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Editorial: Updates in contraception and abortion care: ghosts of the past, present, and future. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-11-02 Paul D Blumenthal
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Reducing health disparities in endometrial cancer care in 2024. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-10-26 Chelsea E Stewart,Andrea Nañez,Martins Ayoola-Adeola,Dana Chase
PURPOSE OF REVIEW To summarize the most recent publications explaining disparities among patients diagnosed with endometrial cancer and identify areas of improvement. RECENT FINDINGS Racial disparities in endometrial cancer care have been identified along the cancer continuum including risk, diagnosis, access to treatment, and overall survival. The mortality gap in endometrial cancer is one of the
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A review of the state of cervical cancer: updates from prevention to recurrent disease. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-10-12 Sarah M Crafton,Puja S Venkat,Ritu Salani
PURPOSE OF REVIEW To summarize the recent updates in cervical cancer from prevention and early detection to the management of early stage and recurrent disease as well as future areas of exploration. RECENT FINDINGS The importance of the human papilloma virus vaccine and screening continue to make an impact in reducing the global burden of cervical cancer. In early-stage, low risk disease, new studies
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Medical abortion in the second trimester - an update. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-10-09 Helena Kopp Kallner
The safety and efficacy of medical abortion in the second trimester is provider independent and may therefore offer advantages over surgical second trimester abortion in certain settings. Due to bleeding risk, medical abortions in the second trimester are still mostly performed in a clinic or hospital setting. The most effective regimen for abortion includes pretreatment with oral mifepristone and
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Latest advances in immuno-oncology for endometrial cancer: single-agent and combination regimens. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-09-29 Michael Richardson,Dana M Chase
PURPOSE OF REVIEW The scope of immuno-oncology in endometrial cancer has changed rapidly in the last several years, requiring up-to-date knowledge for those who treat these patients. RECENT FINDINGS This article will focus on molecular profiling, recent trials, and FDA approvals of targeted immuno-oncology medications in endometrial cancer. These include immune checkpoint inhibitors alone or with combination
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Genetic risk assessment in breast and gynecologic malignancies- what's to know in 2024? Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-09-29 Daniella Kamara,Erica Silver,Mariana Niell-Swiller
PURPOSE OF REVIEW Hereditary cancer risk assessment and counseling have become integral in oncology care, especially in breast and gynecologic malignancies where genetic test results impact management. However, a large number of patients who could benefit from genetic testing are not getting tested. As such, genetic risk assessment and counseling methods have had to evolve to meet the needs of this
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Travel for abortion care: implications for clinical practice. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-09-12 Klaira Lerma,Leah Coplon,Vinita Goyal
PURPOSE OF REVIEW Traveling long distances to obtain abortion care due to restrictions and scarce availability is associated with significant obstacles. We review clinical strategies that can facilitate abortion access and outline considerations to ensure person-centered and equitable care. RECENT FINDINGS Establishing a patient's gestational duration prior to travel may be beneficial to ensure they
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Controversies in axillary management of patients with breast cancer - updates for 2024. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-09-08 Nikolas Tauber,Vesna Bjelic-Radisic,Marc Thill,Maggie Banys-Paluchowski
PURPOSE OF REVIEW For some time now, the question of de-escalation in axillary staging in breast cancer patients has been raised. The aim is to improve the patients' quality of life and reduce morbidity by optimizing surgical strategies with a high level of oncological safety. This review offers a current overview of published evidence and clinical practice, aiming to guide the surgical community as
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Cervical preparation for second-trimester procedural abortion. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-30 Farsam Fraz,Serena M Liu,Kate A Shaw
PURPOSE OF REVIEW To review the evidence-informed options for cervical preparation prior to second-trimester dilation and evacuation (D&E). RECENT FINDINGS As abortion restrictions increase and the number of abortion clinics and providers decreases, pregnant people are facing more barriers to abortion access. Those in need are now often required to travel for second-trimester abortion care, only to
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Evaluation and management of urethral and periurethral masses in women. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-29 Stephanie W Zuo,Gnankang Sarah Napoe
PURPOSE OF REVIEW Female periurethral masses are an uncommon occurrence. The purpose of this review is to describe etiologies of female urethral and periurethral masses and to provide an update on diagnosis and management. RECENT FINDINGS The most common causes of periurethral and urethral masses in women are urethral caruncles, urethral diverticula, and Skene's gland cysts. Urethral meatal lesions
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Management of missing intrauterine device strings and migrated intrauterine devices. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-21 Stephanie I Amaya,Paul D Blumenthal
PURPOSE OF REVIEW The purpose of this review is to review the recent literature with respect to the management of missing intrauterine device (IUD) strings. As IUD use has increased over time, it is important to review management options for this uncommon but possible complication. RECENT FINDINGS This article will cover stepwise approaches to management of missing IUD strings based on the most recent
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The evolving role of emergency medicine in family planning services. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-17 Carl Preiksaitis,Andrea Henkel
PURPOSE OF REVIEW The emergency department serves as an essential access point for a variety of healthcare services. This review will examine the recent expansion of family planning and reproductive health services in the emergency department. RECENT FINDINGS An increasing number of patients present to emergency departments for early pregnancy loss (EPL), abortion care, and contraceptive management
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Racial disparities in early pregnancy: a narrative review. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-13 Oluremi Mogekwu,Swena Kapoor,Melissa Carmichael,Elizabeth Egbase
PURPOSE OF REVIEW This review introduces the recognized body of evidence on social determinants of health, which continue to show that a person's health is determined by their broader environmental and social context and that societal inequities harm health and healthcare outcomes. An area of inequity is race, which, although a social construct, has a significant impact on a person's morbidity and
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Update on gestational diabetes and adverse pregnancy outcomes. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-09 Bryan Ugwudike,ManHo Kwok
PURPOSE OF REVIEW To explore the recent literature concerning the effect of gestational diabetes (GDM) on adverse pregnancy outcomes (APO). RECENT FINDINGS Literature search on PubMed, Medline and British Journal of Obstetrics and Gynaecology was conducted using keywords. Search fields were filtered down to include articles from 2019 onwards. GDM is common during pregnancy and is on the rise because
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Strategies to communicate pregnancy complications: a systematic review and practical points for healthcare professionals. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-09 Ioannis Karapanos,Angeliki Bolou,Maya Nazer,Stamatina Iliodromiti,Elena Greco
PURPOSE/METHODS This systematic review aims to provide an overview of strategies available for healthcare professionals (HCPs) to effectively communicate unexpected news in pregnancy, specifically for the most common pregnancy complications. Three medical databases and grey literature were searched until March 2023 using subject headings and keywords. Snowball techniques were also used. The articles
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Postpartum maternal tachycardia - diagnostic pitfalls! Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-09 Charlotte Mathur,Arun Tohani,Vinod Patil,Ayub Khan,Chineze Otigbah
PURPOSE OF REVIEW Maternal tachycardia is a common sign with a multitude of causes. We attempt to look at the most common sinister ones in the postpartum period. RECENT FINDINGS Current guidelines differ in the definition of maternal tachycardia. It has been associated with adverse outcomes such as increased length of stay as well as higher mortality if there is underlying peripartum cardiomyopathy
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Oral gonadotrophin-releasing hormone (GnRH) antagonists: the continuing search for the ideal nonsurgical therapy of uterine fibroids with a cautionary tale. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-09 Ogagaoghene Sim-Ifere,Mehrnoosh Aref-Adib,Funlayo Odejinmi
PURPOSE OF REVIEW Uterine fibroids are very common with a prevalence of over 70%. They present a significant economic and psychological burden. A variety of nonsurgical treatments exist for its management encompassing hormonal and nonhormonal methods. Gonadotrophin-releasing hormone (GnRH) antagonists are a novel treatment for uterine fibroids. They cause a rapid reduction in endogenous GnRH, leading
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Management of postpartum perineal wound complications. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-09 Jaber Saad,Caitlyn Painter
PURPOSE OF REVIEW Perineal wound complications occur in up to 25% of postpartum patients. Wound complications are most common after obstetric anal sphincter injuries (OASIS) but can occur after any laceration. It is imperative that any provider caring for postpartum patients understand the best evidence-based practices to recognize and manage these complications. We present a review of the available
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Twin charts should be the standard reference to assess growth in twin pregnancy. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-09 Smriti Prasad,Asma Khalil
PURPOSE OF REVIEW Twin pregnancies are characterized by slower growth velocity compared with singletons, especially during the third trimester and, therefore, tend to be smaller than singletons. Growth surveillance is instrumental in the identification of twin pregnancies at risk of adverse outcomes. Whether the phenomenon of slow growth is an adaptive physiological response or represents pathological
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The presentation and management of cesarean scar defects: an updated review on an evolving diagnosis. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-08-01 Meghan McGrattan,Anna Kobylianskii,Peter Thiel,M Jonathon Solnik,Ally Murji
PURPOSE OF REVIEW The purpose of this review is to provide a clinically relevant synthesis of the current literature on cesarean scar defects, focusing on their epidemiology and clinical presentation, diagnosis, treatment, and prevention. RECENT FINDINGS Cesarean scar defects (CSDs) are an emerging area of gynecologic research, with an influx of higher quality cohorts, randomized controlled trials
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Evolving best practices in the surgical management of endometriosis - examining the evidence and expert opinion. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-06-12 Elisa Jorgensen,Alison Fitzgerald,Nisse Clark
PURPOSE OF REVIEW Endometriosis is a common and often debilitating condition, with multiple theories of pathogenesis. Despite the prevalence of endometriosis, the optimal surgical management remains unclear. RECENT FINDINGS Laparoscopy is the gold standard for the diagnosis of endometriosis, with biopsy confirmation more accurate than visual diagnosis alone. It is not clear from the existing data whether
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Skeletal muscle relaxants for the treatment of myofascial pelvic pain and high tone pelvic floor disorders. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-06-06 Virginia Flatow,Jean Uy-Kroh,Erin T Carey,Charles Ascher-Walsh,Susan Khalil
PURPOSE OF REVIEW Chronic pelvic main is a complex process that includes many causes. In gynecology, the treatment of myofascial pelvic pain and high tone pelvic floor disorders can be managed with skeletal muscle relaxants for select clinical indications. A review of skeletal muscle relaxants will be included for gynecologic indications. RECENT FINDINGS There are limited studies on vaginal skeletal
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Update on antiadhesion barriers and therapeutics in gynecological surgery. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-06-06 Olanrewaju Dawodu,Briana Baxter,Jin Hee Kim
PURPOSE OF REVIEW Postoperative adhesions remain a clinical challenge to both patients and providers, as they are associated with significant complications and a high economic burden. This article provides a clinical review of currently available antiadhesive agents and promising new therapies that have advanced past animal studies. RECENT FINDINGS Several agents have been investigated on their ability
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An update and review of nontubal ectopic pregnancy management. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-06-06 Katherine Kostroun,Virginia-Arlene Go,Randal D Robinson
PURPOSE OF REVIEW Nontubal ectopic pregnancies appear to be increasing in prevalence. Increasingly, minimally invasive methods for management are being utilized. A current literature review and recommendations for management of nontubal ectopic pregnancy is presented in this review. RECENT FINDINGS Nontubal ectopic pregnancies are less common than tubal ectopic pregnancies but present a unique and
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The minimally invasive approach to abdominal cerclage: indications, complications, and techniques for placement. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-05-31 Caitlin Waters,Gabriella Pinho,Sara Kim,Jennifer Blaber,Xun Lian
PURPOSE OF REVIEW Laparoscopic abdominal cerclage placement has become the favored approach for management of refractory cervical insufficiency. There are special considerations with respect to surgical method, management of pregnancy loss, and delivery following placement. This review addresses current literature on transabdominal cerclage with a focus on up-to-date minimally invasive techniques.
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The genetic background of female reproductive disorders: a systematic review. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-05-29 Triada Doulgeraki,Maria Papageorgopoulou,Stamatina Iliodromiti
PURPOSE OF REVIEW Reproductive function is the interplay between environmental factors and the genetic footprint of each individual. The development in genetic analysis has strengthened its role in the investigation of female reproductive disorders, potential treatment options and provision of personalized care. Despite the increasing requirement of genetic testing, the evidence of the gene-disease
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Pelvic abscess - to drain or not to drain? Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-05-26 Sophie Michelle Strong,Stylianos Michail Lazanakis,Elizabeth Ball
PURPOSE OF REVIEW Pelvic abscess is a common gynaecological condition, particularly during and after the Covid-19 pandemic, possibly resulting from obstacles to accessing care during this time. To date, no consensus guideline on management exists with a lack of applicable randomized controlled trials (RCTs) comparing medical management with antibiotics alone, image-guided drainage and surgical management
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Take it or leave it: oophorectomy at the time of benign hysterectomy. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-05-26 Hilary R Haber,Hannah M French,Peter R Movilla,Keith B Isaacson,Stephanie N Morris
PURPOSE OF REVIEW Previous modeling data suggest ovarian conservation up to age 65 for women without adnexal disease and at average risk of ovarian cancer because of an increase in mortality associated with ovarian removal. Recent modeling data challenges this practice. This review of recent literature will update providers regarding consideration for oophorectomy at time of benign hysterectomy. RECENT
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The impact of the Dobbs decision on in-vitro fertilization and fertility care. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-05-23 Ashley Ulker,M Blake Evans,LaTasha B Craig
PURPOSE OF REVIEW The 2022 Supreme Court ruling in Dobbs vs Jackson marks a frightening new reality in America. Physicians and patients have been left confused and concerned regarding the broader implications of this ruling. Now that the constitutional right to an abortion has been overturned and the power has been relinquished to individual states, there is justifiable concern regarding the impact
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Diagnostic and surgical approaches to congenital uterine anomalies for the minimally invasive gynecologic surgeon. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-05-18 Colleen Murphy,Annemieke Wilcox,Alla Vash-Margita
PURPOSE OF REVIEW Congenital uterine anomalies (CUAs) impact the physical and psychosocial wellbeing of affected patients. Managing these conditions depends on the clinical scenario, and in some cases, can involve the use of minimally invasive surgical techniques. The purpose of this review is to provide an update of the diagnosis, perioperative considerations, and treatment of CUAs. RECENT FINDINGS
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Perioperative visits in minimally invasive gynecologic surgery. Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-05-09 Caitlin Ingraham,Gretchen Makai
PURPOSE OF REVIEW Perioperative visits for gynecologic surgery patients have traditionally included in-person examinations and counseling, but the advent of telemedicine has prompted clinicians to consider varying approaches to perioperative care. We aim to educate readers on the optimal setting and context of perioperative visits and provide insight from our experience to optimize care. RECENT FINDINGS
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Noninvasive preimplantation genetic testing using the embryo spent culture medium: an update Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-05-05 Belen Lledo, Ruth Morales, Jose Antonio Ortiz, Andrea Bernabeu, Rafael Bernabeu
Purpose of review The presence of cell-free DNA (cf-DNA) in the embryo spent culture medium allows to develop a noninvasive PGT-A (niPGTA). Noninvasive PGT-A may provide a simpler, safer and less costly approach to preimplantation genetic testing of aneuploidy (PGT-A). Furthermore, niPGTA would provide wider access to embryo genetic analysis and circumvent many legal and ethical considerations. However
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New treatment options for nonsurgical management of uterine fibroids Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-05-04 SiWon Lee, Elizabeth A. Stewart
Purpose of review Uterine fibroids is a common problem in reproductive-age individuals, frequently causing abnormal uterine bleeding, bulk symptoms, and adverse reproductive outcomes. Traditionally, almost half of the women with symptomatic fibroids received surgery for definitive treatment. There are a growing number of nonsurgical options for treatment that have become available for patients who
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Appendectomy in endometriosis: an update on surgical indications and management of uncommon diseases Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-05-03 Veronica D. Galaviz, Anthony D. Nguyen, Peter L. Sticco, Keith T. Downing
Purpose of review Abnormal appendiceal disease is commonly encountered following an appendectomy when performed in patients with endometriosis. Appendiceal endometriosis is the most notable finding and can affect up to 39% of patients with endometriosis. Despite this knowledge, guidelines for performing an appendectomy have not been formally established. In this article, we review the surgical indications
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Gynecologic counseling for patients undergoing bariatric surgery: a scoping review Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-28 Elizabeth Cook, Olga Fajardo, Rachel Lane Walden, Lara Harvey
Purpose of review Obesity is associated with several gynecologic conditions. While bariatric surgery is regarded as the most effective treatment option for obesity, gynecologic counseling for patients planning bariatric surgery is limited and often focused on fertility. The goal of this scoping review is to investigate the current recommendations for gynecologic counseling prior to bariatric surgery
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Surgical management of endometriosis to optimize fertility Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-26 Kacey M. Hamilton, Katherine VanHise, Mireille D. Truong, Kelly N. Wright, Matthew T. Siedhoff
Purpose of review Surgery is an integral element of treatment for infertility caused by endometriosis. This review summarizes the purported mechanisms of infertility in endometriosis, as well as the impacts of surgery for endometriosis on fertility, including pregnancy achieved spontaneously and with assisted reproductive technology (ART). Recent findings Endometriosis’ effect on fertility is multifactorial
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Growing pains: strategies for improving ergonomics in minimally invasive gynecologic surgery Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-26 Emily Lin, Riley Young, Jessica Shields, Katherine Smith, Lisa Chao
Purpose of review To evaluate factors contributing to the development of work-related musculoskeletal disorders (WMSDs) and review strategies for mitigating ergonomic strain in minimally invasive gynecologic surgery. Recent findings Factors associated with increased ergonomic strain and the development of WMSDs include increasing patient body mass index (BMI), smaller surgeon hand size, noninclusive
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The future of frozen-thawed embryo transfer in hormone replacement therapy cycles Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-03-29 Kristine Løssl, Anne Lærke Spangmose, Louise Laub Asserhøj, Tine Vrist Dam, Anja Pinborg
Purpose of review This review focuses on the efficacy of letrozole stimulated frozen-thawed embryo transfer (FET) compared to hormone replacement therapy (HRT) FET in women with polycystic ovarian syndrome (PCOS) and/or oligo-anovulation. Further, obstetric and perinatal risks in HRT FET are summarized. Recent findings The presence of a corpus luteum seems to reduce the risk of pregnancy-related
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How effective are lifestyle interventions for overweight women trying to conceive? Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-03-29 Roman Alexander Friedrich Hiller, Georg Griesinger
Purpose of review To summarize and critically review the current knowledge on the effectiveness of lifestyle modifications for overweight women trying to conceive. Recent findings Overweight is associated with a wide spectrum of disorders, which may directly or indirectly affect fertility [from menstrual cycle irregularities to a lower chance of live birth after assisted reproductive technology (ART)
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Does PGT-A affect cumulative live birth rate? Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-03-20 Serin Seckin, Eric J. Forman
Purpose of review Preimplantation genetic testing for the purpose of aneuploidy screening (PGT-A) has increased in use over the last decade. Recent findings Whether PGT-A benefits all of the patients that choose to employ it has been a concern, as recent studies have highlighted a potential decrease in cumulative live birth rate (CLBR) for younger patients undergoing embryo transfer. However, there
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Treatment options for molecular subtypes of endometrial cancer in 2023 Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-03-20 Hannah C. Karpel, Brian Slomovitz, Robert L. Coleman, Bhavana Pothuri
Purpose of review This article reviews treatment strategies in endometrial cancer by molecular subtype. Recent findings The Cancer Genome Atlas (TCGA) classifies four molecular subtypes of endometrial cancer – mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H), copy number high (CNH)/p53abn, copy number low (CNL)/no specific molecular profile (NSMP), and POLEmut – which are
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Complex vulvar and vaginal disease in menopause Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Ashley E. Fuller, Rebecca Dunsmoor-Su
Purpose of review Menopause is a time of vulvar and vaginal changes that are physiologic and are often symptomatic. These changes can impact up to 50% of women in menopause. There are also several vulvar dermatoses that are more common after menopause and should be recognized early to allow for symptomatic treatment. Some of these conditions can lead to squamous cell carcinoma over time, and early
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The importance of follicular flushing in optimizing oocyte retrieval Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-03-17 George Lainas, Tryfon Lainas, Efstratios Kolibianakis
Purpose of review To critically evaluate the use of follicular flushing during oocyte retrieval. Recent findings The latest meta-analysis evaluating follicular flushing does not favour its use over single aspiration. The randomized controlled trials (RCTs) included, however, are characterized by significant heterogeneity regarding the population analysed, the needle type and lumen used, the aspiration
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Management of blood pressure in pregnancy: new perspectives from the CHAP trial Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Kerry D. Holliman, Virginia Lowe, Gabriella Nonni
Purpose of review Chronic hypertension affects up to 10% of pregnancies in the United States and the incidence of hypertensive diseases of pregnancy has more than doubled in the past decade, affecting minority women at disproportionate rates. Recent data show potential benefit by lowering the threshold of blood pressure treatment for pregnant women to >140/90 mmHg. Recent findings In April 2022,
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Contemporary management of epilepsy in pregnancy Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Kelly F. Darmawan, Danielle M. Panelli
Purpose of review The number of reproductive aged people with epilepsy in the United States is increasing, making epilepsy during pregnancy more prevalent. Simultaneously, more people are using newer generations of antiseizure medications before, during and after pregnancy. Here, we review current evidence on contemporary management and outcomes of pregnancies among people with epilepsy. Recent findings
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Aspirin in pregnancy: a review of indications, timing, dosing and efficacy Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Noor Joudi, Martha Rode
Purpose of review The aim of this study was to evaluate the recent literature examining the utility of low-dose daily aspirin (LDA) in the prevention of preeclampsia and other potential adverse perinatal sequelae. The evidence supporting various aspirin doses and timing of initiation of treatment for this purpose will be examined. The potential benefits of LDA therapy in pregnancy will be discussed
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The pregnancy at risk for delivery at the threshold of viability Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Mark G. Boddy, Alexis S. Davis, Nicola Perlman
Purpose of review To examine updated recommendations for obstetrical interventions that may improve neonatal outcomes in extremely preterm births. Recent findings Several recent studies of antenatal steroids at the threshold of viability have demonstrated benefits in both survival and survival without major morbidity. This has led to revised recommendations from the American College of Obstetricians
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Fetal growth disorders in twin gestations Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Yair J. Blumenfeld, Jill N. Anderson
Purpose of review Twin gestations account for approximately 3% of all births. Although there appear to be physiologic differences in the third trimester growth of twins compared with singleton gestations, reasons for this remain unclear. As growth-restricted fetuses and neonates are at increased risk for adverse outcomes, there is a clinical need to optimize our ability to delineate normally from
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Understanding the distinction between cleft lip and cleft palate: a critical step for successful prenatal detection Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Kathleen Minor, Jane Chueh
Purpose of review Orofacial clefts (OCs) are among the most common congenital anomalies, however, prenatal detection of cleft palate without cleft lip (CP) remains low. CP is associated with a higher risk of associated structural anomalies, recurrence risk and genetic aberrations. There is opportunity to optimize prenatal diagnosis, counseling and diagnostic genetic testing for OCs. Recent findings
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Differences of sexual development: genetic counseling considerations in the prenatal setting Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Kelly Chen, Brooke M. Dunleavy, Karina L. Talreja, Renee Jones
Purpose of review With the rapid adoption of noninvasive prenatal screening (NIPS), predictive fetal sex information is available early in pregnancy. This information can conflict with the results of other prenatal tests such as fetal ultrasound or diagnostic testing and raise the possibility of a fetal difference of sexual development (DSD). In this review, we describe recent studies examining the
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Foetal genome editing Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Sourav K. Bose, Kara Kennedy, William H. Peranteau
Purpose of review The development of modern gene editing tools alongside promising innovations in gene sequencing and prenatal diagnostics as well as a shifting regulatory climate around targeted therapeutics offer an opportunity to address monogenic diseases prior to the onset of pathology. In this review, we seek to highlight recent progress in preclinical studies evaluating the potential in-utero
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The role of menopausal hormone therapy in the prevention and treatment of low bone density in perimenopausal and postmenopausal women Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Nandi Shah, Danit Ariel
Purpose of review The purpose of this review is to summarize the evidence on the benefits of menopausal hormone therapy (MHT) for the maintenance of skeletal health, prevention of osteoporosis and related fractures in peri and postmenopausal women. Recent findings We will review the impact of estrogen on skeletal health as well as the physiology of bone loss during the perimenopause and postmenopause
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Perimenopausal depression: review of recent findings and implications for future research Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Katherine Williams
Purpose of review The purpose of this review is to provide an update on the most recent research regarding potential causes and treatments for perimenopausal depression. Recent findings Erratic estrogen fluctuations and alterations in the neurosteroid allopregnanolone are important contributors to perimenopausal mood symptoms. These hormone changes augment increased risk associated with recent stressful
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Counseling on hormone replacement therapy: the real risks and benefits Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Amy J. Voedisch
Purpose of review The menopause transition can be a time of great upheaval and suffering for some patients. Hormone replacement therapy (HRT) can relieve symptoms and improve quality of life but the perceived risks of HRT have decreased use over the past two decades. Understanding the real risks and benefits will ease physician and other healthcare professionals discomfort with counseling and prescribing
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Pap smear recommendations in older women, does the data support stopping? Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Emma Grabinski, Rebecca Dunsmoor-Su
Purpose of review To review the recommendations for cervical cancer screening in older women and to determine the evidence upon which the current and emerging recommendations are based on. To evaluate the possible consequences of stopping cervical cancer screening in older women. Recent findings Recommendations are to space cervical cancer screening intervals for women aged 21–65 and stop in women
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The aging brain: risk factors and interventions for long term brain health in women Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Jessica Z.K. Caldwell, Nancy Isenberg
Purpose of review Poor cognitive aging and dementia pose a significant public health burden, and women face unique risks compared to men. Recent research highlights the role of genetics, menopause, chronic disease, and lifestyle in risk and resilience in women's cognitive aging. This work suggests avenues for clinical action at midlife that may change the course of brain health in aging. Recent findings
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Menopause, weight, and metabolic health – considerations for a patient centered, multidisciplinary approach Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-04-01 Leasa Lowy, Anastasia Kasianchuk
Purpose of review To examine the complexity of weight and metabolic changes during the menopausal transition and propose a multidisciplinary care approach to support long-term metabolic health. Recent findings Menopause, weight and metabolic health changes are influenced by many interplaying factors, and therefore, require a multipronged, multidisciplinary patient centered approach. This approach
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New insights into decidualization: immunological and genetic factors Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-03-14 Isabel Cuadrado-Torroglosa, Juan Antonio García-Velasco, Diana Alecsandru
Purpose of review Nowadays, there are many efforts focused on improving embryo quality for assisted reproduction treatments. Nevertheless, there are important maternal aspects, such as decidualization, also essential for pregnancy, often forgotten. With this review, we intend to highlight the main events involved in this endometrial phenomenon, as well as the cells and molecules that have recently
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The impact of air pollution and endocrine disruptors on reproduction and assisted reproduction Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-03-14 Denis A. Seli, Hugh S. Taylor
Purpose of review Rapid increase in world population accompanied by global industrialization has led to an increase in deployment of natural resources, resulting in growing levels of pollution. Here, we review recent literature on the impact of environmental pollution on human reproductive health and assisted reproduction outcomes, focusing on two of the most common: air pollution and endocrine disruptors
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Frozen embryo transfers in a natural cycle: how to do it right Curr. Opin. Obstet. Gynecol. (IF 2.1) Pub Date : 2023-03-14 Barbara Lawrenz, Laura Melado, Human M. Fatemi
Purpose of review Assisted reproductive technology treatment has seen a significant shift from fresh to frozen embryo transfers (FET). Endometrial receptivity in the FET cycle can be achieved through a hormonal replacement cycle or a natural cycle, and the preparation approach has important implications on the pregnancy itself. In the natural cycle approach, planning of the embryo transfer timing