Abstract:
PURPOSE OF REVIEW:This article reviews new concepts in the aetiology of recurrent miscarriage, presents new outcome data and evaluates new modalities of treatment for unexplained recurrent miscarriage. RECENT FINDINGS:Preimplantation genetic diagnosis has been considered an option for couples who have structural chromosomal abnormalities or unexplained recurrent miscarriage. The association between thrombophilias and adverse pregnancy outcome is further reviewed. In relation to this, there is increasing support for the use of thromboprophylaxis in improving pregnancy outcome in women with inherited thrombophilias. Nonrandomized studies have shown that the reduction in insulin levels with metformin in insulin-resistant individuals may reduce miscarriage risk by restoring normal haemostasis and improving the endometrial milieu. With respect to immunological concepts there is now evidence to suggest that, in addition to a suppression of maternal cell-mediated immunity, some elements of the innate immune system are activated in successful pregnancies. SUMMARY:With the exception of aspirin and heparin for the prevention of recurrent miscarriage in women with the antiphospholipid syndrome, no other suggested therapies for this heterogeneous group of patients have been evaluated in randomized controlled trials. These include thromboprophylaxis for inherited thrombophilias and use of insulin sensitizers in women with insulin resistance and/or polycystic ovarian syndrome. The role of the innate immune system in pregnancy was recently highlighted, and use of nonspecific therapies to suppress the maternal immune response to pregnancy should be reassessed.
journal_name
Curr Opin Obstet Gynecoljournal_title
Current opinion in obstetrics & gynecologyauthors
Carrington B,Sacks G,Regan Ldoi
10.1097/01.gco.0000194112.86051.26keywords:
subject
Has Abstractpub_date
2005-12-01 00:00:00pages
591-7issue
6eissn
1040-872Xissn
1473-656Xpii
00001703-200512000-00008journal_volume
17pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:There has been increasing interest in developing assisted reproductive technologies to overcome failure at fertilization and early embryonic arrest. Some of the affected patients harbor too few copies of mitochondrial DNA (mtDNA) in their eggs at the time of fertilization, which results in development...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000265
更新日期:2016-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Neonatal herpes simplex virus infection is often severe, if not fatal. What is our understanding of the epidemiology of this disease? How is it diagnosed? Would maternal screening for herpes simplex virus-2 (HSV-2) in pregnancy make a difference? Does maternal HSV alter transmission of HIV vertically ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3283294840
更新日期:2009-04-01 00:00:00
abstract:PURPOSE OF REVIEW:To review recent findings related to possible causes of recurrent implantation failure of endometrial origin in normal uterus. RECENT FINDINGS:Recent evidences suggest that in apparently normal endometria, RIF may associate with molecular and functional changes in the uterus such as abnormal endometr...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000468
更新日期:2018-08-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe the current role of radiation therapy and specific types of radiation therapy used in the management of early stage, locoregionally advanced, and metastatic breast cancer. RECENT FINDINGS:The role of radiation therapy in the management of breast cancer has not changed in recent decades, h...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3283425401
更新日期:2011-02-01 00:00:00
abstract::Current studies verify the safety of surgery in the elderly. Delirium is a costly complication, but its incidence and severity can be reduced by pre- and postoperative interventions. Avoidance of even mild hypothermia has now been shown to reduce cardiovascular morbidity. New information available on the cardiovascula...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1997-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The aromatase inhibitors are increasingly used as adjuvant therapy in postmenopausal women with hormone receptor positive breast cancer. With additional experience using these agents, unanticipated side effects have become apparent. Women who experience side effects from adjuvant endocrine therapy are...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e328334e44e
更新日期:2010-02-01 00:00:00
abstract:PURPOSE OF REVIEW:To analyse the reasons why foetal heart rate (FHR) monitoring failed to fulfil the initial expectations of unequivocally decreasing perinatal morbidity and mortality, and to summarize the most recent advances in this field. RECENT FINDINGS:It is now clear that expectations towards FHR monitoring at t...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e328337233c
更新日期:2010-04-01 00:00:00
abstract::Treatment of invasive vulvar malignancy has become more individualized during the past decade. In the past, radical vulvectomy with bilateral inguinofemoral lymphadenectomy was the standard therapy for invasive squamous cell carcinoma and melanoma of the vulva. This is no longer always the case. The treatment of stage...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1991-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Noninvasive prenatal testing (NIPT) through the analysis of cell-free DNA in maternal plasma has rapidly changed screening for fetal chromosome abnormalities. We review practical and ethical challenges associated with the transition, progress in their resolution, and identify new emerging difficulties...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000254
更新日期:2016-04-01 00:00:00
abstract::Acquired immunodeficiency virus infections had recently been the leading cause of death in minority women of reproductive age in several urban cities in the United States. In addition, more than 80% of infants with human immunodeficiency virus type 1 infection acquired the infection perinatally. These alarming data ha...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1992-02-01 00:00:00
abstract::Magnetic resonance imaging represents a new method of imaging the pelvic viscera and pelvic floor musculature. Rapid sequences allow us to perform magnetic resonance imaging dynamically during straining or pelvic floor contraction, which can elegantly demonstrate the patterns of pelvic floor prolapse. The technique is...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-199808000-00003
更新日期:1998-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Fetal and newborn brain injury causes lifelong morbidity for the survivors, with high emotional costs to the individual and the family plus a heavy economic burden for society. This is timely and relevant. Techniques are now available to prevent, detect, and treat those central nervous injuries that r...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3282f734db
更新日期:2008-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The increased risk of infertility in men with varicocele is well established. Varicocelectomy has been shown to improve semen parameters and increase pregnancy rates. Yet varicocele pathophysiology is poorly understood and potential implications for testosterone production are less clear. Evidence sug...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e328348a3e2
更新日期:2011-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Spontaneous preterm birth complicates 3-11% of pregnancies and is a major cause of neonatal mortality and morbidity worldwide. If accurate tests can be identified, a potentially effective screening strategy with an adjunct preventive therapy may be trialled to reduce the rate of spontaneous preterm bi...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章
doi:10.1097/GCO.0b013e328359823a
更新日期:2012-12-01 00:00:00
abstract::For the majority of women, gynecologic cancer is a survivable disease. A brief overview of the recent findings on the psychological and behavioral aspects of gynecologic cancer is provided. The discussion is organized by disease-relevant time points, from prevention to recovery or death. Recognition of the positive re...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 00:00:00
abstract:PURPOSE OF REVIEW:To evaluate the impact of early pregnancy complications involving placentation and early placental development on adverse obstetric outcome in ongoing and subsequent pregnancies. RECENT FINDINGS:We found an increased risk of adverse outcome (odds ratio >2.0) in ongoing pregnancies of preterm delivery...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3283404e44
更新日期:2010-12-01 00:00:00
abstract:PURPOSE OF REVIEW:In this review, the role of simulation as a strategy for training and performance improvement is reviewed. The review is timely, as providing safe and high-quality healthcare is the goal of every healthcare system and soon reimbursement will be tied to quality measures. Simulation has emerged as a str...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000030
更新日期:2013-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Maternal mental health disorders, including anxiety and depression, are one of the most common obstetric complications, presenting in pregnancy and postpartum. RECENT FINDINGS:Maternal mental health disorders are associated with adverse maternal and neonatal outcomes. Screening women in pregnancy and...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000524
更新日期:2019-04-01 00:00:00
abstract::Congenital heart disease in pregnancy is increasingly common because of the advances in surgery and medical therapy which have taken place over the last 30 years, which means that more affected women are surviving into the reproductive age. Antenatal counselling needs to be tailored to the specific lesion, with pulmon...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-200204000-00006
更新日期:2002-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The last several years have seen a number of important clinical and academic advances in long-acting reversible contraceptive (LARC) methods, such that many professional medical organizations now recommend these methods as first-line contraception for all women. RECENT FINDINGS:Recent data support th...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000227
更新日期:2015-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The present article provides an overview of the molecular mechanisms underlying adolescent endometriosis and advances in both medical and surgical management. RECENT FINDINGS:Molecular and cellular features of endometriotic lesions differ from eutopic endometrium. There is altered estrogen-mediated c...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000483
更新日期:2018-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To avoid both overtreatment and undertreatment accurate risk assessment is mandatory. The present review gives an overview of recently published articles covering prognostic and predictive factors for adjuvant therapy in early breast cancer. RECENT FINDINGS:Gene expression signatures enhance prognost...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章
doi:10.1097/GCO.0000000000000594
更新日期:2020-02-01 00:00:00
abstract:PURPOSE OF REVIEW:To evaluate the role of fluorodeoxyglucose (FDG) PET/CT as cancer response testing in gynecological malignancies. RECENT FINDINGS:The application of FDG PET/CT in patients with endometrial and ovarian cancer to evaluate treatment response was found to have no clinical benefits.Patients with cervical ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e32835a7e96
更新日期:2013-02-01 00:00:00
abstract::The management of advanced ovarian cancer relies on appropriate surgical cytoreduction in conjunction with appropriate adjuvant chemotherapy. In the past year several studies have continued to support aggressive cytoreduction at the initial operation, including for stage IV disease, as well as in a second-look setting...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-199802000-00010
更新日期:1998-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Prescribing habits for the treatment of symptomatic hypogonadism have recently stirred controversy surrounding testosterone replacement therapy. As a result, the gynecologist will need to recognize this iatrogenic form of decreased sperm production in couples seeking fertility advice. We have compiled...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000192
更新日期:2015-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review was to summarize recently published clinical and animal-based studies of antenatal corticosteroids, describe current recommendations for practice, and suggest priority areas for future research. RECENT FINDINGS:A single course of antenatal corticosteroids is known to improv...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-200212000-00006
更新日期:2002-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To review recent literature on medical accuracy, program effectiveness, and ethical concerns related to abstinence-only policies for adolescent sexuality education. RECENT FINDINGS:The federal government invests over 175 million dollars annually in 'abstinence-only-until-marriage' programs. These pro...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3282efdc0b
更新日期:2007-10-01 00:00:00
abstract::Our understanding of the causes, mechanisms, and prenatal management of fetal obstructive uropathy has increased significantly. Improved methods of prenatal evaluation have allowed the better selection of fetuses for invasive therapy, and studies indicate better survival and renal outcomes in carefully selected cases....
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-199904000-00011
更新日期:1999-04-01 00:00:00
abstract::The proper use of forceps or vacuum extractor, or both, remains a safe and effective modality in achieving the universal goal of a healthy mother and baby. Their use requires continued experience, sharing of information, and possibly attention to subtleties of design. This review looks at the current situation with sp...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1994-10-01 00:00:00
abstract::Human papillomavirus testing has been evaluated as an adjunct to cervical cytologic screening. There is a well-established association between high-risk malignant subtypes of human papillomavirus infection and the development of neoplastic change. Although human papillomavirus infection is a necessary condition for ma...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-200002000-00002
更新日期:2000-02-01 00:00:00