Obstetrics, Gynaecology and Reproductive Medicine最新文献

英文中文

Cervical ectopic pregnancy: an overview of the literature, emerging management strategies and case-based perspectives 宫颈异位妊娠：文献综述，新兴的管理策略和基于病例的观点

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-08-01 DOI: 10.1016/j.ogrm.2025.05.004

Brittany Jasper, Giulia Gremmo, Rebecca McKay, Lukasz Polanski

Cervical ectopic pregnancy is a rare diagnosis, occurring in 0.01% of all pregnancies and accounting for less than 1% of all ectopic pregnancies. This condition involves implantation within the cervical canal and carries a significant risk of catastrophic haemorrhage, morbidity, and mortality due to the cervix's rich vascularization and resistance to uterotonics. Early and accurate diagnosis, often via transvaginal ultrasound, is essential to guide management and minimize complications. This article provides a comprehensive review of cervical ectopic pregnancy, covering its background, diagnostic challenges, and management options. It explores medical approaches, such as systemic and local methotrexate, surgical interventions including suction aspiration, hysteroscopic management, and prophylactic cerclage, as well as emerging therapies. Fertility considerations, limitations of existing evidence, and recommendations for future research are also discussed. A case-based perspective highlights these principles, offering insights into clinical decision-making for this rare and complex condition.

宫颈异位妊娠是一种罕见的诊断，发生在所有妊娠的0.01%，占所有异位妊娠的不到1%。这种情况包括在宫颈管内植入，由于宫颈血管丰富和对子宫强直的抵抗，有很大的灾难性出血、发病率和死亡率的风险。早期和准确的诊断，通常通过阴道超声，对指导治疗和减少并发症至关重要。本文提供了一个全面的回顾宫颈异位妊娠，涵盖其背景，诊断的挑战，和管理方案。它探讨了医学方法，如全身和局部甲氨蝶呤，手术干预，包括抽吸，宫腔镜管理和预防性环扎术，以及新兴疗法。还讨论了生育方面的考虑、现有证据的局限性以及对未来研究的建议。以病例为基础的观点强调了这些原则，为这种罕见而复杂的疾病的临床决策提供了见解。

{"title":"Cervical ectopic pregnancy: an overview of the literature, emerging management strategies and case-based perspectives","authors":"Brittany Jasper, Giulia Gremmo, Rebecca McKay, Lukasz Polanski","doi":"10.1016/j.ogrm.2025.05.004","DOIUrl":"10.1016/j.ogrm.2025.05.004","url":null,"abstract":"<div><div>Cervical ectopic pregnancy is a rare diagnosis, occurring in 0.01% of all pregnancies and accounting for less than 1% of all ectopic pregnancies. This condition involves implantation within the cervical canal and carries a significant risk of catastrophic haemorrhage, morbidity, and mortality due to the cervix's rich vascularization and resistance to uterotonics. Early and accurate diagnosis, often via transvaginal ultrasound, is essential to guide management and minimize complications. This article provides a comprehensive review of cervical ectopic pregnancy, covering its background, diagnostic challenges, and management options. It explores medical approaches, such as systemic and local methotrexate, surgical interventions including suction aspiration, hysteroscopic management, and prophylactic cerclage, as well as emerging therapies. Fertility considerations, limitations of existing evidence, and recommendations for future research are also discussed. A case-based perspective highlights these principles, offering insights into clinical decision-making for this rare and complex condition.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 8","pages":"Pages 234-238"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749645","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

Navigating urological complications in gynaecological surgery: a gynaecologist's perspective 导航泌尿外科并发症在妇科手术：妇科医生的观点

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-08-01 DOI: 10.1016/j.ogrm.2025.05.001

Natalia Price, Vincent Koo, Mahmoud Mohammed, Paul Moran

The anatomical proximity between the female reproductive and urological systems makes iatrogenic urological complications common during gynaecological surgeries. These complications can lead to severe long-term sequelae. Therefore, it is imperative for pelvic surgeons to be well-acquainted with the prevention and management of such injuries. This review presents an evidence-based analysis of the aetiology, incidence, risk factors, diagnosis, and management of bladder, ureteric, and urethral injuries in the context of gynaecological surgery.

女性生殖系统和泌尿系统在解剖学上的接近使得妇科手术中常见的医源性泌尿系统并发症。这些并发症可导致严重的长期后遗症。因此，盆腔外科医生必须熟悉这类损伤的预防和处理。本文综述了妇科手术中膀胱、输尿管和尿道损伤的病因、发生率、危险因素、诊断和处理的循证分析。

引用次数: 0

A review of the use of robotic surgery in gynaecology with practical applications 机器人手术在妇科的实际应用综述

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-08-01 DOI: 10.1016/j.ogrm.2025.05.003

Ayisha A Ashmore, Aemn Ismail

Robotic surgery has revolutionized minimally invasive procedures, particularly in gynaecology, offering enhanced precision, dexterity, and improved patient outcomes. Since the FDA approval of the da Vinci system in 2000 for gynaecological applications, robotic-assisted techniques have expanded across oncological and benign gynaecological procedures. This review explores the evolution, setup, and applications of robotic surgery in gynaecology, including its role in endometrial and cervical cancer staging, ovarian cancer, urogynaecology, and complex benign conditions such as endometriosis. Despite advantages such as reduced blood loss, shorter hospital stays, and improved surgical ergonomics, robotic surgery faces challenges, including high costs, prolonged setup, and a steep learning curve. Technological advancements, including artificial intelligence integration and improved instrumentation, may enhance accessibility and efficiency. Future research should focus on cost-effectiveness and long-term patient outcomes to establish robotic surgery's role in standard gynaecological practice. Training initiatives are essential to ensure widespread adoption and optimal utilization of robotic platforms.

机器人手术彻底改变了微创手术，特别是在妇科手术中，提供了更高的精度、灵活性和改善的患者预后。自2000年FDA批准达芬奇系统用于妇科应用以来，机器人辅助技术已经扩展到肿瘤和良性妇科手术。本文综述了妇科机器人手术的发展、设置和应用，包括其在子宫内膜癌和宫颈癌分期、卵巢癌、泌尿妇科以及子宫内膜异位症等复杂良性疾病中的作用。尽管有减少失血、缩短住院时间和改进手术人体工程学等优点，但机器人手术面临着挑战，包括高成本、长时间的设置和陡峭的学习曲线。技术进步，包括人工智能集成和改进的仪器，可能会提高可访问性和效率。未来的研究应该集中在成本效益和长期患者的结果，以建立机器人手术在标准妇科实践中的作用。培训举措对于确保机器人平台的广泛采用和最佳利用至关重要。

{"title":"A review of the use of robotic surgery in gynaecology with practical applications","authors":"Ayisha A Ashmore, Aemn Ismail","doi":"10.1016/j.ogrm.2025.05.003","DOIUrl":"10.1016/j.ogrm.2025.05.003","url":null,"abstract":"<div><div>Robotic surgery has revolutionized minimally invasive procedures, particularly in gynaecology, offering enhanced precision, dexterity, and improved patient outcomes. Since the FDA approval of the da Vinci system in 2000 for gynaecological applications, robotic-assisted techniques have expanded across oncological and benign gynaecological procedures. This review explores the evolution, setup, and applications of robotic surgery in gynaecology, including its role in endometrial and cervical cancer staging, ovarian cancer, urogynaecology, and complex benign conditions such as endometriosis. Despite advantages such as reduced blood loss, shorter hospital stays, and improved surgical ergonomics, robotic surgery faces challenges, including high costs, prolonged setup, and a steep learning curve. Technological advancements, including artificial intelligence integration and improved instrumentation, may enhance accessibility and efficiency. Future research should focus on cost-effectiveness and long-term patient outcomes to establish robotic surgery's role in standard gynaecological practice. Training initiatives are essential to ensure widespread adoption and optimal utilization of robotic platforms.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 8","pages":"Pages 226-233"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749644","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

Self-assessment questions 自我评估的问题

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-08-01 DOI: 10.1016/j.ogrm.2025.05.005

Anna Richmond

引用次数: 0

Pelvic organ prolapse: anatomical and functional assessment 盆腔器官脱垂：解剖和功能评估

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-08-01 DOI: 10.1016/j.ogrm.2025.05.002

Georgina Smart, Veenu Tyagi

Pelvic organ prolapse is an increasingly common condition that relates to weakened endopelvic fascia and pelvic floor dysfunction. Around 11% of patients presenting with prolapse undergo surgical management of the same and a vast proportion of these patients will also have a re-do operation due to recurrence. Prolapse can be exceptionally debilitating to quality of life for some women and the effect it has doesn't always correlate with the stage of prolapse. History taking includes not only prolapse specific symptoms but also other pelvic floor symptoms known to have the same aetiology such as bladder or bowel dysfunction including incontinence. A key part of consultation is to determine the effect on quality of life and there are validated questionnaires available to help with this. We have different classification systems in use for examining and staging prolapse: the POP-Q system being the one now globally recommended for use.

盆腔器官脱垂是一种越来越常见的疾病，与盆腔内筋膜减弱和盆底功能障碍有关。约11%的脱垂患者接受手术治疗，其中很大一部分患者因复发而再次手术。对于一些女性来说，脱垂会极大地削弱她们的生活质量，而且这种影响并不总是与脱垂的阶段有关。病史记录不仅包括脱垂特异性症状，还包括其他已知具有相同病因的盆底症状，如膀胱或肠功能障碍，包括尿失禁。咨询的一个关键部分是确定对生活质量的影响，有有效的问卷可以帮助解决这个问题。我们有不同的分类系统用于检查和分级脱垂：POP-Q系统是目前全球推荐使用的。

引用次数: 0

Thinking outside the pelvis: a modern approach to chronic pelvic pain 骨盆外思考：一种治疗慢性骨盆疼痛的现代方法

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-05-23 DOI: 10.1016/j.ogrm.2025.04.001

Julia Lord, Katy Vincent

Chronic pelvic pain is a major public health problem that impacts all areas of a woman's life. The diagnosis is frequently difficult and delayed with women often presenting to a variety of specialties and undergoing multiple investigations before a diagnosis is reached. Aetiology is frequently multifactorial with both precipitating and perpetuating factors. An understanding of the role of the nervous system in chronic pain is essential both to plan appropriate management and to provide the patient with an acceptable explanation of her symptoms. Optimal management is within a multidisciplinary team who can fully address the range of factors that may maintain pelvic pain. Focussing solely on the pelvic organs and associated pathologies is likely to leave the majority of women with persistent symptoms.

慢性盆腔疼痛是影响女性生活各个方面的主要公共卫生问题。诊断往往是困难的和延迟的，妇女往往提出了各种专业，并进行了多次检查之前的诊断达成。病因通常是多因素的，既有诱发因素，也有延续因素。了解神经系统在慢性疼痛中的作用对于制定适当的治疗方案和为患者提供可接受的症状解释都是至关重要的。最佳的治疗是在一个多学科的团队中，他们可以充分解决可能维持骨盆疼痛的各种因素。仅关注盆腔器官和相关病理可能会使大多数女性持续出现症状。

引用次数: 0

Self-assessment questions 自我评估的问题

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-05-11 DOI: 10.1016/j.ogrm.2025.04.004

Anna Richmond

引用次数: 0

Preterm labour and birth: prevention strategies and preparation for delivery 早产和分娩：预防战略和分娩准备

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-05-07 DOI: 10.1016/j.ogrm.2025.04.003

Alexandra Emms, Nicole Pilarski, Victoria Hodgetts-Morton

Preterm birth (PTB) is the leading cause of child mortality (under the age of 5 years), and accounts for 10% of all births worldwide. It is the most important single determinant for infant survival and quality of life. The aetiology of PTB is multifactorial; spontaneous PTB is often associated with cervical weakness, infectious processes, uterine overdistension or a decline in progesterone function. Iatrogenic PTB is predominantly due to maternal medical conditions such as pre-eclampsia or fetal growth restriction. This article will review the key elements of risk assessment and stratification, additional screening protocols following secondary care referral, and prophylactic management strategies for the prevention of PTB. It will also provide an overview of perinatal optimization when PTB is planned or imminent. It encompasses guidance from NICE, RCOG, UK Preterm Birth Network and BAPM to consolidate information in a concise and comprehensive format.

早产（PTB）是儿童（5岁以下）死亡的主要原因，占全世界出生总数的10%。它是婴儿生存和生活质量最重要的单一决定因素。肺结核的病因是多因素的；自发性PTB通常与宫颈无力、感染过程、子宫过度膨胀或黄体酮功能下降有关。医源性肺结核主要是由于母亲的医疗条件，如先兆子痫或胎儿生长受限。本文将回顾风险评估和分层的关键要素，二级医疗转诊后的额外筛查方案，以及预防肺结核的预防性管理策略。它还将提供围产期优化的概述，当计划或迫在眉睫的PTB。它包括NICE， RCOG，英国早产网络和BAPM的指导，以简洁和全面的形式整合信息。

引用次数: 0

Renal disease in pregnancy 妊娠期肾病

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-05-06 DOI: 10.1016/j.ogrm.2025.04.005

Mona Hersi, Natasha Asselin-Miller, Charlotte Patient

Renal disease affects approximately 3% of pregnant women in high income countries and is associated with increased maternal and fetal risks. Pre-pregnancy counselling will allow the mother to better understand the risks and optimize her management prior to pregnancy. Alongside providing pregnancy care in an appropriate centre with a multidisciplinary team this will help to minimize risk and improve outcomes.

肾病影响高收入国家约3%的孕妇，并与孕产妇和胎儿风险增加有关。孕前咨询将使母亲更好地了解风险，并在怀孕前优化其管理。除了在适当的中心与多学科团队提供妊娠护理外，这将有助于最大限度地降低风险并改善结果。

引用次数: 0

How to manage risk and respond to safety concerns in gynaecology: doing ‘safety differently’ 如何管理风险和应对妇科安全问题：“以不同的方式做安全”

Q3 Medicine

Obstetrics, Gynaecology and Reproductive Medicine

Pub Date : 2025-05-05 DOI: 10.1016/j.ogrm.2025.04.002

Cathrine Holland

Healthcare providers must seek to reduce the risk of harm to patients using their services. A good safety culture within an organization assures service users, staff, and the public, that there is commitment to provision of safe, high quality and effective care. Managing risk is everybody's responsibility, and all clinicians should understand risk management processes. Robust risk management demonstrates a blame-free reporting culture and learning from clinical errors whilst pro-actively measuring patient safety indicators within the organization. This review outlines the key elements of risk management within gynaecology and explains how risks are identified, assessed, quantified and managed. The new NHS Patient Safety Incident Response Framework is introduced, together with the new tools used to respond to and learn from incidents and events.

医疗保健提供者必须设法降低使用其服务的患者受到伤害的风险。在机构内建立良好的安全文化，可确保服务使用者、员工和公众对提供安全、优质和有效护理的承诺。管理风险是每个人的责任，所有临床医生都应该了解风险管理流程。健全的风险管理体现了无责任报告文化和从临床错误中学习，同时主动衡量组织内的患者安全指标。本综述概述了妇科风险管理的关键要素，并解释了如何识别、评估、量化和管理风险。引入了新的NHS患者安全事件响应框架，以及用于响应和从事件和事件中学习的新工具。

引用次数: 0

首页上一页

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.

﹀