anomalies such as neural tube defects or ventral wall defects. Patients who are undergoing cell-free DNA screening should be offered maternal serum alpha-fetoprotein screening or ultrasound evaluation for risk assessment. The cell-free DNA screening test should not be considered in isolation from other clinical findings and test results. Management decisions, including termination of the pregnancy, should not be based on the results of the cell-free DNA screening alone. Patients should be counseled that a negative cell-free DNA test result does not ensure an unaffected pregnancy. Given the performance of conventional screening methods, the limitations of cell-free DNA screening performance, and the limited data on cost-effectiveness in the low-risk obstetric population, conventional screening methods remain the most appropriate choice for first-line screening for most women in the general obstetric population.","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131238647","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 : 1900-01-01DOI: 10.1097/01.PGO.0000512395.81716.5e
K. Gard, K. Marko, N. Gaba
{"title":"Nonhormonal Treatment of Vasomotor Symptoms","authors":"K. Gard, K. Marko, N. Gaba","doi":"10.1097/01.PGO.0000512395.81716.5e","DOIUrl":"https://doi.org/10.1097/01.PGO.0000512395.81716.5e","url":null,"abstract":"","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126107480","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 : 1900-01-01DOI: 10.1097/01.PGO.0000525673.81376.e8
Dyese Taylor, Anna Fuchs, Graham Ashmead
{"title":"Antiphospholipid Syndrome in Pregnancy","authors":"Dyese Taylor, Anna Fuchs, Graham Ashmead","doi":"10.1097/01.PGO.0000525673.81376.e8","DOIUrl":"https://doi.org/10.1097/01.PGO.0000525673.81376.e8","url":null,"abstract":"","PeriodicalId":193089,"journal":{"name":"Topics in Obstetrics & Gynecology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115269715","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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