Abstract:
PURPOSE OF REVIEW:To provide an overview of the latest views and evidence available to clinicians managing couples with recurrent early pregnancy loss (RPL). RECENT FINDINGS:RPL is a heterogeneous condition associated with many pathologies, none of which is found in more than 50% of couples after routine investigations. The recommended treatment of low-dose aspirin and heparin in women with antiphospholipid syndrome has a weak evidence base. Recent randomized controlled trials (RCTs) of low-dose aspirin and heparin have failed to find an improvement in live birth rates, even in the presence of thrombophilia. Although parental karyotypic abnormalities are associated with RPL, conservative management of such couples may be optimal. Observational studies of hysteroscopic metroplasty have promising results, but evidence from RCTs is awaited. Progestogen therapy may improve pregnancy outcomes, but further RCTs are needed. Immunological factors are thought to be important in idiopathic RPL. Research is focused on natural killer cells and cytokines in influencing implantation as potential therapeutic treatments. Currently, RCTs have not substantiated a benefit for immunotherapy. SUMMARY:Management of RPL remains challenging, with many controversial issues regarding the underlying pathophysiology. Improvements in live birth rates in subsequent pregnancies have not been found in RCTs of treatment for most of the associated conditions. All women can be offered supportive care in subsequent pregnancies. Empirical treatment is widely used in idiopathic RPL. A better option may be to encourage women to participate in high-quality and methodologically sound studies to guide optimal management.
journal_name
Curr Opin Obstet Gynecoljournal_title
Current opinion in obstetrics & gynecologyauthors
Tang AW,Quenby Sdoi
10.1097/GCO.0b013e32833e124esubject
Has Abstractpub_date
2010-12-01 00:00:00pages
446-51issue
6eissn
1040-872Xissn
1473-656Xjournal_volume
22pub_type
杂志文章,评审abstract::During the past few years enormous progress has been made in the understanding of the molecular mechanisms involved in parturition; however, the answer to the fundamental question of how labor is initiated remains elusive. This is a very important question because alterations in the timing of birth (preterm and post-t...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00
abstract::Infertility is a common medical problem resulting from one or more defects in the reproductive tract. Of the known causes of infertility, cervico-utero-tubal factors are important because they are generally manageable. Cervical factors include changes in cervical architecture, mucus, or both, resulting in a hostile en...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 00:00:00
abstract::This paper reviews psychologic aspects of sexual abuse in female adolescents. It documents that sexual abuse is widespread, occurring at an alarming rate at all socioeconomic levels of society. It is perpetrated principally by adult men in the victim's family. Often its effects are tragic. Adolescent female sexual abu...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1991-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Hysteroscopic myomectomy was a revolution for surgical treatment of symptomatic submucosal myoma. RECENT FINDINGS:A new International Federation of Gynecology and Obstetrics classification for myoma was recently described. Type 0, 1 and 2 are submucosal like in the European Society for Human Reproduc...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3283630e10
更新日期:2013-08-01 00:00:00
abstract::During the period under review (December 1990 through January 1992), the revised World Health Organization Histological Classification of Ovarian Neoplasms and Tumor-like Lesions was completed, and it is presented herein. This system of classification incorporates recent advances and includes newly recognized entities...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Ductal carcinoma in situ (DCIS) accounts for approximately 20% of mammographically diagnosed breast cancers. Currently, there is a trend to consider DCIS as a lesion for which treatment deescalation is advocated to avoid overtreatment, that is, radiotherapy in addition to breast-conserving surgery or ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000237
更新日期:2016-02-01 00:00:00
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:Therapeutics targeting the ErbB protein family receptors have not always yielded favorable or successful results in present cancer therapy. This review discusses the possibility of the clinical adaptation of targeting against heparin-binding epidermal growth factor-like growth factor (HB-EGF), one of ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3283409c91
更新日期:2011-02-01 00:00:00
abstract::The obstetrician-gynecologist must assume a dual role in the future provision of health care to women. Not only should the obstetrician-gynecologist function as a consultant for medical and surgical problems peculiar to the female reproductive tract, but also assume a broader-based role for preventive medicine and hea...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::Neuromodulation is one option for the management of a wide variety of lower urinary tract disorders, including non-neuropathic and neuropathic bladder dysfunctions. The mechanisms of action of the reported techniques remain unclear; urodynamic changes are minimal, but symptomatic improvements are common. Although the ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-199810000-00010
更新日期:1998-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Selective intrauterine growth restriction (sIUGR) in twin pregnancies presents a complex management problem for the fetal medicine specialist. This review summarizes what is currently known about sIUGR pathophysiology, particularly in monochorionic pregnancies and looks at the results of early trials ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000326
更新日期:2016-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Although cervical cytology screening programs have dramatically decreased rates of invasive cancer in developed countries, most guidelines in the USA were overaggressive in their management of abnormal cytology in adolescents and young women. These management strategies resulted in costly over-treatme...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.gco.0000179665.90778.f7
更新日期:2005-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize recent advances in oocyte and embryo cryopreservation techniques and outcomes. RECENT FINDINGS:Vitrification is gradually replacing slow freezing due to a better survival rate after thawing. Most units use vitrification for both oocyte and blastocyst cryopreservation, as these two biolog...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e32834874e2
更新日期:2011-08-01 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:PURPOSE OF REVIEW:The different patterns of autoreactivity that may account for the premature infertility observed in patients with premature ovarian failure are described. RECENT FINDINGS:Animal model studies have detailed fundamental immune dysregulatory patterns that induce ovarian failure in the context of global ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e328220e90c
更新日期:2007-08-01 00:00:00
abstract:PURPOSE OF REVIEW:In the past 10 years, clinicians have become more suspect regarding thromboembolic events and potential thrombosis in children at risk. Although adolescents are not typically considered to be a high-risk group, they are the main seekers of contraception in our society today, thereby placing them at so...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e32830ab83f
更新日期:2008-10-01 00:00:00
abstract::Selective oestrogen receptor modulators are a range of compounds which mimic some, but not all, agonist actions of oestrogen in different tissues. They were developed with the aim of maximizing the benefits of oestrogen-like drugs in a number of important conditions whilst reducing adverse side-effects. The molecular ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-199806000-00002
更新日期:1998-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Microarray-based comparative genomic hybridization (array-CGH) which detects aneuploidies and submicroscopic deletions and duplications in one assay is now offered for genetic diagnosis in children and adults. Its application to prenatal diagnosis is still limited, but very promising. We predict that ...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.gco.0000192986.22718.cc
更新日期:2006-04-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide clinicians with a review of recent research and clinically applicable tools regarding teen pregnancy. RECENT FINDINGS:Teen pregnancy rates have declined but still remain a significant problem in the USA. Teen pregnancy prevention was identified by Centers for Disease Control and Prevention...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0000000000000102
更新日期:2014-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This review is timely and relevant for several reasons. The incidence of adenomyosis begins to rise from the mid-thirties. Moreover, more women are delaying their first pregnancy until later in their thirties or forties, and consequently adenomyosis is encountered more frequently in the fertility clin...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.gco.0000169103.85128.c0
更新日期:2005-06-01 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
abstract:PURPOSE OF REVIEW:The past 15 years have seen a five-fold increase in the incidence of acquired heart disease as a cause of maternal mortality in the UK, and advances in the surgical correction of congenital heart disease have enabled many more women to survive childhood and present at the antenatal clinic. This review...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e328332a762
更新日期:2009-12-01 00:00:00
abstract::The battle against the epidemic of sexually transmitted infections continues but the clinician has new diagnostic and therapeutic weapons. This manuscript reviews new technologies, as well as novel applications of newer methodologies, such as utilization of amplified DNA techniques for urine specimens or patient-colle...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/00001703-199910000-00006
更新日期:1999-10-01 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::Laparoscopic oophorectomy is one of the most controversial and challenging areas of endoscopic surgery. Judicious preoperative evaluation along with careful patient selection can reduce the risk of operating on an unsuspected ovarian malignancy. Appropriate patient consent and planning should be obtained before the pr...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1995-08-01 00:00:00
abstract:PURPOSE OF REVIEW:This article will review recent changes in the standard of care for olaparib, niraparib, and rucaparib, as well as ongoing trials evaluating this class of drugs in combination with antiangiogenic agents and PD-1/PD-L1 inhibitors. RECENT FINDINGS:Niraparib received FDA approval for use in patients wit...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章
doi:10.1097/GCO.0000000000000675
更新日期:2021-02-01 00:00:00
abstract::Minimally invasive surgery enables the avoidance of, preparation for, participation in, and treatment of complications following assisted reproductive technology (ART). The major recent changes are, the development of surgical techniques to diagnose and treat intrafallopian tubal abnormalities; the use of operative en...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1994-06-01 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:PURPOSE OF REVIEW:Currently, a number of different stress urinary incontinence (SUI) procedures exist. The relatively recent adoption of the midurethral sling into clinical practice has changed the surgical management of SUI. This critical evaluation of the trends in SUI surgery emphasizes the public health burden of S...
journal_title:Current opinion in obstetrics & gynecology
pub_type: 杂志文章,评审
doi:10.1097/GCO.0b013e3283648cdd
更新日期:2013-10-01 00:00:00
abstract::Various malignant neoplasms, either primary or secondary, can affect the vagina. The most common primary malignant tumors of the vagina are squamous cell cancers; however, they are among the most uncommon of all primary gynecologic cancers. Vaginal intraepithelial neoplasia is being diagnosed with increasing frequency...
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