Obstetrics, Gynaecology and Reproductive Medicine最新文献

英文中文

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.ogrm.2025.07.010

Anna Richmond

引用次数: 0

Urinary tract infections in obstetrics and gynaecology: diagnosis, management and recurrence prevention 妇产科尿路感染：诊断、管理和复发预防

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.ogrm.2025.07.009

Zainab Al-Jawahiri, Priyanka Krishnaswamy, Maya Basu

Urinary tract infections (UTIs) are among the most common bacterial infections in adults, with significant clinical implications. Acute uncomplicated UTIs, typically caused by Escherichia coli, present with classic symptoms such as dysuria, frequency, and urgency, and are most often managed with antibiotics. However, recurrent UTIs, defined as two or more infections within six months or three or more within a year, pose a greater challenge in clinical management due to their multifactorial nature. Risk factors for recurrent UTIs include anatomical abnormalities, sexual activity, use of spermicides, postmenopausal status, and a history of prior infections. This review aims to examine the pathophysiology, diagnosis, and treatment strategies for both acute and recurrent UTIs in women, trans men and non-binary people. Understanding the complexities of these infections is essential for improving patient outcomes, preventing unnecessary antimicrobial use, and guiding evidence-based management strategies.

尿路感染（uti）是成人最常见的细菌感染之一，具有重要的临床意义。急性无并发症尿路感染，通常由大肠杆菌引起，表现为排尿困难、尿频和尿急等典型症状，通常使用抗生素治疗。然而，复发性尿路感染，定义为六个月内两次或以上感染或一年内三次或以上感染，由于其多因素的性质，在临床管理中提出了更大的挑战。复发性尿路感染的危险因素包括解剖异常、性活动、使用杀精剂、绝经后状态和既往感染史。本综述旨在探讨女性、跨性别男性和非二元性人群急性和复发性尿路感染的病理生理、诊断和治疗策略。了解这些感染的复杂性对于改善患者预后、防止不必要的抗微生物药物使用和指导循证管理战略至关重要。

引用次数: 0

Ovarian hyperstimulation syndrome 卵巢过度刺激综合征

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.ogrm.2025.07.008

Zohra Amin, Nikolas Tsampras, Raj Mathur

Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication of ovarian stimulation with gonadotropins. It is characterized by enlarged ovaries along with fluid shift from intravascular compartment to the extravascular space. Clinical features include abdominal distension, discomfort, ascites, and pleural effusion. There is a risk of thromboembolism, and renal and respiratory dysfunction. Presence of polycystic ovaries, raised Antral Follicle Count, high Anti-Mullerian hormone, and occurrence of pregnancy in the treatment cycle are risk factors. GnRH antagonist protocol, individualized FSH dose, GnRH agonist trigger, elective cryopreservation of all embryos and dopamine agonists are important preventative measures. All women at risk of OHSS should have adequate information and access to 24-hour care. Women presenting with possible OHSS should be assessed and investigated to confirm the diagnosis and classify severity. Mild and moderate OHSS can be managed on an outpatient basis, while severe OHSS often needs in-patient care. Principles of management are maintaining intravascular hydration by encouraging fluid intake guided by thirst, close monitoring of fluid balance, prevention of thromboembolic complications, drainage of ascites in selected cases and symptom relief. If conception occurs in the treatment cycle, the course of OHSS is likely to be more severe and protracted.

卵巢过度刺激综合征（OHSS）是一种严重的医源性并发症卵巢刺激与促性腺激素。其特征是卵巢增大，并伴有液体从血管内腔向血管外腔转移。临床表现包括腹胀、不适、腹水和胸腔积液。有血栓栓塞、肾脏和呼吸功能障碍的风险。多囊卵巢、窦卵泡计数升高、抗苗勒管激素增高以及治疗周期内发生妊娠均为危险因素。GnRH拮抗剂方案，个体化FSH剂量，GnRH激动剂触发，所有胚胎的选择性冷冻保存和多巴胺激动剂是重要的预防措施。所有有OHSS风险的妇女都应获得充分的信息并获得24小时护理。应对可能出现OHSS的妇女进行评估和调查，以确认诊断并对严重程度进行分类。轻度和中度OHSS可以在门诊治疗，而严重的OHSS通常需要住院治疗。管理原则是通过在口渴的指导下鼓励液体摄入来维持血管内水合作用，密切监测液体平衡，预防血栓栓塞并发症，在选定的病例中引流腹水和缓解症状。如果怀孕发生在治疗周期，OHSS的病程可能更严重和持久。

{"title":"Ovarian hyperstimulation syndrome","authors":"Zohra Amin, Nikolas Tsampras, Raj Mathur","doi":"10.1016/j.ogrm.2025.07.008","DOIUrl":"10.1016/j.ogrm.2025.07.008","url":null,"abstract":"<div><div>Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication of ovarian stimulation with gonadotropins. It is characterized by enlarged ovaries along with fluid shift from intravascular compartment to the extravascular space. Clinical features include abdominal distension, discomfort, ascites, and pleural effusion. There is a risk of thromboembolism, and renal and respiratory dysfunction. Presence of polycystic ovaries, raised Antral Follicle Count, high Anti-Mullerian hormone, and occurrence of pregnancy in the treatment cycle are risk factors. GnRH antagonist protocol, individualized FSH dose, GnRH agonist trigger, elective cryopreservation of all embryos and dopamine agonists are important preventative measures. All women at risk of OHSS should have adequate information and access to 24-hour care. Women presenting with possible OHSS should be assessed and investigated to confirm the diagnosis and classify severity. Mild and moderate OHSS can be managed on an outpatient basis, while severe OHSS often needs in-patient care. Principles of management are maintaining intravascular hydration by encouraging fluid intake guided by thirst, close monitoring of fluid balance, prevention of thromboembolic complications, drainage of ascites in selected cases and symptom relief. If conception occurs in the treatment cycle, the course of OHSS is likely to be more severe and protracted.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 11","pages":"Pages 320-324"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145448925","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}

引用次数: 0

Perinatal optimisation: the role of the multi-disciplinary team 围产期优化：多学科团队的作用

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.ogrm.2025.07.007

Li Yan Chow, Emma E Williams, Deena-Shefali Patel, Cheryl Battersby

Premature birth is associated with high risk of neonatal morbidity and mortality. There has been focus therefore on improving awareness and prediction of preterm birth, involving primary and secondary care providers, so that modifiable risk factors can be addressed early. Antenatal and peripartum optimisation measures aim to reduce neonatal morbidity associated with being born prematurely. Such optimisation pathways involve collaborative working within and between large multi-disciplinary teams and institutions, with shared goals, joint coordination of care and delivery of evidence based best practice within the perinatal period to improve outcomes for mother and infant.

早产与新生儿发病率和死亡率高相关。因此，重点是提高初级和二级保健提供者对早产的认识和预测，以便及早处理可改变的风险因素。产前和围产期优化措施旨在减少与早产有关的新生儿发病率。这种优化途径涉及大型多学科团队和机构内部和之间的协作工作，具有共同的目标，在围产期联合协调护理和提供基于证据的最佳实践，以改善母婴的结果。

引用次数: 0

Pain relief and anaesthesia in maternity care and the role of the obstetric anaesthetist 产妇护理中的疼痛缓解和麻醉以及产科麻醉师的作用

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-11-01 DOI: 10.1016/j.ogrm.2025.07.006

Grace Buckingham, Natalie Edwards, Elizabeth Maronge, Kate F Walker

Pain is a common and treatable symptom in all stages of pregnancy. All agents must be prescribed considering the perceived benefits whilst acknowledging the potential fetal adverse effects. Oral agents can be safe and effective antenatally, and management must be tailored for each individual. Intrapartum analgesia should be multi-modal with consideration for complimentary therapies including continuous labour support and water immersion. Epidural anaesthesia is the gold standard for pain management in labour, with inhalation anaesthetic offering excellent adjunct analgesia. A combined spinal/epidural anaesthesia acts rapidly compared to traditional epidural. Pudendal nerve blocks are effective methods of analgesia with decreasing popularity. TAP blocks and wound infiltration of local anaesthetic reduces post-operative requirement for opioids. The obstetric anaesthetist plays a significant role in the multidisciplinary team in identifying and planning care for high-risk individuals. Furthermore, anaesthetic intervention at the time of delivery is not infrequent and can be optimized.

在怀孕的所有阶段，疼痛都是一种常见且可治疗的症状。所有药物的处方必须考虑到预期的益处，同时承认潜在的胎儿不良影响。口服药物在产前可能是安全有效的，而且治疗必须针对每个人量身定制。分娩时的镇痛应该是多模式的，并考虑到辅助治疗，包括持续的分娩支持和水浸泡。硬膜外麻醉是分娩疼痛管理的金标准，吸入麻醉提供了极好的辅助镇痛。与传统的硬膜外麻醉相比，脊髓/硬膜外联合麻醉作用迅速。阴部神经阻滞是一种有效的镇痛方法，但越来越不受欢迎。TAP阻滞和局部麻醉的伤口浸润减少了术后对阿片类药物的需求。产科麻醉师在多学科团队中扮演着重要的角色，以确定和规划高危人群的护理。此外，分娩时的麻醉干预并不少见，可以优化。

{"title":"Pain relief and anaesthesia in maternity care and the role of the obstetric anaesthetist","authors":"Grace Buckingham, Natalie Edwards, Elizabeth Maronge, Kate F Walker","doi":"10.1016/j.ogrm.2025.07.006","DOIUrl":"10.1016/j.ogrm.2025.07.006","url":null,"abstract":"<div><div>Pain is a common and treatable symptom in all stages of pregnancy. All agents must be prescribed considering the perceived benefits whilst acknowledging the potential fetal adverse effects. Oral agents can be safe and effective antenatally, and management must be tailored for each individual. Intrapartum analgesia should be multi-modal with consideration for complimentary therapies including continuous labour support and water immersion. Epidural anaesthesia is the gold standard for pain management in labour, with inhalation anaesthetic offering excellent adjunct analgesia. A combined spinal/epidural anaesthesia acts rapidly compared to traditional epidural. Pudendal nerve blocks are effective methods of analgesia with decreasing popularity. TAP blocks and wound infiltration of local anaesthetic reduces post-operative requirement for opioids. The obstetric anaesthetist plays a significant role in the multidisciplinary team in identifying and planning care for high-risk individuals. Furthermore, anaesthetic intervention at the time of delivery is not infrequent and can be optimized.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 11","pages":"Pages 307-311"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145448927","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}

引用次数: 0

Induction of ovulation 促排卵

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-10-17 DOI: 10.1016/j.ogrm.2025.09.002

Kimberly Lim Xinyi, Navneet Kaur, Raj Mathur

Anovulation refers to the absence of ovulation and is one of the most common causes of infertility. This review highlights the underlying causes of anovulation and discusses various techniques used to address anovulation-related infertility. Ovulation induction remains an effective treatment to overcome infertility caused by anovulation. A comprehensive approach to ovulation induction involves a combination of lifestyle modifications, medical therapies and surgical methods. Medications for ovulation induction aims to encourage the development of a single dominant follicle, while reducing the complications of ovarian hyperstimulation and multiple pregnancies. Laparoscopic ovarian drilling serves as an adjunct second-line treatment. This review aims to guide clinicians in selecting the safest and most effective treatment, tailored to the individual needs of each patient.

无排卵是指没有排卵，是不孕症最常见的原因之一。这篇综述强调了无排卵的潜在原因，并讨论了用于解决无排卵相关不孕症的各种技术。排卵诱导仍然是克服无排卵引起的不孕症的有效治疗方法。促排卵的综合方法包括生活方式的改变、药物治疗和手术方法的结合。促排卵药物旨在促进单个优势卵泡的发育，同时减少卵巢过度刺激和多胎妊娠的并发症。腹腔镜卵巢钻孔作为辅助二线治疗。本综述旨在指导临床医生选择最安全、最有效的治疗方法，以适应每位患者的个性化需求。

引用次数: 0

Principles of non-surgical cancer therapies for the obstetrician and gynaecologist 给妇产科医生的非手术癌症治疗原则

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-10-01 DOI: 10.1016/j.ogrm.2025.07.002

Tian Wang, Sarah Prewett, Sarah Smith, Simon L Duke

The current management of all gynaecological malignancy requires multidisciplinary investigation and discussion, frequently leading to multi-modality treatment. This article outlines the principles of non-surgical cancer treatment with radiotherapy and systemic anti-cancer therapies. These treatments have different aims depending on the type of cancer, clinical context and patient wishes – the review uses the standard treatments for common cancer sites such as endometrial, ovarian, cervical and vulvar cancer to highlight where the underlying principles apply across these sites. Areas of current research and future clinical promise are also highlighted. The article concludes with a special section on anti-cancer therapies in pregnancy.

目前所有妇科恶性肿瘤的管理需要多学科的调查和讨论，往往导致多模式的治疗。本文概述了非手术治疗肿瘤与放疗和全身抗癌治疗的原则。根据癌症的类型、临床背景和患者的意愿，这些治疗方法有不同的目的——该综述使用了常见癌症部位（如子宫内膜癌、卵巢癌、宫颈癌和外阴癌）的标准治疗方法，以强调这些部位适用的基本原则。目前的研究领域和未来的临床前景也被强调。这篇文章最后有一个关于妊娠期抗癌治疗的专门章节。

引用次数: 0

Demystifying long-acting reversible contraception (LARC): a low-maintenance guide for low-maintenance contraception 揭开长效可逆避孕（LARC）的神秘面纱：低维护的避孕指南

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-10-01 DOI: 10.1016/j.ogrm.2025.07.003

Kajal Radia, Charlotte Gatenby, Ulrike Sauer

Long-acting reversible contraception (LARC) comprises the most effective forms of contraception available and significantly reduce user error causing contraceptive failure. Despite having high user acceptability, usage of LARC methods have decreased in the UK. A key barrier to LARC usage can be clinician's knowledge and education. This review provides an overview of the four LARC methods available in the UK; Progestogen-only implant and injectable, Levonorgestrel-containing and copper intrauterine devices. Whilst all constitute good options, differences in method of insertion and removal, side effects, non-contraceptive benefits and effects on bleeding patterns differ significantly. Here, we compare key factors which can determine patient preference and suitability, to help clinicians feel more confident in discussing and offering LARC methods.

长效可逆避孕（LARC）是目前最有效的避孕方式，可显著减少使用者错误导致的避孕失败。尽管有很高的用户接受度，LARC方法的使用在英国已经减少。使用LARC的一个关键障碍可能是临床医生的知识和教育。本综述概述了英国可用的四种LARC方法；仅孕激素植入和注射，含左炔诺孕酮和铜宫内节育器。虽然所有这些都是不错的选择，但在插入和取出方法、副作用、非避孕益处和对出血模式的影响方面存在显著差异。在这里，我们比较了决定患者偏好和适用性的关键因素，以帮助临床医生更有信心讨论和提供LARC方法。

引用次数: 0

Self-assessment questions 自我评估的问题

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-10-01 DOI: 10.1016/j.ogrm.2025.07.005

Anna Richmond

引用次数: 0

When delay is deadly: ectopic pregnancy, the leading cause of first-trimester death 当延迟是致命的：异位妊娠，妊娠早期死亡的主要原因

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-10-01 DOI: 10.1016/j.ogrm.2025.07.001

Camilla Gangoo

Despite ectopic pregnancy being a well recognized complication within emergency gynaecology, women still die from this condition in the developed world. It accounts for 1% of all pregnancies and the majority are located within the fallopian tube. Women can display symptoms ranging from irregular bleeding to severe abdominal pain or gastrointestinal upset. Ultrasound is the key diagnostic tool to locate the ectopic pregnancy. Ectopic pregnancies can be conservatively managed if a woman is medically stable however systemic Methotrexate or surgical management are alternative treatments. Ultimately, a personalized approach of care is required as women may have a complex fertility history which will impact on options offered. More awareness in the public domain is needed to help women get diagnosed in a timely manner.

尽管异位妊娠是一种公认的妇科急诊并发症，但在发达国家，妇女仍然死于这种情况。它占所有妊娠的1%，大多数发生在输卵管内。女性可能表现出从不规则出血到严重腹痛或胃肠道不适等症状。超声是定位异位妊娠的关键诊断工具。如果女性病情稳定，可以保守治疗异位妊娠，但全身甲氨蝶呤或手术治疗是替代治疗方法。最终，个性化的护理方法是必需的，因为妇女可能有复杂的生育史，这将影响所提供的选择。需要在公共领域提高认识，以帮助妇女及时得到诊断。

引用次数: 0

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Obstetrics, Gynaecology and Reproductive Medicine

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀