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Best Practice & Research Clinical Obstetrics & Gynaecology最新文献

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The clinical relevance of having more than one estrogen in combined hormonal contraception to address the needs of women 在联合激素避孕中使用一种以上雌激素以满足妇女需要的临床意义。
IF 3.9 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Best Practice & Research Clinical Obstetrics & Gynaecology
Pub Date : 2025-02-01 DOI: 10.1016/j.bpobgyn.2024.102571
Caroline Frisendahl , Helena Kopp Kallner , Kristina Gemzell-Danielsson
This chapter examines the potential of natural estrogens, particularly estradiol and estetrol, in combined hormonal contraceptive pills as alternatives to the widely used synthetic ethinyl estradiol. Current evidence highlights the promise of these natural estrogens in providing effective contraception with improved safety profiles and maintained tolerability.

What we know

Estradiol and estetrol exhibit favorable safety and efficacy profiles compared to ethinyl estradiol.

What we think we know

Initial studies suggest that estetrol combined with drosperinone provide effective contraception with a predictable bleeding patternand reduced risk for venous thromboembolism compared to ethinyl estradiol containing pills. Such risk may also be further mitigated by non-oral administration of estradiol.

What we do not know

Long-term efficacy and safety data are needed to confirm the benefits of natural estrogens and their impact on diverse populations and comorbid conditions. By addressing these gaps, future research can enhance our understanding of natural estrogens in hormonal contraception, ultimately refining their use in clinical practice.
本章探讨了天然雌激素的潜力，特别是雌二醇和雌二醇，在联合激素避孕药中作为广泛使用的合成乙基雌二醇的替代品。目前的证据强调了这些天然雌激素在提供有效避孕方面的前景，它们具有更好的安全性和耐受性。我们所知道的：与乙炔雌二醇相比，雌二醇和雌二醇表现出良好的安全性和有效性。我们认为我们知道什么：初步研究表明，与含有乙炔雌二醇的药片相比，雌二醇与drosperinone联合使用可以有效避孕，可预测出血模式，并降低静脉血栓栓塞的风险。这种风险也可以通过非口服雌二醇进一步减轻。我们不知道的是：需要长期疗效和安全性数据来证实天然雌激素的益处及其对不同人群和合并症的影响。通过解决这些差距，未来的研究可以增强我们对激素避孕中天然雌激素的理解，最终完善其在临床实践中的应用。
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引用次数: 0
Improving access to emergency obstetric care in low- and middle-income countries 改善低收入和中等收入国家获得产科急诊的机会。
IF 3.9 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Best Practice & Research Clinical Obstetrics & Gynaecology
Pub Date : 2025-02-01 DOI: 10.1016/j.bpobgyn.2024.102572
Lawrence Chauke
While maternal deaths have declined by a third between 2000 and 2020, approximately 800 women continue to die every day due to pregnancy-related complications. For every woman who dies, many more experience life-debilitating conditions. Most of these deaths occur in low- and middle-income countries (LMICs). Women in Sub-Saharan Africa (SSA) face the highest risk of mortality, with a lifetime risk of dying from pregnancy-related complications estimated at 1 in 40. Given the unpredictable nature of pregnancy complications, emergency obstetric care (EmOC) remains the most effective strategy to reduce the global burden of maternal deaths due to pregnancy related complications. Investing in EmOC can assist countries struggling with high burden of maternal mortality in staying on track toward achieving the United Nations' 2030 Sustainable Development Goals (SDGs). However, LMICs encounter several challenges in accessing these life-saving interventions. This article utilises Thaddeus and Maine's three-delay model to analyse barriers to EmOC in LMICs and to propose potential solutions.
虽然孕产妇死亡率在2000年至2020年期间下降了三分之一，但每天仍有大约800名妇女死于与妊娠有关的并发症。每有一名妇女死亡，就有更多的妇女经历使生命衰弱的疾病。这些死亡大多发生在低收入和中等收入国家。撒哈拉以南非洲地区的妇女面临着最高的死亡风险，一生中死于妊娠相关并发症的风险估计为40分之一。鉴于妊娠并发症的不可预测性，产科急诊仍然是减少全球因妊娠相关并发症造成的孕产妇死亡负担的最有效战略。投资于妇幼保健可以帮助那些与孕产妇死亡率高负担作斗争的国家继续朝着实现联合国2030年可持续发展目标（sdg）迈进。然而，中低收入国家在获得这些拯救生命的干预措施方面面临若干挑战。本文利用Thaddeus和Maine的三延迟模型分析了中低收入国家EmOC的障碍，并提出了可能的解决方案。
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引用次数: 0
Fetal imaging, phenotyping, and genomic testing in modern prenatal diagnosis 胎儿成像，表型，和基因组检测在现代产前诊断。
IF 3.9 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Best Practice & Research Clinical Obstetrics & Gynaecology
Pub Date : 2025-02-01 DOI: 10.1016/j.bpobgyn.2024.102575
Matthew A. Shear , Peter N. Robinson , Teresa N. Sparks
Genetic tests available in the prenatal setting have expanded rapidly with next generation sequencing, and fetal imaging can detect a breadth of many structural and functional abnormalities. To identify a fetal genetic disease, deep phenotyping is increasingly important to generate a differential diagnosis, choose the most appropriate genetic tests, and inform the results of those tests. The Human Phenotype Ontology (HPO) organizes and defines the features of human disease to support deep phenotyping, and ongoing efforts are being made to improve the scope of the HPO to comprehensively include fetal phenotypes. There are important limitations of fetal phenotyping to understand, including ongoing structural development and limited knowledge of how many genetic diseases present uniquely in utero. This article provides an overview of the use of HPO terms and artificial intelligence in the approach to fetal phenotyping and genetic testing.
随着下一代测序的发展，产前环境中可用的基因检测迅速扩大，胎儿成像可以检测到许多结构和功能异常。为了识别胎儿遗传疾病，深度表型分析对于鉴别诊断、选择最合适的基因检测并告知这些检测结果变得越来越重要。人类表型本体（Human Phenotype Ontology， HPO）组织和定义了人类疾病的特征，以支持深度表型，并且正在努力改进HPO的范围，以全面包括胎儿表型。胎儿表型有重要的局限性需要了解，包括正在进行的结构发育和有限的知识有多少遗传疾病在子宫内独特存在。本文概述了在胎儿表型和基因检测方法中使用HPO术语和人工智能。
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引用次数: 0
Preface: Emergency obstetrics in low- and middle-income countries 前言：低收入和中等收入国家的产科急诊。
IF 3.9 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Best Practice & Research Clinical Obstetrics & Gynaecology
Pub Date : 2025-02-01 DOI: 10.1016/j.bpobgyn.2024.102576
Nnabuike Chibuoke Ngene (Dr), Jagidesa Moodley (Emeritus Professor)
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引用次数: 0
Common myths and misconceptions surrounding hormonal contraception 关于激素避孕的常见神话和误解。
IF 3.9 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Best Practice & Research Clinical Obstetrics & Gynaecology
Pub Date : 2025-02-01 DOI: 10.1016/j.bpobgyn.2024.102573
Kirsten I. Black , Maxime Vromman , Rebecca S. French
Numerous community and professional myths and misconceptions around hormonal contraception exist, many promulgated through social media. As a result of these and other factors, people are moving away from hormonal methods and potentially exposing themselves to increased risk of unintended pregnancy. A number of key myths and misconceptions have been identified in a range of papers and here we summarise the evidence around the basis for these misunderstandings. The themes we explore are the physical side effects, the mental health effects, the impact on sexuality, the concerns about infertility, the concept of “unnaturalness”, concerns about menstruation, concerns about safety and destigmatisation of side effects. For many of these themes, there is some evidence justifying the concern, but overall for most people, we argue that the benefits of hormonal contraception outweigh the disadvantages.
关于激素避孕存在着许多社区和专业的神话和误解，其中许多是通过社交媒体传播的。由于这些和其他因素的影响，人们正在逐渐放弃激素避孕方法，这可能会增加他们意外怀孕的风险。在一系列的论文中已经发现了一些关键的神话和误解，在这里我们总结了围绕这些误解基础的证据。我们探讨的主题是对身体的副作用、对精神健康的影响、对性行为的影响、对不孕不育的担忧、“不自然”的概念、对月经的担忧、对安全性的担忧以及对副作用的污名化。对于其中的许多主题，有一些证据证明这种担忧是合理的，但总的来说，我们认为对大多数人来说，激素避孕的好处大于坏处。
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引用次数: 0
IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Best Practice & Research Clinical Obstetrics & Gynaecology
Pub Date : 2025-01-01
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引用次数: 0
IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Best Practice & Research Clinical Obstetrics & Gynaecology
Pub Date : 2025-01-01
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引用次数: 0
IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Best Practice & Research Clinical Obstetrics & Gynaecology
Pub Date : 2025-01-01
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引用次数: 0
IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Best Practice & Research Clinical Obstetrics & Gynaecology
Pub Date : 2025-01-01
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引用次数: 0
IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Best Practice & Research Clinical Obstetrics & Gynaecology
Pub Date : 2025-01-01
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引用次数: 0
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